Biosecurity and bioterrorism : biodefense strategy, practice, and science
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Even amidst the devastation following the earthquake and tsunami in Japan that killed more than 20,000 people, it was the accident at the Fukushima Daiichi nuclear power plant that led the country's prime minister, Naoto Kan, to fear for "the very existence of the Japanese nation." While accidents that result in mass radiological releases have been rare throughout the operating histories of existing nuclear power plants, the growing number of plants worldwide increases the likelihood that such releases will occur again in the future. Nuclear power is an important source of energy in the U. S. and will be for the foreseeable future. ⋯ S. policies and practices for "outside the fence" management of such an event in the U. S.; and makes recommendations for steps that can be taken to strengthen U. S. government, industry, and community response to large-scale accidents at nuclear power plants.
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In recent years, improved biosurveillance has become a bipartisan national security priority. As has been pointed out by the National Biosurveillance Advisory Subcommittee and others, building a national biosurveillance enterprise requires having strong biosurveillance systems at the state and local levels, and additional policies are needed to strengthen their biosurveillance capabilities. Because of the foundational role that state and local health departments play in biosurveillance, we sought to determine to what extent state and local health departments have the right capabilities in place to provide the information needed to detect and manage an epidemic or public health emergency-both for state and local outbreak management and for reporting to federal agencies during national public health crises. We also sought to identify those policies or actions that would improve state and local biosurveillance and make recommendations to federal policymakers who are interested in improving national biosurveillance capabilities.
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The World Health Organization's revised International Health Regulations (IHR (2005)) call for member state compliance by mid-2012. Variation in disease surveillance and core public health capacities will affect each member state's ability to meet this deadline. We report on topics presented at the preconference workshop, "The Interaction of Disease Surveillance and the International Health Regulations," held at the 2010 International Society for Disease Surveillance conference in Park City, Utah. ⋯ Topics to address at future workshops include progress and challenges to IHR implementation across all member states and additional examples of how disease surveillance supports the IHRs in resource-constrained countries. The preconference workshop provided the opportunity to convene public health experts from all regions of the world. Stronger collaborations and support to better detect and respond to public health events through building sustainable disease surveillance systems will not only help member states to meet IHR compliance by 2012, but will also improve pandemic preparedness and global health security.
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We qualitatively examined the impact of the permanent closure of St. Vincent's Hospital in New York City on the remaining hospitals in the area and analyzed how these hospitals responded to this event. We conducted a descriptive survey consisting of interviews with clinical (n = 24) and administrative (n = 11) staff from 4 hospitals in lower Manhattan after the sudden closure of St. ⋯ The impact on hospital operations resulting from the closure of St. Vincent's Hospital is a surrogate medical surge event and met thresholds for activating emergency operations plans. Novel operating methods used in response to this surge event offer practical and broadly applicable principles that might improve medical surge management in other hospitals.
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The events and aftermath of September 11, 2001, accelerated a search for personnel reliability test measures to identify individuals who could pose a threat to our nation's security and safety. The creation and administration of a behavioral health screen for BSL-4 laboratory workers at the National Institutes of Health represents a pioneering effort to proactively build a BSL-4 safety culture promoting worker cohesiveness, trust, respect, and reliability with a balance of worker privacy and public safety.