Key Topic Guide Series - Public Health / Bioterrorism Alerting
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Epidemiology
Wysocki, Bernard, Agency Chief Spurs Bioterror Research -- And Controversy. The Wall Street Journal, December 6, 2005, p. A1
Dr. Anthony Fauci, Director of the Allergy and Infectious Diseases Institute, National Institutes of Health, has taken the unusual step of using NIH funds to support competing companies to develop vaccines for the Project Bioshield stockpile. Available free online for a limited time only.
Lim, Meng-Kin, MD, Hostile Use of the Life Sciences. The New England Journal of Medicine, Vol. 353, No. 21, November 24, 2005. p. 2214-2215. Requires subscription.
Steinbrook, Robert, MD, Biomedical Research and Biosecurity. The New England Journal of Medicine, Vol. 353, No. 21, November 24, 2005. p. 2212-2214. Requires subscription.
"Establishing biosecurity policies for biomedical research without obstructiong scientific progress or disrupting the usual procedures for scientific communication is a complex matter. At the moment, however, it is far easier to describe the challenges than to resolve them."
Wysocki, Bernard, "U.S. Struggles for Drugs to Counter Biological Threats". The Wall Street Journal, July 11, 2005, p. A1
Large pharmaceutical companies shy away from vaccine research and production, leaving the federal Project Bioshield dependent on smaller biotechnology companies for building its stockpile. Requires subscription or $2.95 charge to download.
McHugh M., Staiti A.B., Felland L.E., "How prepared
are Americans for public health emergencies? Twelve communities
weigh in"
Health Aff (Millwood). 2004 May-Jun;23(3):201-9.
(Issue available at the Resource Center)
Abstract:
Since the terrorist attacks of 11 September 2001, emergency preparedness
has become a top priority in metropolitan areas, and some of these
areas have received considerable federal funding to help support
improvements. Although much progress has been made, preparedness
still varies across communities, with the larger ones exhibiting
stronger response capabilities, and some weaknesses are evident,
particularly in the areas of communications and workforce education.
Experience with other public health emergencies, strong leadership,
successful collaboration, and adequate funding contributed to high
states of readiness. Important challenges include a shortage of
funding, delay in the receipt of federal funding, and staffing shortages.
Boston Public Health
Commission, Communicable Disease Control (CDC) Division
www.bphc.org/programs/initiative.asp
The Commission, through its Bioterrorism Inititative, is committed
to providing the citizens of Boston with information about bioterrorism
incidents and reporting. There is information for both clinicians
and "everyone else" including a simple checklist of steps that can
be taken to reduce the impact of bioterrorism events. In addition,
the Bioterrorism Surveillance and Education Initiative has been
working in collaboration with emergency response agencies, the Massachusetts
Department of Public Health, and Boston hospitals and health care
providers for several years to develop an early warning system for
possible bioterrorist attacks.
Boston ResourceNet
http://www.bostonresourcenet.org
This on-line resource
directory of human service agencies and services is jointly sponsored
by Action for Boston Community Development (ABCD) and the Boston
Public Health Commission. It provides links to providers of
education, health, employment, social support, legal, housing and
other services.
Guide to Community Preventive Services
www.thecommunityguide.org
Maintained by the Centers for Disease Control, this source links to reliable sources for health decision-making.
NOVA Online, Bioterror
FAQ
www.pbs.org/wgbh/nova/bioterror/faq.html
Public Broadcasting Systems' (PBS) NOVA television program has sponsored this Frequently Asked Questions Page as a public service. It includes a couple of links to other sources of information for the general public.
Small Step
www.smallstep.gov
HHS and the Ad Council have collaborated to create this web site and related television ad campaigns that educate the public on "small steps" they can take to improve their health. The advice focuses on nutritional and exercise topics.
Boston Public Health
Commission, Communicable Disease Control (CDC) Division
http://www.bphc.org/programs/program.asp?b=5&p=93
The Commission, through its Bioterrorism Inititative, is committed
to providing the citizens of Boston with information about bioterrorism
incidents and reporting. There is information for both clinicians
and "everyone else" including a simple checklist of steps that can
be taken to reduce the impact of bioterrorism events. In addition,
the Bioterrorism Surveillance and Education Initiative has been
working in collaboration with emergency response agencies, the Massachusetts
Department of Public Health, and Boston hospitals and health care
providers for several years to develop an early warning system for
possible bioterrorist attacks. Verna McKenna, MD, has been working
in collaboration with the Boston Public Health Commission on volume-based
Emergency Room (ER) surveillance systems.
HealthKey Collaborative
Plans for Secure Public Health Infrastructure
www.healthkey.org
The HealthKey Collaborative, of which the Massachusetts Health Data
Consortium has been a member, is the five-state consortium of community
health information organizations that began its work in 1997 with
a three-state health information infrastructure project. Most recently,
HealthKey, funded by The Robert Wood Johnson Foundation, has completed
a two-year program of community-sponsored projects focused on implementing
standard policies and technologies to assure secure exchange of
electronic health information. Several of the projects deal directly
with infrastructure elements crucial to public health and bioterrorism
preparedness.
HealthKey will leverage
its experience in secure health information infrastructure implementations
in multiple states to accelerate progress toward functional integration
of HAN, NEDSS and other public health information infrastructure
initiatives, with a focus on assuring compliance with federal privacy
and security regulations under HIPAA.
The Institute of Medicine
(IOM)
www.iom.edu/project.asp
The Institute of Medicine (IOM) is studying how to improve public
health infrastructure and strategy. This 18-month project, "Assuring
the Health of the Public in the 21st Century", aims to "describe
a new, more inclusive framework for assuring population-level health
that can be effectively communicated to and acted upon by diverse
communities."
Massachusetts Department
of Public Health, Emergency Preparedness and Response, Advisory
Committee
www.state.ma.us/dph/bioterrorism/advisorygrps/index.htm
The Massachusetts Department of Public Health (DPH) is working vigorously to coordinate with local agencies and health care providers for bioterrorism alerting and surveillance. There are three Assistant Commissioners within Massachusetts DPH who are each focusing on a slightly different area of the effort: Al DeMaria (Smallpox Vaccination); Ralph Timperi (Laboratory Protocols and Training); and Nancy Ridley.
Massachusetts Health Council
http://www.mahealthcouncil.org/
The Council is a non-profit, non-partisan statewide organization of more than 150 governmental and voluntary agencies, consumer and advocacy groups, professional societies, and private corporations committed to improving and protecting the health of the citizens of Massachusetts. The Council publishes an annual study, Common Health for the Commonwealth, which examines trends in twelve health, social, economic, and environmental indicators.
Partners in Information Access for the Public Health Workforce
http://phpartners.org/
This website was created by
a collaboration of U.S. government agencies, public health organizations and health sciences libraries to
help the public health workforce find and use information effectively to improve and protect the public's health. It includes both federal and state statistics banks, health education links, legislative updates, conference calendars, as well as connections to discussion and e-mail lists.
Public Health Data
Standards Consortium
www.phdsc.org
The Public Health Data Standards Consortium has established a website
that includes resources and links on public health coordination
efforts and standards development projects. The website also includes
implementation case studies, "knowledge resources" consisting of
tutorials, papers, websites, presentations, and an extensive HIPAA
area categorized by specific HIPAA regulation: privacy, security,
transactions, etc.
Trust for America's
Health
http://www.healthyamericans.org
Trust for Healthy Americans
is a "not-profit, non-partisan organization dedicated to saving
lives by protecting the health of every community and working to
make disease prevention a national priority." The Trust published the its third annual public health and bioterrorism preparedness report
Ready or Not?: Protecting the Public's Health from Diseases, Disasters, and Bioterrorism, 2005 in December 2005. The Trust also monitors cancer prevention and care, by state, in its Cancer Tracking Fact Sheet. Recently the Trust has turned its attention to obesity in looking for ways to affect public policies to reduce incidence.
Boston Bioterrorism
Surveillance Reports
www.btsurveillance.org
Data are obtained from diagnoses assigned during routine care by
clinicians in Harvard Vanguard Medical Associates. The practice's
electronic medical system is queried each night for specific diagnoses
assigned during the preceding day. Diagnoses of interest are grouped
into syndromes, e.g. Lower Respiratory. Individuals with new episodes
in each syndrome are identified as those with no prior encounter
in the same syndrome during the preceding six weeks. As of 2002,
the system currently reports Harvard Vanguard Medical Associates'
patients who are members of Harvard Pilgrim Health Care.
The National Electronic
Disease Surveillance Systems (NEDSS)
www.cdc.gov/od/hissb/docs.htm#nedss
The National Electronic Disease Surveillance Systems (NEDSS) is
conceived as an integrated electronic information system that will
automatically gather surveillance information from in real-time
from disparate sources and facilitate its sharing, analysis, interpretation,
and communication. This will be done chiefly through the creation
of standards in these five areas: Data Architecture; User Interface;
Information Systems Software Architecture; Tools for Interpretation,
Analysis, and Dissemination of Data; Secure Data Transfer.
The Health Alert Network
(HAN)
www.phppo.cdc.gov/han
The Health Alert Network (HAN), operating under the Public Health
Practice Program Office of the CDC, focuses on "ensuring communications
capacity" at public health agencies at all levels. Full broadband
Internet connections, education (including distance education),
and a robust health alert IT infrastructure are the central goals
of this initiative.
Agency for Healthcare Research and Quality (AHRQ)
http://ahrq.gov/browse/bioterbr.htm
As part of AHRQ's mission to "support research designed to improve the quality of health care...", the Agency has created a Bioterrorism Planning and Response web page which includes links to a series of free Web-assisted conference calls, issue briefs, evidence reports, tools and resources and instructions for joining the Bioterrorism Preparedness LISTSERV.
Children's Hospital's Bioterrorism
Syndromic Surveillance Project (BSS) is directed by Kenneth D. Mandl,
MD, MPH, Co-director of the Center
for Biopreparedness at Children's Hospital Boston. In a March 2005 Issue Brief, The Agency for Healthcare Research and Quality (AHRQ) described the syndromic surveillance program and automated decision-support early disease detection tools in use at the Center for Biopreparedness.
Harvard Vanguard Medical
Associates, a large, multi-specialty group practice in eastern
Massachusetts, is contributing data to the Boston
Bioterrorism Surveillance Reports project. Data are obtained from diagnoses assigned during routine care by clinicians in Harvard Vanguard. The practice's electronic medical system is queried each night for specific diagnoses assigned during the preceding day. Diagnoses of interest are grouped into syndromes, e.g. Lower Respiratory. Individuals with new episodes in each syndrome are identified as those with no prior encounter in the same syndrome during the preceding six weeks. As of 2002, the system currently reports Harvard Vanguard Medical Associates' patients who are members of Harvard Pilgrim Health Care.
Louisiana Department of Health and Hospitals
http://www.dhh.state.la.us/
Both the Louisiana Department of Health and Hospitals and the Southern Governors' Association (see below) have been chosen to implement and promote the use of electronic health records to secure health information and to improve health care responsiveness in the event of a natural disaster.
See the press release at hhs.gov/healthit
Southern Governors' Association, Gulf Coast Health Information Task Force
http://www.southerngovernors.org/
Along with the Louisiana Department of Health and Hospitals (see above) the Southern Governors' Association has been chosen to implement and promote the use of electronic health records to secure health information and to improve health care responsiveness in the event of a natural disaster.
See the press release at hhs.gov/healthit
UCLA, School of Public
Health, Department of Epidemiology, Epidemiological Information
on Terrorism
www.ph.ucla.edu/epi/bioter/bioterrorism.html
UCLA, School of Public Health, Department of Epidemiology, Epidemiological
Information on Terrorism describes clinical signs and manifestations
of likely biological agents, including comparative information to
other infections. The website also includes links to courses, lectures,
tutorials, and to government and private agencies involved in bioterrorism
surveillance. Key links are sorted by microbial agent. There are
also links to analyses of significant outbreaks.
For more info please contact us via
e-mail or at 781.419.7800. We welcome your further questions
& look forward to your participation in our work and our events!
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