Overview - SFDPHPrevention and control concepts Prevention and control responses Chain model of...
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Communicable disease challenges Prevention and control concepts Prevention and control responses Infectious Disease Threats in the 21st Century: Prevention, Control, and Emergency Response Tom´ as J. Arag´on, MD, DrPH Health Officer, City & County of San Francisco Director, Population Health Division San Francisco Department of Public Health Adjunct Faculty, Division of Epidemiology UC Berkeley School of Public Health May 17, 2013 Tom´ as J. Arag´on, MD, DrPH, Health Officer Infectious Disease Threats in the 21st Century Communicable disease challenges Prevention and control concepts Prevention and control responses Overview 1 Communicable disease challenges 2 Prevention and control concepts 3 Prevention and control responses Tom´ as J. Arag´on, MD, DrPH, Health Officer Infectious Disease Threats in the 21st Century
Transcript of Overview - SFDPHPrevention and control concepts Prevention and control responses Chain model of...
Communicable
disease
challenges
Preventionandcontrolconcepts
Preventionandcontrolresp
onses
InfectiousDisease
Threatsin
the21st
Century:
Prevention,Control,andEmergency
Response
Tom
asJ.
Aragon
,MD,DrPH
HealthOfficer,City&
Cou
nty
ofSan
Francisco
Director,Pop
ulation
HealthDivision
San
FranciscoDepartm
entof
Public
Health
Adjunct
Faculty,Divisionof
Epidem
iology
UCBerkeleySchool
ofPublic
Health
May
17,20
13
TomasJ.Aragon,MD,DrP
H,HealthOfficer
InfectiousDisease
Threats
inthe21st
Century
Communicable
disease
challenges
Preventionandcontrolconcepts
Preventionandcontrolresp
onses
Overview
1Com
municable
disease
challenges
2Prevention
andcontrol
concepts
3Prevention
andcontrol
respon
ses
TomasJ.Aragon,MD,DrP
H,HealthOfficer
InfectiousDisease
Threats
inthe21st
Century
Communicable
disease
challenges
Preventionandcontrolconcepts
Preventionandcontrolresp
onses
Recentandongoingchallenges
Meningo
coccal
disease
inMSM
H7N
9Avian
Influenza
Ain
China
Typhoidcase
atSFRestaurant
Novel
coronavirus(nCoV
)in
Middle
East
Human
Immunodeficiency
Virus(H
IV)
TomasJ.Aragon,MD,DrP
H,HealthOfficer
InfectiousDisease
Threats
inthe21st
Century
Communicable
disease
challenges
Preventionandcontrolconcepts
Preventionandcontrolresp
onses
Meningo
coccal
disease
TomasJ.Aragon,MD,DrP
H,HealthOfficer
InfectiousDisease
Threats
inthe21st
Century
Communicable
disease
challenges
Preventionandcontrolconcepts
Preventionandcontrolresp
onses
Human
Avian
Influenza
A(H
7N9)
TomasJ.Aragon,MD,DrP
H,HealthOfficer
InfectiousDisease
Threats
inthe21st
Century
Communicable
disease
challenges
Preventionandcontrolconcepts
Preventionandcontrolresp
onses
“TyphoidMary”
(MaryMallon)
TomasJ.Aragon,MD,DrP
H,HealthOfficer
InfectiousDisease
Threats
inthe21st
Century
Communicable
disease
challenges
Preventionandcontrolconcepts
Preventionandcontrolresp
onses
Human
SARSCoronavirus,SARSoutbreak,2003
TomasJ.Aragon,MD,DrP
H,HealthOfficer
InfectiousDisease
Threats
inthe21st
Century
Communicable
disease
challenges
Preventionandcontrolconcepts
Preventionandcontrolresp
onses
Human
Immunodeficiency
Virus(H
IV)
TomasJ.Aragon,MD,DrP
H,HealthOfficer
InfectiousDisease
Threats
inthe21st
Century
Communicable
disease
challenges
Preventionandcontrolconcepts
Preventionandcontrolresp
onses
Chainmodelof
infectiousdiseases
Source:
Epidem
iologic
MethodsfortheStudyofInfectiousDiseases,
Oxford
TomasJ.Aragon,MD,DrP
H,HealthOfficer
InfectiousDisease
Threats
inthe21st
Century
Communicable
disease
challenges
Preventionandcontrolconcepts
Preventionandcontrolresp
onses
Naturalhistory
ofinfectionandinfectiousness
When
thelatentperiodislongerthan
theincubationperiod,an
infected
personbecom
esinfectiousaftersymptom
onset.
TomasJ.Aragon,MD,DrP
H,HealthOfficer
InfectiousDisease
Threats
inthe21st
Century
Communicable
disease
challenges
Preventionandcontrolconcepts
Preventionandcontrolresp
onses
Convergence
modelforhuman-m
icrobeinteraction
Institute
ofMedicine.
Microbialthreats
tohealth:Emergence,Detection,and
Response.National
Academ
yPress,2003
TomasJ.Aragon,MD,DrP
H,HealthOfficer
InfectiousDisease
Threats
inthe21st
Century
Communicable
disease
challenges
Preventionandcontrolconcepts
Preventionandcontrolresp
onses
Transm
ission
dynam
ics
TomasJ.Aragon,MD,DrP
H,HealthOfficer
InfectiousDisease
Threats
inthe21st
Century
Communicable
disease
challenges
Preventionandcontrolconcepts
Preventionandcontrolresp
onses
Transm
ission
containment
Con
trol
strategies
1Reduce
contact
rate
(c)
2Reduce
fraction
ofpop
ulation
that
isinfectious(P
)
3Reduce
biologicalinfectiousness(affects
p)
4Reduce
biologicalsusceptibility
(affects
p)
5Interrupttransm
ission
(physical,chem
ical)(affects
p)
6Reduce
fraction
ofpop
ulation
that
issusceptible
(x)
Con
trol
measures...
areintervention
sdesigned
toaddress
control
strategies.Always
consider
mutliple
perspectives:
host,agent,infectioussources,and
environment(physical,social,econ
omic,political,etc.)
TomasJ.Aragon,MD,DrP
H,HealthOfficer
InfectiousDisease
Threats
inthe21st
Century
Communicable
disease
challenges
Preventionandcontrolconcepts
Preventionandcontrolresp
onses
Example:Response
tohuman
pandem
icinfluenza
1Surveillance
andepidem
iology
2Lab
oratorydiagn
ostics
3Transm
ission
containment
Com
munitymitigationmeasures
Isolation(ofcases)
Quaran
tine(ofexposed)
Social
distancing
Sheltering(ofnon-exp
osed)
Vaccinedistribution
anduse
Antiviraldrugdistribution
anduse
4Infectioncontrol
andclinical
guidelines
5Environmentalandoccupational
health
6Medical
&mentalhealthcare,andsurgecapacity
7Public
healthcommunications(m
edia,public,clinicians,
facilities)
TomasJ.Aragon,MD,DrP
H,HealthOfficer
InfectiousDisease
Threats
inthe21st
Century
Communicable
disease
challenges
Preventionandcontrolconcepts
Preventionandcontrolresp
onses
Summaryof
talk
Com
municable
diseaechallenges
Meningo
coccal
disease
inMSM
H7N
9Avian
Influenza
Ain
China
Typhoidcase
atSFRestaurant
Novel
coronavirus(nCoV
)in
Middle
East
Human
Immunodeficiency
Virus(H
IV)
Con
cepts
forprevention
andcontrol
Transm
ission
mechanisms
Transm
ission
dynam
ics
Transm
ission
containment
TomasJ.Aragon,MD,DrP
H,HealthOfficer
InfectiousDisease
Threats
inthe21st
Century
