Public Health in International and Humanitarian Disaster Management Question

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Question:

You are an Emergency Manager in your respective country. A highly infectious influenza strain has been detected. There is a limited quantity of the vaccine to prevent this particular strain of influenza. Discuss your plan for distributing this vaccine. Who receives the vaccine and who does not? How did you come to this conclusion?


Instructions:

The answers should be at least 3 substantive paragraphs, well developed, referenced, and properly formatted. “Substantive” means that the writer has added to the dialogue with referenced facts or pertinent personal experience leading to a reasoned argument that advances the scholarly discussion. Discussion question answers must include at least one reference that is not from the assigned reading.

Reference to appropriate authoritative resources and official websites. Must be accessible online. Use New Times Roman 12 font with 1” margins and APA style.

The required readings & 1 example from other student is attached, but do your original work.


Teaching Points:

Now that we have a good understanding of public health and disaster management, we are going to merge the two topics to better understand how public health interventions can positively effect disasters. We know that public health examines the health of communities or populations so, how can this be translated to disaster management.

Allow me to paint a scenario. There is a significant disaster somewhere in the world. The international community responds rapidly and aggressively sending millions of dollars of aid in the form of rescue workers, supplies, and equipment. The response entities are composed of rescue teams, field hospitals, peacekeeping forces, etc. These response elements complete their respective missions within three to four weeks and then return to their home countries. One of the peacekeeping forces prior to leaving makes the decision to empty waste water containers into a river next to their compound. Shortly after this, Cholera cases begin to develop and rapidly increase causing thousands of indigenous people to become ill and hundreds of deaths. The Cholera outbreak is directly linked to the peacekeeping force disposing of their waste in the river.

Another scenario to ponder, following an earthquake, thousands of indigenous people received elective limb amputations due to untreated and infected open fractures. They were discharged to home after their respective recovery course in the hospital. Unfortunately, most of these people’s homes were destroyed during the earthquake and there was no follow-up care and limited physical rehabilitation.

These described scenarios are two accounts of real-world events that unfolded in the aftermath of the 2010 earthquake that devastated Haiti. These incidents alone demonstrate the importance and value of public health measures throughout all phases of a disaster. However, public health is not a significant part of disaster response in the United States and it is my suspicion that it is not very well practiced elsewhere.

Why is incorporating public health measures into disaster response and recovery important? We can lead with another question to help answer this question. Why do we respond to disasters? To save lives, property and the environment and hopefully improve the standard of living after the disaster. Public health measures or interventions can be quite diverse, ranging from dentistry to disease surveillance. Although, it is not realistic to assume that all aspects of public health measures can be accomplished or are needed for every international disaster. However, if we apply public health measures to a disaster, what can be accomplished?

  • Improved preparedness: Researching what if any indigenous disease exist and if available, appropriately vaccinating responders.
  • Surveillance: Establishing surveillance systems for responders and indigenous populations.
  • Recovery: Analyzing collected data and developing processes for managing any identified risks and recovery needs.

Obviously, these are only a few examples of the public health measures that can be applied to humanitarian disasters. Merging public health and emergency management is not a common idea but, with better understanding of the field, it can improve outcomes. The challenge is, especially in the United States, to essentially rethink the decades of response focused disaster management activities and improve the utilization of evidence-based practice in the disaster management field.

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Copyright 2011. Jones & Bartlett Learning. All rights reserved. May not be reproduced in any form without permission from the publisher, except fair uses permitted under U.S. or applicable copyright law. 58707_CH13_Kapur.qxd:Achorn Int'l 9/16/10 12:01 AM Page 227 CHAPTER 13 Pandemic Influenza Terry Mulligan and G. Bobby Kapur INTRODUCTION The large number of severely ill patients with influenza A H1N1 in 2009 who survived their illness serves as an important indicator that the public health response to an influenza pandemic today differs significantly from that noted during the 1918 influenza pandemic. In 2009, the surveillance, prevention measures, and antiviral treatments employed allowed countries to reduce mortality numbers from this potentially deadly infectious disease to the point that they were well below those observed in the devastating 1918 outbreak.1 Given their more effective and widely available resources, nations have the obligation to develop collaborative strategies among hospitals and public health systems to ensure that, if the resurgence of a pandemic influenza occurs, the benefits of public health and healthcare infrastructures can be offered to the greatest number of people. Although it is difficult to predict the exact components of the next pandemic influenza virus, the current global experiences with influenza A H1N1 will serve as the framework and basis of discussions about pandemic influenza for this chapter. Case Study In April 2009, public health authorities in Mexico noted that the number of seasonal influenza cases was not decreasing as might be expected from March to May, and the healthcare divisions of the Mexican Institute for Social Security (Instituto Mexicano del Seguro Social [IMSS]) were informed of this aberration. – 227 – EBSCO Publishing : eBook Collection (EBSCOhost) - printed on 11/13/2019 8:42 PM via THOMAS JEFFERSON UNIVERSITY - EAST FALLS AN: 347934 ; Smith, Jeffrey P., Kapur, G. Bobby.; Emergency Public Health: Preparedness and Response Account: s4084935.main.ehost 58707_CH13_Kapur.qxd:Achorn Int'l Copyright 2011. Jones & Bartlett Learning. All rights reserved. May not be reproduced in any form without permission from the publisher, except fair uses permitted under U.S. or applicable copyright law. 228 9/16/10 12:01 AM Page 228 CHAPTER 13 / Pandemic Influenza In addition, certain sentinel events occurred in Mexico from March to April that initiated increased surveillance epidemiological studies:2 • • • • Outbreaks of influenza-like illness in the state of Veracruz Outbreaks of influenza-like illness in the state of Tlaxcala Outbreaks of influenza-like illness in the state of San Luis Potosí A suspected case of nontypical pneumonia in the state of Oaxaca On April 23, 2009, public health officials in Mexico declared that a novel influenza A H1N1 virus (H1N1) had been isolated in samples from patients in Veracruz and Oaxaca. Through the end of September 2009, more than 4,100 deaths were associated with the H1N1 pandemic globally, including 3,020 deaths in the Western Hemisphere. As of December 2, 2009, Mexico had 66,070 confirmed cases of pandemic H1N1 flu and reported 671 deaths from this cause.3 The IMSS serves as Mexico’s national public healthcare institution, providing health services to approximately 40 million people through nearly 1,100 primary healthcare centers and 259 hospitals. IMSS facilities treated the largest number of H1N1 cases and experienced the largest number of deaths from this influenza variant in Mexico during this episode.2 Multiple factors played a role in the variation of both morbidity and mortality among patients in Mexico: • Patient factors (comorbid diseases, nutritional status, immune levels) • Population factors (density, number of people in community with H1N1) • Health policy (access to care, quality of care) In Mexico, many of the patients with flu symptoms would self-diagnose and select and purchase medications for their disease on their own; prescriptions are not required in this country. At the onset of the epidemic, prior to scaling up of the Mexican healthcare system, people with H1N1 infection might take as long as nine days to see a physician.3 At the beginning of the H1N1 pandemic, Mexico was the only country to implement a large-scale strategy for school closures and bans on public gatherings. Mexico City, the world’s third largest city, banned all nonessential activities. Estimates show that the pandemic cost Mexico approximately $4 billion.3 On June 11, 2009, the World Health Organization ( WHO) confirmed that this event qualified as the first influenza pandemic in 40 years.4 EBSCO Publishing : eBook Collection (EBSCOhost) - printed on 11/13/2019 8:42 PM via THOMAS JEFFERSON UNIVERSITY - EAST FALLS AN: 347934 ; Smith, Jeffrey P., Kapur, G. Bobby.; Emergency Public Health: Preparedness and Response Account: s4084935.main.ehost 58707_CH13_Kapur.qxd:Achorn Int'l 9/16/10 12:01 AM Page 229 Copyright 2011. Jones & Bartlett Learning. All rights reserved. May not be reproduced in any form without permission from the publisher, except fair uses permitted under U.S. or applicable copyright law. Background BACKGROUND For the 2009–2010 flu season, more than 99 percent of circulating influenza viruses identified in the United States were influenza A H1N1 (2009 H1N1).5 The clinical presentation of patients with uncomplicated 2009 H1N1 influenza virus infection is generally similar to that of patients with seasonal influenza and includes abrupt onset of fever, cough, sore throat, myalgias, arthralgias, chills, headache, and fatigue. Vomiting and diarrhea are reported more often with 2009 H1N1 than with seasonal influenza.6 As is common with seasonal influenza, some patients with 2009 H1N1 may present without fever. Clinical judgment and local surveillance data for influenza and other respiratory pathogens are important in considering the differential diagnosis of patients presenting with an influenza-like illness. The 2009 H1N1 variant, although widespread globally, has not yet reached the mortality levels of prior pandemics in the past 100 years (Table 13-1). Differential Diagnosis and Clinical Presentation of Influenza The fever and respiratory manifestations of influenza are not specific, and similar findings can present with several other pathogens: • • • • • • Respiratory syncytial virus (RSV) Parainfluenza viruses Adenoviruses Rhinoviruses Coronaviruses Mycoplasma pneumonia In contrast to influenza viruses, most of these pathogens do not usually cause severe disease, particularly in previously healthy adults. RSV and parainfluenza viruses can, however, lead to severe respiratory illnesses in young children and the elderly, and they should be considered in the differential diagnosis if these pathogens are known to be circulating in the community.7 Because the clinical picture of seasonal influenza can often be indistinguishable from illnesses caused by other respiratory infections, management can be challenging even when the diagnosis of influenza is confirmed. Influenza virus infections can span the spectrum from subclinical infection to severe deterioration and can result in a wide variety of complications. Even if an alternative etiology is determined, viral or bacterial co-infections can occur. The tendency for influenza to arise in community epidemics and to affect persons EBSCO Publishing : eBook Collection (EBSCOhost) - printed on 11/13/2019 8:42 PM via THOMAS JEFFERSON UNIVERSITY - EAST FALLS AN: 347934 ; Smith, Jeffrey P., Kapur, G. Bobby.; Emergency Public Health: Preparedness and Response Account: s4084935.main.ehost 229 Characteristics of the Three Pandemics of the Twentieth Century Southern China Southern China 1957–1958 “Asian Flu” 1968–1969 “Hong Kong Flu” H3N2 H2N2 H1N1 1.3–1.6 1.5 1.5–1.8
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Explanation & Answer

Attached.

Running head: PUBLIC HEALTH AND HUMANITARIAN DISASTER MANAGEMENT 1

Public Health and Humanitarian Disaster Management
Institutional Affiliation
Students Name
Date

PUBLIC HEALTH AND HUMANITARIAN DISASTER MANAGEMENT

2

As an emergency manager in charge, in a scenario where there is an outbreak of
influenza in a country with limited vaccines, it requires a proper planning process to control
the disease. Since the disease has been termed a highly infectious one, it requires a quick plan
which is profession...


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