TABLE 16.13.

National and International Strategies for Coping with Emerging Infectious Diseases

Goal/Topic	Activities	Examples
Surveillance	Detect, promptly investigate, and monitor emerging pathogens, the diseases they cause, and the factors influencing their emergence	Monitoring in sentinel surveillance networks (e.g., blood banks, emergency departments, laboratories, sentinel settings) Population-based surveillance Increase field investigation of outbreaks Dissemination of epidemiological data locally and internationally using electronic media; Internet, websites, ProMED, MMWR, Eurosurveillance, and others Rapid laboratory diagnosis; Monitor vectorborne diseases
Applied research	Integrate laboratory science and epidemiology to optimize public health practices	Promote reporting by sentinel laboratories and clinical settings Improve laboratory diagnostic techniques, genotyping, subtyping, and mapping “fingerprinting” (e.g., Escherichia coli, cholera, poliomyelitis, measles, meningitis)
Prevention and control	Safe animal husbandry; vector control; safe water and sanitation; food control; immunization, rapid diagnosis, directly managed treatment (DOTS); preventive treatment for tropical diseases; promote cooperation between public health, clinical services, veterinary services and IT monitoring of infectious diseases and preventive activities, e.g., immunization	Enhance communication of public health information about emerging diseases and ensure rapid implementation of preventable strategies. Wide and immediate dissemination of health information on infectious diseases to health professionals, general public, groups at special risk Promote health education on prevention of spread of communicable diseases
Infrastructure	Strengthen local, state, and federal public health infrastructures to support surveillance and implement prevention and control programs	Improve laboratories, reporting, and training
International cooperation	Strengthen international effort and funding to promote immunization, nutrition interventions, maternal and child health	WHO, UNICEF, UNDP, WB, FAO, GAVI, Médecins sans Frontières, bilateral aid programs Rotary International, Gates Foundation, and many others working side by side and in growing cooperation to help national governments achieve MDGs
International Health Regulations (IHR 2005)	Approved by WHO and in effect in 2007, ratified by most countries	Legal obligations to report infectious or other public health emergencies (chemical, radiation) of international public health significance. All countries agreed to increase surveillance capacity for emergencies such as SARS or human influenza

Note: DOTS = directly observed treatment, short-course; IT = information technology; ProMED = Program for Monitoring Emerging Diseases; WHO = World Health Organization; UNICEF = United Nations Children’s Fund; UNDP = United Nations Development Programme; WB = World Bank; FAO = Food and Agriculture Organization; GAVI = Global Alliance for Vaccines and Immunization; SARS = severe acute respiratory syndrome.

Sources: Modified from Centers for Disease Control and Prevention. Addressing emerging infectious disease threats. Atlanta, GA: US Public Health Service; 1994. National Institutes of Health. Understanding emerging and re-emerging infectious diseases, 2007. Available at: http://www.ncbi.nlm.nih.gov/books/NBK20370/ [Accessed 2 June 2013]. World Health Organization. International health regulations. 2005. Available at: http://www.who.int/features/qa/39/en/index.html [Accessed 17 January 2008]. National Institute of Allergy and Infectious Diseases. Emerging and re-emerging infectious diseases. Available at: http://www.niaid.nih.gov/topics/emerging/Pages/Default.aspx [Accessed 2 June 2013].