Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Illustrations of the use of the decision instrument in selected case scenarios Alert and Response Operation Team International Health Regulation, Alert and Response Project Which event should be notified to WHO? • The following four diseases which are deemed always to be unusual or unexpected and may have serious public health impact, and hence must be notified to WHO in all circumstances: – – – – Smallpox Poliomyelitis due to wild type poliovirus Human Influenza caused by a new sub type; and SARS • The IHR (2005) also require notification of all (public health) events which may constitute a public health emergency of international concern, in accordance with the Decision Instrument in Annex 2. Assessment and notification of events according to decision instrument criteria • At the national level, States Parties are required to assess all urgent events within 48 hours by applying a specific algorithm contained in Annex II. • The algoritm provides the parameters to decide whether or not a specific event needs to be notified to WHO under the IHR. • When a State Party identifies an event as notifiable, it must be notified to WHO immediately, i.e., within 24 hours after having carried out the assessment. • The four decision criteria are: (1) the seriousness of the event's public health impact; (2) the unusual or unexpected nature of the event; (3) the risk of international disease spread; and (4) or the risk that travel or trade restrictions will be imposed by other countries. Accordingly notification may be required for: • Events, irrespective of their origin or source, including those caused by biological (of infectious or non-infectious nature) chemical agents or radio nuclear materials; • Events where the underlying agent, disease or mode of transmission is new, newly discovered or as yet unknown at the time of notification; • Events involving transmission or potential transmission through persons, vectors, cargo or goods (including food products) and environmental dispersion; • Events that carry potential future impact on public health and require immediate action to reduce the consequences; • Events arising outside of their known usual occurrence patterns. Annex 2 Concordance Study Introduction • Mandate WHO to conduct studies to review and evaluate the functioning of Annex 2 of the IHR: Article 54.3 of the IHR, as well as World Health Assembly resolutions 58.37 and 61.2. • 2008: WHO technical consultation recommended that an assessment be carried out to evaluate agreement among NFPs when judging certain described events using Annex 2. • The University of Geneva Hospitals’ Infection Control Programme in Switzerland was commissioned to carry out this assessment. Methods • The survey exploring NFPs’ use of Annex 2 of the IHR was based on several fictitious scenarios that described events devised to represent a wide range of public health risks with a varying likelihood of being considered notifiable. • The survey was made available in the six WHO languages via a secure web site. • Each State Party could submit only one completed survey. Participation was voluntary and anonymous. • Gold standard responses Analysis • The degree of consensus among NFPs on a particular survey item was expressed as the proportion of participants who chose the most commonly selected response for that item. • The degree of concordance between NFPs and the expert panel was expressed as the proportion of participating NFPs who selected the panel’s standard response for that item, where applicable. Results • 142 (74%) States parties participating. • The very high response rate in this survey suggests a considerable interest among NFPs in the IHR and the notification assessment using Annex 2. Results Results Results Scenario 1 – Pneumonia of unknown etiology Scenario 2 – Arsenic contamination of ground water Scenario 3 – International distribution of ineffective HIV drug Scenario 4 – Multidrug-resistant Klebsiella pneumoniae Scenario 5 – Dengue fever Scenario 6 – Outbreak of salmonellosis linked with chicken Scenario 7 – Imported case of wild type polio Scenario 8 – Fuel explosion with important number of casualties Scenario 9 – Ochratoxin A detected in imported wheat Scenario 10 – Outbreak of foot and mouth disease among livestock