Anticipation/prediction so that epidemics be prevented e.g. meningitis, measles 2. Early detection to know when there is a problem e.g. EWARS 3. Rapid Response guidelines/trained staff/supplies in place before epidemic 4. Effective Response appropriate control methods adequate resources and logistics 1 Establish Epidemic Committee 2. Set priorities 3. Agree epidemic preparedness plan 4. Implement surveillance 5. Respond rapidly and effectively

1. Principles of Epidemic
Preparedness and
Response

2. Reported Cases of Encephalitis in Nepal,
1997-1998
0
50
100
150
200
250
300
350
Week No
Cases
1997
1998
Source: EWARS

3. Objectives of Epidemic
Preparedness and Response
1. Anticipation/prediction
• so that epidemics be prevented
• e.g. meningitis, measles
2. Early detection
• to know when there is a problem
• e.g. EWARS
3. Rapid Response
• guidelines/trained staff/supplies
• in place before epidemic
4. Effective Response
• appropriate control methods
• adequate resources and logistics

4. 0
10
20
30
40
50
60
70
80
90
1
4
7
1
0
1
3
1
6
1
9
2
2
2
5
2
8
3
1
3
4
3
7
4
0
Outbreak Detection and Response
Without Preparedness
Delayed
Response
DAY
CASES
Opportunity
for control
Late
Detection
First
Case

5. 0
10
20
30
40
50
60
70
80
90
1
4
7
1
0
1
3
1
6
1
9
2
2
2
5
2
8
3
1
3
4
3
7
4
0
Outbreak Detection and Response
With Preparedness
Rapid
Response
DAY
CASES
Early
Detection
Potential
Cases Prevented

6. FASTER
BETTER

7. Components of Epidemic Preparedness
1 Establish Epidemic Committee
2. Set priorities
3. Agree epidemic preparedness plan
4. Implement surveillance
5. Respond rapidly and effectively

8. Epidemic Preparedness
and Response Committee - I
• Who should be on the committee ?
• Technical
• Political
• Practical
• What are the tasks of the committee?
• Before the epidemic
• During the epidemic
• After the epidemic

9. Epidemic Preparedness
and Response Committee II
• Before the epidemic !
• Set priorities
• Write the epidemic preparedness and
response plan
• Define prevention and control strategies
(versatility, adaptability)
• Assign specific responsibilities for
surveillance, preparedness and response
• Identify and mobilise resources

10. Epidemic Preparedness
and Response Committee IIa
• Identify and mobilise resources
• HUMAN
• FINANCIAL
• PRACTICAL

11. Priority Setting - I
• What are the major epidemic prone diseases ?
• What is the risk of an epidemic ?
• time since last outbreak,
• frequency of previous outbreaks
• recent disease trends
• What would be the likely impact of an epidemic ?
• Potential number of cases
• Potential deaths
• Likelihood of spread
• Control measures ?
• Are effective and affordable measures available ?
• Resources ?
• Do we have adequate resources ?

12. Priority setting - II
Epidemic Risk Impact Control Resources
prone disease measures
Cholera
Meningitis
Measles
JE
Malaria
Viral HF
High High
Low
Low
Low Low
High
High
Low
High
Low
Low
X
X
X

13. Epidemic Preparedness
and Response Plan - I
• List the priority diseases
• Define the surveillance, preparedness and
response measures to be implemented
• Identify responsibilities (who does what)
• Identify co-ordination mechanisms (leadership)
• Specify resources available for preparedness and
response (budget)

14. • What should be done ?
• Who should do it ?
• What resources or supplies
will be required ?
Epidemic Preparedness
and Response Plan - II

15. Surveillance - I
Health Care System Public Health Authority
Case
Detection
Confirm
Decision
Control
Measures
Investigation
Response
Report
OUTBREAK

16. Surveillance - II
Support function
• advocacy for training
• supervision
• resource
• standards/guidelines

17. Epidemic Preparedness
and Response Committee - II
• During the epidemic !
• Implement the plan
• Rapid and coordinated response
• Implement prevention and control strategies
• Identify and mobilise resources

18. Rapid Response - I
• Early epidemic control team meeting
• Early assessment of the potential scale of
the outbreak
• Co-ordinated investigation and
implementation of control measures
• Public information
– Health education
– Media strategy

19. Outbreak
investigation
Laboratory
Support services
and
logistics
Media
Control measures
Reports
Public
Authorities
Environment
Epidemic
response
committee

20. Epidemic Preparedness
and Response Committee - III
• After the epidemic !
• Evaluate the preparedness and the response
• Review and update the plan
• Modify prevention and control strategies
• Identify and mobilise resources
• Anticipate new outbreaks
• Strengthen surveillance

21. PREPAREDNESS OUTBREAK CONTROL
Detect &
Confirm
Investigate
Analyse
Respond
Evaluate
Predict
& Prevent
Treat
Control
Committee
Priorities
Plan
Co-ordination
Responsibilities
Resources
Supplies
Training
Surveillance
Rapid Response

22. Preparedness planning in
different settings
• Hospital
• Local
• Disease-specific
• National
• International

23. Be
Prepared !