???????????????? ???????? (2005?12?13??18?) Control of Infectious Diseases during World Trade Organisation (WTO)Sixth Ministerial Conference (13 - 18 December 2005) -????? Preparation and Experience

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???????????????? ???????? (2005?12?13??18?)
Control of Infectious Diseases during World
Trade Organisation (WTO)Sixth Ministerial
Conference (13 - 18 December 2005)-????? Pre
paration and Experience

• ????? ?????
• Dr. SK Chuang
• Department of Health, HKSARG

2
???? Content

• ??
• ??????
• ????
• ??????
• ???????
• ????????
• ?????
• ????

• Background
• Roles of Department of Health
• Action phases
• Public health action
• Pre-conference preparatory phase
• Outbreak management phase
• Post-conference phase
• Communication

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??Background

• ????????????????????????
• WTO is the only global international organisation
  dealing with the rules of trade between nations.
• ???????????????,?????????????
• The highest decision making body of the WTO is
  the Ministerial Conference (MC), which has to
  meet at least once every two years.
• ??????????????????????????
• MC can take decisions on all matters under any of
  the multilateral trade agreements.

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(No Transcript)
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???????????????
???????
?????
?????
?????
???????
???????
???????
?????
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????????Emergency Coordination during MC6
Multi-agency Coordination Centre (MACC)
CSs Committee ???????
???
SCG
Multi-agency Coordination Centre with 19 DLOs
MVCC
HA ???
FSD ???
Police ???
TD???
GFS ?? ????
22 DCOs
Other departmental emergency centres ??????????
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??????Roles of Department of Health

• ??????????????????????????????
• To provide early warning and advanced notice of
  threats of epidemics to MC6 Steering Committee
• ?????????,?????????
• To investigate infectious diseases outbreaks,
  institute prompt control measures
• ?????????????????????
• To establish field command, medical surveillance
  and administration of related orders

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???????Threats of Mass Gathering

• ??????(??????????)
• Bioterrorism (response coordinated by Security
  Bureau)
• ?????????
• Food borne infections
• ????????????????????
• Person to person spread of respiratory diseases
  outbreak, noroviral infection
• ????????????????????????
• Emerging infections, SARS, Avian influenza

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????????????Perceived Difficulties in
Investigation and Control

• ????
• VIPs
• ????
• Language barrier
• ????
• Security measures
• ????
• High profile event

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????????Preparedness by DH

• ???? (three phase)
• ??????? (Pre-conference preparatory phase)
• 2005?12?13?0?0??? (before 0000 of 13 December
  2005)
• ???????? (Outbreak Management Phase)
• 2005?12?13?0?0??2005?12?21?0?0? (0000 of 13
  December to 0000 of 15 December 2005)
• ????? (Post-conference phase)
• 2005?12?21?0?0??? (after 0000 of 21 December
  2005)
• ???????? (Outbreak Management Phase)
• 2005?12?13??21? (13 - 21 December 2005)
• ??????/???????????? (lag time for huge flow of
  participants /protestors out of Hong Kong)

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??????Public Health Actions

• ??
• surveillance
• ???????
• Investigation and Control
• ????
• Lab support
• ??????
• Infection control
• ??????
• Port health measures
• ????
• Communication

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???????Pre-conference Preparatory Phase

• ?? (surveillance)
• ?????????,??????
• Maintain, gather global information, inform
  relevant parties
• ???????????????
• Alert AED for prompt notification of infectious
  diseases
• ?????????????,??????????????
• Issue letters to doctors about MC6 and increase
  vigilance about infectious diseases
• ??????????????????????????????????
• Notify Ministry of Health, Guangdong, and Macao
  counterparts about our MC6 preparations for
  Infectious disease surveillance

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???????Pre-conference Preparatory Phase

• ???????
• Invesitgation and control
• ????????????
• Contingency plan for bioterrorism
• ?????????????????
• Scenario planning for human avian influenza cases
• ??????,?????????????
• Develop and translate questionnaires into 4
  official languages
• ?????
• Infectious diseases investigation
• ????????
• Food poisoning outbreaks
• ??????
• Staff mobilisatin plans
• ?????????????????
• Temporary permit for staff to enter the
  conference venue
• ????
• Food menus
• ??????????????????

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????Questionnaires
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???????Pre-conference preparatory phase

• ???? (lab support)
• ??????????? (continue and support testing of
  specimen)
• ?????? (infection control measures)
• ???? (provide training to staff of MC6)
• ?????? (port health measures)
• ???????? (prepare health education materials)
• ???? (communication)
• ???????????????????? (media, provide contact
  lists, letters to doctors and professionals)
• ?? (others)
• ???????????????????????? (influenza vaccination
  for staff involved in MC6)

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?????? (existing surveillance systems)
????????Outbreak management phase

• ???????????
• Statutory notification and reporting of
  communicable diseases of public health
  significance)
• ????????(???)
• Cluster reporting from institutions (syndromes)
• ????
• Sentinel surveillance
• ?????/???????
• General practitioners /outpatient clinics
• ????/???
• Child care centres/kindergartens
• ????
• Elderly homes
• ?????
• Lab surveillance

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????????Outbreak management phase

• ???? (Enhancement)
• ????????
• Daily monitoring of notification figures
• ?????????/????????????????
• Generate alerts for uncommon patterns/deviation
  from baselines
• ???????????????
• Monitor MC6 related events
• ?????????????????????????
• Continue gathering global epidemic intelligence
  on influenza and other infectious diseases from
  neighbouring regions
• ???????????????????????????????,???????????
• Provide daily report on regional avian influenza
  situation, local outbreaks of media interest to
  all interested parties
• ??????? (investigation and control measures)
• ?????????/?????????????
• Outbreak teams, cases/contact tracing, secure
  backup support

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????????Outbreak management phase

• ???? (lab support)
• ??????,???????????
• Ensure sufficient staff, ready to receive
  specimens during non-office hours
• ?????? (infection control measures)
• ??????????????????
• Ensure sufficient personal protective equipments
  for DH staff
• ?????? (port health measures)
• ??????????????
• Temperature screening, health education
• ???? (communication)
• ?????????????????????????
• Emergency coordination centres, hotlines, support
  MC6 PR section
• ???? (logistic support)
• ??????????
• Vans and drivers and translators

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????Communication

• ???? (interdepartmental)
• ???????-??30???/??????????
• Bulletin board system - connects the emergency
  coordination centres of 30 department/bureau
• 24????????
• Emergency contact on 24 hours basis
• ?????????
• DH headquarters duty officers
• ???? (within department)
• ???/24???? (duty room/24 hrs on call)
• ???? (video conferencing)
• ???? (backup)
• ?????? (health care professionals)
• ???? (office hour)
• ????????? (CENO online)
• ?? (fax)
• ?? (telephone)
• ?? (emails)
• ?? (post)

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????Communication
Informant

• Initial Report
• Preferably by BBS using Incident Report Form as
  soon as practicable even if information is not
  yet complete
• Further Report
• Preferably by BBS using Incident Report Form
• Quote MACC Reference Number
• Address to designated MACC/AC for telephone report

Initial / Further / Departmental Incident Report
Tel
BBS
Fax
Email

• For initial report made to MACC
• MACC Message Form will be faxed to ECC, if
  activated, of reporting Bureau/ Department/ Agency

MACC
BROADCAST ON BBS
MACC Log
MACC Message Form
MACC Incident Register
MACC Situation Report
MACC Incident Report
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(No Transcript)
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?????Post-conference phase

• ??????????
• Stand down of all measures to baseline level
• ????/???? prepare reports of surveillance/investi
  gation
• ?????????????????????
• Evaluation of overall activities for
  sustainability and performance management of
  contingency measures

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?? (drills)

• ????(three drills)
• 10?5? (5 October)
• 10???????????????
• Chemical, biological, radiological, nuclear
  drills end of October
• 12??????????
• Early December for Emergency Coordination Centres

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???????What actually happened?

• ???????????
• ?????????????????????????48???????,???????,???12?1
  5???????,?????????????????????????
• ??????????????????

• One imported malaria case
• The patient was 48 year old African male delegate
  from Gabon attending MC6. He had onset of illness
  before arrival in Hong Kong. He was admitted to
  hospital on 15 December with stable condition.
  Two other members of his delegation were
  asymptomatic.
• Food Complaint related to lunch boxes served to
  the Police

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??? (Press release)
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??Thank you