Biosecurity and bioterrorism : biodefense strategy, practice, and science最新文献

{"title":"The changing face of crises and aid in the Asia-Pacific.","authors":"Elin A Gursky,&nbsp;Frederick M Burkle,&nbsp;David W Hamon,&nbsp;Peter Walker,&nbsp;Georges C Benjamin","doi":"10.1089/bsp.2014.0025","DOIUrl":"https://doi.org/10.1089/bsp.2014.0025","url":null,"abstract":"<p><p>Both US foreign policy and global attention attest to the strategic, economic, and political importance of Asia. Yet, the region faces urgent challenges that must be addressed if it is to remain stable and prosperous. The densely populated countries of the Asia-Pacific are beleaguered by poverty, population displacement, decreasing access to potable water and adequate sanitation, and high rates of disease morbidity and mortality. New and reemerging diseases known to have originated in Asia over the past decades have spread globally by international trade, tourism, worker migration, and agricultural exportation. Unremitting naturally occurring and man-made disasters have strained Southeast Asia's already fragile disaster and public health response infrastructures and the essential services they provide (eg, surveillance, vaccination, maternal and child health, and mental health programs). Following disasters, governments often contract with the broader humanitarian community (eg, indigenous and international NGOs) and seek the assistance of militaries to provide essential services. Yet, their roles and capabilities in addressing acute and chronic health issues in the wake of complex disasters remain unclear. Current mechanisms of nation-state and outside organization interaction, including dissimilar operational platforms, may limit true partnership on behalf of the health security mission. Additionally, concerns regarding skill sets and the lack of standards-based training raise questions about the balance between developing internal response capabilities and professionalizing external, deployable resources. Both the mega-disasters that are forecast for the region and the global health security threats that are expected to emanate from them require an increased focus on improving the Asia-Pacific's emergency preparedness and response posture. </p>","PeriodicalId":87059,"journal":{"name":"Biosecurity and bioterrorism : biodefense strategy, practice, and science","volume":"12 6","pages":"310-7"},"PeriodicalIF":0.0,"publicationDate":"2014-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/bsp.2014.0025","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32707169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Re: optimization of interventions in ebola.","authors":"Viroj Wiwanitkit","doi":"10.1089/bsp.2014.1031","DOIUrl":"https://doi.org/10.1089/bsp.2014.1031","url":null,"abstract":"","PeriodicalId":87059,"journal":{"name":"Biosecurity and bioterrorism : biodefense strategy, practice, and science","volume":"12 6","pages":"373"},"PeriodicalIF":0.0,"publicationDate":"2014-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/bsp.2014.1031","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32876088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regional collaboration among Urban Area Security Initiative regions: results of the Johns Hopkins urban area survey.","authors":"Nicole A Errett,&nbsp;Calvin Bowman,&nbsp;Daniel J Barnett,&nbsp;Beth A Resnick,&nbsp;Shannon Frattaroli,&nbsp;Lainie Rutkow","doi":"10.1089/bsp.2014.0057","DOIUrl":"https://doi.org/10.1089/bsp.2014.0057","url":null,"abstract":"<p><p>Regional collaboration has been identified as a potential facilitator of public health preparedness efforts. The Urban Area Security Initiative (UASI) grant program, administered by the Federal Emergency Management Agency (FEMA) since 2003, has provided 64 high-risk metropolitan areas funding to enhance their regional preparedness capabilities. This study describes informal and formal regional collaboration infrastructure, as well as regional collaboration-related activities and assessment methods, in FFY2010 UASI regions. A cross-sectional online survey was administered via Survey Monkey from September through December 2013. Points of contact from FFY2010 funded UASI metropolitan areas completed the survey, with a response rate of 77.8% (n=49). Summary statistics were calculated to describe the current informal and formal regional collaboration infrastructure. Additionally, the cross-sectional survey collected rates of agreement with 8 collaborative preparedness statements at 3 time points. The survey found that UASI regions are engaging in collaborative activities and investments to build capabilities, with most collaboration occurring in the prevention, protection, and response mission areas. Collaborative relationships in preparedness among emergency managers and municipal chief executive officers improved during the FFY2010 UASI performance period compared to the pre-UASI award period, with lasting effects. The majority of UASI regions reported conducting independent assessments of capabilities and their measurement at the UASI region level. Urban areas that received a FFY2010 UASI grant award are engaging in collaborative activities and have established interjurisdictional relationships in preparedness. The use of grant funds to encourage collaboration in preparedness has the potential to leverage limited resources and promote informed investments. </p>","PeriodicalId":87059,"journal":{"name":"Biosecurity and bioterrorism : biodefense strategy, practice, and science","volume":"12 6","pages":"356-65"},"PeriodicalIF":0.0,"publicationDate":"2014-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/bsp.2014.0057","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32814638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Travel bans will increase the damage wrought by ebola.","authors":"Jennifer B Nuzzo,&nbsp;Anita J Cicero,&nbsp;Richard Waldhorn,&nbsp;Thomas V Inglesby","doi":"10.1089/bsp.2014.1030","DOIUrl":"https://doi.org/10.1089/bsp.2014.1030","url":null,"abstract":"Cases of Ebola that have turned up in Dallas and New York City have prompted calls for a travel ban to prohibit travelers from Sierra Leone, Liberia, and Guinea from entering the US during the ongoing Ebola outbreak. But travel bans have not worked in past epidemics and will not stop Ebola from spreading. Banning travel would slow the movement of people and goods to those countries, harm the international response to the outbreak in West Africa, and increase the prospect of ongoing global spread of Ebola. In addition, travel bans could lead to complete isolation of those 3 countries and would further worsen the economic and humanitarian toll of this crisis. US travel bans would also run counter to international agreements and could encourage other countries to impose their own bans against the United States and other countries in future outbreaks. The occurrence of secondary cases in 2 US nurses who treated the first Ebola patient in Dallas, and the corresponding lack of secondary cases occurring among members of the broader community, underscores the importance of focusing our Ebola control efforts on US hospitals and ensuring that clinicians in these settings have all of the training and protective equipment necessary to safely diagnose and treat Ebola patients.","PeriodicalId":87059,"journal":{"name":"Biosecurity and bioterrorism : biodefense strategy, practice, and science","volume":"12 6","pages":"306-9"},"PeriodicalIF":0.0,"publicationDate":"2014-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/bsp.2014.1030","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32816604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sociocultural dimensions of the ebola virus disease outbreak in Liberia.","authors":"Sanjana J Ravi,&nbsp;Eric M Gauldin","doi":"10.1089/bsp.2014.1002","DOIUrl":"https://doi.org/10.1089/bsp.2014.1002","url":null,"abstract":"S ince December 2013, an outbreak of Ebola virus disease in the West African nation of Guinea has rapidly evolved into a humanitarian crisis of unforeseen proportions, overwhelming vulnerable communities in Liberia, Sierra Leone, Nigeria, and Senegal. While previous outbreaks of Ebola cumulatively resulted in 2,486 cases and 1,590 deaths, the current Ebola epidemic has so far resulted in 8,376 infections and claimed 4,024 lives (as of October 10, 2014), prompting the World Health Organization (WHO) to designate it as a public health emergency of international concern. Officials from the US Centers for Disease Control and Prevention (CDC) estimate that, in the absence of public health interventions, Liberia and Sierra Leone could experience as many as 550,000 cases (or 1.4 million after correcting for underreporting) by January 2015. Few research initiatives thus far have analyzed the community dynamics of Ebola outbreaks. Similarly, current relief efforts have not focused on ways to address the social and cultural factors shaping West Africans’ perceptions of and responses to Ebola or their perceptions of the international community’s efforts to mitigate the epidemic. To date, surveillance and infection control measures have failed to stop the outbreak, prompting WHO to call for greater community engagement efforts to enhance ongoing relief activities. This article examines some of the social and cultural factors at play in the Ebola outbreak in Liberia and suggests the type of sociocultural investigation that has been largely absent in attempts to thwart the Ebola threat. WHO assessments show that Liberia has borne the brunt of the current outbreak, having reported the most cases (more than 3,000) and deaths (nearly 2,000), as well as the highest case-fatality rate (70.8%). Some of the practices and social norms shaping the trajectory of the Liberian outbreak include funeral rituals, disparate gender roles, and the stigma faced by those who contract Ebola.","PeriodicalId":87059,"journal":{"name":"Biosecurity and bioterrorism : biodefense strategy, practice, and science","volume":"12 6","pages":"301-5"},"PeriodicalIF":0.0,"publicationDate":"2014-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/bsp.2014.1002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32767470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing US-Japan cooperation to combat antimicrobial resistance.","authors":"C Sachi Gerbin","doi":"10.1089/bsp.2014.0034","DOIUrl":"https://doi.org/10.1089/bsp.2014.0034","url":null,"abstract":"<p><p>The Global Health Security Agenda (GHSA) is aimed at preventing, detecting, and responding to infectious disease threats. To move toward these goals, the United States has committed to partner with at least 30 countries around the world. One of the objectives of the GHSA includes \"[p]reventing the emergence and spread of antimicrobial drug resistant organisms.\" Antimicrobial resistance (AMR) has become a growing global health security problem, with inappropriate use of antimicrobial medications in humans and animals and a lack of new antimicrobial medications contributing to this problem. While AMR is a growing global concern, working on it regionally can make this multifaceted problem more manageable. The United States and Japan, both world leaders in the life sciences, are close allies that have established cooperative programs in medical research and global health that can be used to work on combating AMR and advance the GHSA. Although the United States and Japan have cooperated on health issues in the past, their cooperation on the growing problem of AMR has been limited. Their existing networks, cooperative programs, and close relationships can and should be used to work on combating this expanding problem. </p>","PeriodicalId":87059,"journal":{"name":"Biosecurity and bioterrorism : biodefense strategy, practice, and science","volume":"12 6","pages":"337-45"},"PeriodicalIF":0.0,"publicationDate":"2014-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/bsp.2014.0034","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32876087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimization of interventions in ebola: differential contagion.","authors":"Amesh A Adalja,&nbsp;D A Henderson","doi":"10.1089/bsp.2014.0925","DOIUrl":"https://doi.org/10.1089/bsp.2014.0925","url":null,"abstract":"Managing any contagious infectious disease outbreak involves breaking the chain of transmission from those who are infected with the pathogen to those who are not. Not all pathogens, however, are equal in their contagiousness, and considerable variation exists. \u0000 \u0000The viral disease measles, for example, is considered to be one of the most contagious human diseases. Its high rate of contagion is driven by 2 attributes: the ability to spread through the air via small particles (ie, airborne transmission) and the fact that one of the symptoms of measles is coughing, an effective means of expelling those particles. On average, a person infected with measles can infect 15 other people through the course of his or her illness.1 Diseases like tetanus and anthrax, on the other hand, are not contagious at all because they lack the ability to spread between humans. In between these 2 extremes lie all the other infectious diseases. \u0000 \u0000Another factor that affects infectiousness is the course of illness. Disease symptoms such as coughing, vomiting, and diarrhea can serve to heighten the transmission of a pathogen. For example, a person with whooping cough is more contagious when he is coughing than when he is not because the expelling of infectious material renders him more contagious. \u0000 \u0000Ebola viral disease (EVD) is no different. Ebola is spread exclusively through blood and bodily fluids. Thus, those Ebola patients experiencing symptoms of vomiting and diarrhea—because they are literally expelling infectious bodily fluids—would be expected to be more contagious than those without these symptoms, who may have less opportunity to spread the illness. \u0000 \u0000Another feature of Ebola is the hemorrhagic manifestations that occur in approximately half of patients. This often terminal manifestation includes bleeding from multiple bodily orifices, IV sites, needle punctures, and gums. An individual who is hemorrhaging, much like the vomiting patient, would be expected to be more contagious since viral particles are being emitted into the environment from the patient's body via blood. \u0000 \u0000The phenomenon of varied contagiousness was seen in the 1972 smallpox outbreak in the former Yugoslavia, in which 1 individual with hemorrhagic smallpox spread the virus to 38 contacts. Other victims transmitted infection to only 2 to 3 others.2 \u0000 \u0000If this differential contagiousness occurs with Ebola as well, it could be employed to optimize isolation and contact tracing activities—essential in a resource-challenged setting such as West Africa. If those individuals with hemorrhagic disease, vomiting, and diarrhea are the most infectious, then infection control should be prioritized to ensure that these patients are cared for with the appropriate protective measures in place. When contact tracing activities are performed, prioritizing the location of those who had contact with such cases could occur. Close contacts should be identified whenever possible and either kept under surveillance","PeriodicalId":87059,"journal":{"name":"Biosecurity and bioterrorism : biodefense strategy, practice, and science","volume":"12 6","pages":"299-300"},"PeriodicalIF":0.0,"publicationDate":"2014-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/bsp.2014.0925","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32703711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Engaging the States of the former soviet union in health security.","authors":"David R Franz","doi":"10.1089/bsp.2014.0063","DOIUrl":"https://doi.org/10.1089/bsp.2014.0063","url":null,"abstract":"While it would be comforting to assure that the job would be finished when our cooperative programs—the Department of Defense’s Nunn-Lugar Cooperative Threat Reduction Program, begun for biology in 1994, or the Department of State’s Biological Engagement Program, launched in 2006— complete their assignments and depart any country, the answer to the verification question will always be beyond our grasp, particularly in regions where we lack open and transparent relationships. The BWC is necessary but not sufficient for our national and global biosecurity. Verifying that any individual nation state is in compliance is not possible. The BWC is an important international norm and law; as a nation, it is critical that we demonstrate globally and consistently our full support of it and work with other signatories to enforce the norm and law it represents. The Department of State takes the lead on BWC issues, but to enhance security from external biological attack requires an integrated international effort by the whole-ofgovernment, academe, industry, and nongovernmental organizations. A robust network of multinational partnerships is also needed. Finally, the US government must understand the power of human relationships in this complex biological world. As a relevant 2009 National Academy of Sciences (NAS) report stated, we should ‘‘recognize that personal relationships and professional networks that are developed through USG Cooperative Threat Reduction programs contribute directly to our national security.’’ The Global Health Security Agenda concept newly introduced by the White House appears to be compatible with that principle.","PeriodicalId":87059,"journal":{"name":"Biosecurity and bioterrorism : biodefense strategy, practice, and science","volume":"12 6","pages":"366-9"},"PeriodicalIF":0.0,"publicationDate":"2014-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/bsp.2014.0063","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32755613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biosurveillance capability requirements for the global health security agenda: lessons from the 2009 H1N1 pandemic.","authors":"Michael A Stoto","doi":"10.1089/bsp.2014.0030","DOIUrl":"https://doi.org/10.1089/bsp.2014.0030","url":null,"abstract":"<p><p>The biosurveillance capabilities needed to rapidly detect and characterize emerging biological threats are an essential part of the Global Health Security Agenda (GHSA). The analyses of the global public health system's functioning during the 2009 H1N1 pandemic suggest that while capacities such as those identified in the GHSA are essential building blocks, the global biosurveillance system must possess 3 critical capabilities: (1) the ability to detect outbreaks and determine whether they are of significant global concern, (2) the ability to describe the epidemiologic characteristics of the pathogen responsible, and (3) the ability to track the pathogen's spread through national populations and around the world and to measure the impact of control strategies. The GHSA capacities-laboratory and diagnostic capacity, reporting networks, and so on-were essential in 2009 and surely will be in future events. But the 2009 H1N1 experience reminds us that it is not just detection but epidemiologic characterization that is necessary. Similarly, real-time biosurveillance systems are important, but as the 2009 H1N1 experience shows, they may contain inaccurate information about epidemiologic risks. Rather, the ability of scientists in Mexico, the United States, and other countries to make sense of the emerging laboratory and epidemiologic information that was critical-an example of global social capital-enabled an effective global response. Thus, to ensure that it is meeting its goals, the GHSA must track capabilities as well as capacities. </p>","PeriodicalId":87059,"journal":{"name":"Biosecurity and bioterrorism : biodefense strategy, practice, and science","volume":"12 5","pages":"225-30"},"PeriodicalIF":0.0,"publicationDate":"2014-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/bsp.2014.0030","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32695531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Special issue on the global health security agenda.","authors":"Gigi Gronvall,&nbsp;Tom Inglesby","doi":"10.1089/bsp.2014.0731","DOIUrl":"https://doi.org/10.1089/bsp.2014.0731","url":null,"abstract":"","PeriodicalId":87059,"journal":{"name":"Biosecurity and bioterrorism : biodefense strategy, practice, and science","volume":"12 5","pages":"219-20"},"PeriodicalIF":0.0,"publicationDate":"2014-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/bsp.2014.0731","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32695529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}