Transcript bongminyang

SARS Epidemic:
A Global Challenge
Bong-Min Yang, PhD
& Sung-il Cho, MD, PhD
of
School of Public Health
Seoul National University
Why significant global issue?
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Multi-country outbreaks
Spread through air travel and human
migration
Causative agent still unknown
Severity of illness
Impacts on clinical and public health
services
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David P. Fidler (2004)
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“SARS was a crisis, but victory was
achieved”
Political Impact
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Multinational organizations, particularly
WHO, become to have increasing influence
on global governance
– After successful control, much credit given WHO for
initiation and coordination of surveillance, research and
control measures
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WHO Initiated
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–
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–
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Global Alert (12 March, 2003)
Travel Advisory (15 March, 2003)
Enhanced global surveillance
Global Outbreak Alert and Response Network (GOARN)
Specific Global Networks (Lab, Case management,
Epidemiology)
Political Impact 2
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Importance of global cooperation to an outbreak
of infectious disease is fully realized
– It validated the value of global public health networking
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Weakness of China’s public health infrastructure
was revealed
– China first downplayed the extent and the risk of the infection,
then joined the international network to control
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Afterward, Chinese public health infrastructure
was strengthened a lot
– Case reporting structure established
– Strengthened emergency response system
– Provide funding for prevention of SARS
Economic Impact
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Direct costs
– Medical treatment costs, and costs of some equipment
and supplies for prevention
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Indirect costs
– Travel/airline
– Tourism
– Trade/investment
– Shrunk consumer confidence
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Global indirect costs estimated to be
around US$80 billion (McKibbin, 2003)
Estimation of the impact of SARS on selected Asian
Economies
Estimated
reduction in
annual GDP
growth if SARS
lasts for 1
quarter in
2003(percentage
point)
Estimated
reduction in
annual GDP
growth if SARS
lasts for 2
quarters in 2003
(percentage
point)
Estimated
reduction in GDP
level if SARS
lasts for 1
quarter in 2003
(US$ billion)
Estimated
reduction in GDP
level if SARS
lasts for 2
quarters in 2003
(US$ billion)
2003
2003
2003
2003
East Asia
0.4
1.0
8.8
20.0
The PRC
0.2
0.5
2.3
5.8
HK, China
1.8
4.0
3.0
6.6
Korea
0.2
0.5
1.3
3.0
Taipei, China
0.9
1.9
2.5
5.3
Southeast Asia
0.5
1.4
3.2
7.7
Indonesia
0.5
1.4
0.7
2.0
Malaysia
0.6
1.5
0.5
1.3
Philippines
0.3
0.8
0.2
0.6
Singapore
1.1
2.3
1.0
2.0
Thailand
0.7
1.6
0.8
1.8
Economies
Source: ERD of ADB using OEF model, staff estimates
Korea’s exports have decreased, but not much
Chart 4
Lessons Drawn
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Importance of
– early detection
– quarantine and surveillance
– informing the public in time, and correctly
– Supporting basic and specific research
– Increasing public health capacity: manpower
and facility
– Promoting international cooperation and
collaboration
SARS Situation in Korea
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No death related with SARS
– 3 probable cases
– 17 suspected cases
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Mostly those who visited China
Overall 65 reports for assessment
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Korean Strategies for SARS Prevention
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Early detection of imported cases
– Quarantine
– Surveillance
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Prevention of secondary infection
– Medical facilities
– Protection of health care personnel (mask, etc.)
– Isolation of patients
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Information and education
– Hand washing
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Laboratory capability
– Support laboratory diagnosis
SARS Management System
Headquarter
Chair: Minister of Health
Communicable Disease Task force
Chair: NIH director
SARS Control Team
Emergency Response Team
Chair : Municipal/Provincial vice mayor
Municipal/Provincial health director
Local SARS Control Team
Local Emergency Response Team
Chair: Vice district chair
District health officer
Quarantine
Assessment
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Questionn
aire
Examinati
on
(fever etc)
Isolation
Isolation
room
 Patient care
 Special
investigation
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Follow-up
Suspected Cases
 Identify
passengers
from high
risk areas
 Collaborate
with
immigration
office
 Examine air
crews
Information
 For travelers
 For visitors
and
immigrants
 Media
 Travel
agencies
Quarantine Activities
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Check body temperature for travellers
from China (5,000/day)
Examine aircrafts (45 planes and
7,000 persons/day)
20,000 passengers/day screened,
using infrared automatic body
temperature thermometer
Patient Surveillence
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Case report network
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Education of health care workers
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Monitor emergency rooms
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Networking of infection specialists
Public Information and Education
http://dis.mohw.go.kr/sars_index.asp
Tasks Underway after SARS Epidemic
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Establish infrastructure for communicable disease
control
– New establishment of CDC
– Strengthen public health care sector
– Networking of quarantine office and CDC
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Strengthening response capacity for emerging
disease
– Global monitoring
– Laboratory capacity and research
– Emergency response preparedness