|
Over the last 20 years , we have had at least seven public health emergencies of international concern , and they are happening more frequently and with greater intensity .
They include influenza ,
COVID , dengue , rabies , measles , cholera , malaria , even diphtheria .”
— Mariana Portillo Torres ,
MD
|
Asian countries , this appeared for the first time in the U . S . last year , and diseases such as dengue and malaria came back for the first time after 30 to 50 years , and states such as Arkansas , Texas , Arizona and Florida reported malaria cases after many , many years of absence . So , why are these emerging pathogens not only on the rise but happening with more frequency ? There are global factors , such as international travel and commerce , changes in demographics and behavior , as well as environmental changes and land use and a breakdown in public health measures ,” Torres explained . “ There are also disease factors , such as an increase in transmission , an increase in host susceptibility , as well as the emergence of new diseases .”
Torres pointed to the profusion of headlines in the news addressing emerging and re-emerging pathogens . “ It is very overwhelming ,” she acknowledged . “ The focus can be on avian flu one day , and then measles on another . We ’ re getting so much news about pathogens that we don ’ t really know what to focus our attention on , so that ’ s why we created an assessment of what we believe to be the most important emerging and re-emerging threats right now for the U . S .”
The co-presenters listed avian influenza , H5N1 influenza , mosquito-borne diseases malaria and dengue , measles , Mpox , and Disease X as the pathogens of most concern currently .
Torres addressed the global concern around what Disease X might be .
“ Are we ready ? What have we learned from COVID-19 ? It is difficult to know for sure because nobody knows when this is going to happen ,” she admitted . “ But we need to understand there are some aspects of Disease X that can help us understand how to prepare after COVID-19 . SARS- Co-V2 was a virus , and viruses have been responsible for most of the public health emergencies of international concern . So , Disease X is likely going to be a virus , and it ’ s likely going to be airborne , humanto-human transmission . Without apparent symptoms , it will spread , and therefore it will present significant challenges in tracking and outbreak control . There is potential for large-scale and rapid spread as well as the potential for significant morbidity and mortality .”
Torres emphasized that response to Disease X requires a multi-pronged approach , focusing on air quality , a rapid-response strategy that allows for speedy ramp-up for peak-demand situation , a proven path toward vaccine development , a One-Health focus , international cooperation in genetic sequencing of emerging pathogens , and strengthening and supporting outbreak investigations nationally and internationally .
|
“ It ’ s a matter of time and preparation , and being aware of the potential for Disease X to emerge ,” Torres noted . “ We know that if we don ’ t launch a response on time , there will be patient harm , loss of trust , large public health impacts , significant spread and loss of resources , and of course , antimicrobial resistance among other consequences .”
Kley reviewed the IP & C measures that offer a practical solution to emerging and re-emerging pathogens .
“ The prospect of Disease X is a bit unsettling , but this is the world that we live in today and it just serves to remind us why it is so vital that we remain vigilant and implement practical control measures for mitigating these pathogens ,” she said . “ Some key measures include an emergency response plan , patient screening , and cleaning and disinfecting against these high-consequence pathogens . We should be thinking of pandemic preparedness , much like firefighters are always on the ready despite no fire . Emerging infectious disease ( EID ) response should be part of a facility ’ s overall emergency response plan , so be sure that you ’ re collaborating with your safety and / or emergency response folks at your respective facilities . The primary goals of your plan are to reduce morbidity and mortality and minimize transmission . We don ’ t want our hospitals to be amplifiers of an outbreak or a pandemic . We want to make sure we ’ re protecting healthcare workers , patients and any visitors that come through our doors and we want to preserve the overall functioning of not only our facility but of the entire U . S . healthcare system . It ’ s a CMS requirement that hospitals have a written emergency response plan that also addresses emerging infectious diseases . You want to make sure that your plan aligns with your state or local plans , so get your hands on those now . Given the extended and devastating disruption of COVID-19 , we can expect that his is going to be a focal point for surveyors going forward . You may be aware that the Joint Commission ’ s infection control chapter recently underwent a full rewrite and the changes go into effect in July . First , with this rewrite came a new standard IC 07.01.01 , which requires hospitals to be prepared for high-consequence or special pathogens and the Joint Commission will survey us to the CMS requirements . The rationale for the Joint Commission ’ s new standard is to ensure that we have a standardized approach to emerging pathogen preparedness that is grounded in the hierarchy of controls . The intent of this is to strengthen our protocols and our processes for all infectious threats , not just the emerging ones .”
Kley explained that the Joint Commission defines high-consequence or special
|
The prospect of Disease X is a bit unsettling , but this is the world that we live in today and it just serves to remind us why it is so vital that we remain vigilant and implement practical control measures for mitigating these pathogens . Some key measures include an emergency response plan , patient screening , and cleaning and disinfecting against these highconsequence pathogens .” — Doe Kley , RN , MPH , LTC-CIP , CIC |