1. Abubakar I, Gautret P, Brunette GW, et al. Global perspectives for prevention of infectious diseases associated with mass gatherings. The Lancet Infectious Diseases. 2012;12(1):66–74.
Abstract: We assess risks of communicable diseases that are associated with mass gatherings (MGs), outline approaches to risk assessment and mitigation, and draw attention to some key challenges encountered by organisers and participants. Crowding and lack of sanitation at MGs can lead to the emergence of infectious diseases, and rapid population movement can spread them across the world. Many infections pose huge challenges to planners of MGs; however, these events also provide an opportunity to engage in public health action that will benefit host communities and the countries from which participants originate.
2. Anyamba A, Linthicum KJ, Small J, Britch SC, Tucker CJ. Remote Sensing Contributions to Prediction and Risk Assessment of Natural Disasters Caused by Large-Scale Rift Valley Fever Outbreaks. Proceedings of the IEEE. 2012;100(10):2824 –2834. doi:10.1109/JPROC.2012.2194469.
Abstract: Remotely sensed vegetation measurements for the last 30 years combined with other climate data sets such as rainfall and sea surface temperatures have come to play an important role in the study of the ecology of arthropod-borne diseases. We show that epidemics and epizootics of previously unpredictable Rift Valley fever (RVF) are directly influenced by large-scale flooding associated with the El Niño/Southern Oscillation (ENSO). This flooding affects the ecology of disease transmitting arthropod vectors through vegetation development and other bioclimatic factors. This information is now utilized to monitor, model, and map areas of potential RVF outbreaks and is used as an early warning system for risk reduction of outbreaks to human and animal health, trade, and associated economic impacts. The continuation of such satellite measurements is critical to anticipating, preventing, and managing disease epidemics and epizootics and other climate-related disasters.
3. Boman M, Hosani FA, Cakici B, Guttmann C, Mannaei AA. Syndromic surveillance in the United Arab Emirates. In: 2012 International Conference on Innovations in Information Technology, IIT 2012.; 2012:31–35. Available at:
Abstract: Opportunities for innovation in view of three complex problems faced by the UAE health care providers are described. The information dissemination problem faced could be approached by creating new channels for providing the population with public health information. These channels are precisely the ones typically used in so-called syndromic surveillance, including care-related data from communicable disease spread indicators, but also tweets and blog posts, for example. Syndromic surveillance could likewise assist the health authorities in addressing the knowledge elicitation problem: how to get more information on the life style, self care, and prevention among individual citizens. To some extent the prediction problem – how to predict the spread of infectious disease in the future and how to mathematically model social behaviour in the case of various health-threatening scenarios – would also be addressed by syndromic surveillance. Fully employed, the solutions proposed would provide new ICT services enabling preparedness for many forms of communicable disease outbreaks, as well as for natural disasters.
4. Breton D, Bringay S, Marques F, Poncelet P, Roche M. Mining Web Data for Epidemiological Surveillance. Washio T, Luo J, eds. Emerging Trends in Knowledge Discovery and Data Mining. 2013:11–21.
Abstract: Epidemiological surveillance is an important issue of public health policy. In this paper, we describe a method based on knowledge extraction from news and news classification to understand the epidemic evolution. Descriptive studies are useful for gathering information on the incidence and characteristics of an epidemic. New approaches, based on new modes of mass publication through the web, are developed: based on the analysis of user queries or on the echo that an epidemic may have in the media. In this study, we focus on a particular media: web news. We propose the Epimining approach, which allows the extraction of information from web news (based on pattern research) and a fine classification of these news into various classes (new cases, deaths…). The experiments conducted on a real corpora (AFP news) showed a precision greater than 94% and an F-measure above 85%. We also investigate the interest of tacking into account the data collected through social networks such as Twitter to trigger alarms.
5. Chandan S, Saha S, Barrett C, et al. Modeling the Interaction between Emergency Communications and Behavior in the Aftermath of a Disaster. In: Greenberg AM, Kennedy WG, Bos ND, eds. Social Computing, Behavioral-Cultural Modeling and Prediction. Lecture Notes in Computer Science. Springer Berlin Heidelberg; 2013:476–485. Accessed March 25, 2013.
Abstract: We describe results from a computer simulation-based study of a large-scale, human-initiated crisis in a densely populated urban setting. We focus on the interaction between human behavior and the communication infrastructure in the aftermath of the crisis. We study the effects of sending emergency broadcasts immediately after the event, advising people to shelter in place, and show that this relatively mild intervention can have a large beneficial impact.
6. Curtis JW, Curtis A, Upperman JS. Using a Geographic Information System (GIS) to Assess Pediatric Surge Potential After an Earthquake. DISASTER MEDICINE AND PUBLIC HEALTH PREPAREDNESS. 2012;6(2):163–169. doi:10.1001/dmp.2012.25.
Abstract: Geographic information systems (GIS) and geospatial technology (GT) can help hospitals improve plans for postdisaster surge by assessing numbers of potential patients in a catchment area and providing estimates of special needs populations, such as pediatrics. In this study, census-derived variables are computed for blockgroups within a 3-mile radius from Children’s Hospital Los Angeles (CHLA) and from Los Angeles County-University of Southern California (LAC-USC) Medical Center. Landslide and liquefaction zones are overlaid on US Census Bureau blockgroups. Units that intersect with the hazard zones are selected for computation of pediatric surge potential in case of an earthquake. In addition, cartographic visualization and cluster analysis are performed on the entire 3-mile study area to identify hot spots of socially vulnerable populations. The results suggest the need for locally specified vulnerability models for pediatric populations. GIS and GT have untapped potential to contribute local specificity to planning for surge potential after a disaster. Although this case focuses on an earthquake hazard, the methodology is appropriate for an all-hazards approach. With the advent of Google Earth, GIS output can now be easily shared with medical personnel for broader application and improvement in planning.
7. Dasaklis TK, Pappis CP, Rachaniotis NP. Epidemics control and logistics operations: A review. International Journal of Production Economics. 2012;139(2):393–410. doi:10.1016/j.ijpe.2012.05.023.
Abstract: Outbreaks of epidemics account for a great number of deaths. Communicable or infectious diseases are also a major cause of mortality in the aftermath of natural or man-made disasters. Effective control of an epidemic outbreak calls for a rapid response. Available resources such as essential medical supplies and well-trained personnel need to be deployed rapidly and to be managed in conjunction with available information and financial resources in order to contain the epidemic before it reaches uncontrollable or disastrous proportions. Therefore, the establishment and management of an emergency supply chain during the containment effort are of paramount importance. This paper focuses on defining the role of logistics operations and their management that may assist the control of epidemic outbreaks, critically reviewing existing literature and pinpointing gaps. Through the analysis of the selected literature a series of insights are derived and several future research directions are proposed. In conclusion, this paper provides both academics and practitioners with an overview of literature on epidemics control and logistics operations aiming at stimulating further interest in the area of epidemics control supply chain management.
8. Dugas AF, Morton M, Beard R, et al. Interventions to Mitigate Emergency Department and Hospital Crowding During an Infectious Respiratory Disease Outbreak: Results from an Expert Panel. PLoS Currents. 2013. doi:10.1371/currents.dis.1f277e0d2bf80f4b2bb1dd5f63a13993.
Abstract: Objective: To identify and prioritize potential Emergency Department (ED) and hospital-based interventions which could mitigate the impact of crowding during patient surge from a widespread infectious respiratory disease outbreak and determine potential data sources that may be useful for triggering decisions to implement these high priority interventions. Design: Expert panel utilizing Nominal Group Technique to identify and prioritize interventions, and in addition, determine appropriate “triggers” for implementation of the high priority interventions in the context of four different infectious respiratory disease scenarios that vary by patient volumes (high versus low) and illness severity (high versus low). Setting: One day in-person conference held November, 2011. Participants: Regional and national experts representing the fields of public health, disease surveillance, clinical medicine, ED operations, and hospital operations. Main Outcome Measure: Prioritized list of potential interventions to reduce ED and hospital crowding, respectively. In addition, we created a prioritized list of potential data sources which could be useful to trigger interventions. Results: High priority interventions to mitigate ED surge included standardizing admission and discharge criteria and instituting infection control measures. To mitigate hospital crowding, panelists prioritized mandatory vaccination and an algorithm for antiviral use. Data sources identified for triggering implementation of these interventions were most commonly ED and hospital utilization metrics. Conclusions: We developed a prioritized list of potentially useful interventions to mitigate ED and hospital crowding in various outbreak scenarios. The data sources identified to “trigger” the implementation of these high priority interventions consist mainly of sources available at the local, institutional level.
9. Eisenman DP, Williams MV, Glik D, Long A, Plough AL, Ong M. The public health disaster trust scale: Validation of a brief measure. Journal of Public Health Management and Practice. 2012;18(4):E11–E18. Eisenman-The-Public-Health-Disaster-Trust-Scale.pdf.
Abstract: Context: Trust contributes to community resilience by the critical influence it has on the community’s responses to public health recommendations before, during, and after disasters. However, trust in public health is a multifactorial concept that has rarely been defined and measured empirically in public health jurisdictional risk assessment surveys. Measuring trust helps public health departments identify and ameliorate a threat to effective risk communications and increase resilience. Such a measure should be brief to be incorporated into assessments conducted by public health departments. Objective: We report on a brief scale of public health disaster–related trust, its psychometric properties, and its validity. Design: On the basis of a literature review, our conceptual model of public health disaster–related trust and previously conducted focus groups, we postulated that public health disaster–related trust includes 4 major domains: competency, honesty, fairness, and confidentiality. Setting: A random-digit-dialed telephone survey of the Los Angeles county population, conducted in 2004-2005 in 6 languages. Participants: Two thousand five hundred eighty-eight adults aged 18 years and older including oversamples of African Americans and Asian Americans. Main Outcome Measures: Trust was measured by 4 items scored on a 4-point Likert scale. A summary score from 4 to 16 was constructed. Results: Scores ranged from 4 to 16 and were normally distributed with a mean of 8.5 (SD 2.7). Cronbach α = 0.79. As hypothesized, scores were lower among racial/ethnic minority populations than whites. Also, trust was associated with lower likelihood of following public health recommendations in a hypothetical disaster and lower likelihood of household disaster preparedness. Conclusions: The Public Health Disaster Trust scale may facilitate identifying communities where trust is low and prioritizing them for inclusion in community partnership building efforts under Function 2 of the Centers for Disease Control and Prevention’s Public Health Preparedness Capability 1. The scale is brief, reliable, and validated in multiple ethnic populations and languages.
10. Elliot AJ, Hughes HE, Hughes TC, et al. Establishing an emergency department syndromic surveillance system to support the London 2012 Olympic and Paralympic Games. Emerg Med J. 2012. doi:10.1136/emermed-2011-200684.
Abstract: Background: The London 2012 Olympic and Paralympic Games is a mass gathering event that will present a major public health challenge. The Health Protection Agency, in collaboration with the College of Emergency Medicine, has established the Emergency Department Sentinel Syndromic Surveillance System (EDSSS) to support the public health surveillance requirements of the Games. Methods: This feasibility study assesses the usefulness of EDSSS in monitoring indicators of disease in the community. Daily counts of anonymised attendance data from six emergency departments across England were analysed by patient demographics (age, gender, partial postcode), triage coding and diagnosis codes. Generic and specific syndromic indicators were developed using aggregations of diagnosis codes recorded during each attendance. Results: Over 339 000 attendances were recorded (26 July 2010 to 25 July 2011). The highest attendances recorded on weekdays between 10:00 and 11:00 and on weekends between 12:00 and 13:00. The mean daily attendance per emergency department was 257 (range 38–435). Syndromic indicators were developed including: respiratory, gastrointestinal, cardiac, acute respiratory infection, gastroenteritis and myocardial ischaemia. Respiratory and acute respiratory infection indicators peaked during December 2010, concomitant with national influenza activity, as monitored through other influenza surveillance systems. Conclusions: The EDSSS has been established to provide an enhanced surveillance system for the London 2012 Olympics. Further validation of the data will be required; however, the results from this initial descriptive study demonstrate the potential for identifying unusual and/or severe outbreaks of infectious disease, or other incidents with public health impact, within the community.
11. Esposito DH, Han PV, Kozarsky PE, et al. Characteristics and spectrum of disease among ill returned travelers from pre- and post-earthquake Haiti: The GeoSentinel experience. Am. J. Trop. Med. Hyg. 2012;86(1):23–28. doi:10.4269/ajtmh.2012.11-0430.
Abstract: To describe patient characteristics and disease spectrum among foreign visitors to Haiti before and after the 2010 earthquake, we used GeoSentinel Global Surveillance Network data and compared 1 year post-earthquake versus 3 years pre-earthquake. Post-earthquake travelers were younger, predominantly from the United States, more frequently international assistance workers, and more often medically counseled before their trip than pre-earthquake travelers. Work-related stress and upper respiratory tract infections were more frequent post-earthquake; acute diarrhea, dengue, and Plasmodium falciparum malaria were important contributors of morbidity both pre- and post-earthquake. These data highlight the importance of providing destination- and disaster-specific pre-travel counseling and post-travel evaluation and medical management to persons traveling to or returning from a disaster location, and evaluations should include attention to the psychological wellbeing of these travelers. For travel to Haiti, focus should be on mosquito-borne illnesses (dengue and P. falciparum malaria) and travelers’ diarrhea.
12. Harcourt SE, Fletcher J, Loveridge P, et al. Developing a new syndromic surveillance system for the London 2012 Olympic and Paralympic Games. Epidemiol. Infect. 2012;140(12):2152–2156. doi:10.1017/S0950268812001781.
Abstract: Syndromic surveillance is vital for monitoring public health during mass gatherings. The London 2012 Olympic and Paralympic Games represents a major challenge to health protection services and community surveillance. In response to this challenge the Health Protection Agency has developed a new syndromic surveillance system that monitors daily general practitioner out-of-hours and unscheduled care attendances. This new national system will fill a gap identified in the existing general practice-based syndromic surveillance systems by providing surveillance capability of general practice activity during evenings/nights, over weekends and public holidays. The system will complement and supplement the existing tele-health phone line, general practitioner and emergency department syndromic surveillance systems. This new national system will contribute to improving public health reassurance, especially to meet the challenges of the London 2012 Olympic and Paralympic Games.
13. Khan K, McNabb SJN, Memish ZA, et al. Infectious disease surveillance and modelling across geographic frontiers and scientific specialties. Lancet Infect Dis. 2012;12(3):222–230. doi:10.1016/S1473-3099(11)70313-9.
Abstract: Infectious disease surveillance for mass gatherings (MGs) can be directed locally and globally; however, epidemic intelligence from these two levels is not well integrated. Modelling activities related to MGs have historically focused on crowd behaviours around MG focal points and their relation to the safety of attendees. The integration of developments in internet-based global infectious disease surveillance, transportation modelling of populations travelling to and from MGs, mobile phone technology for surveillance during MGs, metapopulation epidemic modelling, and crowd behaviour modelling is important for progress in MG health. Integration of surveillance across geographic frontiers and modelling across scientific specialties could produce the first real-time risk monitoring and assessment platform that could strengthen awareness of global infectious disease threats before, during, and immediately after MGs. An integrated platform of this kind could help identify infectious disease threats of international concern at the earliest stages possible; provide insights into which diseases are most likely to spread into the MG; help with anticipatory surveillance at the MG; enable mathematical modelling to predict the spread of infectious diseases to and from MGs; simulate the effect of public health interventions aimed at different local and global levels; serve as a foundation for scientific research and innovation in MG health; and strengthen engagement between the scientific community and stakeholders at local, national, and global levels.
14. Kohlhoff SA, Crouch B, Roblin PM, et al. Evaluation of Hospital Mass Screening and Infection Control Practices in a Pandemic Influenza Full-Scale Exercise. DISASTER MEDICINE AND PUBLIC HEALTH PREPAREDNESS. 2012;6(4):378–384. doi:10.1001/dmp.2012.73.
Abstract: Objective: Nonpharmacologic interventions such as limiting nosocomial spread have been suggested for mitigation of respiratory epidemics at health care facilities. This observational study tested the efficacy of a mass screening, isolation, and triage protocol in correctly identifying and placing in a cohort exercise subjects according to case status in the emergency departments at 3 acute care hospitals in Brooklyn, New York, during a simulated pandemic influenza outbreak. Methods: During a 1-day, full-scale exercise using 354 volunteer victims, variables assessing adherence to the mass screening protocol and infection control recommendations were evaluated using standardized forms. Results: While all hospitals were able to apply the suggested mass screening protocol for separation based on case status, significant differences were observed in several infection control variables among participating hospitals and different hospital areas. Conclusions: Implementation of mass screening and other infection control interventions during a hospital full-scale exercise was feasible and resulted in measurable outcomes. Hospital drills may be an effective way of detecting and addressing variability in following infection control recommendations.
15. Mackey TK, Liang BA. Lessons from SARS and H1N1/A: employing a WHO-WTO forum to promote optimal economic-public health pandemic response. J Public Health Policy. 2012;33(1):119–130. doi:10.1057/jphp.2011.51.
Abstract: No formal system exists to review trade restrictions imposed during international public health emergencies rapidly. Failure to put one in place creates disincentives for surveillance and reporting, thereby undermining protection efforts. The 2003 SARS outbreak exposed weaknesses in global governance that caused uncoordinated public health and economic responses. New International Health Regulations (IHR), applied first during the 2009 H1N1 influenza outbreak, demonstrated improvement. Yet they failed to allow for management of public health emergencies in a way that balanced threats to health and those to economies and trade. Establishment of a joint WHO-WTO committee to adjudicate these conflicts might better achieve that balance.
16. McCormick S, Whitney K. The making of public health emergencies: West Nile virus in New York City. Sociology of Health & Illness. 2013;35(2):268–279. doi:10.1111/1467-9566.12002.
Abstract: In this article we use the case of the West Nile virus (WNV) to investigate the social construction of public health emergencies (PHEs) and the subsequent changes in public health governance that they instigate. Informed by medical sociological literature on the social construction of illness, science and technology studies, and risk and disaster literature, we create a conceptual framework for connecting health and crisis. Our investigation of the WNV analyses PHEs as brief, but vitally important, moments in which a ‘crisis’ is co-constructed between states, affected populations and disease vectors. In these moments of crisis new interventions are enacted, which have long-term effects for institutional structures and disease management. Using extensive qualitative data collection, we conceptualise two mechanisms that underlie the declaration of PHEs and the expansion of related ’emergencies’ across space and time: (i) crisis interventions that have the potential to marginalise the interaction of citizens with state institutions and (ii) institutional rearrangement of state agencies stemming from the original crisis issue, resulting in altered networks and institutional practices and drawing heavily upon the crisis as a symbol of similar, future public health threats.
17. Mimura S, Kamigaki T, Oshitani H. Infectious disease risk after the Great East Japan Earthquake. Journal of Disaster Research. 2012;7(6):741–745.
Abstract: Infectious disease outbreaks in postdisaster settings provide significant social impact although those outbreaks do not always occur. It is important to assess the potential risks of infectious disease in each setting. The Great East Japan Earthquake, which occurred March 11, 2011, imposed a huge impact on public health services. After the earthquake and following tsunami, many evacuation centers were sites of crowding as well as poor sanitation conditions because of the large-scale of destruction. Some shelters became sites of infectious disease outbreaks such as influenza and norovirus enteritis, although the size of these outbreaks was quite localized. Improvements in the response to infectious diseases through lessons learned from the Great East Japan Earthquake are expected to be the triggers for improving preparedness for public health emergencies.
18. Rebmann T, Elliott MB, Reddick D, D. Swick Z. US school/academic institution disaster and pandemic preparedness and seasonal influenza vaccination among school nurses. American Journal of Infection Control. 2012;40(7):584–589. doi:10.1016/j.ajic.2012.02.027.
Abstract: Background: School pandemic preparedness is essential, but has not been evaluated. Methods: An online survey was sent to school nurses (from state school nurse associations and/or state departments of education) between May and July 2011. Overall school pandemic preparedness scores were calculated by assigning 1 point for each item in the school’s pandemic plan; the maximum score was 11. Linear regression was used to describe factors associated with higher school pandemic preparedness scores. Nurse influenza vaccine uptake was assessed as well. Results: A total of 1,997 nurses from 26 states completed the survey. Almost three-quarters (73.7%; n = 1,472) reported receiving the seasonal influenza vaccine during the 2010-11 season. Very few (2.2%; n = 43) reported that their school/district had a mandatory influenza vaccination policy. Pandemic preparedness scores ranged from 0 to 10 points, with an average score of 4.3. Determinants of school pandemic preparedness were as follows: planning to be a point of dispensing during a future pandemic (P < .001), having experienced multiple student or employee hospitalizations and/or deaths related to H1N1 during the pandemic (P = .01 or