public health response in zika virus & mers-cov infections

Public Health Response in Zika Virus & MERS-CoV

Infections: Kuala Lumpur International Airport (KLIA)

Experiences

Dr. Harishah Talib Public Health Physician

KLIA Health Officer MBBS(India), MPH(Malaya), EIP(Malaysia)

E-mail: [email protected]

mailto:[email protected]

1. Disaster Management Plan Ministry Of Health Malaysia

2. Zika Virus Preparedness Plan At KLIA

3. MERS-CoV screening

4. Conclusion

CAPSCA-AP/08-Thailand Nov 15-18 2016 2

Contents

1-Disaster Management Plan Ministry Of Health Malaysia

Disaster: 1. Disaster As a result of

Communicable Disease Outbreak /Pandemic Event

2. Mass Casualty Incident (MCI)

3. Environment-linked Disaster

4. Chemical, Biological, Radiological and Nuclear explosives (CBRNe)


National CPRC, Ministry of Health Malaysia

PHEIC/ CRISIS/ DISASTER NOT PHEIC PHEIC

Crisis and disaster Incident

Medical Specialist/ Medical Officer/ any

related officer

DDGH (PA) - Focal Point

Director of Disease Control

State Health Director

Hospital Director

Director General of Health

YB Minister of Health

WHO or other related external agencies

Monitoring of control measures and prevention and incident status assessment (risk assessment)

District Health Officer

WHO-EIS

Information from other sources

PHEIC

Malaysia National IHR FP

CRISIS/DISASTER

1-Flow of notification

National CPRC, Ministry of Health Malaysia

1-Ministry Of Health Malaysia Organisation chart

http://www.moh.gov.my/english.php/file_manager/dl_item/593246796447456762334a6e595735706332467a6153396a59584a30595639695a584e68636c39435356387858304677636d6c73587a49774d545975616e426e

1-Monitor All type of Events: Disaster/Outbreak/ Crisis/Emergency (DOCE)

Response

Prevent

Detect

• Points of Entry (POE) • Healthcare System – public and private • Community • NGOs

• RAT and RRT • Patient Transfer • Mx of patients / deceased • Mx of contacts • Designated hospitals for EVD case • Quarantine • Risk assessment & Risk communication • Interagency Collaboration & cooperation

• On going Surveillance and preparedness • Engagement- Meeting with relevant agencies • Advisory to Malaysians, expatriates, Foreign

students • Entry/Exit screening, HAC, Flight

Announcement • Risk assessment & Risk communication

- Clinical or Lab - Temp. screen - Self declaration - Self reporting

-Ongoing Surveillance and Preparedness - Health Education/ Advisory - RA & RC - Stockpile

- Clinical Mx - Infection Prevention Control (IPC) - PPE, medicines/ antiviral/vaccines

1-NCPRC - Command, Control And Coordination of the Preparedness & Response at the National Level

2- Zika virus preparedness plan


2-Flow chart for screening of passengers from Zika Virus Countries

2-Interagency meeting at KLIA

-MA Sepang -Airlines - Immigration Department -Customs Department -Other related agencies


2-Flight Announcement: Zika Virus Advisory


FLIGHT ANNOUNCEMENT: ZIKA VIRUS ADVISORY Ladies and gentlemen We extend you a welcome on board. For your health safety, we would appreciate your attention and action on this Health Advisory, concerning Zika virus On 1st February 2016, WHO announced that the recent outbreak of Zika Virus and cluster of neurological disorders and neonatal malformations reported in the Americas region constitutes a Public Health Emergency of International Concern. The Ministry of Health will carry out screening of travellers from 12 countries as follows: I Brazil I Colombia I El Salvador I French Guiana I French Polynesia I Haiti I Honduras I Martinique I Panama I Puerto Rico I Suriname I Venezuela (Bolivarian Republic of) I (WHO report on 17 March 2016) We wish to seek the cooperation of passengers who have history of travel to these countries since the past seven (7) days to present your selves to the Health Personnel at the Health screening area after disembarking from the aircraft. We thank you for your attention. Thank You.

2-Fever screening

CAPSCA-AP/08-Thailand Nov 15-18 2016

2-Zika Health education Activities on Zika Virus Infection


2-Zika Screening at Health Quarantine Centre


2-Flight Disinsection


GD Box location In front of MAS Transfer Counter ,Level 4 KLIA Next to immigration Counter -KLIA 2

Submission of GD form and spray can at KLIA/klia2

2-Vector Surveillance and Control


Search and destroy of breeding places

Ovitrap surveillance

2- Zika Screening for Olympic Athletes

All olimpic and paralimpic athletes RIO-2016 and the contingent : screened for zika virus: August-September 2016

2- Suspected Zika virus case on-board

• Public Health Team activated to the gate upon received

information from the AOC.

• Passengers and crew without symptoms will be given Health Alert Card (HAC). Get details of passengers and crew for follow up actions as needed.

• Suspected case (identified by crew) will be interviewed for history and physical examination.

• If he/she does not fulfilled the case definition of suspected case of Zika (Annex2), HAC will be issued and health advice given.

• Suspected of Zika virus infection, he/she will be referred to the nearest health facilities for further management.

• To notify suspected case to National CPRC, JKN and Nearest District Health Office.


KLIA Call Centre receive notification or case report from the reporter (AOCC personal); Case maybe communicable disease (either suspected or comfirmed).


3-Preparedness plan for MERS-CoV Infection at KLIA

• RRT together with Airlines Liason Officer, AVSEC, Terminal Operation MAB, PP from MENARA / MAS Med. Centre ready at Gate C21 (Designated Gate for the action of emergency of public health at KLIA).

In the aircraft arrived, PPKP with the help of Airlines Liason Officer to do announcement in the aircraft (for the sake of avoiding panic) other than explaining about the action and purpose of public health for the passengers

• Medical examination on

symptomatic cases

• Tagging of cases and close contact

• Screening of the asymptomatic contact.

• Obtain the flight manifest (informations required are name, passport number or ic number, seat number in the flight, home, office or mobile number or email address as well as home address of all passengers & crew).


3-Preparedness plan for MERS-CoV Infection at KLIA

Red tag for suspected cases / yellow tag for close contact


3-Flight disinfection

Carry out disinfection or decontamination in case

there is contamination or if caused by communicable

disease.


3-MERS-CoV Health Alert Card / Home assessment Tool

• PK report the case or syndrome or the occurence of PHEIC to the Director and Deputy Director of Public Health at the state level and Report to the District Health Office.

• Prepare the report and send to JKNS.


3 - Notification of suspected MERS-CoV Cases

•All flight landed at KLIA •From 18 Sept. until 15 October 2016 •Screening for communicable diseases esp: MERS-CoV

•Dedicated gate: C17 •Number of passengers: 200-480/flight •Total hajj: 22,000 •Referral hospital: 4 hospital in Selangor


4-Screening of Hajj for MERS-CoV


4-Screening of Hajj Pillgrims for MERS-CoV

• SOP for public health emergency preparedness and response is available at PoE

• Strengthening the Networking & Collaboration at national & international level

• Collaboration with multi agencies at PoE

• Communication system and reporting system

• Exercises – Table-top, Simulation

• Training


5-Conclusion

5-Conclusion

•SOP for public health emergency preparedness and response is available

•Strengthening the Networking & Collaboration at local national & international level

•Collaboration with multi agencies at PoE •Communication system and reporting to NFP

•Exercises – Table-top, Simulation •Training


Thank you


public health response in zika virus & mers-cov infections

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