A growing global network’s role in outbreak response: AFHSC-GEIS 2008-2009

Abstract

A cornerstone of effective disease surveillance programs comprises the early identification of infectious threats and the subsequent rapid response to prevent further spread. Effectively identifying, tracking and responding to these threats is often difficult and requires international cooperation due to the rapidity with which diseases cross national borders and spread throughout the global community as a result of travel and migration by humans and animals. From Oct.1, 2008 to Sept. 30, 2009, the United States Department of Defense’s (DoD) Armed Forces Health Surveillance Center Global Emerging Infections Surveillance and Response System (AFHSC-GEIS) identified 76 outbreaks in 53 countries. Emerging infectious disease outbreaks were identified by the global network and included a wide spectrum of support activities in collaboration with host country partners, several of which were in direct support of the World Health Organization’s (WHO) International Health Regulations (IHR) (2005). The network also supported military forces around the world affected by the novel influenza A/H1N1 pandemic of 2009. With IHR (2005) as the guiding framework for action, the AFHSC-GEIS network of international partners and overseas research laboratories continues to develop into a far-reaching system for identifying, analyzing and responding to emerging disease threats.

Molecular typing of bacteria for epidemiological surveillance and outbreak investigation / Molekulare Typisierung von Bakterien für die epidemiologische Überwachung und Ausbruchsabklärung

“…With industrialization of food processing, worldwide shipment of fresh and frozen food and an increased demand for fresh bagged produce foodrelated outbreaks shifted from local, often family-based, outbreaks to multistate or multicountry outbreaks, often caused by a single source (Shane et al, 2002;Tauxe, 2002;Denny et al, 2007;Nygren et al, 2013;Schmid et al, 2014;Ruppitsch et al, 2015b;Inns et al, 2016). Disease surveillance is an inevitable cornerstone for early identification of infectious disease outbreaks and for timely implementation of accurate measures to combat transmission and morbidity (Johns et al, 2011). Today, where pathogens easily cross national borders, the monitoring of diseases requires an efficient local, national, and international surveillance system.…”

“…A relatively new aspect in epidemiology is the recent expansion of Internet data sources for outbreak alert and response (Morse, 2014), such as ProMED-mail (Madoff et al, 2004), FrontlineSMS (Frontline SMS, 2010, HealthMap Freifeld et al, 2008;2010), MedISys (http://medisys.newsbrief.eu), GPHIN (www. phac-aspc.gc.ca/gphin), and AFHSC-GEIS (Johns et al, 2011), which may push governments to more transparency and may complement traditional public health infrastructure. Finally, these Internet data sources could accelerate implementing appropriate measures by health authorities.…”

Initial Identification and Characterization of an Emerging Zoonotic Influenza Virus Prior to Pandemic Spread

“…In the case of the 28 March sample, this diagnosis was made using an in-house accredited (homebrew) universal influenza PCR assay at NHRC. In the case of the 30 March sample, the initial (unreportable) "untypeable influenza A" identification was made at the point of care using an experimental diagnostic device in the course of the trial (1,13).…”

“…Aliquots of both samples were shipped through the CDC's Laboratory Response Network for reference lab testing and typing, as required for otherwise uncharacterizable influenzapositive samples (1,13). Such samples could represent newly emerging zoonotic influenza viruses, reassorted (shifted) strains carrying novel antigens, or significantly divergent (drifted) descendants of currently recognized strains, all of which would be of critical importance to public health activities.…”

“…Among these emerging technologies are highthroughput, rapid analysis methods capable of universal detection and characterization of pathogens, regardless of previous strain characterization or novelty. These methods include the T5000 Universal Biosensor (Ibis Biosciences, Carlsbad, CA) (3,4,9,13,17,18). NHRC has been involved in testing this platform for several years and has conducted published validations of its scope and discriminatory power (17,4).…”