Good Emergency Management Practice: The Essentials
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delay in its detection. Trading partners may require surveillance to demonstrate freedom from disease. Also, any positive surveillance result that is obtained later can be regarded as indicating an incursion. It is equally important to publish negative results from investigations of suspect cases. Every year, there should be a number of suspect cases of most TADs which are investigated. Maintaining and publishing records of these is important in establishing international confidence that there is a functioning scanning surveillance system. An absence of suspect cases will certainly be taken internationally as evidence of a non-functional surveillance system and should also prompt action to improve surveillance nationally. The reports can be published in summary form, either in an annual report or in “real time” as an updated table on a Web site, or both. Surveillance is dealt with in more detail in the chapter on prevention.
Contingency plans and operations manuals Contingency plans and operations manuals are critical to enabling a swift response when an incursion is detected. Any delays in implementing control measures have a very significant negative impact on the speed with which an outbreak is controlled and therefore its size and, consequently, its cost. Contingency plans and operations manuals should be regularly reviewed to ensure that they stay fit for purpose. Such reviews are essential. Contingency plans and operations manuals are addressed in more detail in section 8. Respond.
Laboratory capacity Each contingency plan must contain detailed plans for ramping up laboratory testing capacity requirements during an emergency. This capacity is best provided locally in order to get rapid results, as long as testing can be performed accurately with existing resources. This might require contractual arrangements with laboratories inside or outside of the country. There must be an adequate level of equipment, training and supplies available on standby for immediate use at the start of an outbreak. Ensuring that this is the case requires preparedness planning during “peacetime”. Once an outbreak occurs, the need for testing will increase very rapidly. All testing should use accepted assays and methods as well as internal quality controls under appropriate biological safety requirements. To assure test quality, it is also advisable to work with an international reference laboratory during “peacetime”. This will build the relationships needed for rapidly submitting samples to the international reference laboratory for testing.
Vaccine supplies If during the contingency planning process, it emerges that vaccination is likely to be used for control, it is important that this vaccine be available in the required type and quantities at an early stage of an outbreak. The type and quantities should be decided and then a country must either establish a vaccine production capacity and antigen bank locally, or source the vaccine from outside the country, either through governmental links or from a private company. Particularly in the latter situation, it would be important to have a preproduction contract in place guaranteeing a given level of supply in the event of an outbreak.
