Global Disease Detection Operations Center Ray R Arthur

Global Disease Detection Operations Center Ray R. Arthur, Ph. D 1 Director, Global Disease Detection Operations Center for Global Health, Centers for Disease Control and Prevention

Global Disease Detection Program CDC Contribution: Worldwide Surveillance & Response • Detection and verification of international disease events and threats • Operational support for rapid deployment of CDC assets and field teams • US compliance with IHR • CDC’s liaison with Global Outbreak Alert and Response Network (GOARN) 2 GDD Operations Center Team • Director: Ph. D Microbiologist/Virologist • Analysts (4): Med Epi, Vet Epi, Ph. D Epi • Emergency Coordinator 2

International Outbreak Alert & Response Epidemic Intelligence Framework Event-based surveillance Indicator-based surveillance “Surveillance” systems Identified risks Mandatory notification Laboratory surveillance Emerging risks Syndromic surveillance Mortality monitoring ealth care activity monitoring Prescription monitoring Non healthcare based Poison centres Behavioural surveillance Environmental surveillance Veterinary surveillance Food safety/Water supply Drug post-licensing monitoring 3 Data Events Collect Analyse Interpret Capture Filter Validate Signal Event monitoring Domestic Media review EI focal points International Info scanning tools Distribution lists International agencies Asses s Public health Alert Investigate Control Disseminate Early Warning and Response System Rapid inquiries (Enternet) E-Alerts (Eurosurveillance) Intern. Health Regulations measures (WHO) Threat bulletin (ECDC) WEB Source: ECDC

International Outbreak Alert & Response Screen sources of epidemic intelligence Capture disease event Information CDC programs (US & overseas), WHO, Media reports (Argus, GPHIN), Pro. MED, OIE, FAO, Classified Potential international public health Importance? Enter in database & report Response 4 4

Internet Event-based Surveillance Systems Country No. Languages Moderated US 40 Yes Japan 3 No Canada 9 Yes Health. Map US 7 No Med. ISys EU 26 No Pro. MED US 4 Yes Finland 2 No System Name Argus Biocaster GPHIN PULS Available systems

International Outbreak Alert & Response Project Argus: Media “tipping” Analysis: § § 3 Chief Analysts 4 deputy Chief Analysts 8 Senior Analysts 30 Analysts Reading Fluency: § ~40 Languages Statistics* § 228 Countries § >10, 000 Sources § 335 Million articles archived 6 *June 2006 - Jan. 2010

International Outbreak Alert & Response Screen sources of epidemic intelligence Potential international public health Importance? Enter in database & report Response 7 Analyse and assign “threat” level (GDD analyst and Subject Matter Experts) § Serious impact on public health § Unusual or unexpected § Significant risk for international spread § Significant risk for trade and travel restrictions

International Outbreak Alert & Response Screen sources of epidemic intelligence Potential international public health Importance? YES Enter in database & report Response 8 Enter event into Event Analysis Management System Disseminate Event information § CDC Programs § USG Agencies

What We are Watching Now 9

International Outbreak Alert & Response Screen sources of epidemic intelligence Potential international public health Importance? Enter in database & report Malawi, 2009 Response 10 Fund and facilitate response to disease event Global Outbreak Alert and Response Network (GOARN) and/or Bilateral

Global Disease Detection Operations Center: International Outbreak Alert & Response • Diseases: Ebola, Marburg, • • H 1 N 1, H 5 N 1 Influenza, Cholera, Monkeypox, Plague, RVF, Zika, DEG, Typhoid, Lead poisoning, and others Deploying CDC expertise Outbreak responses 50 28 Countries ~$ 4 -5 million since 2006 Diseases Cholera VHF Anthrax H 1 N 1 Typhoid Rabies Other* 0 2 4 6 8 10 12 14 16 Number of Responses 11 * Acute Hemorrhagic Fever Syndrome, Acute GI Syndrome, Acute Neurological Syndrome, Aflatoxin, E. coli, Fungal Disease, H 1 N 1, HEV, Lead Poisoning, Legionellosis, Liver Disease, Measles, Meningitis, Q Fever

IMPACT: Early Warning, Alerting for Response Through refined methodologies, systems and protocols: § Coordination of investigations where etiology is unknown § Ad hoc reports to CDC staff in the US and at international locations § Rapid assessments from the field § Transporting samples § Expert analysis and prediction of disease agent 12 Kasai Occidental, Democratic Republic of Congo, Sept. 2007 12

Summary: GDD Operations Center § Housed in Emergency Operations Center (EOC) § Consolidating international outbreak information from sources inside and outside of CDC § Systematically conducting risk assessments, reporting and responding to infectious disease events in support of IHR § Adding value by leveraging technical expertise of CDC programs § Facilitating rapid responses via emergency response outbreak contingency funds 13

Thank You http: //www. cdc. gov/globalhealth/GDD/ GDD-Outbreak@cdc. gov