Emergency Preparedness and Response

20th Order ( Arahan 20 )

What is an Emergency ?
It is divided into 3
   * accident -- unexpected event which cause damage or harm.
   * emergency -- an unforeseen combination of circumstance
      (immediate action )
   * disaster -- a sudden disaster event bringing great damage and lost.

Why should be prepared for an Emergency ?

• There are unaccounted,unplanned and unexpected events.
• Accidents happen at any time.
• Emergency often increased in crisis.

What are the level of emergency ?

Level 1
If within the capabilities of the organisation.

Level 2
If external assistance is required : Mutual aid, district or other agencies. 
MKN Arahan 20 may apply.

Level 3
State of national disaster. MKN take over.

Aim of emergency response !!
* Control, reduce or stop the cause.
* Control situation and limit secondary damage.
* Continue operation and recover quickly.

Objective 
* Save life.
* Save property,asset and reputation.
* Save community and the environment.

Incident Commander 

Operation
* Damage control
* Rescue
* Evacuation
* Traffic control

 Planning
* Situation analysis
* Record 
* Documents

Logistic
* Communication
* First aid 
* Transport

Administrator
* Legal
* Recovery 

Emergency planning

Thread and hazard identification
* Use imagination, think of the unexpected.

Assessment of emergency scenario.
* Impacts beyond control such regional communication loss and national power outage.

Types of Potential Hazards

* Natural event
   - storm, earthquake, flood.
* Human event 
  -terrorisme
* Technology event
  -aircraft crash

Potential impact of hazard

* Health,safety and environment.
- Person in affected area.
- Personnel responding to the incident.
- Pollution to the environment.

* Legal
- Regulatory and contractual obligation.

Resources planning

* Based on identified threats and hazards.
- Fire, flood, explosion, spills, collapse.
* Existing external and internal resources.
* Consideratiom for mutual aid agreement.
* Arrangement with vendors and suppliers.

Plans

* Written plans
- Strategic
- Operations
- Mitigation
- Recovery plans

* Roles and responsibility
- Incident commander, recovery manager, communication and public relations.

* Lines and authority.

Incident Procedure
* Control of access to the area.
* Identification of personnel at the incident.
* Accounting for personnel in incident activities.
* Accounting for person affected, or injured by the emergency.

References 

http://www.slideshare.net/pokjak80/chapter4-emergency-preparedness?next_slideshow=1

News

Setting a dinner table for wildlife can affect their risk of disease.

Supplemental feeding of wildlife can increase the spread of some infectious diseases and decrease the spread of others. A new study by University of Georgia ecologists finds that the outcome depends on the type of pathogen and the source of food.

The findings, published in the journal Ecology Letters, have implications for human health and wildlife conservation, and contain practical suggestions for wildlife disease management and a roadmap for future study.

Supplemental feeding--when people provide food to wildlife--is growing more common. As people move into previously undeveloped areas and habitat is lost to development or agriculture, wildlife ecology changes. Natural sources of food often decrease, and new abundant sources, provided by people, appear. Sometimes these are intentional, like backyard bird feeders or winter feeding stations for an elk herd in a national park; sometimes they're accidental, like landfills or poorly secured garbage cans. The resulting changes in behavior and nutrition can affect how diseases impact wildlife.

With pathogens like bacteria or viruses that are spread by close contact, food sources that attract large numbers of animals can encourage transmission, including transmission from one species to another--even to humans. This is suggested with the spread of Nipah virus in Malaysia, where infected fruit bats are attracted to fruit trees planted by farmers, bringing them into contact with livestock and people.

References

http://www.sciencedaily.com/releases/2015/03/150330122617.htm

Responsibility Of Local Authority

What are the role of a Local Authority in handling a problem of infectious disease in an event ?

What is an event ?

• Event can be considered as any organised activity that takes place wholly or partly on public land (including roads  footpaths, parks, council venues and sports grounds).

• The scale of some events may require the lodgement of a development application under the Environmental Planning and Assessment Act 1979.

• Events range from small functions to large multi-organisational experiences, involving thousands of people,requiring complex management.

Hazard Identification

•   Hazard identification involves identifying possible hazards in the lead up
•   to during and at the conclusion of an event.
•   Provision of first aid/medical facilities and quiet areas 
•   Provision of facilities- toilets, washing facilities, drinking, drinking water and disposal of waste water.
•   Waste management - waste collection during setting up, during and after the event.

Consent authority under the Environmental Planning and Assessment Act 1979

The Environmental Planning and Assessment Act provides a framework for determining if development consent is required for particular events. Consent may be required for activities such as building, carrying out work and the use of private land for the staging of certain events. Depending upon the scale of the event, a local, regional, or state environmental plan may apply. High impact (designated) activities will require an Environmental Impact Statement.

Consent and inspection authority under the Food Act 2003 .

A person selling food or operating stalls and outlets used for selling food, produce, fruits and vegetables or pre-packaged food for human consumption, is deemed to be a ‘food business’. This includes not-for-profit operations. A ‘food business’ is required to sell safe and suitable food in accordance with the provisions of the Food Act 2003.

Event scheduling

Scheduling is critical to the success of an event. Issues to be considered include:

• Weather and other seasonal factors
• Avoiding unnecessary disruption
• Avoiding similar events in the same area being held at the same time
• Impact of the event on surrounding in frastructure, for example avoiding certain road closures at critical periods
• Availability of required resources
• Integration with complementary activities

References :

http://www.olg.nsw.gov.au/sites/default/files/Council-CommunityEvents-Policy-Toolkit-%20for-Councils.pdf

Role of AEHO

Function Of Assistant Environmental Health

Officer during & after Flood Disaster.

During Flood

* Respect and accept commands from the operation commander disaster at         
   the state level .
 
* Provide an effective operating room , operating within the specified time .

* Health rapid risk assessment conducted on a daily basis to inform the 

   development of flooding in their respective places .
 
* Monitor the state of occurrence of infectious diseases , especially water-borne 

   diseases and food and other related diseases.
 
* Ask for help from other agencies in matters such as air transport or by boat to

   the temporary settlement located in rural areas and who combed away from 

   the  highway .
 
* Mobilizing teams of public health and medicine to certain areas according to 

   the needs circumstances and requirements of public health after obtaining 

   permission from the  commander of the operation of  the flood.

After Flood

* Assessing the impact of floods on the placement invoked or village flood 

   victims format available .

* Receive reports and monitor the situation in the region has been hit by flood 

   in terms of an increased incidence of infectious diseases ,especially food and 

   water -borne diseases such as cholera , typhoid food poisoning ,diarrhea and 

   dysentery .

* Provides the latest report on the situation with flooding affecting public health 

   action is taken, the weaknesses that have been identified and 

   recommendations made ​​for future action .

* Held a post mortem investigation of the actions taken .

* Give advice to the public in a water storage area so that consideration is given

   to the reservoir where the water does not become a breeding aedes and 

   potential for the spread of dengue fever.

* Improving advice and health education to the public regarding control 

   measures to prevent infectious diseases , especially in areas that have been 

   flooded.

* Make recommendations and proposals for action to be taken to improve public

   health conditions in the areas identified as high risk. 

During Flood

After Flood

References

http://www.infosihat.gov.my/infosihat/media/garis_panduan/B/pdf/04_panduanBanjir_BM.pdf

News

DenGGi

SHAH ALAM - Kes demam denggi di Selangor terus menunjukkan peningkatan dengan 12,427 kes direkod sehingga 21 Februari, naik 66 peratus daripada 7,507 kes bagi tempoh sama tahun lepas.
 
Pengerusi Jawatankuasa Tetap Kesihatan, Kebajikan, Pembangunan Wanita dan Keluarga Dr Daroyah Alwi berkata, daripada jumlah kes itu sebanyak 29 kematian akibat demam denggi dilaporkan dalam tempoh berkenaan.
 
"Pada bulan Januari, jumlah kematian akibat demam denggi adalah sebanyak 17 kes manakala untuk bulan ini sehingga 21 Februari pula mencatatkan 12 kes yang mana menjadikan jumlah keseluruhan setakat ini adalah sebanyak 29 kes," katanya dalam sidang akhbar di sini, hari ini.
 
Beliau berkata, daerah Petaling masih mencatatkan kes demam denggi tertinggi iaitu 5,967 diikuti Hulu Langat dengan 2,222 kes dan Klang sebanyak 1,824 kes.
 
Mengulas lanjut, Daroyah berkata tapak pembinaan dikenal pasti menjadi faktor utama menyumbang kepada pembiakan nyamuk Aedes terutamanya di daerah yang mencatatkan kes demam denggi yang tinggi.
 
"Berikutan itu, Kementerian Kesihatan telah melaksanakan operasi bersepadu di tapak-tapak pembinaan sekitar Selangor bermula 10 Februari lalu, bagi membendung peningkatan kes denggi selain mengurangkan risiko jangkitan.
 
Daripada 46 lokasi yang telah diperiksa, 45 daripadanya didapati positif dengan pembiakan nyamuk Aedes," katanya. - Bernama

References

http://www.sinarharian.com.my/mobile/edisi/selangor-kl/demam-denggi-di-selangor-meningkat-66-peratus-1.363930

Tuberculosis

Tuberculosis

What is Tuberculosis (TB) ?

• Tuberculosis (TB) is a serious infectious disease that mainly affect lungs. 
• The bacteria that cause tuberculosis are spread from one person to another through tiny droplets released into the air via coughs and sneezes.
• TB disease caused by a bacterium called Mycobacterium tuberculosis.

What are the symptoms ?

• Coughing that lasts three or more weeks
• Coughing up blood
• Chest pain, or pain with breathing or coughing
• Unintentional weight loss
• Fatigue
• Fever

Prevention

Infants often are vaccinated with bacille Calmette-Guerin (BCG) vaccine because it can prevent severe tuberculosis in children.

• Stay home. 

Don't go to work or school or sleep in a room with other people during the first few weeks of treatment for active tuberculosis.

• Ventilate the room. 

Tuberculosis germs spread more easily in small closed spaces where air doesn't move. If it's not too cold outdoors, open the windows and use a fan to blow indoor air outside.

• Cover your mouth. 

Use a tissue to cover your mouth anytime you laugh, sneeze or cough. Put the dirty tissue in a bag, seal it and throw it away.

• Wear a mask. 

Wearing a surgical mask when you're around other people during the first three weeks of treatment may help lessen the risk of transmission.

References

http://www.cdc.gov/tb/

http://www.myhealth.gov.my/index.php/tuberkulosis-tb

Leprosy

Leprosy

What is Leprosy ?

• Leprosy is an infectious disease that causes severe, disfiguring skin sores and nerve damage in the arms and legs.
• You can catch it only if you come into close and repeated contact with nose and mouth droplets from someone with untreated leprosy. 
• Children are more likely to get leprosy than adults.

What are the symptoms ?

• skin sores
• lumps
• bumps 

Prevention and Control

• Leprosy is a long-lasting infection caused by bacteria.

• The disease was once feared as a highly contagious and devastating disease.

BCG 

BCG vaccination has a documented and substantial effect in preventing leprosy and is therefore considered as an important tool for leprosy control.

• Public education and community awareness are crucial to encourage individuals with leprosy and their families to undergo evaluation and treatment with MDT.

• Household contacts of patients with leprosy should be monitored closely for the development of leprosy signs and symptoms.

• A study demonstrated that prophylaxis with a single dose of rifampicin was 57% effective in preventing leprosy for the first two years in individuals who have close contact with newly diagnosed patients with leprosy.

• There is currently no widely used standard for using medications for the prevention of leprosy.

• Currently, there is no single commercial vaccine that confers complete immunity against leprosy in all individuals.

• Several vaccines, including the BCG vaccine, provide variable levels of protection against leprosy in certain populations.

References

http://www.cdc.gov/leprosy/

www.who.int/hiv/pub/guidelines/ethiopia_tb.pdf

HFMD

Hand Foot and Mouth Disease

What is HFMD ?

• It is an infectious disease.
• Can lead to painful sores in mouth, rash in hand, and fever.

What are the symptoms ?

• Fever
• Sore throat
• Mouth ulcers on the inside of the mouth or sides of the tongue
• Rash (flat or raised spots) or small blisters on palms of hands, soles of feet, and/or buttocks.

Prevention and Control

Good hygiene is the best protection against hand, foot, and mouth disease. 

• Wash hands carefully.      

Be sure to wash your hands frequently and thoroughly, especially after using the toilet or changing a diaper and before preparing food and eating. When soap and water aren't available, use hand wipes or gels treated with germ-killing alcohol.

• Disinfect common areas. 

Get in the habit of cleaning high-traffic areas and surfaces first with soap and water, then with a diluted solution of chlorine bleach and water. Child care centers should follow a strict schedule of cleaning and disinfecting all common areas, including shared items such as toys, as the virus can live on these objects for days. Clean your baby's pacifiers often.

• Teach good hygiene. 

Show your children how to practice good hygiene and how to keep themselves clean. Explain to them why it's best not to put their fingers, hands or any other objects in their mouths.

• Isolate contagious people. 

Because hand-foot-and-mouth disease is highly contagious, people with the illness should limit their exposure to others while they have active signs and symptoms. Keep children with hand-foot-and-mouth disease out of child care or school until fever is gone and mouth sores have healed. If you have the illness, stay home from work.

References

http://www.healthline.com/health/hand-foot-mouth-disease#Prevention8

http://www.cdc.gov/hand-foot-mouth/about/prevention-treatment.html

Measles

MEASLES

What is Measles ?

1. Measles is a highly contagious viral disease, which affects mostly children. It is transmitted via droplets from the nose, mouth or throat of infected persons.
2. Measles is a very contagious (easily spread) infection that causes a rash all over your body.
3. MMR (measles, mumps, and rubella) and MMRV (measles, mumps, rubella, and chickenpox) vaccines.

What causes Measles ?

• Measles is caused by a virus. 
• It is spread when an infected person coughs, sneezes, or shares food or drinks. 
• The measles virus can travel through the air.

What are the symptoms ?

The first symptoms of measles are like a bad cold—a high fever.

• Cough, runny nose, and red eyes
• Rash of tiny, red spots that start at the head and spread to the rest of the body
• Diarrhea
• Ear infection

Incubation Period

• appear 10–12 days after infection.

Prevention and control 

Children should get 2 doses of MMR vaccine:

• The first at 12-15 months of age
• The second before the start of school at 4-6 years of age.

These are the recommended ages. But children can get the second dose at any age, as long as it is at least 28 days after the first dose.

Virus

Virus

References

https://myhealth.alberta.ca/health/pages/conditions.aspx?Hwid=hw198187
http://www.who.int/topics/measles/en/

HFMD

Hand, Foot, and Mouth Disease (HFMD)

What is HFMD ?

• It is an infectious disease.
• Can lead to painful sores in mouth, rash in hand, fever.

Where is this disease infected the most ?
--> Common places such tropical and subtropical countries.
--> Mostly in nursery.
--> HFMD is an acute illness.

• Dehydration - if intake of liquid is limited due to painful.
• Develop aseptic or viral meningtis.
• Cardiovascular or respiratory.

Common about HFMD

• Hand, foot, and mouth disease, or HFMD, is a contagious illness that is caused by different viruses.
• Infants and children younger than 5 years old are more likely to get this disease. 
• However, older children and adults can also get it.

Hand, foot, and mouth disease is caused by viruses that belong to the Enterovirus genus (group). This group of viruses includes polioviruses, coxsackieviruses, echoviruses, and enteroviruses.

• Coxsackievirus A16 is the most common cause of hand, foot, and mouth disease in the United States, but other coxsackieviruses have been associated with the illness.
• Enterovirus 71 has also been associated with hand, foot, and mouth disease.

Dengue

DENGUE

in Malaysia

• Dengue fever is a disease caused by a family of viruses that are transmitted by mosquitoes. It is an acute illness of sudden onset.

• Symptoms such asheadache, fever, exhaustion, severe muscle and joint pain, swollen glands (lymphadenopathy), and rash.

• Caused by one of four serotypes of virus, it is possible to get dengue fever multiple times. 

• The virus is contracted from the bite of a striped Aedes aegypti mosquito that has previously bitten an infected person.

Symptoms

• Severe headache
• Severe eye pain (behind eyes)
• Joint pain
• Muscle and/or bone pain
• Mild bleeding manifestation (e.g., nose or gum bleed, petechiae, or easy bruising)

Prevention & Control

• Eliminate the places where the mosquito lays her eggs.

• In urban areas, Aedes mosquitos breed on water collections in artificial containers.

• Larvicide treatment is another effective way to control the vector larvae.

Effective ways to reduce:

• Empty children's wading pools at least once a week.
• Change water in birdbaths at least weekly.
• Get rid of old tires in your yard, as they collect standing water.
• Empty unused containers, such as flower pots, regularly or store them upside down.
• Drain any collected water from afire pit regularly.

References 

http://www.healthmap.org/site/diseasedaily/article/controlling-spread-dengue-fever-82511

http://www.cdc.gov/dengue/symptoms/