Nigeria_Bio-preparedness_Initiative_Training_chuch.pptx

Bio-preparedness relates to access control & security procedures, to reduce the risk of transmission of infectious diseases and invasive alien species and to prevent the malicious use of dangerous pathogens, parts of them or toxins in direct or indirect act against humans, livestock or crops.
It also refers to the Biological all –hazard approach covering a broad scope of activities relating to the protection of humans, animals, and/or plant health.
Pathogens associated with high morbidity and/or mortality
Pathogens with high likelihood of secondary cases (person-to-person spread)
Absence of an effective vaccine or prophylaxis or treatment
Pathogen for which clinical or public assuredness concerns might prompt the use of a bio-containment unit

1. Nigeria Bio-preparedness Initiative Training July,2019 By DR Annette Achuzia & SSGT Nurse R Adebayo

2. Bio-preparedness an Introduction Bio-preparedness relates to access control & security procedures, to reduce the risk of transmission of infectious diseases and invasive alien species and to prevent the malicious use of dangerous pathogens, parts of them or toxins in direct or indirect act against humans, livestock or crops. It also refers to the Biological all –hazard approach covering a broad scope of activities relating to the protection of humans, animals, and/or plant health.

3. Pathogens of Concern Pathogens associated with high morbidity and/or mortality Pathogens with high likelihood of secondary cases (person-to-person spread) Absence of an effective vaccine or prophylaxis or treatment Pathogen for which clinical or public assuredness concerns might prompt the use of a bio-containment unit

4. Infectious, Highly Hazardous, and Communicable

5. Diseases Warranting Special Patient Isolation Viral Haemorrhagic Fevers Ebola/Marburg Lassa South American Arenaviruses ( Junin , Machupo , Sabia , etc ) Crimean Congo Haemorrhagic Fevers (CCHF) Old world hantavirus (HFRS) Andes hantavirus (HPS ) Encephalitis Pathogens Nipah Hendra Respiratory Pathogens MERS/SARS Extensively Drug Resistant TB (XDR) Novel/highly pathogenic influenza e.g. H7N9 Others Monkey pox Novel pathogen With high mortality Other diseases to consider (due to laboratory risk or perception ): Tick-borne encephalitis complex ( Russian spring-summer encephalitis), Omsk HF, Kyasanur Forest Disease ; Alkhurma HF, Other Hantavirus haemorrhagic fever with renal syndrome (HFRS ),

6. VHF: Definition These are Syndromes characterized by an acute systemic febrile illness (usually with malaise, myalgia, and prostration) that is accompanied by endothelial dysfunction and clotting abnormalities, resulting in haemorrhage capillary leak syndrome.

7. Etiologic Agents of VHF Family Genus Disease or Species Filoviridae Ebolavirus Zaire, Sudan, Ivory Coast, Reston Arenaviridae Marburgvirus Lassa (“Old World”) Bunyaviridae Arenavirus “ New World”: Junin , Machupo , Sabia Guanarito , Flaviviridae Nairovirus Crimean-Congo haemorrhagic fever Phlebovirus Rift Valley fever Hantavirus Haemorrhagic fever with renal syndrome Flavivirus ( HFRS): Seoul, Hantaan , Puumala , etc Omsk HF Kyasanur forest disease Dengue Yellow Fever

8. Viral Haemorrhagic fever

9. Signs and Symptoms Generalized Vascular Permeability Symptoms Fever, headache, malaise, dizziness Myalgia Nausea/vomiting Signs Petechiae Positive tourniquet test Bleeding manifestations Hypotension Shock and death

10. VHF Misconceptions Misconception Misconception Misconception Misconception They all have the same features They all spread easily They are easily recognizable Bleeding is primary cause of death

11. VHF: A Wide Landscape • Some VHF have relatively low mortality Kyanasur Forest, Puumala , Omsk, Lassa Primary mode of transmission varies - Arthropod transmission ( flaviviruses , CCHF, RVF…) - Rodent transmission ( arenaviruses , hantaviruses) Person-to-person (Ebola, Marburg) • Many VHF are not transmissible person-to-person Yellow fever, dengue, • Almost all are laboratory hazards for contact/aerosol (dengue is an exception)

12. Ebola Virus Disease Acute and severe febrile illness caused by one of four known species human Ebola viruses Traditionally one of the viral haemorrhagic fevers (VHF) Closely related to Marburg virus (several previous outbreaks in Uganda) • Case fatality ranges from 20-90% • Transmissible from person to person

13. A Brief History of Ebola… Human Ebola outbreaks have all originated in Africa West Africa Outbreak (2014-2016) - Centered in Guinea, Sierra Leone, Liberia 28,610 cases, 11,308 fatalities Current DRC outbreak - First case confirmed Aug 1, 2018 - Nord-Kivu and Ituri provinces on Uganda border - As of July 2, 2019: 2275 confirmed cases, 1598 fatalities

14. Ebola/Marburg Cycle of Transmission