Disaster Resources
Haiti Earthquake Response
To hear stories from those members on location, visit our blog site. View a photographic record from SCCM's Disaster Field Team as they travel from their base in Santo Domingo to Jimani. See the improvised hospitals set up in this border town, using nearby buildings, tents, and trailers to house patients. See what the team saw in Santo Domingo as dedicated medical staff try to care for ill and injured Haitians as well as their own people in need. View all of the moving photographs at http://www.sccmblogs.org/galleryRD.
Volunteer Opportunities
Project Medishare Seeks Haiti Volunteers
The University of Miami/Project Medishare is seeking healthcare volunteers to deploy to Haiti as part of its Haiti Relief Program. Professionals from all medical specialties are needed, including physicians, nurses, pharmacists and respiratory therapists, as earthquake victims are still in need of care and rehabilitation. Volunteers will be working at the University of Miami/Project Medishare camp situated at the Mais Gate Airport in Port Au Prince.
Find additional information at www.projectmedishare.org. The Society of Critical Care Medicine has agreed to distribute this information to its membership, but please contact Project Medishare directly if you have questions or concerns.
Other Volunteer Opportunities
Below are the organizations with whom SCCM has been in contact regarding members of the critical care team travelling to Haiti to provide medical care. For the details on how to volunteer and what will be required, visit each organizations' website through the provided link.
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U.S. Department of Health and Human Services - HHS has set up an email address where medical professionals can send offers of volunteer medical care services to assist in the ongoing effort to provide healthcare to the people of Haiti. People/groups interested in volunteering should send an email to Haiti.volunteer@hhs.gov.
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Project HOPE - Preferential considerations for priority deployment include the ability to self-fund air transportation, as well as experience in disaster relief operations and French and/or Creole speaking ability. Volunteers must be coordinated through Project HOPE prior to travel. Details are posted on the Project HOPE website.
Centers for International Disaster Information – People with experience in disaster relief who wish to volunteer assistance can do so through the CIDI Database or visit www.cidi.org for the most recent information on their relief efforts, including opportunities to donate equipment and medicine.
Partners in Health (PIH) - PIH operates a hospital in Haiti and is seeking surgeons (especially trauma/orthopedic surgeons), emergency room doctors and nurses, and full surgical teams (including anesthesiologists, scrub and post-op nurses, and nurse anesthetists). If you are a health professional interested in volunteering, contact PIH directly. Visit www.pih.org/inforesources/news/Haiti_Earthquake.html for more information.
Financial Contributions
The organizations listed below are among many that are accepting cash donations to help those in need in Haiti.
- Hospital Albert Schweitzer – This hospital, located in Deschapelles, Haiti, 40 miles NW of Port-Au-Prince, has received some damage but is still operating and helping to provide medical care to the overwhelming numbers of Haitians injured in the recent earthquake. They do not currently have the capability to accept material goods or personnel but are in need of funds to pay overtime wages to the staff and to buy replacement medicines and supplies. If you would like to make a donation that will have immediate impact, you can do so on their website www.hashaiti.org.
- American Red Cross – Donations can be made through www.redcross.org.
Health and Human Services (HHS) Disaster Preparedness Resources
The Hospital Preparedness Program (HPP) enhances the ability of hospitals and healthcare systems to prepare for and respond to bioterrorism and other public health emergencies.
The Agency for Healthcare Research and Quality (AHRQ) offers hospitals advice on emergency evacuation, assessment, and recovery.
The Bioterrorism Training and Curriculum Development Program (BTCDP) provides funds via cooperative agreements to educational institutions to develop emergency preparedness training curricula for healthcare professionals and other first responders. When the program started in 2002, it focused on bioterrorism training; however, since 2006, training has focused on all types of hazards, including other forms of terrorism (e.g., the use of chemical, explosive, incendiary, or nuclear agents against civilian populations), natural disasters, and any type of public health emergency.
The Department of Health and Human Services' (HHS) Office of the Assistant Secretary for Preparedness and Response oversees the Emergency System for Advance Registration of Volunteer Health Professionals (ESAR-VHP) Program. ESAR-VHP was started to establish a national network of State-based programs that effectively facilitate the use of health professional volunteers in local, State, and Federal emergency responses.
Threats to Monitor
Increased Potential for Dengue Infection in Travelers Returning from International and Selected Domestic Areas
Summary - Dengue virus transmission has been increasing to epidemic levels in many parts of the tropics and subtropics. Travelers to these areas are at risk of acquiring dengue virus and developing dengue fever (DF) or the severe form of the disease, dengue hemorrhagic fever (DHF). The Centers for Disease Control and Prevention (CDC) strongly advises that health care providers in the United States should: 1) consider DF and DHF when evaluating patients returning from dengue-affected areas--both domestic and abroad--who present with an acute febrile illness within two weeks of their return, 2) submit serum specimens for appropriate laboratory testing, and 3) report all presumptive and confirmed cases of DF and DHF to their local or state health department.
Background - Dengue transmission has been increasing to epidemic levels in many parts of the tropics and subtropics where it had previously been absent or mild. Dengue-affected areas are widely distributed throughout Africa, Asia, Pacific, the Americas and the Caribbean. This calendar year, more than 50 countries have reported evidence of dengue transmission; including 17 countries in Asia, 17 in the Americas, 10 in Africa, seven in the Caribbean, and one in the Pacific. With an extensive dengue outbreak occurring in Puerto Rico and evidence of continued transmission in Key West, Florida, travel to certain domestic locations may also pose a risk for the traveler. The mosquitoes known to transmit dengue virus, Aedes aegypti and Aedes albopictus, are present throughout much of the southeastern United States and infected returning travelers may pose a risk for initiating local transmission.
Symptoms - Dengue virus infections can manifest as a subclinical infection or DF, and may develop into potentially fatal DHF. DF is a self-limited febrile illness that is characterized by high fever plus two or more of the following: headache, retro-orbital pain, joint pain, muscle or bone pain, rash, mild hemorrhagic manifestations (e.g., bleeding of nose or gums, petechiae, or easy bruising), and leukopenia. Because the incubation period for dengue infection ranges from 3 to 14 days, the patient may not present with illness until after returning from travel. Clinical management of DF consists of symptomatic treatment (avoid aspirin, NSAIDS and corticosteroids, as they can promote hemorrhage) and monitoring for the development of severe disease at or around the time of defervescence. A small proportion of patients develop DHF, which is characterized by presence of resolving fever or a recent history of fever, lasting 2–7 days, any hemorrhagic manifestation, thrombocytopenia (platelet count ≤100,000/mm3), and increased vascular permeability, evidenced by hemoconcentration, hypoalbuminemia or hypoproteinemia, ascites, or pleural effusion. DHF can result in circulatory instability or shock. Adequate management requires timely recognition and hospitalization, close monitoring of hemodynamic status, and judicious administration of intravascular fluids. There is no antiviral drug or vaccine against the dengue virus. Updated guidelines for the management of dengue can be found at http://whqlibdoc.who.int/publications/2009/9789241547871_eng.pdf
Recommendations
- Health care providers seeing patients with dengue-like illness who have recently traveled to Puerto Rico, Key West, Florida or international dengue-affected areas (See world distribution of dengue maps at http://wwwnc.cdc.gov/travel/yellowbook/2010/chapter-5/dengue-fever-dengue-hemorrhagic-fever.aspx) should report cases to the local or state health department and send specimens for laboratory testing. DF and DHF are now nationally notifiable conditions in the United States. Please remember that apart from individuals traveling for tourism, individuals responding to international disasters (e.g., Haiti earthquake), participating in medical or religious missionary work, and visiting friends and relatives are often returning from dengue-affected areas and should be evaluated for dengue infection if they present with dengue-like illness during or after their travel.
- Reporting to local public health officials and consideration of hospitalization to initiate supportive care should not be delayed pending test results. Reporting suspected dengue cases will trigger a public health investigation and the implementation of prevention measures.
- Specimens from patients with acute febrile illness, who returned from dengue-affected areas within the past 14 days, should be submitted to their local or state health department, if the health department laboratory offers dengue testing. State health departments with the capacity to test for dengue include: AZ, CA, CT, FL, NY, PR, and TX.
- If the local or state health department does not perform dengue testing, submit specimens directly to CDC laboratories in San Juan, Puerto Rico (address below). CDC offers free diagnostic testing for health care providers and confirmatory dengue testing for health department and private laboratories. A completed CDC Dengue Case Investigation Form (http://www.cdc.gov/Dengue/resources/DCIF_English_ColorSept1508_FINAL_.pdf) must accompany the specimens for the appropriate testing to be performed.
Whenever possible, submit paired acute and convalescent specimens (2 ml of centrifuged serum.) Accuracy is increased when both acute and convalescent specimens are available for testing. But providers should not wait and should submit acute specimens as soon as available; a convalescent specimen can be submitted when available.
|
Type of specimen |
Interval since onset of symptoms |
Type of Analysis |
| Acute |
until day 5 |
RT-PCR for dengue virus |
| Convalescent |
6 to 30 days |
ELISA for dengu IgM |
For More Information
- Instructions for the preparing and delivering specimens for dengue testing to the CDC Dengue Branch is available at: www.cdc.gov/Dengue/resources/TestpolEng_2.pdf.
- Additional information about dengue is available at: www.cdc.gov/dengue
- Call CDC’s toll-free information line, 800-CDC-INFO (800-232-4636) TTY: (888) 232-6348, which is available 24 hours a day, every day.
West Nile Virus
Clinical Guidelines (CDC)
Overview on transmission, symptoms, and prevention.
The pages providing statistics and maps are now available here.
Pandemics
To help keep communities healthy during the flu season, click here for specific action steps to support flu response efforts. The status of pandemic threats can be monitored by searching the contents of the CDC's Emerging Infectious Diseases Journal and a new page maintained by the U.S. Government.
Natural Disasters
Visit the Natural Disasters and Severe Weather section of the CDC website for information on natural disasters such as hurricanes, tornados, floods, earthquakes, etc.
U.S. Terrorism Threat Level
Click here for a description of the U.S. Department of Homeland Security's Advisory System. The DHS site also includes a Citizens Page, which provides a basic overview on what people can do to prepare against attack, and recommends visiting the ready.gov Web page for further information.
Biological Terrorism Response Manual
A bioterrorism STAT manual for the identification and management of the principal diseases associated with biological terrorism is available here.
Mass Trauma
The U.S. Centers for Disease Control and Prevention (CDC) has redesigned its Emergency Preparedness and Response Mass Casualty Website, which provides information on topics, such as coping with a traumatic event, rapid assessment of injuries, explosion and blast injuries, possible research, and injuries, mass trauma and nerve agent fact sheets.
To read selected presentations from CDC speakers at the 1st National Congress on Public Health Readiness click here. This site is also available in Spanish.
The American Academy of Experts in Traumatic Stress offers downloadable information on Acute Traumatic Stress Management (ATSM). In addition, the CDC's Traumatic Incident Stress web page contains information on physical, cognitive, emotional, and behavioral stress. It also offers a guideline on how to overcome these barriers.
Avian Influenza
While the threat of pandemic avian influenza has lessened, the CDC identifies that the Avian Influenza (Bird Flu) retains the potential to mutate and pose a major threat to humans, possibly leading to a pandemic. For updates on the threat of pandemics and steps being taken by health officials worldwide, check the CDC's site here.
Hazardous Material
The CDC offers information to help prepare for protection during and after a chemical emergency. Click here for further details.
Nuclear/Radiation Threat
United Nations
Learn about the UN's view of past and present disarmament issues.
Nuclear Threat Initiative (NTI)
A private organization that monitors today's global threats.
American College of Radiology
The ACR has published "Radiation Disasters: Preparedness and Response for Radiology." This primer serves as a quick reference in the event of a radiation disaster and summarizes current information on preparing for a radiation emergency, handling contaminated persons and radiation exposure health effects. In addition, the primer includes information on radiological findings related to agents of biological and chemical terrorism.
The CDC offers a variety of information on Radiation. Click here for further details.