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King County hoping to stay abreast of ongoing SARS threat

This week, Public Health - Seattle & King County sponsored a seminar that uses the Toronto experience with Severe Acute Respiratory Syndrome (SARS) to highlight the broad legal, policy and health care challenges in preparing for an outbreak of infectious disease or similar public health emergency. Public Health is leading the region in the unprecedented challenge of meeting preparedness and clinical requirements for disease surveillance, mass treatment operations, and for isolation and quarantine protocols and training.

National and local experts discussed the lessons learned from responding to the SARS outbreak earlier this year. Jane Speakman, solicitor, city of Toronto, provided a legal perspective and Venkatarama Koppaka, M.D., Division of Global Migration and Quarantine National Center for Infectious Diseases, Centers for Disease Control and Prevention the Centers for Disease Control and Prevention reported on community response and containment issues.

"We are preparing to meet the challenge of SARS, should it re-emerge, or any other emergent infectious disease threat," said Dr. Alonzo Plough, director of Public Health, "We have learned from the successes in controlling SARS last season and we are applying these lessons locally."

Public Health sponsored the seminar to improve understanding of quarantine and isolation among local emergency medical personnel, law enforcement, emergency managers, hospitals and medical staff, school personnel and community-based providers who could be called upon to apply these public health tools. A successful program of isolation and quarantine would place new demands on local agencies and ancillary services such as delivery of food and medical supplies.

"When used appropriately, isolation and quarantine can be valuable tools to help control the spread of contagious diseases," said Dr Jeffrey Duchin, chief of the Communicable Disease, Epidemiology and Immunization Section for Public Health.

Isolation is the separation and restriction of movement of ill people to stop the spread of that illness to others. People in isolation may be cared for in their homes, in hospitals or at designated health care facilities. Quarantine, in contrast, applies to people who have been exposed to a contagious illness and may be infected but are not yet ill. Separating exposed people and restricting their movements is intended to stop the spread of that illness. Quarantine can be highly effective in protecting the public from disease.

The first line of defense in controlling SARS is surveillance: rapid detection of cases and their close contacts followed by implementation of control measures. The public health system relies on local health care providers and hospitals to promptly recognize and report suspected SARS cases so that disease control measures can be implemented. In accordance with guidelines from the Centers for Disease Control and Prevention (CDC), Public Health has been working with public health workers, clinicians and hospitals, focusing on how to recognize and report possible SARS cases and implement infection control measures and SARS emergency response planning.

Planning for a disease outbreak must consider a broad spectrum of legal, policy, health care delivery, law enforcement, and logistical issues unparalleled in several decades. The ultimate goal is to create a prepared public health response team integrated with regional partners, operates under coordinated, multi-agency plans and procedures, and is capable of addressing the consequences of all hazards, which Public Health is pursuing.

This week's Isolation and Quarantine Seminar was part of Public Health's ongoing effort to build multi-agency cooperation to re-spond to pubic health emergencies. Public Health has been building partnerships with 19 hospitals, 30 cities, 20 law enforcement agencies, six emergency medical service providers and more than 30 fire departments throughout the county to plan for public health emergencies such as SARS. Public Health officials serve on nine local homeland security and emergency preparedness committees to achieve close and frequent coordination with its regional partners

Public Health's planning efforts have earned national recognition. Public Health - Seattle & King County has just been awarded a prestigious grant for $600,000 by the National Association of County and City Health Officials (NACCHO), and designated by NACCHO and the CDC as a national center for excellence in preparedness.

King County residents can learn about SARS, including how it is spread and simple means that are available to individuals to help stop SARS should it occur locally. Information is available from Public Health - Seattle & King County at www.metrokc.gov/-health/sars.

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