Managing major public health crises

BMJ 2001; 323 doi: https://doi.org/10.1136/bmj.323.7325.1321 (Published 08 December 2001) Cite this as: BMJ 2001;323:1321

Lessons from recent events in the United States and the United Kingdom

  1. Angus Nicoll, director,
  2. Deborah Wilson, consultant,
  3. Nigel Calvert, consultant,
  4. Peter Borriello, director
  1. Public Health Laboratory Service Communicable Disease Surveillance Centre, London NW9 5EQ
  2. Communicable Disease Control, County Durham and Darlington Health Authority, Appleton House, Lanchester Rd, Durham DH1 5XZ
  3. North Cumbria Communicable Disease Control Unit, Carlisle and District Primary Care Trust, Carlisle CA1 2SE
  4. Public Health Laboratory Service Central Public Health Laboratory, London NW9 5HT

    The recent terrorist attacks in New York have shown how all societies need rescue, health, and public health services to respond immediately to major disasters. Subsequent covert releases of anthrax (and scares and hoaxes) have been straining public health and reference laboratory services.1 The epidemic of foot and mouth disease in the United Kingdom has not directly threatened human health, but its control has required huge efforts and resources. Control measures have affected health services: primary care has had to deal with the stress experienced by affected communities; public health services have responded to disposing of over four million animals with concomitant zoonoses like bovine spongiform encephalopathy, Escherichia coli O157, and the specialist microbiological reference laboratories were needed to exclude cases of human infection.2

    What lessons can be learnt from these events? This question is timely in Britain, because the arrangements for health protection in the new NHS are yet to be finalised, though we know that regional directors of public health will oversee this function (see box 1). 3 4

    Box 1 : Components of health protection3

    Monitoring of and protection against communicable disease

    Protection against non-communicable environmental hazards

    Planning for and response to emergencies


    Events in the United States emphasise the need to be able to deliver …

    View Full Text

    Sign in

    Log in through your institution