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Preventing and managing outbreaks

Reflections on IMED 2018, Vienna, Austria, November 2018

Strengthening surveillance systems and the frontline; both key to preventing and managing outbreaks

The International Meeting on Emerging Diseases and Surveillance (IMED) was attended by more than 700 frontline healthcare professionals, lab technicians, data scientists and policymakers from 90 countries, all with a wealth of knowledge and experience in infectious diseases, surveillance and outbreak management.

The meeting covered topics related to various emerging and re-emerging diseases such as MERS, Ebola, Nipah, Zika, Measles and Polio. The sessions also reflected the multisectoral approach needed to tackle emerging infectious diseases outbreaks.

We must take a one-health approach, engage in public-private partnerships, have strong surveillance systems, and strengthen the frontline workforce to prepare for and respond to epidemics and pandemics.

Disease surveillance in the digital era

Director of Worldpop Andrew Tatum  delivered the first plenary session. He argued there is a strong need for reliable and accurate data on human population distribution and composition to help monitor and tackle outbreaks. The vast majority of population growth taking place in urban areas and low-income countries. But how can we measure population demographics, when there is a lack of national census or information recorded in some countries?

Haripriya Mukundarajan from Stanford University, showcased ABUZZ - a crowdsourced approach to surveillance, using mobile phones as mosquito sensors to capture the sound of their wings. Often viewed as the “Shazam” for mosquitoes, ABUZZ gets local citizens around the world, to capture the sound of mosquitoes through their mobile phones.

Modern mobile phones contain high-performance microphones which can capture the species-specific audio frequencies in sounds produced by the beating wings of mosquitoes. Through machine learning and neural networks, the audio recordings can be filtered based on their frequencies, providing species-specific identification. This innovative technological solution, allows anyone to participate in mosquito surveillance and data acquisition, potentially identifying infectious mosquitoes.

Both these talks highlighted how mobile technology and machine learning was revolutionising the way in which surveillance data is captured to predict disease outbreaks.

Frontline workforce development

Alongside healthcare workers from Ukraine, Georgia, India, Singapore, Sierra Leone, and Japan, I took part in a roundtable. Despite the diversity in backgrounds, one point remained unanimous; frontline healthcare workers need better guidance and tools to strengthen their ability to detect and manage infections.

This point was stressed by Hilary Bower, an Epidemiologist from UK Public Health Rapid Support Team and Assistant Professor of Infectious Disease Epidemiology at the London School of Hygiene and Tropical Medicine. She agreed that we are in an era where we have a vast amount of scientific knowledge, tools and innovations to help predict the next outbreak, however, we still need to focus on building the capacity of the frontline.

“The initial rate-limited factor in preventing the spread of infectious diseases is not the international outbreak response. It is the response at the “frontline”- in communities and countries at risk” Hilary Bower

She noted that it is at this level that we need to start the outbreak response, with the people who will be seeing the first case of an infectious disease. We need to ensure that they can recognise the problem and start the response right when they see it.

Strengthening the frontline requires training of healthcare professionals at the community and national level, a stockpile of supplies such as Personal Protective Equipment, scaling up of preparedness planning through national action plans, and participation from community members to help with case identification.

Where do we go from here?

The conference provided the opportunity to present a poster on behalf of BMJ on its flagship global health programme, the Clinical Decision Support (CDS) Training Initiative. The initiative supports frontline healthcare workers on infectious diseases and their differential diagnoses, by providing them access to BMJ Best Practice (an online clinical decision support tool) and BMJ Learning (an online interactive multimedia learning platform). The resources strengthen their ability to correctly detect, diagnose and manage infectious diseases and prevent wider spread of disease.

Competing Interests: I have read and understood the BMJ Group Conflicts of Interests Policy and Declare I do not have any conflicts of interests.

Convening people

The actors involved in global health are changing, and a multi-sectoral, cross-cutting approach is essential for tackling the priority issues.

We have extensive experience in bringing together thought leaders, policy makers, healthcare professionals and senior stakeholders from all sectors with an interest and mission for improving global health and global health security.
Our programme of events collectively attracts more than 10,000 delegates annually from over 85 countries, including: Contact Lalitha Bhagavatheeswaran to talk to us today. 

Transforming health outcomes worldwide

The BMJ

Lalitha Bhagavatheeswaran is the Clinical Outreach and Engagement Manager of the Clinical Decision Support Training Initiative, BMJ’s flagship Global Health Initiative programme.

Lalitha has worked for organisations such as the Dalla Lana School of Public Health, University of Toronto, Wellcome Trust and Royal Society of Medicine. Her interests are in infectious diseases, health systems strengthening and improving access to education for girls around the world. She is currently the Chair of the Board of Trustees for the Global Health Film initiative. 

Lalitha Bhagavatheeswaran, BMJ Global Health and Global Health Security
Tel: +44 (0) 20 3655 5545
Email: lalithab@bmj.com

The BMJ

Mitali Wroczynski works closely with ministries of health, agriculture, and defence to influence policy decision-making, and develop new global health partnerships.

She pioneered BMJ’s clinical decision support training initiative that supports healthcare professionals working in low and middle-income countries to improve the detection, diagnosis, and management of infectious diseases and contributes to building health system resilience. Mitali has also played a key role in making risk communication a central issue for managing major infectious disease outbreaks, epidemics or pandemics, as part of the EU-funded programme, TELL ME.  

Contact Mitali to find out how together we can address global health and global health securities priorities: 

Mitali Wroczynski
Head of Strategic Partnerships, Global Health & Global Health Security
Tel: +44 (0) 20 7383 6517
mwroczynski@bmj.com

The BMJ

The Practical Approach to Care Kit (PACK) is a clinical decision support programme guides primary healthcare clinicians through the diagnosis and management process of more than 500 common symptoms and conditions, including:

  • Cardiovascular and respiratory disease
  • Tuberculosis
  • HIV and AIDS and other infectious diseases
  • Skin disorders
  • Women’s health
  • Mental health
  • End-of-life care. 

This four pillar training programme improves primary health care in low and middle income countries. It works most effectively by partnering with governments, universities and NGOs to partner with us. Provide PACK to your clinicians working in remote areas today by contacting Dr. Tracy Eastman.

Dr Tracy Eastman, KTU Director of PACK Global Development and Delivery
Tel: +44 (0) 208 872 6323
Email: teastman@bmj.com