Containment Zone WHO Strategy for
Pandemic Flu Initial Emergence
The World
Health Organization’s latest interim protocol for “rapid operations to contain
the initial emergence of pandemic influenza” includes a “Containment Zone” and a
surrounding “Buffer Zone” that have been detailed in a 20-page document on the
WHO website (www.who.int).
The
fundamental containment strategy is to rapidly identify the initial (“index”)
cases forming a cluster of persons infected with a new pandemic flu virus while
still limited to a localized geographical area and initiate routine control
measures. Then, a “Containment Zone” will be drawn around this area with the
index cluster of patients and both widespread antiviral drug prophylaxis and
non-pharmaceutical interventions such as social distancing will be recommended.
The five (5)
critical activities within the Containment Zone include (see page 12 of the WHO
May 2007 document):
1. Extensive antiviral prophylaxis (20
days of antivirals would be given, not 10 days).
2. Perimeter control (“it is critical to
discourage to the extent possible all non-essential movement of persons in and
out of the Containment Zone” and to include “exit screening procedures”. page
13).
3. Multiple non-pharmaceutical measures
(including “isolation of ill persons, voluntary quarantine of exposed persons,
social distancing measures such as school closures and cancellation of mass
gatherings, & other measures to minimize persons density (e.g. staggered
work and market hours”. page 14).
4. Surveillance and laboratory testing
5. Detailed assessment of the novel
virus
The three
(3) primary activities in the “Buffer Zone” that will be drawn outside of the
“containment zone” include (see page 14of 20):
1. Active and comprehensive surveillance
with laboratory testing.
2. Isolation and treatment of suspect
cases
3. Antiviral prophylaxis of contacts of
suspect cases
Additional
specific guidelines are provided in this 20-page document. At the same time,
nine (9) annexes to this document “will be added shortly” (page 18) and will
further help international planners anticipate and prepare better for the next
human influenza pandemic.
Daniel R.
Lucey, MD, MPH
Director,
Center for Biological Counterterrorism & Emerging Diseases
EROne
Institute Department of Emergency Medicine
Co-Director, M.S. Graduate Program in Biohazardous Threat
Agents and Emerging Infectious Diseases
Website for
this newsletter: www.BePast.org
e-mail:Daniel.R.Lucey@Medstar.net