2013 NEHA AEC July 9 11, One Health and All-Hazards: the New Environmental Health. Want this on you?

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Marianna Watkins
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1 One Health and All-Hazards: the New Environmental Health Christopher Eddy, MPH, REHS, RS, M.B.A. (candidate) Erik Balster, MPH, REHS, RS July 11, 2013 Next best thing to the Cover of the Rolling Stone? Want this on you? 2013 NEHA AEC July 9 11,

(first) The research: Partnership The second CE The

2 Current J of Environmental Health Opening: A Story about Higher Education It really started with a CE (first) The research: Partnership The second CE The mentee becomes the master The product 2013 NEHA AEC July 9 11,

3 Six Points of Significance All-Hazards Preparedness Bioterrorism/ Agroterrorism Pandemic Preparedness Food Security, Defense, Safety Epidemiological Investigation Capacity (FBI) Protection of Functional needs and Vulnerable Populations Or Four Points of Focus National Security = Counter-terrorism All-Hazards Preparedness (CBRNE) Rapid Discovery of infectious disease events Community Resilience All-hazards Preparedness All-hazards disaster preparedness, as defined by the Department of Homeland Security is designed to prevent man-made, natural, and accidental disasters. bio-surveillance begins at the local level. Sources: IOM (Institute of Medicine). Information sharing and collaboration: Applications to integrated biosurveillance: Workshop summary. Washington, DC: The National Academies Press; United States. Homeland security: DHS' efforts to enhance first responders' all-hazards capabilities continue to evolve: report to the chairman and ranking Democratic member, Subcommittee on Economic Development, Public Buildings and Emergency Management, Committee on Transportation and Infrastructure, House of Representation. Washington, DC: United States Government Accountability Office; NEHA AEC July 9 11,

The BIG Problem Emerging zoonotic infectious diseases, the very pathogens that terrorists may likely use

controversially so, for only one pandemic threat: influenza The Way (Through an Epi-Zoonotic Event) COOP

4 The BIG Problem Emerging zoonotic infectious diseases, the very pathogens that terrorists may likely use to attack the United States, will likely evade early detection systems and vaccination preparation processes!! Rather than utilizing a broad all-hazards approach, the United States remains prepared, and controversially so, for only one pandemic threat: influenza The Way (Through an Epi-Zoonotic Event) COOP Food-borne Outbreak C.I.C.P. Zoonotic Disease Control Baseline Event Zoonotic Intelligence + Sentinal Detection Mode of Transmission Public Outreach Yes Vaccine No What else is there? 2013 NEHA AEC July 9 11,

5 Source: Pandemic Threat 2013 NEHA AEC July 9 11,

6 Zoonotic diseases, under control? Not so fast The 2012 Institute of Medicine Workshop publication authors state that global efforts to cease SARS, H1N1, H5N1, and MRSA pandemics alone cost approximately $140,000,000 (140 billion dollars) in direct economic impact! RIGHT NOW MERS-CoV 2013 Influenza A H3N2 Avian Influnza A H7N9 Source: IOM (Institute of Medicine). Information sharing and collaboration: Applications to integrated biosurveillance: Workshop summary. Washington, DC: The National Academies Press; What is One Health? One Health (continued) Source: NEHA AEC July 9 11,

Turning Point Survey Environmental Health Professionals at the 2009 National

7 Methodology Literature Review Extensive, continuous, constantly evolving never actually stopped even after the manuscript was submitted! Turning Point Survey Environmental Health Professionals at the 2009 National Environmental Health Association AEC in Atlanta Association of Ohio Health Commissioners 2013 NEHA AEC July 9 11,

8 Results Practitioners believe strongly that coordinated sentinel environmental health, veterinary, and human medical biosurveillance disease reporting systems can signal the beginning of an infectious disease event early enough to minimize its impact Data indicates they are not presently engaged in meaningful biosurveillance systems One Health concepts are proven to be largely unimplemented: surveyed public health official s report (70% - both groups averaged) they do not participate Results 22% of those surveyed (both groups averaged) report that they believe public health has been directly involved in One Health Both surveyed groups agree (84% - both groups averaged) that that their own professional organizations should initiate lead roles in coordinating and implementing such One Health biosurveillance systems. Conclusions One Health needs a leader responsibility for bringing the collective groups together local up biosurveillance capacity the National Environmental Health Association would be an ideal candidate for this position While veterinarians and physicians are both subject matter experts in their respective fields, they both can reside within the broader realm of environmental health. The mediator: NEHA 2013 NEHA AEC July 9 11,

The New Environmental Health NEHA should lead its constituency towards the integration of state and federal biosurveillance systems Environmental health professionals are key, due to

development of a sophisticated residential, community health public information system that cautions people about the risks associated with food, water, animal, and contaminated

9 The New Environmental Health NEHA should lead its constituency towards the integration of state and federal biosurveillance systems Environmental health professionals are key, due to skill set and locale, to serve as the bedrock of biosurveillance systems development of a sophisticated and integrated residential, community health public information system the development of a sophisticated residential, community health public information system that cautions people about the risks associated with food, water, animal, and contaminated environmental media The End? Borrelia Miyamotoi Tick From Japan? Middle East Respiratory Syndrome Coronovirus MERS? Sources 2013 NEHA AEC July 9 11,

10 The End? 2013 NEHA AEC July 9 11,

Preventing disease Promoting and protecting health

Preventing disease Promoting and protecting health CONTENTS Context Global Health Security what is it? Health security the perfect storm Regional Health Security what is it? Caribbean Regional Health Security: