Rift Valley Fever Simulation Exercise

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Grant Wiggins
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1 GHSA, a «One Health» multisectoral approach for ZDAP implementation : Rift Valley Fever Simulation Exercise Dr Alioune Badara LY Deputy Director HEOC/MoH Dakar, Senegal 3 rd International ZDAP Conference Da Nang, Viet Nam, August 29-30, 2017

2 Health Emergency Operations Center (HEOC) Ministerial Order n 17973/MSAS/SG/BL on 12/ 1 st /2014 modified in april 2017

3 Missions: o Coordination of Prevention, Preparation and Response for any emergency situation Sectorial response (lead: MoH) National response (lead: Min of Interior) Hospita l Plan ORSEC Prehosp. SAMU HEOC Other Ministries Direction s/service s Other Ministries MINT/DPC Health HEOC Organizations Institutions Parteners o One Health Surveillance System o PoE o IHR 2005 Focal Point

5 Justification Source: CDC

6 RFV brief summary Viral zoonosis, mainly affects animals but also humans; Transmitted by mosquitoes (Aedes & Culex in West Africa); Sensitive species: ovine +++, goats, cattle, dromedaries, gazelles...; In Animals, manifestations related to age and species: fever, abortions, juvenile mortality; In Human: often benign but serious and fatal cases can occur (meningoencephalitis, bleeding, ocular forms); Diagnostic: virus isolation, Elisa, PCR)

focused in one scenario Participants: administration, senior staff, key

7 Different formes of simulations Table top exercise Important step in preparation and response Unformal discussion directed by a facilitator, focused in one scenario Participants: administration, senior staff, key personnel Aim: To better understand roles and responsibilities of each of the targeted staff member

8 Objectives General:To test our capability to coordinate effectively an important public health threat according to One Health approach and a multisectorial response; Specifc: To assess and to improve surveillance systems coordination in human and animal sectors (detection, notification, early warning system ); To improve communication capacities in emergency situation according to different targeted people (communicate with communities, professional of each sector, brieffing authorithies ); To determine level to activate the HEOC (number of RFV cases? number of death?...) To develop an Incident Action Plan

Agriculture, Armed forces and Communication Journalists in Health and Development

9 Participants National experts (32 ) from 7 ministries: Health (health facilities and Lab), Interior & Pulic Security, Livestock, Environment (wildlife, national parks), Agriculture, Armed forces and Communication Journalists in Health and Development Network Partners (CDC, OMS, FAO, USAID, PATH) Assessors (5) Facilitators (2) Observers (3)

cases were primarily identified Several cases of abortion and juvenile mortality

10 Scenario Human index case identified in Mbour Hospital located at 80 km from Dakar confirmed by IPD Several areas are affected in Dakar, Louga Several human cases were primarily identified Several cases of abortion and juvenile mortality have been observed in sheep flocks in the northern Saint-Louis region (Matam) and in Dakar

11 Scenario (2) Border endemic countries (Mauritanie and Mali) Three months before Aïd El Kébir with sheeps imported High social and economic impact

12 Exercise process Day1 Brief summary on RVF Presentation of the scenario section by section and discussions on each; Focus on surveillance systems existing in health and animal sectors Human cases management in health structures Day 2 Composition of Incident Management System in case HEOC activation and elaboration of an Incident Action Plan Crisis communication with communities, professionals, authorities by press release, interviews with different media Day 3 Information for planning team to adjust measures and take evidence based decisions for next operationnal period. Composition and Deployment of RRT (missions and working) Others issues: compensation for breeders, psychological assistance, livestock immunization

13 Lessons learned Need to strengh and to integrate the different surveillance systems existing in the different sectors (passive and active); Capacity building for Human Ressources in charge of Surveillance (FETP/CDC); Need to get modern equipments (GPS, communication etc.) ; Put in place a formal system of notification and early warning system for human cases and zoonotic animal cases ; Train actors of other sectors to familiarize them on the Incident Management System concept.

14 General recommandations Develop a training Plan with the sectors on the Incident Management System concept; Organize thematic simulations for example on livestock vaccination, corpses management ; Develop an Animal Health Surveillance Guide that identifies alert and epidemic thresholds; Develop surveillance procedures that integrate the GHSA key sectors; Conduct entomological studies to better characterize the potential vectors and to better understand their dynamics.

General recommandations (2) Review the administrative rules for animals movement in case of zoonotic disease outbreak (quarantaine, transborder ); Implement rapidly a vaccination program for

15 General recommandations (2) Review the administrative rules for animals movement in case of zoonotic disease outbreak (quarantaine, transborder ); Implement rapidly a vaccination program for livestock around the affected areas; Reinforce public sensitization on RVF and Zoonotic diseases; Establish a Transboundary Management Committee; Psychological assistance of family members of victims; Set up a compensation fund for affected breeders

16 Conclusion A high-level functional exercise that highlighted the importance of strong leadership in coordinating a multisectoral response in health emergency situations. Main issues needed to be improved in the different sectors have been identified and taken into account in the After Action Plan (capacity building, new SOPs, strength and integrate surveillance systems, importance of communication aspects, public awareness about RFV and other ZD, develop operational research programs...

17 ACKNOWLEGEMENT TO DTRA FOR BUILDING AND TOTAL EQUIPMENT OF HEOC SITE Pause 1 ere pierre (16/08/2016)

18 Thank you for your attention

Rift Valley Fever outbreak response, Sudan

Rift Valley Fever outbreak response, Sudan Laboratory: NAMRU-3 was deployed in Kosti (PCR) for 5 days and in Khartoum (IgM by ELISA) for 7 days. NAMRU-3 confirmed 16/47 human cases in Kosti and Khartoum