CDC: Excerpts from Public Health Law News

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Excerpts from CDC?s Public Health Law News that may be of interest to FT readers.:

Comments in italics are mine.

J.

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Wednesday, February 21, 2007
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From the Public Health Law Program, Office of the Chief of Public Health Practice, CDC

http://www2a.cdc.gov/phlp/

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Is there an opportunity here for FT?

*** CDC Invites Applications for Research on Implementation of Public Health Interventions. CDC?s Office of Public Health Research has announced availability of $10 million to support peer-reviewed research on factors that encourage effective ?translation? of public health interventions into actual health impact, including, among others, law-based interventions. Letters of intent are due by March 12; full applications are due by April 10. The full announcement (CDC RFA-CD-07-005 - Improving Public Health Practice through Translation Research) is accessible at http://www.grants.gov/.
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Ethics, law and pandemics?

*** Ethical Challenges in Pandemic Preparedness Lecture (2/28). The University of South Carolina Law School will host a lecture entitled ?Ethical Challenges in Preparing for a Pandemic,? to be held February 28, 2007 at 12:30 p.m. ET. For more information, visit http://www.law.sc.edu/jandj/20070228.shtml.

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If the pandemic-hurricane analogy can be extended, can we expect similar reasons for non-compliance to preparedness interventions and prevention-oriented laws?

?The public?s preparedness for hurricanes in four affected regions?
Public Health Reports (03-04/07) Robert J. Blendon, John M. Benson, and others

http://www.publichealthreports.org/userfiles/122_2/08_PHR122-2_167-176.pdf

The authors of this study examined preparedness issues in communities that were affected by Hurricanes Katrina and Rita, but which were outside the main areas of devastation. Over 2,000 individuals in Mississippi, Alabama, East Baton Rouge Parish, Louisiana, and Harris County, Texas, were interviewed for their opinions on evacuation, preparedness, aid to displaced persons, and stress. The authors found that ?A sizeable minority of respondents might not comply with future government orders to evacuate if another major hurricane threatened their community.? They posited that there are two sets of reasons for noncompliance: a lack of trust in forecasts or a belief that their home will survive; and a need for specific information and services to aid them. For the first group, the authors recommend that emergency planners use ?specific education messages ? to focus on the damage done to populations that ignored evacuation orders prior to major hurricanes and remained in these areas.? For the second, they suggest that state and local plans should be in place well before hurricane season. The interviews also revealed that, ?A substantial proportion of respondents in all of these areas reported that they are not prepared for evacuation from a future hurricane.? Others said they were concerned that evacuees in their community would cause an increase in infectious disease, as well as a strain on local resources. The researchers also found widespread feelings of stress and recommend that public health systems increase education and the availability of mental health services.

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Could genetic testing for influenza exposure be used by employers or insurance companies for screening purposes? If so, this legislation may apply.


__________________LAW BEHIND THE NEWS___________________

Last week, the U.S. House of Representatives Committee on Education and Labor approved the Genetic Information Nondiscrimination Act of 2007. If enacted, the legislation would establish a standard by which to protect the public from discrimination on the basis of information gained from genetic testing. The bill would limit the use of genetic testing as a requirement for enrollment in insurance programs, and also forbid insurers from denying coverage or charging higher premiums based solely on genetic information. The bill would also prohibit employment discrimination on the basis of genetic information. Employers would be prohibited from failing to hire or from discharging an employee because of genetic information, and from limiting, segregating, or classifying employees in a way that would adversely affect the employee?s status.

To read the text of the Genetic Information Nondiscrimination Act of 2007, visit http://www2a.cdc.gov/phlp/docs/110th...ouse_Bills.pdf.

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Re: CDC: Excerpts from Public Health Law News

Another set of excerpts from the CDC Health Law News that may be of interest to FT readers:

J.

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Wednesday, April 11, 2007

From the Public Health Law Program, Office of the Chief of Public Health Practice, CDC

http://www2a.cdc.gov/phlp/

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*** Pandemic Influenza and Public Health Law DVD. The California Distance Learning Health Network has released ?Pandemic Influenza and Public Health Law: What Public Health Departments Need to Know.? This DVD self-study course facilitates partnering between local health departments and other key agencies (law enforcement, county counsels, etc.) within their jurisdictions to explore ?what if? scenarios and clarify their respective roles. For more information, visit http://cdlhn.com/default.htm.

*** Public Health Emergency Preparedness Articles. Last week, the American Journal of Public Health released a series of articles concerning emergency preparedness, public health, and the law. Included in the series are such titles as ?Conceptualizing and Defining Public Health Emergency Preparedness;? ?The Law and Emergencies: Surveillance for Public Health-Related Legal Issues During Hurricanes Katrina and Rita;? ?The Courts, Public Health, and Legal Preparedness;? ?Encouraging Compliance With Quarantine: A Proposal to Provide Job Security and Income Replacement;? and ?Variation in Quarantine Powers Among the 10 Most Populous U.S. States in 2004.? To locate articles in this series, visit http://www.ajph.org/first_look.shtml. These articles are soon to be released in a special Supplement to the Journal.

Mutual aid agreements: essential legal tools for public health preparedness and response
American Journal of Public Health (04/07) Daniel D. Stier and Richard A. Goodman

http://www.ajph.org/cgi/reprint/AJPH.2006.101626v1

The authors of this analysis reviewed the current status of the law regarding agreements to share supplies, equipment, personnel, and information across political boundaries in a public health emergency. ?Mutual aid? agreements like the Emergency Management Assistance Compact (EMAC) are essential to facilitate an effective response to disasters, by ?establishing the rules, processes, and procedures to be followed in sharing information, resources, or personnel.? In this article, the authors describe the basic legal framework for mutual aid agreements, identify gaps in that framework, and make recommendations for addressing those gaps. Mutual aid comprises at least five categories ?over a gradient of potential liability, including the sharing of planning information, epidemiological and laboratory data or information, equipment and supplies, unlicensed personnel, and licensed personnel.? The authors describe international cooperative agreements, such as those between the United States and Canada, and the United States and Mexico. According to the authors, states may, in some circumstances, lack the authority to share confidential health information across international borders. With regard to both international and interstate cooperation, the U.S. Constitution has provided an added complication in the compact clause, which may affect the ability of states to enter into binding agreements without the consent of Congress. However, interstate cooperation has had the support of Congress. For example, Congress has directed the Secretary of Health and Human Services to develop an Emergency System for Advance Registration of Volunteer Health Professionals. Finally, the authors suggest that states share and use lessons learned while developing new agreements, further analyze the compact clause, and cultivate relationships with attorneys from Canada and Mexico.

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This week we bring you the Emergency Management Assistance Compact, (EMAC), a Congressionally-ratified agreement that facilitates mutual aid between states. EMAC is a major legal tool for sharing resources across state boundaries, and has been enacted in all 50 states, the District of Columbia, Puerto Rico, and the U.S. Virgin Islands. The compact provides a framework for assistance between participating states in managing an emergency or disaster. EMAC addresses three major concerns for emergency managers, public health officials, and healthcare providers: liability, reimbursement, and response. The state requesting assistance under EMAC is responsible in tort for the actions of workers from other states. The state that sends assistance is guaranteed payment for its efforts. And finally, EMAC facilitates a quick response to an emergency through the provision of personnel, equipment, and materials at a government?s disposal.

To read the text of the model EMAC, which has been enacted in its entirety in across the United States, visit http://www2a.cdc.gov/phlp/docs/http___www.emacweb.pdf.

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Re: CDC: Excerpts from Public Health Law News

Experts from the CDC Health Law News that may be of interest to FT members:



Wednesday, April 18, 2007
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From the Public Health Law Program, Office of the Chief of Public Health Practice, CDC

http://www2a.cdc.gov/phlp/

*** Avian Influenza Conference (5/31-6/1). Paris Anti-Avian Influenza 2007 will be held at the Institut Pasteur in Paris, France from May 31-June 1, 2007. For more information, visit http://www.isanh.com/avian-influenza/index.php.

“Public health interventions and epidemic intensity during the 1918 influenza pandemic”
Proceedings of the National Academy of Sciences (04/06/07) Richard Hatchett and others

http://www.pnas.org/cgi/doi/10.1073/pnas.0610941104

The authors of this article assessed the impact of nonpharmaceutical interventions (NPIs) on the 1918 U.S. influenza epidemic. NPIs include such measures as voluntary quarantine, closure of schools, and bans on public gatherings. While many authorities have supported the use of NPIs in a future pandemic, this study investigated whether early implementation of such interventions actually reduces disease transmission. The authors analyzed the type and timing of NPIs used in 17 cities during the fall wave of the 1918 pandemic. They then tied that information to the peak weekly death rate and the cumulative excess pneumonia and influenza death rate (CEPID) during the months September to December 1918. The authors found that the CEPID was 50 percent lower in cities that implemented multiple NPIs than in cities that intervened late or not at all. But the study further found that most of the NPIs were relaxed within two to eight weeks, allowing opportunities for reintroduction and transmission of the virus for many months afterward. As a result, second waves of the pandemic occurred after the relaxation of NPIs. The authors offer several possible explanations for the findings. They conclude, “Communities that prepare to implement layered NPIs aggressively are likely to achieve better outcomes than communities that introduce such interventions reactively, and they may be better positioned to manage the disruption caused by the more stringent interventions, such as school closure.” Finally, the authors indicate that an area for further study is the question of when to relax NPIs.

“The Pandemic and All-Hazards Preparedness Act”
Journal of the American Medical Association (04/18/07) James Hodge and others

http://jama.ama-assn.org/cgi/content/full/297/15/1708

The authors of this commentary analyze the Pandemic and All-Hazards Preparedness Act (PAHPA) intended to improve the “organization, direction, and utility” of public health emergency preparedness efforts. According to the authors, PAHPA fails to address some long-standing issues. For example, the Act recognizes that tribal, state, and local entities must participate in public health emergencies, but, according to the authors, “does not specify how federal entities should align with tribal, state, and local governments.” PAHPA mandates that subnational entities create and implement emergency preparedness plans consistent with “measurable evidence-based benchmarks and objective standards.” The authors argue that the use of benchmarks rather than evidence-based public health policies could lead to unintended consequences. PAHPA requires the U.S. Department of Health and Human Services (DHHS) to establish a national electronic network to collect and analyze public health data. The authors suggest that while a database should improve public health surveillance, the collection of such data could jeopardize the security of identifiable, sensitive, and private health information. The authors suggest provisions that could be codified in DHHS regulations to protect the privacy of individuals. The law also authorizes DHHS to oversee federal health personnel, including volunteers. But PAHPA does not speak to the issue of liability protection, which was a recurrent issue during the Hurricane Katrina response. The authors conclude that while PAHPA does address some pivotal issues in public health emergency preparedness, it does not resolve many “complex, long-standing issues.”

[Editor’s note: To read the text of the Pandemic and All-Hazards Preparedness Act, visit http://frwebgate.access.gpo.gov/cgi-...8enr.txt.pdf.]


Canada: Plaintiff who allegedly contracted TB at hospital denied compensation
“Judge rejects TB lawsuit against Vancouver hospital”
CBC News (04/11/07)

http://www.cbc.ca/canada/british-columbia/story/2007/04/11/bc-lawsuit.html?ref=rss

1. Judge rejects TB lawsuit against Vancouver hospital
A Vancouver man who contracted tuberculosis after visiting a patient at St. Paul's Hospital has lost his lawsuit seeking compensation from the hospital.
Derek Downey had gone to the hospital in downtown Vancouver in July 2001 to visit a friend being treated for AIDS.
He did not know that his friend — described in court documents only as "M.L." — also had tuberculosis. It was only diagnosed later.
During the visit, Downey's friend coughed on him. The following month, Downey, too, was diagnosed with TB.
He sued St. Paul's along with Providence Health Care, which runs the hospital, for failing to ensure his safety. Downey argued a patient suspected of having an infectious disease should have been placed in isolation.
The hospital argued Downey might have contracted TB elsewhere, since he was living in an area where he was exposed to intravenous drug users.
In his decision, B.C. Supreme Court Justice Richard Goepel describes that as speculation.
But he also dismissed Downey's suit. The judge writes that hospitals contain sick people who can infect others. And he says visitors know that.

Goepel said the hospital had determined that M.L. did not require isolation — and officials had no duty to warn visitors he might have TB.

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Re: CDC: Excerpts from Public Health Law News

On that last item, Plaintiff who allegedly contracted TB at hospital denied compensation, the full case is here:

http://www.canlii.org/eliisa/highlight.do?text=St.+Paul%27s+Hospital+Downey&language=en&searchTitle=Search+all+CanLII+databases&path=/en/bc/bcsc/doc/2007/2007bcsc478/2007bcsc478.html

The transmission occured on July 18, with the TB diagnosis on July 20. The Act referred to is the Occupier's Liability Act - this type of action would usually be framed in negligence. And the last few paragraphs containing the judge's reasoning are below:


[90]The decision on whether to order respiratory isolation is complex, involving a consideration of a number of factors, not the least of which is a clinical assessment of the patient. For this reason, the attending physician is responsible for making the determination of whether to put a patient in respiratory isolation. In this case, there is no evidence that suggests that Dr. McKenna or Dr. Reynolds fell below the appropriate standard of care in determining that M.L. need not be isolated. All the medical evidence supports the decisions they made.

[91] I do not accept that the Hospital failed to follow the Policy. The Policy left the decision, as to whether to enforce restrictive isolation, to the treating doctor. The Hospital was entitled to rely on the medical judgment of Dr. McKenna and Dr. Reynolds. In this case, the doctors concluded that there was no necessity to place M.L. in isolation. That decision was consistent with established standards and practice. The Hospital’s duty is to isolate patients whom they suspect are contagious. The treating physicians did not suspect that M.L. was contagious. The Hospital did not fail to take the care that was reasonable in the circumstances of this case.

[92] I do not accept Mr. Downey’s submission that the Hospital breached its duty of care by failing to warn him that M.L. might possibly be contagious. The duty to warn cannot be divorced from the duty to isolate. The Hospital’s duty is to take reasonable steps to ensure that patients do not infect others. Having decided that a patient did not require isolation, the Hospital is not required to warn visitors that the patient might possibly have TB. To do so would hold the Hospital to a higher standard than the Act requires.

[93] The Act requires the Hospital to be reasonably safe for visitors. The Hospital is not an insurer of the health of visitors. Hospitals contain sick people. Sick people, for various reasons, can infect others. Visitors to hospitals know there are sick people present. Anyone with a respiratory illness could theoretically have TB. Few, in fact, do. Having properly determined that a respiratory patient does not require isolation, it is not reasonable or necessary to require hospitals to warn visitors that the patient could possibly have TB. Such warnings could dilute the effectiveness of warnings for patients who are in isolation. In the circumstances of this case, the Hospital, having determined that M.L. did not require isolation, was under no duty to warn all who may come into contact with him that he might possibly have TB.

[94] In the result, I find that the Hospital did not breach the duty of care it owed to Mr. Downey. The action is dismissed.

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Re: CDC: Excerpts from Public Health Law News

Two excerpts from the CDC's Health Law News. The first on allowing uninspected poultry meat for sale in Vermont; the second on guidlines for use of face masks during a pandemic.

J.

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Wednesday, May 9, 2007


From the Public Health Law Program, Office of the Chief of Public Health Practice, CDC

http://www2a.cdc.gov/phlp/

?Bill would ease state?s poultry rules?
Rutland Herald (05/04/07)

http://www.rutlandherald.com/apps/pbcs.dll/article?AID=/20070504/NEWS04/705040348/1004/NEWS03

Vermont legislators have approved a bill to allow uninspected poultry to be sold in restaurants and farmers markets. The bill is intended to create new markets for small-scale poultry farmers, allowing those who sell less than 1,000 birds a year to bypass the inspections. Such meat would be labeled as ?uninspected.? But some lawmakers say they are concerned about potential damage to the agriculture industry if a consumer was sickened by uninspected meat. ?One unfortunate incident involving an uninspected bird could extract a price from all producers,? said Sen. Jane Kitchel, former head of the state?s Agency of Human Services, who opposed the provision. Sen. Richard Mazza also urged the Senate not to pass the bill: ?This is not the time to weaken the rules on food safety. We must maintain the highest level of food safety for Vermont products.? The state?s Department of Health and Department of Agriculture also oppose selling uninspected poultry in restaurants. But Amy Shollenberger of Rural Vermont, a small farm advocacy group that supported the bill, said, ?I think it will increase the number of people who sell poultry. It will open up new opportunities for them.?



?U.S. issues guidelines on use of face masks in flu outbreak?
The New York Times (05/04/07) Donald G. McNeil Jr.

http://www.nytimes.com/2007/05/04/health/04mask.html?em&ex=1178424000&en=94a13b963cd08620&ei=5087%0A

CDC has released guidelines for the use of face masks during an influenza outbreak. According to Dr. Michael Bell of CDC?s National Center for Preparedness, Detection and Control of Infectious Diseases, the agency debated the guidance for years because, in part, there is little scientific data proving that masks protect against the influenza virus. ?If there were a fail-safe, perfect solution, we?d recommend it absolutely. But there isn?t a crisp, hard guideline. It?s not like a seat belt, something you should wear at all times,? said Bell. The guidelines suggest that surgical masks ?should be considered? by people in a crowd, and thicker industrial masks ?should be considered? by anyone caring for the sick. The guidelines also re-emphasize the need to adhere to social distancing measures, including avoiding crowds and close contact with others at work or school. According to CDC Director Dr. Julie Gerberding, masks are most useful for people who are already sick, and for healthcare workers who are working with influenza patients. Public health officials are concerned that a rush to buy masks for home use may create a shortage for healthcare workers. For that reason, although federal, state, and city governments are building mask stockpiles, the national influenza plan does not rely as heavily on the use of masks as do other countries, such as France. But according to Dr. Didier Houssin, Chief Medical Officer for Influenza at the Paris Hospital Center, the decision to rely on masks was made ?not so much from medical reasons as from psychological and political reasons.?

[Editor?s note: To read ?Interim Public Health Guidance for the Use of Facemasks and Respirators in Non-Occupational Community Settings during an Influenza Pandemic,? visit http://www.pandemicflu.gov/plan/comm...mmunity.html.]

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Re: CDC: Excerpts from Public Health Law News

Two excerpts from the CDC Health Law News that may be of interest to FT readers: military pandemic preparedness; mock disasters.

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Wednesday, May 16, 2007

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From the Public Health Law Program, Office of the Chief of Public Health Practice, CDC

http://www2a.cdc.gov/phlp/

<http://www2a.cdc.gov/phlp/rss/cdcs_public_health_law_news.xml>


"U.S. military begins planning for avian flu pandemic"

Agence France Presse (05/10/07) Jim Mannion

http://news.yahoo.com/s/afp/20070510/pl_afp/healthfluusmilitary_070510181445

Last week, the U.S. Department of Defense (DoD) released its plan to prepare the nation's military for a role in a potential avian influenza pandemic. The Pentagon's Implementation Plan for Pandemic Influenza provides information and guidelines for military services and combatant commands. The document prepares for a pandemic that would move quickly and involve catastrophic waves of disease, leading to overwhelmed health facilities and crippled state and local authorities. According to the document, the U.S. military's highest priority is to preserve DoD's operational effectiveness, but another priority would be to evacuate non-infected people from where they are living abroad, and to help the country's allies. Troops will also play a role in distributing medical supplies and medications, and providing security for the production and shipment of vaccines. Finally, the military may assist with the isolation and quarantine of people to contain the spread of influenza. "When directed by the president, DoD will provide support to civil authorities in the event of a civil disturbance. DoD will augment civilian law enforcement efforts to restore and maintain order in accordance with existing statutes."



[Editor's note: To read the Department of Defense Implementation Plan for Pandemic Influenza, visit http://fhp.osd.mil/aiWatchboard/pdf/..._Release.pdf.]



"Mock disasters challenge federal, state and local responders"

Associated Press (05/10/07) Deanna Martin

http://www.wabashplaindealer.com/articles/2007/05/11/state_news/state2.txt

Since April 30, federal emergency workers across the United States have been conducting the largest exercise ever undertaken by U.S. Northern Command. Dubbed Ardent Sentry/Northern Edge, the training was developed to find better ways for local first responders to work with the military and federal officials who arrive later in an emergency. Responders in Indiana have simulated a nuclear disaster; in Alaska a series of simulated terrorist attacks have targeted the state's oil pipeline and refineries and other energy resources; and Rhode Island and four other New England states have been hit by a hypothetical Category 3 hurricane. The nuclear disaster in Indianapolis marked the first time officials responded to a national-level disaster without pre-positioning staging equipment. And, for the first time, local and state responders conducted around-the-clock operations for the initial 72 hours after the disaster began. "You've got to practice, and you just can't practice something of this magnitude by just moving a little icon around on a screen. You've got to get out here and sweat," said Maj. Gen. Martin Umbarger, Adjutant General of the Indiana National Guard. The goal of all the operations was to overwhelm authorities with evacuations, failed communications, and destroyed infrastructure. According to Brittan Bates, a Rhode Island exercise officer, "We saw some gaps with [the Federal Emergency Management Agency], and we now know we have to have some conversations with them to figure out exactly how that needs to be done." The simulation will continue through May 18.



[Editor's note: To learn more about Ardent Sentry/Northern Edge, visit http://www.northcom.mil/News/2007/AS...ct_sheet.pdf.]

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Re: CDC: Excerpts from Public Health Law News

Excerpts from today's Health Law News that may be of interest. The first item on Florida quarintine law is very instructive.


Wednesday, May 30, 2007
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From the Public Health Law Program, Office of the Chief of Public Health Practice, CDC

http://www2a.cdc.gov/phlp/

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*** Florida Courts and Pandemic Preparedness. The Florida Court Education Council’s Publications Committee has released Pandemic Influenza Benchguide: Legal Issues Concerning Quarantine and Isolation, available at http://www.flcourts.org/gen_public/c...benchguide.pdf
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*** American Health Lawyers Association 2007 Annual Meeting (6/24-6/27). AHLA will hold its 2007 Annual Meeting and In-House Counsel Program June 24-27 in Chicago. For more information, visit http://www.healthlawyers.org/Templat...nual_Meeting07
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“TB patient isolated after taking two flights”
The New York Times (05/30/07) Lawrence K. Altman

http://www.nytimes.com/2007/05/30/us/30tb.html?_r=1&hp&oref=slogin

An Atlanta man is under federally enforced isolation after being diagnosed with XDR TB (extensively drug-resistant tuberculosis). Federal and international officials have begun an airline contact investigation to track down passengers and crew from two trans-Atlantic flights on which the man was a passenger earlier this month. CDC is advising passengers and crew members -- particularly passengers who were seated within two of the man, to be tested for tuberculosis. Contact passengers from the two flights, a May 12 flight from Atlanta to Paris and a May 24 flight from Prague to Montreal, will also be advised to undergo a medical evaluation with a follow-up test eight to ten weeks later. “We’re not concerned about a generic threat to travelers,” said CDC Director Dr. Julie L. Gerberding. The agency advised contact testing out of an abundance of caution, even though the risk of infection is believed to be low, she said, noting that the number of tuberculosis bacteria in the infected man’s sputum were too low to be detected, but still enough to infect others. The man had been advised of the results of tests taken before he left for Europe and not to take commercial flights home. But while CDC worked with a U.S. Embassy to provide assistance, the man flew to Montreal and drove into the United States. He was then isolated for 72 hours in a New York hospital, and is now in isolation in an Atlanta hospital. XDR TB is often fatal, extremely resistant to standard antibiotics, and represents a growing public health threat in many countries. CDC has not yet determined the source of the man’s infection. Those who think they may have been exposed to TB or XDR TB can call (800) CDC-INFO for more information.

[Editor’s note: To learn more about XDR TB, and to read the CDC Health Advisory and a transcript from CDC’s press conference on this investigation, visit http://www.cdc.gov/tb/xdrtb/.]

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Isolation and quarantine are two common public health strategies designed to protect the public by preventing exposure to infected or potentially infected persons. In general, isolation refers to the separation and restriction of movement of persons who have a specific infectious illness from those who are healthy. Quarantine generally refers to the separation and restriction of movement of persons who have been exposed to an infectious agent and therefore may become infectious. Both isolation and quarantine are intended to stop the spread of infectious disease, and both may be either voluntary or compelled through legal authority. States generally have intrastate quarantine authority, i.e,. the authority to compel isolation and quarantine within their borders. The Federal government, however, generally acting through CDC, has foreign and interstate quarantine authority, i.e., the authority to prevent the introduction, transmission, and spread of communicable diseases from foreign countries into the United States, and from one state into another. Federal quarantine authority is primarily found in the U.S. Code at 42 U.S.C. Section 264 and in the Code of Federal Regulations at 42 C.F.R., Parts 70 and 71. In exercising its quarantine authority, the Federal government is empowered to detain, medically examine, or conditionally release persons suspected of carrying specified communicable diseases. The specified communicable diseases for which federal isolation and quarantine are authorized are set forth through Executive Order 13295 (as amended) and include, among other illnesses, infectious tuberculosis.

To read 42 U.S.C. Section 264, click here: http://www2a.cdc.gov/phlp/docs/sec264.pdf.

To read the existing federal quarantine regulations, 42 C.F.R. Parts 70 and 71, visit: http://www.access.gpo.gov/nara/cfr/w...2cfr70_03.html.
and http://www.access.gpo.gov/nara/cfr/w...2cfr71_03.html.

To read the proposed federal quarantine regulations, click here: http://www.cdc.gov/ncidod/dq/nprm/index.htm.

To read Executive Order 13295, click here: http://www.cdc.gov/ncidod/sars/executiveorder040403.htm.

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Switzerland: U.N. approves resolution for affordable drugs and overriding patents
“WHO resolution urges development of cheap drugs despite U.S. rejection”
Associated Press (05/23/07) Bradley S. Klapper

http://www.irrawaddy.org/aviewer.asp?a=7140&z=163

China: Food safety crackdown to include recall system
“China to introduce new food safety rules”
Agence France Presse (05/29/07)

http://www.france24.com/france24Public/en/administration/afp-news.html?id=070529062433.tyz1x0ru&cat=null

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Re: CDC: Excerpts from Public Health Law News

This weeks' excerpts from CDC's Health Law News....lots on TB cases...




Wednesday, June 6, 2007
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From the Public Health Law Program, Office of the Chief of Public Health Practice, CDC

http://www2a.cdc.gov/phlp/

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?Quarantines not rare for tuberculosis patients?
Associated Press (06/03/07) Colleen Slevin

http://www.examiner.com/a-761261~Quarantines_not_rare_for_tuberculosis_patients.html

While CDC?s isolation order against extensively drug-resistant tuberculosis (XDR TB) patient Andrew Speaker is thought to be the first such federal order in at least 40 years, states have regularly invoked their quarantine powers to isolate tuberculosis patients. Speaker was recently diagnosed with XDR TB while on his honeymoon in Europe, and CDC issued an order for his isolation. CDC lifted the order on Saturday, when Speaker checked into National Jewish Medical and Research Center in Denver, Colorado. Denver health authorities issued a local quarantine order, as they have done for previous XDR TB patients, according to CDC?s Website. Speaker is one of many tuberculosis patients under court order. A New Mexico resident is also at the facility in Denver; 17 TB patients in Texas were placed in an involuntary quarantine facility in San Antonio; and California reported detaining four TB patients in 2006. The Colorado quarantine law was updated in 2002 in response to a rise in multidrug-resistant TB cases. The Colorado chief medical officer has the authority to issue a quarantine or isolation order for any multidrug-resistant TB patient who refuses to take prescription medications, even if the patient is not considered to be contagious. According to CDC, 49 cases of XDR TB have been reported in the United States in the last 13 years, and about ten percent of the world?s two billion TB-infected people have XDR TB.


?ACLU files lawsuit against county for treatment of TB patient?
Arizona Republic (05/30/07) Dennis Wagner

http://www.azcentral.com/news/articles/0530tbguy0530.html

The American Civil Liberties Union (ACLU) has filed a federal lawsuit on behalf of an extensively drug-resistant tuberculosis (XDR TB) patient held in an Arizona jail. Under court order, Robert Daniels has been held in isolation in a jail ward at the Maricopa Medical Center for ten months, since public health officials discovered that he had failed to take his medications and went out in public without a mask. While under the custody of Sheriff Joe Arpaio, Daniels has been held without a phone, television, radio, shower, or hot water, and with lights on 24 hours a day, according to court records. The lawsuit charges the Maricopa County Sheriff?s Office with violating Daniels? constitutional rights and also the Americans with Disabilities Act. Linda Cosme, an ACLU attorney, said Daniels is extremely depressed, and she expects to file motions seeking an expedited hearing and an injunction to immediately improve Daniels? treatment. Arpaio defended the conditions under which Daniels is being held: ?I run a safe jail, and he?s going to be treated like anyone else.? Daniels recently learned that his condition might require surgery. ?I?m slowly dying in this room,? he said. ?I didn?t realize how serious this (TB) was, and I regret that, but nothing justifies the kind of treatment I?ve received in here. The solitary confinement starts to mess with your head and it has taken a serious toll on my body.?

?Vaccine claims to get their day in court?
Associated Press (06/04/07) Kevin Freking

http://www.sfgate.com/cgi-bin/article.cgi?f=/n/a/2007/06/04/national/w151828D62.DTL&type=politics

The debate over the relationship between childhood vaccines, mercury, and autism is slated to have its day in court. Of more than 4,800 claims filed against the U.S. government, one has been chosen to test the theory that autism is caused by the measles, mumps, and rubella vaccine that once contained the preservative thimerosal. Thimerosal contains a form of mercury. In 1999, the government asked vaccine makers to eliminate or reduce the mercury content of vaccines to avoid any chance that infants might be exposed to more mercury than considered safe by federal guidelines. But experts, including the Institute of Medicine (IOM), say vaccines do not cause autism. A 2004 IOM report reviewed five large studies and found no association between autism and vaccines with thimerosal. Dr. Paul Offit, chief of the division of infectious diseases at the Children?s Hospital of Philadelphia, suggested that because mercury is part of the natural environment, children are regularly exposed. The National Autism Association believes drug manufacturers and federal regulators work too closely together, leading the government to protect the industry from liability. Three special masters will hear the case in the U.S. Court of Federal Claims. The hearing will be open to the public, and transcripts will be posted on the Court?s Website after each day?s proceedings.

[Editor?s note: To follow the Omnibus Autism Proceeding and the case Cedillo v. HHS, in the U.S. Court of Federal Claims, visit http://www.uscfc.uscourts.gov/OSM/OSMAutism.htm. To read the IOM report, Immunization Safety Review: Vaccines and Autism, visit http://books.nap.edu/catalog.php?record_id=10997. To learn CDC?s position on mercury and vaccines, visit http://www.cdc.gov/od/science/iso/co...imerosal.htm.]


National: Legal experts weigh in on XDR TB case
?TB quarantine raises legal questions?
Associated Press (06/01/07) Mike Stobbe

http://www.losangeleschronicle.com/articles/viewArticle.asp?articleID=28609

[cartski]

Re: CDC: Excerpts from Public Health Law News

Lots more on the TB situation....

Wednesday, June 13, 2007
__________________________________________________ ______________________

From the Public Health Law Program, Office of the Chief of Public Health Practice, CDC

http://www2a.cdc.gov/phlp/

__________________________________________________ ______________________

*** XDR TB Quarantine Orders. CDC has released the text of the three orders issued for the detention of an XDR TB patient between May 25 and May 30, 2007, and the final order, issued June 2, 2007, rescinding the earlier orders. The Order for Provisional Quarantine is available at http://www2a.cdc.gov/phlp/docs/quarantine1.pdf; the Order Pursuant to Section 361 is available at http://www2a.cdc.gov/phlp/docs/quarantine2.pdf; the Revised Order Pursuant to Section 361 is at http://www2a.cdc.gov/phlp/docs/quarantine3.pdf; and the Order Rescinding Movement Restrictions is available at http://www2a.cdc.gov/phlp/docs/quarantine4.pdf.

*** Bench Books. The Public Health Law Program has added three new benchbooks, from Arizona, Florida, and Utah to the growing portfolio. Please visit http://www2a.cdc.gov/phlp/port_bench.asp

*** Disaster Management Conference (7/8-7/11). The Canadian Centre for Emergency Preparedness will present the 17th World Conference on Disaster Management, July 8-11, 2007, in Toronto. For more information, visit http://www.wcdm.org/.

*** Biosecurity Policies Seminar (7/23-7/25). The Massachusetts Institute of Technology Professional Institute will present “Combating Bioterrorism / Pandemics: Implementing Policies for Biosecurity,” July 23-25, 2007, in Cambridge, Massachusetts. The course will look at the collaborations between public health, law enforcement, and national security agencies during threats of bioterrorism and global pandemics. Experts will explore the obstacles agencies must overcome when groups with deeply embedded professional norms and organizational cultures collaborate with each other.
Visit http://web.mit.edu/mitpep/pi/courses...terrorism.html for more information.

National: Historian looks at tuberculosis
“Return of the White Plague”
Washington Post (06/10/07) Howard Markel

http://www.washingtonpost.com/wp-dyn/content/article/2007/06/08/AR2007060802480.html

Czech Republic: Criminal complaint filed against American XDR TB patient
“Czech airline takes legal action against U.S. tuberculosis patient”
Associated Press (06/07/07)

http://www.iht.com/articles/ap/2007/06/07/europe/EU-GEN-Czech-US-Tuberculosis-Infection.php

__________
Last week, Missouri Gov. Matt Blunt signed a bill to protect medical professionals who help during declared emergencies. The new law bars most lawsuits and administrative penalties against licensed healthcare providers deployed by the governor or any state agency who provide healthcare “necessitated by the emergency,” although it would still permit penalties for injuries caused by “willful” and “wanton” mistakes. The law identifies the standard of care as that of an “ordinarily careful health care provider in similar circumstances.”

Compare the Missouri law to an amendment to Iowa’s Good Samaritan statute, which extends liability protection to corporations and non-profits that provide emergency aid during an emergency. [See CDC Public Health Law News, Law Behind the News, May 23, 2007, http://www2a.cdc.gov/phlp/dailynews/...specific=399.]

To read the text of the Missouri law, visit http://www2a.cdc.gov/phlp/docs/Bill579.pdf.

[cartski]

Re: CDC: Excerpts from Public Health Law News

Further excerpts from the CDC's Public Health Law News...

__________________________________

Wednesday, June 20, 2007

From the Public Health Law Program, Office of the Chief of Public Health Practice, CDC

http://www2a.cdc.gov/phlp/

*** AMA Launches Preparedness Journal. The American Medical Association has launched a new journal, Disaster Medicine and Public Health Preparedness. The journal intends to support the integration of clinical medicine with public health preparedness and to provide individual healthcare providers with a resource to support their public health activities. For more information or to submit an article, visit http://www.ama-assn.org/ama1/pub/upl...r-medicine.pdf.

*** Gulf Coast Hurricanes Lessons Learned Report. The American Health Lawyers Association has released Lessons Learned from the Gulf Coast Hurricanes, a follow-up publication to the 2004 Emergency Preparedness, Response & Recovery Checklist: Beyond the Emergency Management Plan in the American Health Lawyers Association?s Public Information Series. Visit http://www.healthlawyers.org/Content...onsLearned.pdf.


?New global rules to fight health threats come into force?
Agence France Presse (06/14/07

http://news.yahoo.com/s/afp/20070614/wl_afp/whohealthdisease_070614145019

The World Health Organization?s (WHO) Revised International Health Regulations (IHR), designed to bolster international cooperation during a global public health threat, entered into force on June 15, 2007. Over 190 nations signed on to the new rules in 2005. The IHR are intended to ensure ?Faster and better detection and evaluation of health emergencies with an international scope, those that have the potential to cross frontiers,? said Guenael Rodier, WHO?s IHR coordinator. The rules were developed in response to the emergence of SARS (Severe Acute Respiratory Syndrome), Ebola virus, and avian influenza. Under the IHR, countries are obligated to alert WHO about health threats that may have implications for the global community, from contaminated food to chemical agents. Rules for quarantines, surveillance of travelers, and around-the-clock alert systems are also clarified, the list of named diseases is now open-ended, and countries are now under greater pressure to be transparent in their decisionmaking. According to WHO officials, two-thirds of countries that signed on to the IHR need to make major progress before being able to meet the standards of the new requirements. ?It will be a very great challenge for countries to develop their core capacities, especially the low income countries,? said David Heymann, WHO assistant director-general for communicable diseases.

[Editor?s note: To read the new IHR, see Law Behind the News, below.]

The News originally featured the revised International Health Regulations (IHR) in the December 20, 2006 issue, when they were accepted by the United States. [See http://www2a.cdc.gov/phlp/dailynews/...specific=377.]

The IHR went into effect this week, and in recognition of this public health milestone, the News is pleased to feature them once again. Of particular interest are the rules delineating ?special provisions for travelers,? found in Chapter III, Articles 30-32.

Among the provisions for travelers:

If there is evidence of an imminent public health risk, the State Party may, in accordance with its national law and to the extent necessary to control such a risk, compel the traveler to undergo or advise the traveler, pursuant to paragraph 3 of Article 23, to undergo:
(a) the least invasive and intrusive medical examination that would achieve the public health objective;
(b) vaccination or other prophylaxis; or
(c) additional established health measures that prevent or control the spread of disease, including isolation, quarantine or placing the traveler under public health observation.

To read the full text of the IHR, visit http://www2a.cdc.gov/phlp/docs/IHRWHA58_3-en.pdf.

[cartski]

Re: CDC: Excerpts from Public Health Law News

Further excerpts from the CDC's Health Law News...


Wednesday, June 27, 2007
__________________________________________________ ______________________

From the Public Health Law Program, Office of the Chief of Public Health Practice, CDC

http://www2a.cdc.gov/phlp/

__________________________________________________ ______________________


*** MRSA Study Results. The Association for Professionals in Infection Control and Epidemiology has released its Methicillin Resistant Staphylococcus aureus (MRSA) Study Results. The study is the first to quantify the prevalence of MRSA nationwide, and is available at http://www.apic.org/Content/Navigati...dy_Results.htm.

*** Disaster Management Conference (7/8-7/11). The Canadian Centre for Emergency Preparedness will present the 18th World Conference on Disaster Management, July 8-11, 2007, in Toronto. For more information, visit http://www.wcdm.org/.


?Duck farmer sues over registration rule?
Associated Press (06/22/07)

http://www.chron.com/disp/story.mpl/ap/fn/4913036.html

A Mennonite farmer is suing the Pennsylvania Department of Agriculture for its enforcement of a federal law requiring the registration of farms engaged in the interstate selling of poultry. While Pennsylvania does not require registration, New York state does require monitoring or private testing of poultry before live birds can be sold there. This year, for the first time, Pennsylvania officials have said farms must register with the U.S. Department of Agriculture to participate in the program, which monitors for poultry-borne disease. James Landis is seeking a religious exemption from the law, which would require him to obtain a registration number to continue selling his ducks at live bird markets in New York City. He also contends that Pennsylvania lacks the authority to mandate participation in a voluntary federal program. At the heart of the lawsuit is Landis? belief that the biblical book of Revelation warns that such numbering systems are the work of the Antichrist. ?He sincerely (believes) that if he, as a Christian, were to participate in such a numbering system, it would result in his eternal damnation,? says the lawsuit. According to Landis, the registration requirement violates his religious freedom as guaranteed in Pennsylvania?s Constitution. A hearing was scheduled to be held in the state Commonwealth Court last Thursday.

[Editor?s note: To learn more about the federal Poultry Products Inspection Act, visit http://www.fsis.usda.gov/Regulations...p#Sec.%20460.]


Effect of widespread restrictions on the use of hospital services during SARS outbreak
Canadian Medical Association Journal (06/19/07) Michael J. Schull and others

http://www.cmaj.ca/cgi/content/full/cmaj;176/13/1827

The authors of this study sought to determine the effect of restrictions on the non-urgent use of hospitals in Toronto, Canada, during the 2003 SARS (severe acute respiratory syndrome) epidemic. At the beginning of the outbreak, provincial officials declared a health emergency, triggering restrictions on the use of all 32 hospitals in the Greater Toronto Area, including the restriction of surgeries to urgent cases. The authors? objectives were to determine how well the restrictions actually reduced the elective (non-emergency) use of hospital-based services; whether the restrictions disrupted urgent services or affected vulnerable patients; and whether patients instead received treatment in other sectors of the healthcare system or other locations not subject to the restrictions. The researchers used data from two other regions as a baseline. They then reviewed patient records and determined rates of hospital admissions, emergency department and outpatient visits, diagnostic testing, and drug prescribing for the period from March 2000 to April 2004. The researchers found that the restrictions resulted in a 12 percent decrease in the overall rate of hospital admissions in Toronto, and found they had the greatest effect on reducing the number of elective admissions and procedures. The study did surface some unintended consequences, including the likelihood that ?some potentially seriously ill patients did not present to hospital, and access to specialized care may have been more limited than in the pre-SARS period.? The authors advise that ?Plans to increase surge capacity by restricting non-urgent use of hospital services result in only modest increases in capacity.?

[cartski]

Re: CDC: Excerpts from Public Health Law News

Further excerpts that may be of interest to FT's...




From the Public Health Law Program, Office of the Chief of Public Health Practice, CDC

http://www2a.cdc.gov/phlp/

Wednesday, August 15, 2007
__________________________________________________ ______________________


*** Planning for a Pandemic. Michael O. Leavitt, Secretary of the Department of Health and Human Services, has released "Pandemic Planning Update IV." The document reports generally on the state of influenza pandemic preparedness. To view the report, visit http://www.pandemicflu.gov/plan/panflureport4.pdf.

Nonpharmaceutical interventions implemented during the 1918-1919 influenza pandemic
Journal of the American Medical Association (08/08/07) Howard Markel and others
http://jama.ama-assn.org/cgi/content/short/298/6/644 (subscription required)

This study sought to assess the nonpharmaceutical interventions (NPIs) implemented in 43 U.S. cities during the 1918-1919 influenza pandemic to determine whether variations in mortality were associated with the interventions. Nonpharmaceutical interventions, or social distancing measures, typically include: isolation of the ill and quarantine of people suspected of having contact with the ill; school and business closure; and public gathering bans. The authors of this study reviewed data from 43 of the most populous U.S. cities. Using "historical data collection and contemporary epidemiological and statistical analytic tools," the authors computed the weekly excess death rates (EDR) and determined the use of NPIs. The authors found there were 115,340 excess pneumonia and influenza deaths in the 43 cities during the weeks analyzed. Every city had adopted at least one of the three major types of NPIs, and 15 had applied all three types concurrently. Cities that implemented the interventions earlier reached peak mortality later, had lower peak mortality rates, and lower total mortality. Also, the relationship between increased duration of NPIs and reduced total mortality burden was statistically significant. Upon analysis, the authors found that "[l]ate interventions, regardless of their duration or permutation of use, almost always were associated with worse outcomes. However, timing alone was not consistently associated with success. The combination and choice of NPIs also appeared to be critical." They also found that, in cities that experienced two peaks of excess mortality, "activation of nonpharmaceutical interventions was followed by a diminution of deaths and, typically, when nonpharmaceutical interventions were deactivated, death rates increased."

National: Man smuggling monkey may have violated health laws, international treaty
"Man smuggles monkey into NYC airport"
Associated Press (08/07/07)

http://www.freepress.com/apps/pbcs.dll/article?AID=/20070808/NEWS07/70808006/1009/NEWS07

"It is kind of a spirited monkey."

-- Alison Russell, a Spirit Airlines spokesperson, on an attempt to smuggle a marmoset monkey into the United States under a man's hat last week. The monkey was discovered on the last leg of a flight from Peru to Florida to New York when it was found swinging on the man's ponytail during the flight. Federal public health officials confiscated the monkey upon arrival in New York, and will hold it in quarantine for 31 days. [See Briefly Noted item, above.]



__________________LAW BEHIND THE NEWS___________________

Last week, a man smuggled a marmoset (a species of New World monkey measuring about 20 cm long) onto a flight from Peru to Florida, and onto another flight en route to New York. The monkey was discovered during the flight, and the man and monkey were met by local and federal officials. The marmoset was seized and placed into animal quarantine by CDC. Since 1975, federal quarantine regulations (42 CFR ? 71.53) maintained by CDC have restricted the importation of non-human primates. Non-human primates include animals commonly known as monkeys, chimpanzees, orangutans, gorillas, gibbons, apes, baboons, marmosets, tamirin, lemurs, and lorises. Importers must register with the CDC, implement disease control measures, and may distribute non-human primates only for bona fide scientific, educational, or exhibition purposes, as defined in the regulations. Federal quarantine regulations do not permit the importation of non-human primates for use as pets, hobby, or as an avocation with occasional display to the general public. See: http://www2a.cdc.gov/phlp/docs/42cfr71.53.pdf.

[gsgs]

Re: CDC: Excerpts from Public Health Law News

in math it is good practice to upload used combinatorical data, so the results can be checked.
in virology it's good practice to upload sequences to genbank, so it can be checked.
And even better would be, if the used data are available in easy computer readable format.

In epidemiology it's good practice to upload used statistical data
so the results can be checked.
But I rarely see this.
Why is it ? Are those people afraid someone else could compete
for the grants ? Why don't public institutions like Universities,
foundations support availability of data ?
Why is most data still only available to subscribers of journals ?
Why do Universities (who historically first used the internet !)
apparantly see the internet now as an unwanted competition
and don't support online-research , don't make lectures public ?
(that's what I feel) Is it conform with their public funding ?
(assuming most Universities are public)

[cartski]

Re: CDC: Excerpts from Public Health Law News

Wednesday, August 29, 2007
__________________________________________________ ______________________

From the Public Health Law Program, Office of the Chief of Public Health Practice, CDC

http://www2a.cdc.gov/phlp/

*** Continental Pandemic Influenza Plan. Mexico, the U.S.A., and Canada have developed the North American Plan for Avian and Pandemic Influenza, as part of the Security and Prosperity Partnership of North America. View the plan at, http://www.spp.gov/pdf/nap_flu07.pdf.

Canada: Nurses to receive respirators, needles to combat job-related infections like SARS
"Ontario to supply safety needles"
The Globe and Mail (08/24/07) Steve Rennie

http://www.theglobeandmail.com/servlet/story/RTGAM.20070824.wontneedles24/BNStory/National/?page=rss&id=RTGAM.20070824.wontneedles24

"Study says biolab not a threat to S. End"
Boston Globe (08/24/07) Stephen Smith and Felicia Mello

http://www.boston.com/news/local/articles/2007/08/24/study_says_biolab_not_a_threat_to_s_end/

In response to pending litigation, the National Institutes of Health (NIH) were asked to assess the safety of a high-security research laboratory being built in Boston's South End neighborhood. The Boston University (BU), NIH-funded lab is currently under construction in the crowded South End. It is designed to be a Biosafety Level-4 facility, housing biological agents that could potentially be used by terrorists, including viruses, bacteria, and fungi. South End residents and a conservation group have sued in state and federal court to stop construction of the lab, which they say poses a threat to area residents. The NIH study was conducted to address concerns raised in the suits that BU had not considered other locations for the lab, and that it will create an undue burden on the South End's low-income, racially diverse population. The report compares a germ leak from the lab into the South End neighborhood with what might happen if the lab had been built on more secluded property. "[U]nder realistic conditions, infectious diseases would not occur in the communities as a result," the report concluded. But some bioterrorism specialists opposed to the lab say the report failed to examine pathogens that are easily spread from person to person. "These scenarios are really contrived. The diseases which have been picked are ones which are really not that contagious. And the diseases which have been avoided are the ones we really need to be worried about, like avian flu and SARS," said Jeanne Guillemin, a senior fellow at the MIT Security Studies Program. NIH will hold a public meeting in Boston on September 20, 2007 to discuss the report. Last August, a state judge ruled that BU must supplement its environmental impact statement, and called the state's approval of the project "arbitrary and capricious." A hearing in that case is scheduled for September.

[Editor's note: To read the text of the NIH report, "Draft Supplementary Risk Assessments and Site Suitability Analyses for the National Emerging Infectious Diseases Laboratory Boston University," visit http://www.nems.nih.gov/aspects/nat_...ms/nepa2.cfm.]

[cartski]

Re: CDC: Excerpts from Public Health Law News

Further excerpts from the CCDC...nice to see Winnipeg is on the map for something other than Ebola.....


Wednesday, September 26, 2007
__________________________________________________ ______________________

From the Public Health Law Program, Office of the Chief of Public Health Practice, CDC

http://www2a.cdc.gov/phlp/

__________________________________________________ ______________________


*** Federal Pandemic Preparedness Hearing (09/28). The U.S. Senate Committee on Homeland Security and Governmental Affairs Subcommittee on Oversight of Government Management, the Federal Workforce, and the District of Columbia will hold a hearing at 10 a.m. ET on September 28. The hearing, in Dirksen Senate Office Building, Room 342, is entitled "The Role of Federal Executive Boards' in Pandemic Preparedness." For more details, visit http://hsgac.senate.gov/index.cfm?Fu...&HearingID=483.

*** Capital District Pandemic Preparedness Hearing (10/03). The U.S. Senate Committee on Homeland Security and Governmental Affairs Subcommittee on Oversight of Government Management, the Federal Workforce, and the District of Columbia will also hold "Preparing the National Capital Region for a Pandemic." This hearing is at 10 a.m. ET on October 3, in Room 342 of Dirksen Senate Office Building. For details, visit http://hsgac.senate.gov/index.cfm?Fu...&HearingID=485.

*** Pandemic Influenza Checklist, Law Enforcement. The Department of Health and Human Services (DHHS) has developed a checklist for law enforcement agencies, to provide a general framework for creating a pandemic influenza plan. The checklist is accessible via http://www.pandemicflu.gov/plan/work...nforcement.pdf.

*** Pandemic Influenza Checklist, Correctional Facilities. DHHS has also developed a checklist for prison and jail systems to self-assess and improve their preparedness for responding to pandemic influenza. For details, see http://www.pandemicflu.gov/plan/work...nchecklist.pdf.

*** WHO Report. The World Health Organization has released World Health Report 2007 -- A safer future: global public health security in the 21st century. To read the report, visit http://who.int/whr/2007/en/index.html.

"Preparing racially and ethnically diverse communities for public health emergencies"
Health Affairs (09/07) Dennis P. Andrulis and others

http://content.healthaffairs.org/cgi/content/abstract/26/5/1269

The authors of a Drexel University School of Public Health study say the needs of racial and ethnic minorities are being left out of the nation's public health emergency plans. According to the authors, studies have shown that minority communities are more vulnerable than others before and after a public health disaster. They suggest several reasons for the disparity, including "socioeconomic differences, culture and language barriers, lower perceived personal risk from emergencies, distrust of warning messengers, lack of preparation and protective action, and reliance on informal sources of information." The research team's review of reports and peer-reviewed publications on emergency preparedness found a general lack of information focusing on racial/ethnic minorities. Nearly half of the Websites on emergency preparedness reviewed made no mention of racial/ethnic minorities, and only 12.6 percent provided information or materials on preparing diverse communities. The researchers identified five initiative areas for consideration, and suggest strategies for integrating diverse communities into emergency preparedness: "emergency risk communication; training and education; resource guides for planners and responders; measurement and evaluation; and policy and program initiatives." Among their recommendations include the need to "tailor public health messages, [and] use trusted messengers;" coordinate local government agencies and grass-roots groups representing diverse constituents, and centralize information and resources; and "assess the effectiveness of preparedness programs . [by] including measures to determine the presence of disparities in both processes and outcomes." Finally, the authors recommend drawing on "the expertise and integrat[ing] the perspectives of key organizations and individuals in the fields of cultural competence and disparities reduction with public health preparedness."

[Editor's note: Visit the National Resource Center on Advancing Emergency Preparedness for Culturally Diverse Communities, at http://www.diversitypreparedness.org/.]


"I'm dealing in caffeine and sugar."

-- Julian Schioler, a Winnipeg, Canada, high-school student currently earning a living selling black-market soda to classmates. A new school division policy has recently ended the sale of soft drinks, potato chips, and chocolate in school cafeterias. According to Schioler, he recently sold 48 cans of Coke in two days to caffeine-deprived students. [See Briefly Noted item, above.]