A workshop on Public Health Safety and Preparedness and Response

Presentation on theme: "A workshop on Public Health Safety and Preparedness and Response"— Presentation transcript:

1 A workshop on Public Health Safety and Preparedness and Response
Emergency Response Preparedness and Response To Bioterrorism in Korea 韩国对生物恐怖的应对 17-18 May 2006, Beijing Division of Preparedness and Response to Bioterrorism 韩国CDC生物恐怖应对部 KCDC/MOHW

2 Background 背景 Anthrax letter outbreak since 11th September 2001
2001年9月11日炭疽信事件 Establishment of Strategy on bioterror in Nov 2001 2001年11月生物反恐策略建立 Establishment•Operation of system on duty at emergency 建立和实施突发事件工作制度 Stockpiling of antibiotics, vaccine, equipment and facilities 抗生素、疫苗、设备和器械储备 Dual-Use surveillance system for early detection 可两用的早期识别监测系统 Laboratory Diagnosis System 实验室诊断系统 Reinforcement of Education•Training 加强教育培训 테러 직후 우편물을 이용한 탄저 테러가 발생한 이후 한국은 2001년 11월에 생물테러 종합대책을 수립하였습니다. 생물테러 종합대책에는 비상근무체계 수립 운영, 항생제, 백신, 물자 및 시설 비축, 조기인지를 위한 감시체계 구축, 실험실 진단체계 구축, 교육, 훈련 강화 등의 내용을 명시하고 있습니다. So, I will start with talking about our background. after 11th September 2001 anthrax attacks in the US, two month later Korea government established a strategy on bioterror. What do we established!... that is emergency duty. Nobody knows when outbreaks occur it may happen during holiday It may happen even midnight. So That include Establishment Operation of system on duty at emergency, Stockpiling of antibiotics, vaccine, equipment and facilities, Dual-Use surveillance system for early detection, Laboratory Diagnosis system, Reinforcement of Education Training.

3 Preparedness & Response to Bioterrorism in Korea 韩国生物恐怖的应对
National Bioterrorism preparedness and response 国家级生物反恐应对 Capacity Building 能力建设 Stockpile 物资储备 Laboratory Diagnosis System 实验室诊断系统 Surveillance System 监测系统 한국의 생물테러 대비 및 대응은 크게 4가지 영역으로 살펴볼 수 있습니다. 역량강화, 감시체계 운영, 실험실 진단체계, 물자 비축입니다. 그럼 먼저 역량강화에 대하여 살펴보겠습니다. National Bioterrorism Preparedness and Response in Korea consists of Capacity building, surveillance system, Laboratory Diagnosis system, Stockpiling. First of all, Let’s take a look about capacity building.

4 Capacity Building 能力建设
Strengthening of organization and Professional manpower 机构和专业人员 Construction of Counter terror Intelligence Integration Center 反恐智能联合中心的建设 Construction of Division of Preparedness and Response to Bioterrorism, KCDC in Dec. 2003 韩国CDC生物反恐应对处的建立（ ） Construction•Operation of Bioterrorism Task Force Team in MOHW, KCDC, Province(16), Public Health Center(248) 韩国卫生部/CDC生物反恐工作组建立并开展行动。16个省、248个公共卫生中心 한국은 생물테러 조직 및 인력을 강화하였습니다. 생물테러 정보 통합 센터를 신설하였으며, 2003년 12월 KCDC에 생물테러대응과를 신설하였습니다. 보건복지부, 질병관리본부, 16개 시도, 246개 보건소에 생물테러 TFT을 구성하여 운영하고 있습니다. Korea has strengthened of organization and manpower of bioterrorism. We constructed of counter terror intelligence integration center, And constructed of Division of Preparedness and Response to Bioterrorism, Korea Center for Disease Control and Prevention on December, 2003. We constructed and has been operating of Bioterrorism Task Force Team in Ministry of Health and Welfare, Korea Center for Disease Control and Prevention, 16 Provinces, 246 Public Health Centers.

5 National Bioterror Headquarter
国家反恐总部 President 总统 Nat’l Counter-terror HQ 国家反恐总部 (Prime Minister总理) Counter-terror Intelligence Integration Center 反恐智能联合中心 CTC : Conciliation. Support安抚 MOFAT : Foreign affairs外交 MOL : Immigration移民 MOD : support支持 MOC : Airport机场 MOA&F : Agriculture, animal农业，动物 MOE : Drinking water饮水 MOM : Port港口 FDA ; Food & drug食品和药品 DDA : response应对 LA : investigation调查 PA : On spot response现场处理 Relative Ministries相关部委 Control Center on Spot 现场指挥中心 (Director of Dept. of Infectious Disease Control, KCDC CDC传染病控制处处长 Control of national status Emergency support 国家紧急状态控制 Task Force Team 工作组 Bio-terror HQ 生物反恐总部 ( Vice Min. of MOHW 卫生部副部长) Counter-terror Provincial Council 省级反恐委员会 Investigation Team调查队 Investigation调查 NIS, PA LA, DOD Epidemic Investigation KCDC, Provincial Office 流行调查，CDC省办公室 Case Control Team 病例研究组 Provincial office, Fire, Disaster Adm. KCDC省办公室，救火、灾难管理 Support Team支持性工作队 Fire, Envir. Elect., Comm. Tap., Const. 救火、环境、电力、交通、自来水、建设等、 (If neces. support) First Response Team急救队 (Chief: Director of police队长：警察局长) police, fire, health etc.警察、灭火、卫生等 이 도표는 정부 합동 생물테러 대책본부입니다. 생물테러 발생시 초동조치팀이 현장에 출동하게 되고, 현장에는 현장지휘본부가 설치됩니다. 생물테러대책본부가 구성되고 국가대테러대책회를 통하여 대통령에게 보고되며 관련부서들이 분야별로 참여합니다. This is a organization of National Bioterror Headquarter. First Response Team go out the scene at bioterror outbreak, Control Center on Spot is established on the scene. Bio-terror Headquarter is organized and National Counter Terror Headquarter is composed and reports to the president. And relative ministries pariticipate.

6 Bioterrorism TFT in Ministry of Health and Welfare
卫生部反恐工作组 Bioterrorism TFT 反恐工作组 (Vice-Minister of MOHW 副部长) General Inspection Support Team检查组 Public Health Team 公共卫生组 Medical service, food, Support Team 医疗服务、食品、支持组 Life Security Support Team生活保障组 이 도표는 보건복지부의 생물테러 대책본부입니다. 생물테러 대책본부는 보건대책반, 의료, 식품, 의약품대책반, 저소득생활안정지원반으로 구성되어 있습니다. This is the organization of Bioterrorism Task Force Team in Ministry of Health and Welfare. Bioterrorism Task Force Team consists of Public Health Team, Medical service, food, Support Team, Life Security Support Team.

7 Bioterrorism TFT in KCDC
Bioterrorism Task Force Team 反恐工作组 Countermeasure Team 提供对策组 Epidemiological Investigation Team 流行病学调查组 Surveillance Team 监测组 Microorganism Detection Team 微生物检测组 이 도표는 질병관리본부의 생물테러대책반입니다. 생물테러대책반은 대책팀, 역학조사팀, 감시팀, 미생물탐지팀으로 구성되어 있습니다. This is a organization of Bioterror Task Force Team in Korea Center for Disease Control and Prevention. Task Force Team in KCDC is made of Countermeasure team, Epidemiological Investigation team, Surveillance Team, Microorganism Detection team.

8 Bioterrorism TFT in Province•District
省-区级反恐工作组 Bioterrorism TFT(MOHW) 反恐工作组（卫生部） Anti-Bioterrorism Task-Force Team (KCDC) 反恐工作组（CDC） Anti-Bioterrorism Task-Force Team (Province)反恐工作组（省级） Countermeasure Team 提供对策组 Epidemiological Investigation Team 流调组 Surveillance Team监测组 Microorganism Detection Team 微生物检测组 Anti-Bioterrorism Task-Force Team (District, Public Health Center)反恐工作组（区公卫中心） Countermeasure Team提供对策组 Epidemiological Investigation Team流调组 Surveillance Team监测组 Microorganism Detection Team微生物检测组 이 도표는 시도의 생물테러대책반입니다. 시도의 생물테러대책반도 대책팀, 역학조사팀, 감시팀, 미생물탐지팀으로 구성되어 있습니다. This is a Bioterrorism Task Force Team in Province, District. Task Force Team in Province, District also consists of countermeasure team, Epidemiological Investigation team, Surveillance team, Surveillance team, Microorganism detection team.

9 First Response Team 紧急应对组
(Chief : Director of police) 紧急应对组 （组长：警察局长） Police警察 Fire灭火 Public Health公共卫生 ※ Army support if necessary 必要时，军队支援 생물테러 의심사례 발생시 현장에 가장 먼저 출동하게 되는 초동조치팀입니다. 초동조치팀은 경찰, 소방, 보건으로 구성되어 있으며, 군은 필요시 지원을 합니다. This is a First Response Team. First response team consists of police, Fire, Public Health and they go out the scene at bioterror outbreak. Army supports first responders when it is necessary.

10 Role of First Responders 紧急反应队队员的职责
Police警察 Guard general population 保卫整体人群 Investigation and Searching out a criminal 调查和搜寻罪犯 Fire灭火 Transfer Patients and specimen 转移病人和样品 Disinfection of Environment 环境消毒 Public Health公共卫生 Management of patients•exposures 病人和接触管理 Examination by rapid detection test kit 用快速检测试剂检验 초동조치팀의 기관별 역할을 살펴보면, 경찰은 치안 통제, 정황 조사 및 범인 색출을 하고 소방은 환자, 검체를 신속하게 이송하고, 보건에서는 환자 및 폭로자를 관리하고, 신속진단키트를 이용하여 검체를 검사합니다. This is a role of first responders. Police guard citizen, and investigate, search out a criminal. Fire transfer patients and specimen, and disinfect the scene Public Health manage patients and exposers, Examine by rapid detection test kit.

11 Capacity Building 能力建设
Amendment of law related to bioterrorism反恐相关法律的修改 Definition of Bioterrorism 生物恐怖的定义 Communicable diseases by Bio-terrrorism can be described as communicable diseases outbreaks by the use of a microorganism with the deliberated intention to being caused a infection in order to achieve certain goals 生物恐怖传染性疾病是为达到某种目的，恶意使用微生物，从而引起的感染导致的传染性疾病 Major Communicable Diseases by Bioterrorism : report immediately 主要的生物恐怖传染病：立即报告 – Disease under Control Law : 5 classes 63 diseases 疾病控制法要求报告的疾病：5类63种疾病 – Plague(Class 1), Anthrax(Class 3), Smallpox, Botulism, VHF(Class 4) 鼠疫（1级），炭疽（3级），天花、波特淋菌中毒、VHF（4级） Examination, conservation and control on Communicable Disease Pathogen 传染病病原体的检验、保存和控制 – Hospital, Quarantine station, KFDA, Nat’l Institute of Animal Science Quarantine, Nat’l Plant Quarantine station医院、接种站、KFDA、动物免疫研究所、植物免疫站 – Reports of name pathogen, isolated sample and isolated dates已知病原的报告、分离的样本和分离日期 Establishing of BWC Implementation law BWC实施法的制定 다음으로는 생물테러 관련 법령에 대하여 살펴보겠습니다. 한국은 2002~2005년 동안 전염병 예방법에 생물테러 관련 조항을 추가하였으며, 생물테러와 생물테러 전염병의 정의를 명시하였습니다. 또한 분리 병원체를 신고하도록 규정하고 있으며, 국외로 수출하거나 국내에서 이동하는 병원체에 대하여 신고하도록 되어 있습니다. 현재 BWC 이행 법령을 제정 중에 있습니다. Next, amendment of law related to bioterrorism. Korea add regulation for bioterrorim to communicable disease control law 2002~2005. That regulation add smallpox, botulinum in 2002, state definition of bioterror and bioterror communicable disease. And obligate to report of agents seperated, imported agents, transfer of agents between laboratories. Now Korea is establishing BWC implementation law.

12 Capacity Building 能力建设
Study and research on bioterror 对生物恐怖的研究 Development for practical use 使用方法的制定 Vaccine and antitoxin 疫苗和抗病毒药 New diagnosis method 新的诊断方法 Multiple rapid detection test kit 多价的快速检测试剂 Study on Policy Development 政策研究 Scenario for response to bioterrorism 生物恐怖应对的游戏规则 Effective operation method of surveillance system 监测系统有效的实施方法 한국은 생물테러 관련 연구를 수행하고 있습니다. 탄저, 두창 백신 및 보툴리눔 항독소를 개발하고 있으며, 생물테러 가능 병원체 진단을 위한 최신 기법을 개발하고 있으며, 다중 신속 진단 키트를 개발하고 있습니다. 또한 생물테러 대응을 위한 시나리오를 개발하고 있으며, 감시체계의 효과적인 운영을 위한 방안을 모색하고 있습니다. We are studying and Researching on bioterror. We are developing anthrax and smallpox vaccine and botulinum antitoxin, new method for diagnosis of biological agents and multiple rapid detection test kit. Also we are developing scenario for response to bioterrorism, and policy for effective operation method of surveillance system.

13 Capacity Building 能力建设
Training & Education教育培训 Education for First Responders(Police, Fire, Public Health)紧急反应队伍的教育 Training course in KCDC CDC培训班 Education Program for the first responders at province level 省级紧急反应队员教育项目 Development & Dissemination of Educational materials 教育教材制定和发放 Education for reporters of Emergency Syndromic Surveillance System 突发事件症状监测系统报告员教育 Exercise for response to bioterrorism 反恐演练 – Anthrax Exercise(‘Silent Storm’) March 25, 2005 2005年3月25日炭疽演练（沉默的风暴） 또한 생물테러 교육 및 훈련을 실시하고 있는데, KCDC와 각 시도별로 초동대응요원을 교육하고 있으며, 응급실 증후군 감시체계 보고담당자에 대한 교육을 실시하고 있으며, 교육자료를 개발하여 배포하고 있습니다. 또한 2005년 3월 25일에는 탄저 테러 대응 모의훈련을 실시하였습니다. We are training and educating first responders, We have training course conducted in KCDC and education program for first responders at province level, Are educating reporters of emergency syndromic surveillance system, And are developing and disseminating educational materials such as posters, brochures etc. And We had exercise for response to anthrax titled as silent storm on 25 march 2005.

14 Capacity Building能力建设
Establishment of website建立网络 Public health centers : daily report of Bioterror suspicious case 公共卫生中心：生物恐怖可疑案件的日报 Hospitals 医院 - Emergency dept : daily report based on syndromic surveillance 急诊室：症状监测基础上的日报 - Infectious medicine dept : when suspicious outbreak occur 传染病室：可疑暴发出现时 Provide first responders and general population with bioterror information and news 向紧急反应队员和整体人群提供生物恐怖的信息和消息 생물테러 대응 사이트를 구축하여 운영하고 있는데 이 사이트를 통하여 시도, 보건소는 매일 생물테러 의심사례에 대한 보고를 하고 있으며, 전국 125개 응급실에서는 매일 생물테러 의심 증후군에 대한 보고를 하고 있고, 전국 50개 감염내과에서는 생물테러 발생시 보고를 하고 있으며, 초동대응요원과 시민들에게 생물테러 관련 정보 및 소식을 제공하고 있습니다. We established and have been operating webstie. Province, District report bioterror suspicious case on a daily basis, 125 nationwide Emergency Rooms report Bioterror suspicious syndrome on a daily basis, 50 nationwide infectious Medicine report suspicious patients at bioterror outbreak through this website. And Website provide bioterror information and news to first responders and citizen.

15 Capacity Building 能力建设
이것이 저희가 운영하고 있는 생물테러 웹사이트입니다. This is a main page of website.

16 Capacity Building能力建设
International Cooperation and Collaboration国际合作 International Conference on bioterrorism preparedness and response in 2004, 2005 2004和2005年反生物恐怖国际研讨会 Collaboration with WHO, USA(CDC), JAPAN(NIID) 与WHO、美国CDC、日本NIID合作 Participation in WHO, APEC CTTF, SEARCCT, BWC meeting 参加WHO、APEC CTTF、SEARCCT、BWC会议 또한 국제적으로 협력을 강화하고 있는데 2004, 2005년에는 국제 회의를 개최하였고, WHO, APEC CTTF, SEARCCT, BWC 회의에 참석하고 있으며, WHO, CDC, NIID 등과 협력체계를 구축하고 있습니다. Also we cooperate and collaborate other agencies. We held international conference on bioterror preparedness and response in , Participate WHO, APEC CTTF, SEARCCT, BWC meeting, And collaborate with WHO, CDC, NIID etc.

17 Preparedness & Response to Bioterrorism in Korea 韩国生物恐怖应对
National Bioterrorism preparedness and response 国家级生物恐怖应对 Stockpile 物资储备 Surveillance System 监测系统 Capacity Building 能力建设 Laboratory Diagnosis System 实验室诊断系统 두번째로 감시체계에 대하여 살펴보겠습니다. Second, Let’s take a look Surveillance system.

18 Surveillance System 监测系统
Dual-Use Surveillance System 可以两用的监测系统 Emergency Syndromic Surveillance System 突发事件症状监测系统 Enhanced Emergency Surveillance System during special events 在特殊活动期间加强了突发事件监测系统 Infectious Disease Specialist Network 传染病专报网 한국은 이중으로 감시체계를 운영하고 있는데, 여기에는 응급실 증후군 감시체계, 특정 행사기간동안 운영하는 강화된 응급실 증후군 감시체계, 감염전문가 네트워크가 있습니다. 먼저 응급실 증후군 감시체계를 살펴보겠습니다. We have been operating Dual Use Surveillance System. That consists of Emergency Syndromic Surveillance System, and Infectious Disease Specialist Network. 그럼 Emergency Surveillance System을 살펴보겠습니다.

19 Emergency Syndromic Surveillance System
突发事件症状监测系统 Definition定义 to monitor unusual disease clusters based on sets of pre-diagnosis clinical signs, symptoms, or conditions that collectively may be indicative of a specific disease 以与某种疾病相关的、确诊前的临床表现、症状发作提示为基础，监测异常的疾病集聚性 응급실 증후군 감시체계란 어떤 질병이 생물테러 전염병으로 확진되기 전에 환자의 임상적 상태, 증상 혹은 증후에 근거하여 응급실 대상으로 지속적으로 감시하는 체계입니다. Emergency Surveillance System is to monitor unusual disease clusters based on sets of pre-diagnosis clinical signs, symptoms or conditions that collectively may be indicative of a specific disease.

20 Emergency Syndromic Surveillance System
突发事件症状监测系统 Objectives目的 By closely monitoring the syndrome that are suspected of bioterrorism, possible disease spread due to bioterrorists‘ attacks can be prevented 紧密监测可疑的生物恐怖症状，紧密监测那些可以防止的生物恐怖进攻带来的疾病的传播 The prevalence of water and food borne diarrhea diseases, and respiratory infectious diseases like influenza is promptly recognized for the quick response. 快速鉴别、快速应答水源性和食源性疾病、呼吸道感染，如流感的传播 Reporting : web based 网络报告 Organization : 125 hospitals (Emergency Dept.) 机构：125家医院（急诊室） Experts Committee : have meeting every semester 专家委员会：每学期开会 응급실 증후군 감시체계의 목적은 생물테러로 의심되는 전염병의 발생을 조기에 인지하고, 식수 및 식품매개 수인성 전염병, 인플루엔자 등 호흡기 전염병의 유행을 조기에 인지하고 대처하는 것입니다. 보고 방법은 웹사이트에서 보고를 합니다. 보고 기관은 전국의 125개 병원의 응급의학과입니다. 1년에 4번 자문회의를 개최하며, 효과적인 운영방안을 모색합니다. The purpose of ESS is to monitor the syndromes that are suspected of bioterrorism, possible disease spread due to bioterrorist’s attacks and recognize the prevalence of water and food borne diarrhea diseases and respiratory infectious disease like influenza promptly for quick response. The method of report is via website. Reporting organization is 125 hospitals nationwide. Experts committee have meeting 4times a year to search for effective method of surveillance system.

21 Emergency Syndromic Surveillance System http://bioterrorism. cdc. go
이것은 응급실 증후군 감시체계의 웹사이트입니다. 전국 125개 응급의료기관에서는 이 웹사이트에 들어가서 각자 ID, PW를 입력하고 각 증후군에 대하여 보고를 하며, 보고 여부, 보고율, 통계를 볼 수 있습니다. This is a website of Emergency Surveillance system. 125 hospital go to the website and put their ID, PW and report number of patients suspected of bioterro. And They can check whether they report or not, rate of report, statistics and so on.

22 The reportable diseases and patient 要求报告的疾病和病人
Reportable syndrome 要求报告的症状 Diseases under surveillance监测的疾病种类 Bioterror infectious disease生物恐怖性传染病 Common infectious disease 普通传染病 Acute skin rash syndrome 急性皮疹 Smallpox天花 - Acute neurologic syndrome急性神经症状 Botulism波特淋菌中毒 Acute hemorrhagic syndrome急性出血热 Viral Hemorrhagic Fever 病毒性出血热 Acute respiratory syndrome急性呼吸道症状 Anthrax, Plague炭疽，鼠疫 Influenza, SARS流感，非典 Acute diarrheal syndrome急性腹泻 water and food borne infectious diseases like food poisoning, typhoid, Shigellosis etc 水源性和食源性传染病，如食物中毒、伤寒、志贺氏菌病 이 표는 응급실 증후군 감시체계의 보고 대상 증후군 및 질병입니다. 응급실 증후군 감시체계는 급성발진증후군, 급설신경증후군, 급성출혈열증후군, 급성호흡기증후군, 급성설사증후군에 대하여 보고를 받고 있으며, 각 증후군은 정의를 명시하고 있습니다. 이 증후군을 통하여 두창, 보툴리눔, 바이러스성 출혈열, 탄저, 페스트와 같은 생물테러 가능 전염병을 조기에 인지할 수 있습니다. This is a reportable diseases and patients. Reportable Syndromes of Emergency Surveillance system are Acute Skin rash syndrome, Acute neurologic syndrome, acute hemorrhagic syndrome, acute respiratory syndrome, acute diarrheal syndrome. And We can detect bioterror communicable disease such as smallpox, botulism, viral hemorrhagic fever, anthrax, plague.

23 Reporting system报告系统 이것은 응급실 증후군 감시체계의 보고체계입니다.
                            Reporting system报告系统 이것은 응급실 증후군 감시체계의 보고체계입니다. 각 의료기관에서는 internet homepage에 보고를 하고 보건소에서는 보고된 case에 대하여 역학조사를 실시하고 결과를 보고하며, 시도와 KCDC에서는 분석을 하고 감시를 합니다. The Korean Society of Emergency medicine에서는 보고된 case에 대하여 자문을 합니다. This a reporting system. Hospitals report via website, Public Health Centers investigate and feedback the result of reported cases, Province and KCDC analyze data and keep watching. The Korean Society of Emergency medicine consult about reported cases.

24 Reported Cases of Emergency Syndromic Surveillance(’02-’05) 02-05年突发事件症状监测系统报告的病例
unit : case单位：例 Year年 Acute skin rash syndrome 急性皮疹 Acute neurologic syndrome急性神经症状 Acute hemorrhagic syndrome 急性出血热 Acute diarrhea syndrome outbreak/ (sporadic) 急性腹泻暴发/散发 Acute respiratory syndrome /(severe case) 急性呼吸道症状/严重病例 total 71 9 61 304(47,719) 31,811(13) 2002 30 2 26 84(3,608) 7,027(0) 2003 4 7 5 75(2,484) 6,862(0) 2004 17 16 109(15,127) 8,783(9) 2005 20 14 36(26,500) 9,139(4) 이 표는 2002년에서 2004년동안 응급실 증후군 감시체계에 보고된 건수입니다. 역학 조사 결과 생물테러 발생으로 확인된 경우는 발견되지 않았으며, 호흡기 증후군은 대부분 감기나 인플루엔자로 판명되었습니다. This is a reported cases of Emergency Syndromic Surveillance System between 2002 to 2004. It is confirmed that any bioterror outbreak doesn’t occur. And reported cases of acute respiratory syndrome is approved to flu, influenza.

25 Surveillance System监测系统
Dual-Use Surveillance System 两用的监测系统 Emergency Syndromic Surveillance System 突发事件症状监测系统 Enhanced Emergency Surveillance System during special events 特殊活动期间强化了监测系统 Infectious Disease Specialist Network 传染病专报网 다음으로 특정 행사기간동안 운영되는 강화된 응급실 증후군 감시체계에 대하여 살펴보도록 하겠습니다. Next, Enhanced Emergency Surveillance System during special events를 살펴보겠습니다.

26 Enhanced Emergency Syndromic Surveillance System
强化的突发事件症状监测系统 Definition定义 Enhanced Syndromic Surveillance System is operated through related area during special events such as ADB meeting, APEC meeting etc. 强化的突发事件症状监测系统在特殊活动期间，如ADB会议、 APEC会议等，在相关区域运行 Purpose 目的 Early detection and response to suspicious outbreaks in the related area during special events 在特殊活动期间对在相关区域可疑暴发的早期识别和应对 강화된 응급실 증후군 감시체계는 다음과 같으며, 강화된 응급실 증후군 감시체계의 목적은 -----입니다. Enhanced Syndromic Surveillance System is operated through related area during special events such as ADB meeting, APEC meeting etc. The purpose of EESSS is early detection and response to suspicious outbreaks in the related area during special events.

27 Enhanced Emergency Syndromic Surveillance System 强化的突发事件症状监测系统
Expansion of Reportable organizataion 增加了报告机构 To add emergency departments in events area 增加了活动区域的急诊室 Expansion of Reportable syndrome 增加了报告症状 acute gastro-intestinal syndrome, acute respiratory syndrome, acute pneumonia, acute skin-rash syndrome, acute fever syndrome, septic/non-traumatic shock 急性肠胃炎、急性呼吸道、急性肺炎、急性皮疹、急性高热、脓血/非创伤性休克 강화된 응급실 증후군 감시체계는 기존의 125개 의료기관 외에 행사 개최지역을 중심으로 의료기관을 추가로 지정합니다. 또한 보고 증후군을 확대하여 운영합니다. EESSS appoints additional emergency departments around events area except for existing 125 hospitals. Also EESSS expand the reportable syndrome. Reportable syndromes are acute gastro intestinal syndrome, acute respiratory syndrome, acute pneumonia, acute skin rash syndrome, acute fever syndrome, septic/non-traumatic shock.

28 Operation of EESS 强化的突发事件症状监测系统的运行 ’03 Daegu Universiade
’04 Jeju ADB Meeting ’05 APEC in Jeju – 6 May ~ 14 June 2005 ’05 APEC in Kyeong Ju – 22Aug~28Sep2005 ’05 APEC in Busan – 28 Oct ~ 4 Dec 2005 다음은 강화된 응급실 증후군의 운영 사례입니다. 2003년 대구 유니버시아드, 2004년 제주 ADB 회의, 2005년 5월 제주에서 열린 APEC 기간동안 강화된 응급실 증후군 감시체계를 운영하였으며, 8월 경주에서 열리는 APEC과 11월 부산에서 열리는 APEC에 대비하여 강화된 응급실 증후군 감시체계를 운영할 예정입니다. This is a example of EESSS. We operated EESSS at ’03 Daegu Universiade, ‘04 Jeju ADB Meeting, ’05 APEC in jeju, We have plan to operate EESSS at ’05 APEC in Kyeong JU, ’05 APEC in Busan.

29 Surveillance System监测系统
Dual-Use Surveillance System 两用的监测系统 Emergency Syndromic Surveillance System 突发事件症状监测系统 Enhanced Emergency Surveillance System during special events 特殊活动期间强化了监测系统 Infectious Disease Specialist Network 传染病专报网 다음으로 감염전문가 네트워크에 대하여 살펴보겠습니다. Next, Infectious Disease Specialist Network에 대하여 살펴보겠습니다.

30 Infectious Disease Specialist Network
传染病专报网 Definition定义 provide healthcare professionals with information when a bioterrorists activities or emerging and re-emerging diseases are suspected in order to prevent epidemics 当出现生物恐怖活动或新发和再发疾病被怀疑与生物恐怖有关时，向卫生保健人员提供信息，防止出现流行 provide information, news, materials, and overseas status about infectious disease 提供信息、消息、资料和传染病的国外状况 감염전문가 네트워크는 신종, 재출현 전염병에 대한 정보 교류를 통하여 조기 인지 및 확산을 조치 차단토록 전문의를 중심으로 이루어지는네트워크입니다. 감염전문가 네트워크는 감염병에 대한 소식, MATERIAL, 해외의 상황에 대한 정보를 제공합니다. Infectious Disease Specialist Network provide healthcare professionals with information when a bioterrorists activities or emerging and reemerging diseases are suspected in order to prevent epidemics And provide information, news, materials, and overseas status about infectious disease.

31 Infectious Disease Specialist Network传染病专报网
Reporting organization 报告机构 50 hospitals which have Department of infectious medicine and infectious pediatric 50家有传染病科和儿童传染病科的医院 Reportable patients 报告病人 Patients suspected of bioterror 生物恐怖疑似病人 - anthrax, smallpox, botulism, plague, viral hemorrhagic fever(VHF) 炭疽、天花、波特淋菌中毒、鼠疫、病毒性出血热（VHF） Patients suspected of Diarrhea (mass) 腹泻疑似病人 Advisory committee : 13 Experts consult about a reported case 顾问委员会：每个报告病例经13名专家研究 감염전문가 네트워크의 보고기관은 감염내과 및 감염소아과가 있는 전국 50개 의료기관이며, 보고대상은 두창, 탄저, 보툴리눔 독소증, 페스트 및 바이러스성 출혈열 의심환자이며, 집단발병이 의심되는 설사환자입니다, 13명의 전문가로 구성된 위원회에서는 보고된 CASE에 대하여 자문을 합니다. Reporting organizations are 50 hospitals which have department of infectious medicine and infectious pediatric. Reporting patients are patients suspected of bioterror such as anthrax, smallpox, botulism, plague, viral hemorrhagic fever, patients suspected of diarrhea. Advisory committee(13 experts) consult about reported cases.

32 Reporting System 报告系统 이것은 감염전문가 네트워크의 보고체계입니다.
전국 50개 의료기관에서 website에 생물테러 의심환자 발생시 보고를 하고, 보건소에서는 이에 대한 역학조사를 실시합니다. Advisory Committee에서는 보고된 case에 대하여 자문을 하고, 시도와 KCDC에서는 감시를 하고 결과를 분석합니다. This is a reporting system of Infectious disease specialist network. 50 nationwide hospitals report cases suspected of bioterrorism via website, Public Health Centers implement epidemiological investigation, Advisory Committee consult about reported cases, Province and KCDC analyze the data.

33 Infectious Disease Specialist Network http://bioterrorism. cdc. go
이것은 감염전문가 네트워크의 website입니다. 각 의료기관에서는 생물테러 의심환자에 대한 보고를 하고 자문위원은 이에 대한 자문 결과를 입력합니다. This is a website of infectious Disease specialist Network. Hospitals report the cases suspected of bioterrorism, Experts report the results of reported cases.

34 Acute diarrhea syndrome
Reported cases of Infectious Disease Specialist Network(’02-’05) 02-05年传染病专报网报告的病例 unit : person 单位：人 단위 : 건 Year年 Suspected anthrax 炭疽疑似 Suspected plague 鼠疫疑似 Suspected smallpox 天花疑似 Suspected botulism 波特淋菌中毒疑似 Suspected VHF 病毒性出血热疑似 Acute diarrhea syndrome 急性腹泻 total 7 2 169 2002 1 128 2003 3 18 2004 2005 23 이것은 2002년부터 2004년동안 감염전문가 네트워크에 보고된 의심 환자입니다. 지금까지 생물테러 의심환자로 확인된 경우는 없었으며, 보툴리눔 독소증의 경우 자연 발생 사례로 판명된 경우가 있었으며, 바이러스성 출혈열의 경우 신증후군 출혈열로 판명되었습니다. This is reported cases of infectious disease Specialist Network between 2002 to 2004. It is confirmed that bioterror outbreak doesn’t occur. Cases of suspected botulism is approved by occurring naturally, and cases of suspected viral hemorrhagic fever is approved by renal syndromic hemorrhagic fever.

35 Preparedness & Response to Bioterrorism in Korea 韩国生物恐怖应对
National Bioterrorism preparedness and response 国家级生物恐怖应对 Stockpiling 物资储备 Surveillance System 监测系统 Capacity Building 能力建设 Laboratory Diagnosis System 实验室诊断系统 다음으로는 실험실 진단체계에 대하여 살펴보겠습니다. Next, Laboratory Diagnosis system.

36 Purpose 目的 Promote the readiness of national public health center labs and hospital labs for a swift diagnostic system 提高国家公共卫生中心实验室和医院实验室快速诊断系统的应急能力 Construct laboratory network 创建实验室网络 Share information among related laboratory experts 与各实验室专家分享信息 실험실 진단체계의 목적은 ----입니다. The purpose of the Laboratory Diagnosis system is to promote the readiness of national public health center labs and hospital labs for a swift diagnostic system, Construct laboratory network, Share information between related laboratory experts.

37 Laboratory System 实验室系统
Province Laboratory省级实验室 Public health centers /National quarantine office公卫中心/国家免疫办公室 Hospital labs医院实验室 National Institute of Health国家卫生研究所 Level A A级 Level B1, B2 BI，B2级 Level C C级 share Information & education 信息共享 specimen transfer样品传递 이것은 실험실 체계를 나타내고 있는 그림입니다. 실험실의 기능 및 여건에 따라 A에서부터 D까지 4등급으로 나누어 있으며, 등급에 따른 검체의 이동과 정보의 교류에 대한 흐름을 나타내고 있습니다. This is a system of laboratory. These Laboratories are divided into 4 levels from A to D, This flow represents transfer of specimen and information.

38 Preparedness & Response to Bioterrorism in Korea 韩国生物恐怖应对
National Bioterrorism preparedness and response 国家级生物恐怖应对 Stockpiling 物资储备 Surveillance System 监测系统 Capacity Building 能力建设 Laboratory Diagnosis System 实验室诊断系统 다음으로는 비축물자에 대하여 살펴보겠습니다. Next, Stockpiling.

39 Stockpile 物资储备 Antibiotics and Vaccine 抗生素和疫苗 Equipments 设备 Facilities
设施和器械 Rapid Detection Test Kit 快速诊断试剂盒 비축물자는 항생제와 백신, 장비, 시설, 신속 진단 키트로 나누어 살펴볼 수 있습니다. Stockpiling consists of antibiotics and vaccine, equipment, facilities, rapid detections kit.

40 Antibiotics and vaccine 抗生素和疫苗
Ciprofloxacine Doxycycline Smallpox vaccine and bifurcated needle 탄저와 페스트에 대비하여 Ciprofloxacine, Doxycycline과 같은 항생제를 비축하고 있으며, 두창백신과 주사바늘을 비축하고 있습니다. (정확한 수량을 밝힐 수 없으며, 어느 나라에서도 이에 대한 수량을 밝히고 있지 않습니다.) We are stockpiling antibiotics such as ciprofloxacine, doxycycline preparing for anthrax, plague, And smallpox vaccine and bifurcated needle. (We should not publicize amount of vaccine, So do Other countries. And I even don’t know exactly.)

41 Equipments 设备 Level A Personal Protective Equipment A级的个人防护设备
Level C Personal Protective Equipment C级的个人防护设备 Decon shower 消毒浴液 Pressure Test Kit 压力试剂盒 Fit Test Kit 便携试剂盒 Level A PPE와 Level C PPE, 제독을 하는 데콘 샤워, Level A 보호복을 검사하는 압력검사장비, Level C의 호흡보호구를 검사하기 위한 Fit Test Kit를 비축하고 있습니다. We are stockpiling Level A Protective equipment, Level C protective equipment, Decon shower for decontamination, Pressure Test Kit, Fit Test Kit.

42 Mobile command vehicle
Facilities设施和器械 왼쪽 사진은 KCDC에 있는 BL3 실험실입니다. 현재 한국은 전국에 9개의 BL3급 실험실을 보유하고 있습니다. 오른쪽 사진은 현장지휘본부 차량입니다. 이 차량은 생물테러 발생시 현장에 출동하여 회의를 할 수 있는 본부로 사용될 수 있으며, 역학조사를 실시하고, 장비들을 구비하고 있으며, 제독을 할 수 있는 시설을 갖추고 있습니다. Left picture is a BL3 Laboratory in KCDC, There are 9 BL3 Laboratories in Korea. Right picture is a Mobile command vehicle. This car goes out the scene at bioterror outbreak, Has Decon shower, computer, space to keep personal protective equipment, can be implemented epidemiological investigation. Laboratory in KCDC CDC实验室 Mobile command vehicle 移动指挥车

43 Rapid Detection Test Kit 快速诊断试剂盒
위의 사진은 탄저 진단키트와 보툴리눔 독소 키트입니다. 이 키트들은 1994년 국립보건환경연구원에서 개발하였으며, 10분 이내에 여부를 판정할 수 있습니다. This is a rapid detection test Kit, These are developed in 1994 by National Institute of Health. We can recognize the result in ten minutes. Bioterror pathogen and toxin test Kit 生物恐怖病原体和毒素试剂盒 Anthrax Spore test Kit 炭疽孢子试剂盒 Botulinum toxin test Kit 波特淋菌毒素试剂盒

44 Absence of Evidence is not Evidence of Absence Thank you