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OCR for page 183
APPENDIX
B
Workshop Agenda
The Consequences of Viral Disease
Eradication: Addressing
Post-Immunization Challenges
February 1-2, 2001
Lecture Room
National Academy of Sciences
2101 Constitution Avenue, N.W., Washington, DC
Thursday, February 1, 2001
8:30 Continental Breakfast
9:00 Welcome and workshop introduction
Joshua Lederberg, Ph.D.
Chair, Forum on Emerging Infections
Sackler Founclation Scholar and Nobel Laureate
The Rockefeller University, New York, NY
Keynote address
History and Prospects for Disease Eradication
Ciro de Quadros, M.D., M.P.H.
Director, Division of Vaccines and Immunization
Pan American Health Organization, Washington, DC
Session I: Case Studies of Major Eradication or Elimination Efforts
This session will address the standards and strategies, technical feasibil-
ity, political will, and financial commitment for several diseases targeted for
eradication or elimination. Discussions will identify the successes and fail-
ures of these efforts, and the challenges for post-eradication/elimination
strategies.
183
OCR for page 184
184
CONSIDERATIONS FOR VIRAL DISEASE ERADICATION
10:00 Smallpox
Donald A. Henderson, M.D., M.P.H.
Director, Center for Civilian Biodefense Studies
The Johns Hopkins University, Baltimore, MD
10:30 Break
10:45 The next target after polio: Global eradication of measles
Stephen Cochi, M.D., M.P.H.
Director, Vaccine-Preventable Disease Eradication Division
National Immunization Program, Centers for Disease Control
and Prevention, Atlanta GA
11:15 Eradication of congenital rubella syndrome
Stanley A. Plotkin, M.D.
Aventis Pasteur, Swiftwater, PA
11:45 Post-polio eradication: Issues and challenges
Walter R. Dowdie, M.D.
Public Health Consultant
Task Force for Child Survival and Development, Atlanta, GA
12:15 Lunch
Session II: Biologic Challenges to Post-Eradication
This session will address the science-based underpinnings of how and
when to stop immunization, and the protective actions that remain to be
established. We will examine the current state-of-the-science of several dis-
eases poised for elimination/eradication and identify gaps in our knowI-
edge, primarily focusing on the risk of pathogen transmission to and main-
tenance in susceptible individuals. Through the issues discussed we will
identify the effect they have on the duration of disease elimination/eradica-
tion programs, as well as the likelihood for their success.
1:30 Duration of infection, recrudescence, and environmental stability
of pathogens targeted for elimination
Professor Roy Anderson
Chair, Department of Infectious Disease Epiclemiology
Imperial College School of Medicine, London, UK
OCR for page 185
APPENDIX B
2:15
2.45 Break
185
Laboratory specimens, genetic research, big-engineering, and the
danger of malice
C.~. Peters, M.D.
Professor, Departments of Pathology, and Microbiology and
Immunology
Center for Tropical Diseases, University of Texas Medical
Branch, Galveston, TX
3:00 Natural SIV reservoirs and human zoonotic risk
Beatrice H. Hahn, M.D.
Professor, Departments of Medicine and Microbiology
University of Alabama, Birmingham, AL
3:30 Vaccine-associated cases
Jeffrey I. Cohen, M.D
Head, Medical Virology Section, Laboratory of Clinical
Investigation
National Institute of Allergy and Infectious Diseases,
National Institutes of Health, Bethesda, MD
Adjourn public session
Friday, February 2, 2001
Continental Breakfast
8:00 Opening remarks
loshua Lederberg, Ph.D.
Chair, Forum on Emerging Infections
Session m
Challenges to Post-Eradication Operational and Institutional Remediation
The need for resources will likely increase for countries with multiple
eradication campaigns, particularly as disease prevalence decreases and
surveillance intensifies. This session will address the thoroughness with
which public health systems and laboratories are able to define their limita-
tions and manage their resources.
OCR for page 186
186
8:15
CONSIDERATIONS FOR VIRAL DISEASE ERADICATION
International health regulations and quarantine
Mario Libel, M.D.
Division of Disease Prevention and Control
Pan American Health Organization, Washington, DC
9:00 Disease surveillance, program management, and sustainability of
· . ~
immunization programs
Donald S. Burke, M.D.
Professor and Director, Center for Immunization Research,
Department of International Health
School of Hygiene and Public Health, The Johns Hopkins
University, Baltimore, MD
The capacity of public health services to respond to an outbreak
in the post-eradication era
Car! E. Taylor, M.D., M.P.H.
Professor Emeritus, Department of International Health
School of Hygiene and Public Health, The Johns Hopkins
University, Baltimore, MD
Laboratory security and regulations governing viral
. . . . . .
pat ~ogenesls in a post-lmmumzatlon era
Raymond H. Cypess, D.V.M., Ph.D.
President and CEO
American Type Culture Collection (ATCC), Manassas, VA
Frank Simione, M.S.
American Type Culture Collection (ATCC), Manassas, VA
10:30 Break
Session IV: Medical Intervention and Technological Solutions
Many of the vaccines and drugs available today are the same ones that
have been used for decades. This session will review the present vaccine and
drug armamentaria with a view toward improving their safety, efficacy and
potential value against diseases targeted for eradication.
OCR for page 187
APPENDIX B
10:45 The polio eradication effort: should vaccine eradication be
next;
Vincent R. Racaniello, Ph.D.
Higgins Professor, Department of Microbiology, and Editor,
Journal of Virology
Columbia University College of Physicians & Surgeons,
New York, NY
11:15 Antiviral therapy in the management of post-eradication
outbreaks
Richard J. Whitley, M.D.
Professor, Department of Pediatrics
Ambulatory Care Center, School of Medicine, University of
Alabama, South Birmingham, AL
11:45 Passive antibody and immune-enhancement strategies
Diane E. Griffin, M.D., Ph.D.
Professor and Chair, Department of Molecular Microbiology
and Immunology
School of Hygiene and Public Health, The Johns Hopkins
University, Baltimore, MD
12:15 The potential role of probiotics and microbial ecology in
host defense
Susanna Cunningham-Rundles, Ph.D.
Professor of Immunology
Weill Medical College of Cornell University, New York, NY
12:45 Lunch
:p
187
Session V: The Response to Post-Eradication Outbreaks
Protecting populations that are no longer immune presents formidable
challenges to public health agencies, pharmaceutical manufacturers, secu-
rity analysts, and the public. Resolution of these issues in advance affects
when and how prevention activities can be stopped in conjunction with
disease eradication.
d
OCR for page 188
188
CONSIDERATIONS FOR VIRAL DISEASE ERADICATION
Preparedness of the U.S. health care system to respond to disease
outbreaks
Ken Bloem, M.D.
Senior Fellow, The Johns Hopkins Center for Civilian Biodefense
Studies
Former CEO, Georgetown Medical Center
2:00 Vaccines for post-elimination (eradications contingencies
Thomas Monath, M.D.
Vice President, Research and Medical Affairs
Acambis Inc. (formerly OraVax, Inc.), Cambridge, MA
2:30
3:00
Strategic priorities for addressing post-eradication outbreaks
Robert Kadlec, M.D., M.T.M.H.
Colonel, US Air Force, and Professor, Military Strategy and
Operations
National War College, National Defense University,
Washington, D.C.
Understanding the public and media response to an outbreak
Ann E. Norwood, M.D.
Colonel, US Army, Associate Professor and Associate Chair
Department of Psychiatry, Uniformed Services University of the
Health Sciences, Bethesda, MD
3:30 Me post-eradication research agenda
Joshua Lederberg, Ph.D.
Chair, Forum on Emerging Infections
Sackler Foundation Scholar, and Nobel Laureate
The Rockefeller University, New York, NY
4:00 Break
Session VI:
Panel Session: Identifying the Tllreats and Mitigating the Impact
The challenges and opportunities facing disease eradication and how
they will affect public policy will be identified through an open discussion
among invited panelists, Forum members, speakers, and the workshop au-
dience. Issues to address will include the identification of possible require-
ments that need to be met prior to eradication, such as collections of diverse
isolates and strains, an organism's complete genomic sequence, full under-
standing of the life history of the organism and its mechanisms of patho-
OCR for page 189
APPENDIX B
189
genesis, legal issues and authorities surrounding the response to an epi-
demic; and the ethical considerations pertaining to cessation of immuniza-
tion, as well as preserving biodiversity versus species extinction.
Co-Moderators:
Invited Panelists:
Joshua Lecterberg, Ph.D. Chair, Forum on Emerging Infections
Margaret Hamburg, M.D., Assistant Secretary for Planning and
Evaluation, U.S. Department of Health and Human Services
Gail Cassell, Vice President, Infectious Diseases, Drug Discovery
Research and Clinical Investigation, Eli Lilly & Company,
Indianapolis, IN
Michael Osterholm, Chairman and CEO, Infection Control
Advisory Network, Inc., Eden Prairie, MN
Stephen Teret AD, Professor, Program on Law and Public
Health, The Johns Hopkins School of Hygiene and Public
Health, Baltimore, MD
Samuel L. Katz, M.D., D.Sc., Chairman of the Board, Burroughs
WelIcome Fund, and; Wilburt C. Davison Professor & Chairman
Emeritus, Department of Pediatrics, Duke University Medical
Center, Durham, NC
Ellyn W. Ogden, MPH, Worldwide Polio Eradication
Coordinator and Senior Technical Advisor in Health and Child
Survival, Bureau for Global Programs, U.S. Agency for
International Development, Washington, D.C.
4:15 Pane! discussion, perspectives prom different communities, and
synthesis
Closing remarks
Joshua Lederberg, Ph.D.
Chair, Forum on Emerging Infections
Sackler Foundation Scholar, and Nobel Laureate
The Rockefeller University, New York, NY
Adjournment
Representative terms from entire chapter:
emerging infections
