Review of the DoD-GEIS Influenza Programs Strengthening Global Surveillance and Response (2008) / Chapter Skim
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7 Naval Medical Research Center Detachment Peru Avian and Pandemic Influenza Activities
7 Naval Medical Research Center Detachment Peru Avian and Pandemic Influenza Activities
Pages 147-166
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From page 147... ...
Department of the Defense Global Emerging Infections Surveillance and Response System (DoD-GEIS) focus on surveillance and response capacity.
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From page 148... ...
The mission of the detachment includes support for vaccine and drug development, evaluation of rapid diagnostics, and surveillance of emerging and re-emerging infectious diseases. The programs and collaborations of NMRCD extend through most of the countries of South and Central America (see Figure 7-1)
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From page 149... ...
A site visit team of the Institute of Medicine (IOM) Committee for the Assessment of DoD-GEIS Influenza Surveillance and Response Programs visited NMRCD from March 4-9, 2007. A list of the people met and interviewed and the itinerary followed can be found at the end of this chapter.
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From page 150... ...
In addition to a well-organized in-house data processing center, NMRCD has pioneered in Latin America several innovative information technology systems; one example is ALERTA, which is used for reportable disease surveillance of Peruvian military populations, including virtually all elements of the Peruvian Navy. Employing an effective mix of appropriate technologies including cell phones, radios, and the Internet, this system allows rapid surveillance from remote jungle areas and Pacific-based ships.
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While the site visit team found the avian influenza/pandemic influenza (AI/PI) activities being conducted at NMRCD to be well planned and executed, NMRCD could contribute more significantly to the evaluation of national influenza preparedness.
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Acute and convalescent blood specimens are drawn, and a throat swab is obtained from individuals presenting with an influenza-like illness characterized primarily by a fever, generalized fatigue, sore throat and rhinorrhea. With the help of AI/PI funds this long-standing surveillance protocol has been successfully adapted to incorporate influenza surveillance.
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From page 153... ...
Another plan is to study different strategies to optimize reporting within electronic surveillance systems. Conclusions The site visit team found that NMRCD has a suite of innovative surveillance systems that benefit from not only DoD-GEIS AI/PI funds but also DoD-GEIS core funding as well as leveraging from associations with CDC, the Fogarty International Center, USAID, and SOUTHCOM.
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From page 154... ...
At the present time NMRCD does not have separate laboratory suites for the testing and identification of avian and human influenza isolates. The current laboratory layout will allow for necropsy of dead birds and specimen collection in the BSL-3 unit in the animal care facility laboratory.
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Conclusions The site visit team found NMRCD's plans to improve the laboratory worthwhile. These plans included the extension of diagnostic capabilities and avian influenza surveillance, the addition of capability for coronaviruses and non-H5N1 avian viruses, and the expansion of surveillance efforts to additional countries.
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. Conclusions Although there have not been any reported cases of H5 highly pathogenic avian influenza in Peru or South America in general, NMRCD does have experience in infectious disease outbreak investigations as well as a surge capacity plan in the event that an avian outbreak does occur.
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Considering the demand for training at NMRCD, the successes to date, and the need for wider and deeper human networks to address emerging infections including AI/PI, further investment in physical classroom and teaching laboratory facilities as well as human infrastructure to support training is encouraged. NMRCD is clearly a suitable focal point for U.S.
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From page 158... ...
NMRCD's network is active and wide, encompassing not only the ministries of health and agriculture but also Peruvian Army and Navy medical surveillance channels. The NMRCD influenza program has established substantial networks with relevant entities in the Peruvian government, including the Instituto Nacional de Salud (INS)
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From page 159... ...
In order to strengthen collective Peruvian diagnostic capacity to characterize influenza viruses, NMRCD should continue to work collaboratively with other laboratory resources in country, including offers of assistance, resource sharing, and a common database. Multilateral Agencies Though NMRCD has strong relationships with Peruvian government entities involved in influenza surveillance and response, it is clearly in the position to be a leading source of U.S.
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From page 160... ...
Based on the observations of the site visit team, NMRCD is respected by USAID as an important builder of regional capacity. Perhaps surprisingly, a senior Peruvian USAID staffer said that NMRCD has brought consistency to some programs in the face of turnover in the Peruvian government.
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Host countries appreciate its role and for the most part trust its leaders in sensitive matters. Without a doubt many Latin American countries will turn to NMRCD for its expertise and capabilities in the face of a national emerging infections crisis, such as an outbreak of avian or epidemic influenza.
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162 REVIEW OF THE DOD-GEIS INFLUENZA PROGRAMS WHO (World Health Organization)
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Eugene Philhower, United States Department of Agriculture, Lima, Peru Michele Russell, United States Agency for International Development, Lima, Peru Luis Seminario, United States Agency for International Development, Lima, Peru Twani Ortiz Almeida, Dirección General de Epidemiología, Lima, Peru Jorge Goméz Benavides, Dirección General de Epidemiología, Lima, Peru Paúl Pachas Chavez, Dirección General de Epidemiología, Lima, Peru José Bolarte Espinoza, Dirección General de Epidemiología, Lima, Peru Gladys Ramírez Prada, Dirección General de Epidemiología, Lima, Peru Aguiles Vilchez, Dirección General de Epidemiología, Lima, Peru Roberto Acosta, Servicio Nacional de Sanidad Agraria, Lima, Peru Roberto Antonio Acosta Galvez, Servicio Nacional de Sanidad Agraria, Lima, Peru Ysabel Montoya, Servicio Nacional de Sanidad Agraria, Lima, Peru C Juan Raul Zegarra Valencia, Servicio Nacional de Sanidad Agraria, Lima, Peru Carolina Alvarado Dueñas, Dirección General de Salud a las Personas, Lima, Peru Maria Luz Sotomayor, Dirección General de Salud a las Personas, Lima, Peru Victor Fiestas Solorzano, Instituto Nacional de Salud, Lima, Peru Yvonne Torres, Insituto Nacional de Salud, Lima, Peru José F
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From page 164... ...
Investigation and Response Team, Emerging Diseases Program 0915-1000 Presentation on status of Emerging Infections Program Cmdr. David Blazes, Director of EDP 1000-1015 Break 1015-1100 Presentation on electronic surveillance of Influenza Cecilia Mundaca, Electronic Surveillance Unit, Dr.
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From page 165... ...
Curtis Struble 0930-1000 Courtesy visit at health office of USAID Michele Russell Luis Seminario 1000-1015 Commissary at American Embassy 1015-1200 Travel to NMRCD 1200-1330 Lunch 1330-1400 Travel to PAHO 1400-1600 Meeting Dr. Manuel Peña, PAHO/WHO Representative 1600-1630 Return to hotel Wednesday, March 7, 2007 1000-1100 Tour of SENASA 1200-1300 Lunch 1300-1315 Walk to Dirección General de Epidemiología 1330-1630 Meeting with Ministry of Health Avian Influenza Working Group Representatives of MoH, INS, DGE, SENASA 1630-1700 Return to hotel Thursday, March 8, 2007 0900-1030 Visit bird site (Pantanos de Villa, Chorrillos)
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166 REVIEW OF THE DOD-GEIS INFLUENZA PROGRAMS Friday, March 9, 2007 0830-2130 Closeout day at NMRCD (?
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