Ebola Presentation to NMTC by US Army Medical Health Command

Report
USAPHC’s Response to Ebola
Robert Cohen, MD, MPH
Preventive Medicine Physician
Disease Epidemiology Program
Army Institute of Public Health
UNCLASSIFIED
Disclaimer
The views expressed herein are those of the speaker and do not
necessarily reflect the views of the Army, the US Government, or
USAPHC.
U.S. Army Public Health Command
UNCLASSIFIED
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Outline
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•
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What is Ebola?
History of Ebola
Current Outbreak in West Africa
Operation United Assistance
– Pre-deployment activities
– During/After deployment activities
– Domestic Preparedness
• Future
U.S. Army Public Health Command
UNCLASSIFIED
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What is Ebola?
Smallpox
Influenza
Herpes
Rabies
Coronavirus (SARS)
HIV
Hendra
Ebola
U.S. Army Public Health Command
UNCLASSIFIED
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A Brief History of Ebola
http://www.abc.net.au/news/2014-07-30/map-showing-ebola-outbreaks-in-africa-since-1976/5635152
U.S. Army Public Health Command
UNCLASSIFIED
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Current Outbreak in West Africa
Case Count (as of 8 Dec 2014)
Cases
Deaths
Liberia:
7,690
3,161
Sierra Leone: 7,635
1,660
Guinea:
2,192
1,366
Total:
17,517
6,187
WHO Ebola Response Team. NEJM 2014
U.S. Army Public Health Command
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Stabilization in Liberia and Guinea, not Sierra Leone
The Economist, 4 Dec 2014
U.S. Army Public Health Command
UNCLASSIFIED
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President Obama Orders Operation United Assistance
(OUA)
• Led by 101st Airborne
Division, in collaboration
with US Army Africa
• Beginning Sep 2014
• Up to 3000 US Army troops
will be sent over 12+
months
• Mission: Build 10 Ebola
Treatment Units (ETUs)
with 50 beds each in Liberia
U.S. Army Public Health Command
UNCLASSIFIED
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LEGEND
Liberia
(Capability Status as of 18 Nov 2014)
Mobile Medical Lab (MML)
Proposed Army Lab
-(U) Confirmed EVD Cases:
- Average 10 new cases per
day
- Sierra Leone: 75 per day
- Guinea: 15 per day
Liberian Lab
Forward Logistical Base
Monrovian Medical Unit
Operational ETU
In Progress ETU
USG Supported
-(U) UNDP EVD Program Visit 4 Dec:
- Lack of feedback on relatives
enrolled in ETUs
-Secret burials still occurring,
increasing transmission of EVD
-LNP conducing night patrols to
reduce secret burials
Sinje
-(U) Army Labs
-3 of 4 labs operational
Gbediah
-(U) UNMIL Soldier positive for EVD
-Nigerian
-Currently treated at MMU
-Will be flown to Netherlands
Sources: OUA INTSUM, 20141206
OUA SITREP, 20141207
U.S. Army Public Health Command
UNCLASSIFIED
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Operation United Assistance
HQDA Mission
HQDA establishes a Force Protection Plan of action for Army Forces
deploying in response to the EVD epidemic in West Africa and provides
information and education to the Soldiers, DA Civilians (DAC), Army
Families, deploying contractors, and their communities in order to
provide properly trained and equipped forces in support of Operation
United Assistance.
MEDCOM Mission
On order (O/O), MEDCOM leverages medical personnel, materiel,
research and technology, and subject matter expertise in support of
Operation UNITED ASSISTANCE (OUA).
PHC Mission
PHC leverages public health subject matter expertise in support of
Operation UNITED ASSISTANCE (OUA).
U.S. Army Public Health Command
UNCLASSIFIED
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Three Areas of USAPHC OUA Response
USAPHC is a unique organization within DoD, well-suited to advise units
on:
1) Pre-Deployment (Prepare Soldiers and Reassure Families)
2) During Deployment and Re-Deployment (Protect and Return Soldiers)
3) Domestic Preparedness
http://healthdecide.orcahealth.com/2014/08/01/ori
gins-growing-spread-ebola-virus/
U.S. Army Public Health Command
UNCLASSIFIED
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Pre-Deployment: Prepare Soldiers and
Reassure Families
• Risk assessments and risk
communication
• Information video for deploying
Soldiers and Families
• FAQ sheets
• Training Packages (e.g. PPE)
https://www.youtube.com/watch?v=677xOF9Iua4
• Other Africa-specific public
health training
U.S. Army Public Health Command
UNCLASSIFIED
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During Deployment: Protecting Soldiers
• Personal Protective Equipment
(PPE) guidance
• Hazardous waste management
guidance
• Review of difficult scientific
questions (e.g. how long can
Ebola survive outside the
human body?)
• SME support to deployed units
13
Post-Deployment: Returning Soldiers and
Domestic Preparedness
• Controlled monitoring for 21 days
• Domestic Preparedness for MTFs
• Ebola Rapid Action Team (~12 people)
•
– Mix of clinical/non-clinical experts
– Risk Communication
– Waste Management
– Contact Tracing
DoD Ebola Mission Support Team (30 people)
• Example: returning Air Force Officer with vomiting to Ft. Bliss
– Grounded the crew and plane for 72 hours
– Isolated Officer
– Used as an exercise
U.S. Army Public Health Command
UNCLASSIFIED
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Ongoing OUA Support Efforts (JPEO-CBD)
Ebola Biosurveillance Portal
Ebola Virus Diagnostic Assays
The Ebola
Biosurveillance Portal is
a new information
technology tool
supporting international
efforts to stop the Ebola
Virus outbreak in West
Africa. It leverages
several DoD systems in
development into a
single integrated
system for Ebola
situational awareness
Ebola Virus Therapeutics and
Vaccines
The DoD and the NIH are utilizing
a “whole - of - government”
approach to accelerate the
development of promising
vaccine and anti-viral drug
candidates that are targeted
against Filoviruses
U.S. Army Public Health Command
Two DoD developed Ebola Virus
diagnostic assays have received
Emergency Use Authorizations from
the FDA. These assays have been
fielded to both CDC and DoD labs
Presidential Grand Challenge
JPEO-CBD is participating in
the Presidential Grand
Challenge to procure or
develop improved personal
protective equipment (PPE)
for Ebola Virus. The goal is
to reduce the thermal burden
associated with current PPE
on health care providers
UNCLASSIFIED
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More Ongoing OUA Support Efforts (JPEO-CBD)
Contaminated Human Remains Pouch
In response to a Joint Urgent
Operational Needs
Statement (JUONS), JPEOCBD is developing a human
remains pouch medical,
transport and processing
personnel from individuals
that have died from Ebola
U.S. Army Public Health Command
Transportation Isolation System
JPEO-CBD and the
Defense Threat
Reduction Agency
are developing an
isolation system to
evacuate service
members in the
event they become
infected by the
Ebola Virus. They
system will hold up
to 12 service
members
UNCLASSIFIED
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Future
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There will be another Ebola outbreak in Africa
Or another disease outbreak
We will be better prepared
We may even be able to help prevent
We must try to help prevent
http://www.globalchange.umich.edu/globalchange2/current/lectures/deforest/deforest.html
U.S. Army Public Health Command
UNCLASSIFIED
http://landsat.gsfc.nasa.gov/?p=510
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