Response: Strategies to Counter SARS 4.Emergency Response System Develop Integrated infectious disease information system Establish Emergency Operation Center (EOC ) Establish Incident Command System Establish Taiwan Area’s first-ever Disease Prevention Consulting Committee 5.Enhance Health Education Host 2004 Asia-Pacific Anti-bioterrorism Symposium participants including medical professionals, hospital administrators, college personnel, fire service, police, professional and general public

Taipei City-area hospitals report potential infectious disease cases Taipei City-area hospitals report potential infectious disease cases Department of Health (DOH) receives information about infectious disease cases Epidemic Situation Evaluation in Taipei City Hospitals Cluster Infection Confirmed 1.Samples (or virus contracts) are collected and sent to Kunyang lab for exams (including data sheet) 2.Recall case report on disease progress of deceased patients and patients with serious entrovirus-associated symptoms or new, emerging infectious symptoms 1.Samples (or virus contracts) are collected and sent to Kunyang lab for exams (including data sheet) 2.Recall case report on disease progress of deceased patients and patients with serious entrovirus-associated symptoms or new, emerging infectious symptoms Flow Chart for Reporting Individual Cases with Infectious Diseases to Department of Health of Taipei City Government DOH faxes other municipal & county health departments, who confirm receipt via telephone Inspection （ Including Individual Cases, Family Members, Relatives, Friends, Coworkers, Hospital Staff and other people who might be affected, as well as travel histories and medical records) Case closed Information integration Follow up for 2 theoretical latent periods (No add case) Cases are closed Epidemic Investigation Yes No Northern Region Branch of Center for Disease Control, Department of Health, Executive Yuan Mobile Disease Prevention teams on mission Members of FETP training class

Incident Commander [Mayor] Incident Commander [Mayor] Execution [Department of Health] Execution [Department of Health] Planning [Research and Planning Division] Planning [Research and Planning Division] Financing [Finance Department] Financing [Finance Department] Logistics [Administrative Services] Logistics [Administrative Services] Resource Distribution [Chief Secretary, Department of Health] Resource Distribution [Chief Secretary, Department of Health] Epidemic Investigation [Division for Disease Control and Prevention ] Epidemic Investigation [Division for Disease Control and Prevention ] Medical Care Prior Admission to Hospitals [Medical Affairs Division] Medical Care Prior Admission to Hospitals [Medical Affairs Division] Medical Care [Medical Affairs Division] Medical Care [Medical Affairs Division] Evaluation [Research and Planning Division] Evaluation [Research and Planning Division] Hazard Control [Division for Disease Control and Prevention ] Hazard Control [Division for Disease Control and Prevention ] Deceased Patient Affairs [Personnel Office] Deceased Patient Affairs [Personnel Office] Emergency Response [Government Ethics Office] Emergency Response [Government Ethics Office] Main Contact [Deputy Mayor] Main Contact [Deputy Mayor] Psychiatry [Medical Affairs Division] Psychiatry [Medical Affairs Division] Communication [Personnel Office] Communication [Personnel Office] Safety Inspection [Government Ethics Office] Safety Inspection [Government Ethics Office] Public news release [Information Office] Public news release [Information Office] Media Public opinion survey Taipei City Emergency Response System

1.Avian influenza was announced as a legally defined infectious disease on Dec. 29th, Epidemic Watch: (1) Monitor body temperatures of workers with direct contact with poultry/livestock business and pet bird business (2)Monitor human-contagious avian influenza infections and report to responsible authorities 3.Joint Prevention Task Force supported by different Agencies: Establish Taipei City’s Joint Prevention Task Force for Avian Influenza Provide assistance and consultation for individuals involved in poultry/livestock/domestic pet business and closely monitor all incidents of avian influenza New & Emerging Infectious Disease Prevention

Avian Influenza Prevention & Control Exercises Legend: Department of Health receives reports from animal inspection division of chickens possibly carrying avian influenza virus … Staff dispatched to the scene pack euthanized chickens into plastic bags. Workers are then evacuated from danger zones and are sprayed thoroughly with disinfectant solution by the cleaning staff (especially armpit, groin areas and feet) New & Emerging Infectious Disease Prevention

Joint Prevention Task Force for Avian Influenza of Taipei City Composed of experts from Departments of Health, Economic Development, Environmental Protection and Education to provide assistance, education and consultation specifically to Zoos, Guandu Nature Park, Poultry/Domestic Pet Businesses Staff from Departments of Economic Development and Environment Protection visiting Guandu Nature Park for disease prevention education programs Staff from Departments of Economic Development and Health were visiting Pet Bird/Poultry vendors for disease prevention education

Trend Plot of Reported Enterovirus Cases from Campus Trend Plot of Reported Enterovirus Cases from Emergency Care Enterovirus Epidemic 1 School Reporting System 2,065 Patients were reported being infected with enterovirus by child care facilities (this pioneering model was first established in Taipei City) Hospital Reporting System Emergency Care facilities reported 5,172 patients as being infected with enterovirus. 397 patients were Taipei City residents. 13 patients had complications from severe enterovirus symptoms --7 patients were excluded to be infected with enterovirus. --6 patients were confirmed infected. until June 30 th, 2005