1. SARS: International Coordination SARS: International Coordination and Collaboration James W. LeDuc, Ph.D. Director, Division of Viral and Rickettsial Diseases National Center for Infectious Diseases Centers for Disease Control and Prevention

2. C OORDINATION of response and resources C OLLABORATION in science C OMMUNICATION with global community C APACITY building and response preparedness C HALLENGES and lessons learned International SARS Response

3. C OORDINATION of response and resources C OLLABORATION in science C OMMUNICATION with global community C APACITY building and response preparedness C HALLENGES and lessons learned International SARS Response

4. CDC SARS Investigation 2003 NCID DVRD Infectious Disease Pathology Activity Respiratory and Enteric Viruses Branch Special Pathogens Branch NCID EOC Liaison Field Teams Response Teams CDC OD/OTPER/EOCOD/OC/ECS ChinaTaiwan Canada Hong Kong ThailandVietnam Clinical and Infection Control Global Migration and Quarantine LaboratoryEpidemiology Information Technology Communications International / WHOOccupational Health Team “B” Community Outreach May 1, 2003 Team “P” Environmental DomesticSingapore Special Investigations

5. 84 personnel 1959 days ( = 7.8 work-years) totals: 92 deployments * 2Laos 151Cambodia 334Switzerland 604Thailand 886Hong Kong 98The Philippines 1039Canada 1375Singapore 22610Vietnam 49817China 69630Taiwan total days# staff deployed Country * 6 staff members deployed to 2 or more countries 5 CDC International Response: Personnel 4

6. CDC International Response: Expertise Med/Epi52 Taiwan (17), China (12), Vietnam (8), HK (4), Canada (4), PI (3), Singapore (2), Switzerland (2), Thailand (2), Cambodia (1), Laos (1) Path/Lab8 China (5), Singapore (2), Taiwan (1), Vietnam (1) Infxn Control7 Taiwan (5), HK (1), PI (1), Vietnam (1) Ind Hyg7 Taiwan (4), Canada (3) IT/Data2 HK (1), Singapore (1) PHA4 Taiwan (3), Thailand (2), Laos (1) Media2 Canada (2) Consultant2 Switzerland (2) 84 personnel

7. C OORDINATION of response and resources C OLLABORATION in science C OMMUNICATION with global community C APACITY building and response preparedness C HALLENGES and lessons learned International SARS Response

8. WHO: -Global network of 11 leading laboratories, secure website, conference calls -Coordination of specimen acquisition -Facilitate rapid identification of causative agent, development of diagnostic tests CDC:-Specimen transport and processing ->3000 int’l specimens processed from 27 countries -Key role in virus isolation, characterization and diagnostic test development and deployment Global SARS Response: Laboratory

9. CDC SARS Response: Reagents CDC shipments of SARS diagnostic materials to national and international academic centers, commercial companies, and governmental agencies RNAVirusAntigen Academic3213146 Commercial2615142 Governmental2118443 79466 131

10. International Recipients of SARS diagnostic materials CDC SARS Response: Lab Capacity

11. C OORDINATION of response and resources C OLLABORATION in science C OMMUNICATION with global community C APACITY building and response preparedness C HALLENGES and lessons learned International SARS Response

12. Global SARS Response: Communications WHO:- Secure GOARN website - WHO SARS website with daily updates - WHO global conference calls - CDC-DHHS-WHO video conferences CDC:- Public Response Hotline (phone calls, emails, clinician hotline) - Daily response team briefings and regularly scheduled conference calls - SARS satellite broadcasts - SARS page on CDC website

13. CDC SARS Response: Communications News media calls handled: 10,166 News releases issued: 12 Live telebriefings/news conferences: 21 Health care responder conference calls: 30 Public Response Hotline: 34,229 phone calls answered 3,557 emails answered 2,017 physician hotline calls answered 3 SARS satellite broadcasts: >1.9 million participants CDC SARS website: 17 million page views (3.8 million for April 20-26)

14. C OORDINATION of response and resources C OLLABORATION in science C OMMUNICATION with global community C APACITY building and response preparedness C HALLENGES and lessons learned International SARS Response

15. Surveillance and reporting Diagnosis Infection control Travel advisories and health alerts Exposure management in health-care settings, the workplace, and schools Biosafety, environmental sampling, clean up Specimen handling, collection, and shipment Information for U.S. citizens living abroad and for international adoptions CDC SARS Response: Outbreak Preparedness Guidance

16. http://www.cdc.gov/ncidod/sars/

17. C OORDINATION of response and resources C OLLABORATION in science C OMMUNICATION with global community C APACITY building and response preparedness C HALLENGES and lessons learned International SARS Response

18. Global SARS Response: Lessons Resources: Magnitude of response need and financial burden; shortage of available skilled responders; critical contribution of in- place personnel, epi/surv networks, local/national partnerships Laboratory: Logistics of specimen collection, transport, processing; technical challenges around new pathogen Communications: Need for accurate, consistent, timely information in a rapidly changing environment Capacity building: Need for well validated diagnostics; training; infection control expertise Politics: WHO/CDC response to Taiwan; coordinating role of WHO; importance of existing networks and partnerships