Michigan Dept of Community Health

Today at 8:03 AM





News and Articles
Funding Cuts Threaten
Public Health And Worry
Officials
Huge advances in controlling
infectious diseases, tracking
foodborne illnesses and
purifying the water supply
have vastly improved public
health over the past century.
More recently, closer
communication between
emergency managers and
public health officials has
created the possibility of more
coordinated responses to
public health emergencies as
well as better prevention.
However, there is much work
to be done in all of these
areas and recent cuts to
public health funding may be
jeopardizing the progress.
Read More>>
News and Articles
Training & Events
Tools & Resources
The Michigan Update
Research

About the Guardian
The Guardian of Public Health is a monthly newsletter from the
Office of Public Health Preparedness (OPHP), an office from within
the Michigan Department of Community Health (MDCH). The
Guardian aims to provide its readers with relevant content on topics
that affect the public health of citizens and communities in
Michigan. For questions or comments please contact Rachel
Ruddock at ruddockr@michigan.gov.
Click here to subscribe to the Guardian

The Michigan Update
Brief Summary: Middle East Respiratory Syndrome
Coronavirus (MERS-CoV)
Submitted by: Tiffany Henderson, Regional Epidemiology Unit
Manager

Georgia Looks To Reopen
Some Closed Hospitals As
ERs
An ambulance races down an
empty street in Folkston, Ga.,
population of 5,000. It
bypasses Charlton Memorial
Hospital, makes a sharp right
turn and speeds to an
emergency room 40 miles
away. Why? Because
Charlton Memorial Hospital
has been closed since last
August. Four of Georgia's 65
rural hospitals have shut
down over the past two years.
A dozen more have cut
services in response to
shrinking budgets. The state
of Georgia just offered to
allow struggling hospitals and
those that have closed in the
past year to become rural
free-standing emergency
departments.

Read More>>
Return To Top

Training & Events
Emergency Planning For
Persons With Disabilities,
Their Caregivers, And
Family Members
June 19 from 1:00 p.m. to
2:30 p.m.
Did you know that most
people dont have an
emergency plan? If you are
one of them, plan on
participating in the Emergency
Planning Webinar for people
with disabilities, their
caregivers, and family.



First reported in Saudi Arabia in 2012, Middle East Respiratory
Syndrome is viral respiratory illness caused by a
coronavirus. Between April 2012 and May 2014 there have been
636 laboratory-confirmed cases reported to the World Health
Organization, including 193 deaths. At this time, all cases
confirmed with Middle East Respiratory Syndrome coronavirus
(MERS-CoV) have been linked to countries in the Arabian
Peninsula. Worldwide, 65.6% of cases have been male with the
median age of 49 years. Although there have been asymptomatic
infections, most people who have been confirmed to have MERS-
CoV infection developed severe acute respiratory illness with signs
and symptoms including fever, shortness of breath, cough and
occasionally diarrhea. Most patients have had abnormal findings on
chest X-ray. For those confirmed to be infected with MERS-CoV,
the case fatality rate is around 30% and tends to cause more
severe disease in those that are elderly or have weakened immune
systems. Currently, there is no vaccine and treatment is limited to
supportive care.
MERS-CoV can be spread through close and prolonged contact,
but at this time, there is no evidence of sustained person-to-person
transmission. Investigation is ongoing on the various types of
transmission routes, but camels are believed to be an animal
reservoir for the virus. In the Middle East, there have been
healthcare-related clusters of cases. For example, in Jeddah, Saudi
Arabia, 128 cases were reviewed and it was determined that more
than 60% of those cases likely acquired the infection in a
healthcare setting. Of note, the number of MERS-CoV cases that
has been reported worldwide has significantly increased since mid-
March 2014. There is ongoing research to try to confirm the source
and identify how exactly the virus spreads.
To date, there have been two confirmed cases of MERS in the
United States. The first was a U.S. resident who lived and worked
as a healthcare provider in Saudi Arabia. The traveler became ill
while in Saudi Arabia before flying to Indiana via London and
Chicago. Travel also included a bus trip from Chicago to
Indiana. After recovering and testing negative for active infection,
the patient was discharged from the hospital. There were some
initial concerns about infection in a business associate (Illinois
resident), due to face-to-face contact. Although testing negative for
active infection, preliminary tests indicated the Illinois resident had
antibodies to MERS-CoV. However, after completing more
definitive tests, CDC has confirmed that this person was never
infected with the virus.
Unrelated to the first case, a second case was confirmed on May
11, 2014. The case was a healthcare worker from Saudi Arabia that
traveled on May 1, 2014 to Orlando via London, Boston and
Atlanta.The patient became on ill on the flight from Saudi Arabia
and was hospitalized on May 9, 2014. After determining that the
case was no longer infectious and after a full recovery, the patient
was discharged from the hospital.
You will learn about: The
definition of an emergency or
disaster, how to complete an
emergency plan, and
addressing your needs in an
evacuation (helper animals,
Assistive Technology, etc.).
Register>>
Emergency Response To
Domestic Biological
Incidents
June 18 & 19
Berrien County Health
Department
2106 S M-139 Benton
Harbor MI, 49022
Register: MI-TRAIN
Course:1050075
Contact: Steven Torres,
EPC 269-927-
5621Storres@bchdmi.org
This course prepares
participants to perform safely
and effectively during an
incident involving biological
agents. It provides detailed
technical information and
includes hands-on practice of
actions required of emergency
responders and medical
personnel during a biological
incident.
Return To Top

Tools &
Resources
Real Time Evacuation
Planning Model
The Real Time Evacuation
Model allows emergency
managers and government
planners to run countless
hypotheticals on locations in
the United States to see how
long it would take to evacuate
people.
In an effort to mitigate further transmission within the United States,
public health officials contacted healthcare workers, family
members, and travelers who had close contact with either case,
with requests to monitor their health, receive an evaluation from a
healthcare provider and/or have specimens tested. Household
contacts and healthcare workers who had unprotected close
contact with the patients underwent 14 days of voluntary home
quarantine.
In addition, CDC worked with airlines to identify U.S. travelers that
were on any of the patients flights. Some of these travel contacts
were Michigan residents and state and local public health have
reached out to these ten contacts to provide guidance and health
information. Some of these contacts have provided voluntary
specimens for antibody testing. Although antibody testing can take
weeks, CDC has no indication of any further spread of MERS-CoV
from the two imported cases. Standard recommendations to
prevent respiratory illness include practicing good hand hygiene,
avoiding contact with ill people, avoiding touching eyes, nose
and/or mouth with unwashed hands, and disinfecting frequently
touched surfaces.
The Michigan Department of Community Health (MDCH) and local
public health have had multiple suspect cases of MERS-CoV
reported by various Michigan healthcare facilities. If certain criteria
are met, these Patients Under Investigation have specimens
submitted to MDCH BOL and/or CDC for testing. To date, these
have all tested negative for MERS-CoV. MDCH recently updated
theMERS-CoV Guidance for Healthcare and Public Health
Providers on 5/22/2014. This document includes general
information, guidance on the evaluation and management of
contacts, testing requirements and infection control
recommendations. Please review the guidance and contact MDCH,
Division of Communicable Diseases with any questions or suspect
cases at 517-335-8165.
Return To Top

Research
Ethical Alternatives To Experiments With Novel
Potential Pandemic Pathogens
In PLoS One, researchers outline what they suggest are more
ethical ways to study novel pandemic pathogens. They define a
potential pandemic pathogen as something that may be likely to be
transmitted between humans, is virulent, the present population has
no immunity to it, and it is distinct from others that are currently
circulating. The authors argue that current research methods are
more likely to produce accidental laboratory release rather than
nefarious gains. They suggest nine approaches that could
determine transmission and are less likely to produce an accidental
release.
Read More>>

It can be tailored to It can be
tailored to show large-scale
evacuations caused by a
natural disaster or terrorist
attack, or scaled-down to look
at potential bottlenecks for
crowds leaving events. Its
free and open to anyone with
an internet connection.
Read More>>
Release Of The Fifth
Edition Of The Hospital
Incident Command System
(HICS)
The California Emergency
Medical Services Authority
(EMSA) recently released the
Hospital Incident Command
System (HICS) 2014
Guidebook. This Fifth Edition
has been expanded to meet
the needs of all hospitals,
regardless of their size,
location or patient care
capabilities.
Read More>>
Pediatric Preparedness
For Healthcare Coalitions
Webinar And National Call
Presenters will describe
resources, partnerships and
strategies that HPP Directors
and Healthcare Coalitions
have implemented to
strengthen pediatric
components within their
jurisdictions healthcare
preparedness capabilities.
Read More>>
FDA Launches New Public
Database To Track
Adverse Interactions Of
Medications
Traditionally, adverse
interactions involving
medications have been
difficult to research and track.

FEMAs Disaster Relief Fund: Overview And Select
Issues
The Congressional Research Service issued a report on FEMA
disaster relief funding and issues for improvement. There are
concerns about providing emergency financial assistance to
localities that have not first requested assistance from their state
government. There is also concern as to whether or not there
should a maximum amount given for any one declared disaster and
if using federal disaster relief funds should be based off of what the
state can afford to pay for disaster assistance. Additionally, does
federal disaster relief allow for states and locals to prepare less for
disasters knowing that federal assistance is always available?

Read More>>
GAO Report: Biological Defense: DOD Has
Strengthened Coordination On Medical
Countermeasures But Can Improve Its Process For
Threat Prioritization
The Government Accountability Office (GAO) outlines in one of its
latest reports the US Department of Defense (DOD) process for
partnering with other federal agencies on medical
countermeasures. The GAO found that the DOD does well when
partnering with the Department of Homeland Security and the
Department of Health and Human Services. They have
successfully had several medical countermeasures explored and
further approved by the Food and Drug Administration. However,
the GAO found that the DOD does not update their biological threat
list annually. GAO recommends that the DOD continue to enhance
their successful partnerships and utilize their own process to
annually update their threat list.

Read More>>
Return To Top
The Food and Drug
Administration (FDA) recently
launched a database which
allows the public to query
various datasets. The
OpenFDA project is starting
with nearly a decades worth
of information, covering
reported drug interactions and
errors from 2004 through
2013.
Read More>>
Return To Top







This publication is supported by Cooperative Agreement Number 1U90TP000528-01 from the
Centers for Disease Control and Prevention (CDC). Its contents are solely the responsibility of
the authors and do not necessarily represent the official views of CDC.

MDCH Office of Public Health Preparedness | 201 Townsend Street | Lansing | MI | 48913