By Chelsea Gridley-Smith, PhD, NACCHO Program Analyst

CDC 2016 Preparedness Month Infographic, click to original.

In commemoration of National Preparedness Month, the Centers for Disease Control and Prevention (CDC) is highlighting five themes for each week of September, emphasizing the various aspects of effective preparedness. Each week, the NACCHO Preparedness team is authoring a blog to promote the theme and provide local health departments and other partner agencies with context and resources to share with the communities they serve. This week’s theme is “Prepare Globally.”

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Emergency preparedness in the 21^st century demands that we look beyond our own country’s borders. As globalization continues to shrink the perception of borders, so does the risk for international spread of disease and other serious health risks. These factors makes it vital for cross-collaboration among nations to develop and implement cooperative agreements to prepare, respond to, and recover from a variety of incidents that know no boundaries. LHDs are often first to respond in the event of an emergency, and are therefore acutely aware of the needs and issues specific to a diverse range of high- impact public health incidents in the context of their communities. As a result, local health officials can bring expertise and serve as a resource in coordinating preparedness exercises and tools relevant for events spanning neighboring jurisdictions, states, and even countries.

A recent example of an international disease outbreak is the Zika virus (ZIKV). ZIKV is transmitted to humans primarily through bites of infected mosquitos in the Aedes species, causing minor symptoms like rash, fever, arthralgia, and conjunctivitis. However, the virus is also associated with detrimental effects for pregnant women, resulting in microcephaly, severe disabilities, and impaired brain development in babies born from infected mothers. The virus originated in Brazil early last year, and quickly spread throughout neighboring countries, including the United States. This cross-border outbreak was largely caused by individuals unknowingly infected, traveling to and from Brazil, and only showing symptoms after their arrival back in their home country. The Zika virus is now a public health emergency in many parts of the world, due to a combination of insufficient awareness, international travel, seasonality, mosquito species distribution, inadequate vector control, and the lack of a known vaccine.

Public health disasters, like the Fukushima Daiichi nuclear power plant radiological emergency in 2011, can also pose threats to multiple communities, cities, or even whole countries. This nuclear event resulted in massive radiological contamination, following an earthquake and subsequent tsunami. Although the emergency happened in Japan, radioactive particles were detected throughout the northern hemisphere in the atmosphere and particularly on the west coast of the United States in the Pacific Ocean. In turn, it became a global concern due to the nature of the disaster and the inability to contain radioactive particles.

These examples are just a small representation of how diseases and disasters spread globally and therefore, require preparedness protocols with a multinational approach.

LHDs are on the front lines of public health and are inevitably going to need to address public health effects of global disease outbreaks and natural disasters. To effectively respond to an emergency or disaster, LHDs must form partnerships and foster relationships with various public health professionals (e.g., Emergency Medical Services, fire, law enforcement, the Medical Reserve Corps, private businesses, neighboring health jurisdictions, and others). Many of the same tools that are essential for implementing an effective response to an event that has an impact on one or two communities as outlined by the National Incident Management System and the National Response Framework can be expanded to address larger-scale emergencies spanning counties, states, or even nations — just as exercises planned and employed to simulate various parts of a response at the local level can be broadened to include global health preparedness.

NACCHO has an expansive library of useful tools for LHDs to inform, communicate, collaborate, plan, implement, analyze, and improve preparedness capabilities. Resources most applicable to improving global preparedness are listed below:

• Checklist: Interjurisdictional Legal Coordination for PH Preparedness – to assess legal preparedness in public health emergencies
• Incident Command System (ICS) for Public Health – an overview of the Incident Command System, its history, structure, and application to public health
• Public Health Mutual Aid Agreements – materials to assist LHDs in creating public health mutual aid agreements
• Boston Health Coalition Builds Cross – Agency Emergency Communication Structure – describes how health agencies formed a coalition to establish an emergency communications network
• Outbreak/Epidemiologic Response Plan – provides comprehensive guidance and tools for conducting an investigation and coordinating efforts with various partners

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Local health officials, MRC Unit volunteers, and other partner stakeholders are highly encouraged to share all of their preparedness efforts, resources, and community engagement events throughout National Preparedness Month. Both LHDs and MRC Units are invited to take the NACCHO Preparedness Pledge, participate in our National Preparedness Month Photo Contest, and submit an abstract for our upcoming 2017 Preparedness Summit.