Public Health Response in Zika Virus & MERS-CoV Infections: Kuala Lumpur International Airport (KLIA) Experiences Dr. Harishah Talib Public Health Physician KLIA Health Officer MBBS(India), MPH(Malaya), EIP(Malaysia) E-mail: harishah@moh.gov.my
Contents 1. Disaster Management Plan Ministry Of Health Malaysia 2. Zika Virus Preparedness Plan At KLIA 3. MERS-CoV screening 4. Conclusion CAPSCA-AP/08-Thailand Nov 15-18 2016 2
1-Disaster Management Plan Ministry Of Health Malaysia Disaster: 1. Disaster As a result of Communicable Disease Outbreak /Pandemic Event 2. Mass Casualty Incident (MCI) 3. Environment-linked Disaster 4. Chemical, Biological, Radiological and Nuclear explosives (CBRNe) CAPSCA-AP/08-Thailand Nov 15-18 2016 3
National CPRC, Ministry of Health Malaysia 1-Flow of notification Crisis and disaster Incident Medical Specialist/ Medical Officer/ any related officer District Health Officer Hospital Director WHO-EIS Information from other sources CRISIS/ DISASTER State Health Director Director of Disease Control DDGH (PA) - Focal Point Director General of Health YB Minister of Health Malaysia National IHR FP PHEIC/ CRISIS/DISASTER PHEIC Monitoring of control measures and prevention and incident status assessment (risk assessment) NOT PHEIC PHEIC WHO or other related external agencies
1-Ministry Of Health Malaysia Organisation chart National CPRC, Ministry of Health Malaysia
1-Monitor All type of Events: Disaster/Outbreak/ Crisis/Emergency (DOCE)
1-NCPRC - Command, Control And Coordination of the Preparedness & Response at the National Level Prevent Detect Response -Ongoing Surveillance and Preparedness - Health Education/ Advisory - RA & RC - Stockpile - Clinical or Lab - Temp. screen - Self declaration - Self reporting - Clinical Mx - Infection Prevention Control (IPC) - PPE, medicines/ antiviral/vaccines On going Surveillance and preparedness Engagement- Meeting with relevant agencies Advisory to Malaysians, expatriates, Foreign students Entry/Exit screening, HAC, Flight Announcement Risk assessment & Risk communication Points of Entry (POE) Healthcare System public and private Community NGOs RAT and RRT Patient Transfer Mx of patients / deceased Mx of contacts Designated hospitals for EVD case Quarantine Risk assessment & Risk communication Interagency Collaboration & cooperation
2- Zika virus preparedness plan CAPSCA-AP/08-Thailand Nov 15-18 2016 8
2-Flow chart for screening of passengers from Zika Virus Countries
2-Interagency meeting at KLIA -MA Sepang -Airlines -Immigration Department -Customs Department -Other related agencies CAPSCA-AP/08-Thailand Nov 15-18 2016 10
2-Flight Announcement: Zika Virus Advisory FLIGHT ANNOUNCEMENT: ZIKA VIRUS ADVISORY Ladies and gentlemen We extend you a welcome on board. For your health safety, we would appreciate your attention and action on this Health Advisory, concerning Zika virus On 1st February 2016, WHO announced that the recent outbreak of Zika Virus and cluster of neurological disorders and neonatal malformations reported in the Americas region constitutes a Public Health Emergency of International Concern. The Ministry of Health will carry out screening of travellers from 12 countries as follows: I Brazil I Colombia I El Salvador I French Guiana I French Polynesia I Haiti I Honduras I Martinique I Panama I Puerto Rico I Suriname I Venezuela (Bolivarian Republic of) I (WHO report on 17 March 2016) We wish to seek the cooperation of passengers who have history of travel to these countries since the past seven (7) days to present your selves to the Health Personnel at the Health screening area after disembarking from the aircraft. We thank you for your attention. Thank You. CAPSCA-AP/08-Thailand Nov 15-18 2016 11
2-Fever screening CAPSCA-AP/08-Thailand Nov 15-18 2016
2-Zika Health education Activities on Zika Virus Infection CAPSCA-AP/08-Thailand Nov 15-18 2016
2-Zika Screening at Health Quarantine Centre CAPSCA-AP/08-Thailand Nov 15-18 2016
2-Flight Disinsection Submission of GD form and spray can at KLIA/klia2 CAPSCA-AP/08-Thailand Nov 15-18 2016 GD Box location In front of MAS Transfer Counter,Level 4 KLIA Next to immigration Counter -KLIA 2
2-Vector Surveillance and Control Search and destroy of breeding places Ovitrap surveillance CAPSCA-AP/08-Thailand Nov 15-18 2016 16
2- Zika Screening for Olympic Athletes All olimpic and paralimpic athletes RIO-2016 and the contingent : screened for zika virus: August-September 2016
2- Suspected Zika virus case on-board Public Health Team activated to the gate upon received information from the AOC. Passengers and crew without symptoms will be given Health Alert Card (HAC). Get details of passengers and crew for follow up actions as needed. Suspected case (identified by crew) will be interviewed for history and physical examination. If he/she does not fulfilled the case definition of suspected case of Zika (Annex2), HAC will be issued and health advice given. Suspected of Zika virus infection, he/she will be referred to the nearest health facilities for further management. To notify suspected case to National CPRC, JKN and Nearest District Health Office. CAPSCA-AP/08-Thailand Nov 15-18 2016
3-Preparedness plan for MERS-CoV Infection at KLIA KLIA Call Centre receive notification or case report from the reporter (AOCC personal); Case maybe communicable disease (either suspected or comfirmed). RRT together with Airlines Liason Officer, AVSEC, Terminal Operation MAB, PP from MENARA / MAS Med. Centre ready at Gate C21 (Designated Gate for the action of emergency of public health at KLIA). In the aircraft arrived, PPKP with the help of Airlines Liason Officer to do announcement in the aircraft (for the sake of avoiding panic) other than explaining about the action and purpose of public health for the passengers CAPSCA-AP/08-Thailand Nov 15-18 2016
3-Preparedness plan for MERS-CoV Infection at KLIA Medical examination on symptomatic cases Tagging of cases and close contact Screening of the asymptomatic contact. Obtain the flight manifest (informations required are name, passport number or ic number, seat number in the flight, home, office or mobile number or email address as well as home address of all passengers & crew). CAPSCA-AP/08-Thailand Nov 15-18 2016 Red tag for suspected cases / yellow tag for close contact
3-Flight disinfection Carry out disinfection or decontamination in case there is contamination or if caused by communicable disease. CAPSCA-AP/08-Thailand Nov 15-18 2016 21
3-MERS-CoV Health Alert Card / Home assessment Tool CAPSCA-AP/08-Thailand Nov 15-18 2016
3 - Notification of suspected MERS-CoV Cases PK report the case or syndrome or the occurence of PHEIC to the Director and Deputy Director of Public Health at the state level and Report to the District Health Office. Prepare the report and send to JKNS. CAPSCA-AP/08-Thailand Nov 15-18 2016
4-Screening of Hajj for MERS-CoV All flight landed at KLIA From 18 Sept. until 15 October 2016 Screening for communicable diseases esp: MERS-CoV Dedicated gate: C17 Number of passengers: 200-480/flight Total hajj: 22,000 Referral hospital: 4 hospital in Selangor CAPSCA-AP/08-Thailand Nov 15-18 2016 24
4-Screening of Hajj Pillgrims for MERS-CoV CAPSCA-AP/08-Thailand Nov 15-18 2016 25
5-Conclusion SOP for public health emergency preparedness and response is available at PoE Strengthening the Networking & Collaboration at national & international level Collaboration with multi agencies at PoE Communication system and reporting system Exercises Table-top, Simulation Training CAPSCA-AP/08-Thailand Nov 15-18 2016 26
5-Conclusion SOP for public health emergency preparedness and response is available Strengthening the Networking & Collaboration at local national & international level Collaboration with multi agencies at PoE Communication system and reporting to NFP Exercises Table-top, Simulation Training CAPSCA-AP/08-Thailand Nov 15-18 2016 27
Thank you CAPSCA-AP/08-Thailand Nov 15-18 2016 28