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Aug 8, 2013

ISDS Webinar: Global Public Health Surveillanc, Governance and Viral Sovereignty


Affan Shaikh, M.P.H, Senior Epidemiologist, Public Health Practice, LLC 

Scott JN McNabb, Ph.D., M.S., Research Professor, Emory University, Rollins School of Public Health | Managing Partner, Public Health Practice, LLC

Qanta Ahmed, M.D., Attending Sleep Disorders Medicine, Winthrop University Hospital | Associate Professor of Medicine, State University of New York (SUNY) at Stony Brook, New York

Ziad Memish, M.D., Deputy Minister of Public Health, Ministry of Health, Kingdom of Saudi Arabia

Date: Wednesday, August 14, 2013

Time: 3:00 PM - 4:00 PM EDT

Microbes carry no national passports; neither do they recognize geo-political boundaries or state sovereignty. Yet claims of viral sovereignty brings up unresolved controversies that challenge ethical public health governance and add unnecessary risk of global pandemics.  Viral sovereignty refers to a sovereign state's ownership rights over pathogens found within their border.  It was first coined to describe tensions rising from the Indonesian government's decision to conditionally withholding samples of H5N1 avian influenza in early 2007.

While the World Health Organization's (WHO) 2005 revised International Health Regulations (IHR [2005]) provide a global framework to prevent, protect against, control, and facilitate a public health response to the international spread of disease, its success firmly rests on mutual trust and transparency among parties.  Claims of viral sovereignty indicate the critical balance between respecting legitimate national sovereignty and complying with responsible global transparency is far from achieved.

This webinar reviews the origins of viral sovereignty as well as the rights of global health security and responsibilities of transparency required by the IHR (2005) for successful global public health surveillance today.  It points out the critical, current issues and weighs the pros and cons of various options to move forward.

Hosted by the ISDS Global Outreach Committee


Aug 7, 2013

The Remarkable adaptability of syndromic surveillance to meet public health needs

Article accessed on August 8, 013

Volume 3, Issue 1, March 2013, Pages 41–47



The goal of syndromic surveillance is the earlier detection of epidemics, allowing a timelier public health response than is possible using traditional surveillance methods. Syndromic surveillance application for public health purposes has changed over time and reflects a dynamic evolution from the collection, interpretation of data with dissemination of data to those who need to act, to a more holistic approach that incorporates response as a core component of the surveillance system. Recent infectious disease threats, such as severe acute respiratory syndrome (SARS), avian influenza (H5N1) and pandemic influenza (H1N1), have all highlighted the need for countries to be rapidly aware of the spread of infectious diseases within a region and across the globe. The International Health Regulations (IHR) obligation to report public health emergencies of international concern has raised the importance of early outbreak detection and response. The emphasis in syndromic surveillance is changing from automated, early alert and detection, to situational awareness and response. Published literature on syndromic surveillance reflects the changing nature of public health threats and responses. Syndromic surveillance has demonstrated a remarkable ability to adapt to rapidly shifting public health needs. This adaptability makes it a highly relevant public health tool.

  • Syndromic surveillance;
  • Outbreaks;
  • International Health Regulations;
  • Infectious diseases;
  • Public health

Aug 4, 2013

Risk Map of Cholera Infection for Vaccine Deployment: The Eastern Kolkotta Case

Posted on 3

PLoS One
[Accessed 3 August 2013]

Research Article

Risk Map of Cholera Infection for Vaccine Deployment: The Eastern Kolkata Case
Young Ae You, Mohammad Ali, Suman Kanungo, Binod Sah, Byomkesh Manna, Mahesh Puri, G. Balakrish Nair, Sujit Kumar Bhattacharya, Matteo Convertino, Jacqueline L. Deen, Anna Lena Lopez, Thomas F. Wierzba, John Clemens, Dipika Sur


Despite advancement of our knowledge, cholera remains a public health concern. During March-April 2010, a large cholera outbreak afflicted the eastern part of Kolkata, India. The quantification of importance of socio-environmental factors in the risk of cholera, and the calculation of the risk is fundamental for deploying vaccination strategies. Here we investigate socio-environmental characteristics between high and low risk areas as well as the potential impact of vaccination on the spatial occurrence of the disease.

Methods and Findings
The study area comprised three wards of Kolkata Municipal Corporation. A mass cholera vaccination campaign was conducted in mid-2006 as the part of a clinical trial. Cholera cases and data of the trial to identify high risk areas for cholera were analyzed. We used a generalized additive model (GAM) to detect risk areas, and to evaluate the importance of socio-environmental characteristics between high and low risk areas. During the one-year pre-vaccination and two-year post-vaccination periods, 95 and 183 cholera cases were detected in 111,882 and 121,827 study participants, respectively. The GAM model predicts that high risk areas in the west part of the study area where the outbreak largely occurred. High risk areas in both periods were characterized by poor people, use of unsafe water, and proximity to canals used as the main drainage for rain and waste water. Cholera vaccine uptake was significantly lower in the high risk areas compared to low risk areas.

The study shows that even a parsimonious model like GAM predicts high risk areas where cholera outbreaks largely occurred. This is useful for indicating where interventions would be effective in controlling the disease risk. Data showed that vaccination decreased the risk of infection. Overall, the GAM-based risk map is useful for policymakers, especially those from countries where cholera remains to be endemic with periodic outbreaks.

Citation: You YA, Ali M, Kanungo S, Sah B, Manna B, et al. (2013) Risk Map of Cholera Infection for Vaccine Deployment: The Eastern Kolkata Case. PLoS ONE 8(8): e71173. doi:10.1371/journal.pone.0071173

Editor: Matteo Convertino, University of Florida, United States of America

Received: April 11, 2013; Accepted: June 25, 2013; Published: August 2, 2013

Funding: This study is supported by the Bill & Melinda Gates Foundation through the Diseases of the Most Impoverished Program and the Cholera Vaccine Initiative. Additional funding is provided by the Swedish International Development Cooperation Agency and the Governments of South Korea, Sweden, and Kuwait. No funding bodies had any role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing interests: The authors have declared that no competing interests exist.

Anuj in Himalayas

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