Highlights

Preparedness in New York
• Thirty thousand international travelers arrive at a New York airport every day; we must be aware of diseases that may not receive much attention in medical school.
• New York City has accelerated emergency-preparedness since the West Nile virus outbreak and now takes an all-hazards approach.
• Plans are being practiced for mass prevention and emergency communications.

Surveillance Systems
• Traditional surveillance depends on medical and lab communities to recognize something unusual and reporting it; the medical examiner's office reports any unexplained potentially-infectious deaths.
• Syndromic surveillance detects an increase in prodromal symptoms to try to detect outbreaks earlier, recognizing that people may go to a pharmacy or hotline before a doctor or hospital.
• A number of surveillance systems more reliably screens out artifacts; when many systems respond there is more cause for concern.

Communication
• A broadcast alert system is used to communicate with hospitals, keeping clinicians updated on what, when, and how to report and good triage protocols.
• Communicating uncertainties and handling the demand for information is important.

Contingency Planning
• There is partnership with other agencies to coordinate responses; legal, security, and logistical issues are being addressed to plan for an isolation and quarantine situation.
• Search capacity has been increased to mobilize response via hotlines, databases, lab tests and analysis, and teams to review charts and interview patients.
• Hospitals are being made to think through dealing with a surge of contagious patients, communication procedures, and training staff.
• Proposed changes to the NYC Health Code will strengthen the ability to do detention, isolation and quarantine.
• SARS teams are in place, doing active case and contact management; all staff are fit-tested to be able to do home visits.