Review of Emergency Medical Services Vulnerability to High Consequence Infectious Disease in the United States.

Purpose: Emergency medical services (EMS) responders are a group of medically skilled professionals who perform a wide range of essential medical services within a community including emergency response, patient transport, and mobile integrated healthcare. The proper functioning of the EMS system is paramount to the well-being of the medical system and public health. The intent of this paper is to review current EMS standards and practice to determine the danger a high consequence infectious disease (HCID) may pose to these healthcare workers and the community. Areas Addressed: Through the review of EMS practice several areas were identified as vulnerabilities to the EMS network. These vulnerabilities consisted of the lack of standardized licensing practice, inconsistent medical direction, and the inability to properly implement the use of personal protective equipment (PPE). The compounding of these vulnerabilities allows for HCIDs to pose a serious threat to EMS personnel with the possibility of devastating and crippling the EMS infrastructure within the US. Discussion: The vulnerabilities identified must be addressed both to protect EMS providers and to enhance the resilience of the US healthcare system. Ways to address the identified vulnerabilities should focus on improving the EMS curriculum and increasing minimum levels of education for first responders. Targeting minimum education and training standards could be the most effect method of reducing the dangers of HCIDs to EMS systems.

The Role of Veterinarians in Mass Casualty Disasters: A Continuing Need for Integration to Disaster Management.

The need to prepare veterinarians to serve as part of the disaster medical response for mass casualty incidents has been recognized since at least the 1960's. The potential value of incorporating veterinarians for mass casualty disaster response has been noted by organizations throughout the world. Clinical veterinarians are highly trained medical professionals with access to equipment, medications, and treatment capabilities that can be leveraged in times of crisis. The ongoing threat of disasters with the current widespread healthcare access barriers requires the disaster management community to address the ethical constraints, training deficiencies and legal limitations for veterinary medical response to mass casualty disasters. An ethical imperative exists for veterinarians with translatable clinical skills to provide care to humans in the event of a mass casualty disaster with insufficient alternative traditional medical resources. Though this imperative exists, there is no established training mechanism to prepare veterinarians for the provision of emergency medical care to humans. In addition, the lack of clear guidance regarding what legal protections exist for voluntary responders persists as a barrier to rapid and effective response of veterinarians to mass casualty disasters. Measures need to be undertaken at all levels of government to address and remove the barriers. Failure to do so reduces potentially available medical resources available to an already strained medical system during mass casualty events.

Clinical Update on Dengue, Chikungunya, and Zika: What We Know at the Time of Article Submission.

OBJECTIVE: Mosquito-borne diseases pose a threat to individual health and population health on both a local and a global level. The threat is even more exaggerated during disasters, whether manmade or environmental. With the recent Zika virus outbreak, it is important to highlight other infections that can mimic the Zika virus and to better understand what can be done as public health officials and health care providers. METHODS: This article reviews the recent literature on the Zika virus as well as chikungunya virus and dengue virus. RESULTS: The present findings give a better understanding of the similarities and differences between the 3 infections in terms of their characteristics, clinical presentation, diagnosis methodology, and treatment and what can be done for prevention. Additionally, the article highlights a special population that has received much focus in the latest outbreak, the pregnant individual. CONCLUSION: Education and training are instrumental in controlling the outbreak, and early detection can be lifesaving. (Disaster Med Public Health Preparedness. 2017;11:290-299).