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Organizational and Command Aspects for Coordinating the Public Health Response to an Outbreak of Acute Renal Failure, Republic of Panama, 2006

Published online by Cambridge University Press:  20 September 2011

Miguel A. Cruz ,
Mark E. Keim ,
Joshua G. Schier ,
Raul Gonzalez ,
Angel Valencia  and
Jana L. Telfer
Miguel A. Cruz*
Affiliation:
National Center for Environmental Health/Agency for Toxic Substances and Disease Registry, Centers for Disease Control and Prevention, Atlanta, Georgia USA
Mark E. Keim
Affiliation:
National Center for Environmental Health/Agency for Toxic Substances and Disease Registry, Centers for Disease Control and Prevention, Atlanta, Georgia USA
Joshua G. Schier
Affiliation:
National Center for Environmental Health/Agency for Toxic Substances and Disease Registry, Centers for Disease Control and Prevention, Atlanta, Georgia USA
Raul Gonzalez
Affiliation:
Sistema Institucional de Salud para Emergencias y Desastres, Ministerio de Salud de Panama
Angel Valencia
Affiliation:
Pan American Health Organization, Panama
Jana L. Telfer
Affiliation:
National Center for Environmental Health/Agency for Toxic Substances and Disease Registry, Centers for Disease Control and Prevention, Atlanta, Georgia USA
*
Correspondence: Miguel Cruz, MPH US Centers for Disease Control and PreventionNational Center for Environmental Health/Agency for Toxic Substances and Disease Registry4770 Buford Highway, F-09Atlanta, Georgia 30341 USA E-mail: mcruz@cdc.gov
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Abstract

The Ministry of Health of Panama (MINSA) received several reports of ill persons who had clinical presentations of acute renal insufficiency or failure during September and October 2006. On 01 October 2006, the MINSA formally asked the Pan-American Health Organization (PAHO) and the US Centers for Disease Control and Prevention (CDC) to assist with the investigation. Additional agencies involved in the response included the US Food and Drug Administration (FDA), the Gorgas Institute for Health Studies (GIHS), and the Social Security Health System (SSHS) of Panama. Through a joint effort, the MINSA, CDC, FDA, GIHS, SSHS, and PAHO were able to characterize the illness, identify the etiological agent, identify the population-at-risk, and launch an unprecedented media and social mobilization effort to prevent additional cases.

International outbreak responses may require familiarity with basic emergency management principles beyond technical or scientific considerations. The management, logistical capabilities, team interaction, and efficiency of outbreak investigations can be enhanced substantially by having staff already familiar with common operational frameworks for incident responses. This report describes the inter-agency coordination and organizational structure implemented during an international response to identify the cause of an outbreak of acute renal failure in Panama.

Keywords

acute renal failurecommandcoordinationPanamapublic health
Type
Case Study
Information
Prehospital and Disaster Medicine , Volume 26 , Issue 3 , June 2011 , pp. 217 - 223
Copyright
Copyright Cruz © World Association for Disaster and Emergency Medicine 2011

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