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2 Pivotal Role of Innovations in Tackling Microbial Threats: Lessons from Past Outbreaks
Pages 5-18

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From page 5...
... that began in 2018. LESSONS LEARNED FROM INNOVATION IN POLIO ERADICATION Ananda Bandyopadhyay explored lessons learned from the global effort to achieve polio eradication over the past several decades, with a focus on how innovation can be leveraged in practical, impactful ways.
From page 6...
... . When the eradication program started in 1988 with the formation of the Global Polio Eradication Initiative, roughly 1,000 cases of paralysis related to polio were being reported every day, he noted.
From page 7...
... He explained that the overall purpose of polio surveillance is to detect in a timely manner any circulation of polio viruses in any part of the world. The Bill & Melinda Gates Foundation polio program closely tracks the polio virus in around 70 countries by testing paralyzed children and collecting environmental samples to detect virus transmission, he explained.
From page 8...
... He said that these innovations are facilitating earlier and more sensitive detection, as well as creating integrated methods of detection in which polio surveillance can be combined with surveillance systems like antimicrobial resistance or typhoid surveillance. Bandyopadhyay emphasized that despite these exciting innovations, real-world polio surveillance on the ground is largely done using traditional methods that require workers to seek out and manually transport patients to care, often across difficult terrain.
From page 9...
... He lauded these people working on the ground as the champions and sources of real-world, practical innovations that have contributed to the dramatic reduction in polio cases worldwide. Despite the historic progress in reducing polio transmission, Bandyopadhyay remarked that overcoming the remaining challenges to achieve and sustain eradication will depend on concerted global efforts as well as innovation around new surveillance methodologies, vaccine formulations, and delivery technologies.
From page 10...
... . Epidemiology of Ebola Virus Outbreaks Towner said that the majority of filovirus outbreaks have occurred in the equatorial region of Central Africa, including the 2014 outbreak in West Africa at the nexus of Guinea, Liberia, and Sierra Leone.
From page 11...
... Progress in Diagnostics, Genomics, and Case Investigations for Ebola Virus Towner outlined progress in diagnostics, genomics, and case investigations for Ebola virus disease. The classic response to Ebola focuses on stopping human-to-human transmission and isolating infected patients, as well as contact tracing and patient management.
From page 12...
... The diagnostic testing included more than 500 semen specimens to assess the viral persistence in male survivors as well as samples from the Ebola vaccine trials that were ongoing at the time. Field Diagnostic Laboratory Challenges in the West Africa Outbreak Towner described some of the challenges they encountered while running the field diagnostic laboratory.
From page 13...
... Many different real-time PCR assays were being used across multiple laboratory networks, which necessitated attempts to standardize not only assays but also quality-control proficiency panels to identify poor performers. CDC distributed panels in Sierra Leone and Guinea and found that two of the six laboratories in Sierra Leone had 10 percent incorrect results, which enabled them to implement improvements.
From page 14...
... Innovation in Capacity Building and Infection Control Towner emphasized that investing long term in foreign diagnostic laboratory infrastructure can dramatically reduce the size, duration, and cost of outbreaks of emerging infectious diseases. Since 2010, CDC has invested in the Uganda Virus Research Institute to establish and maintain an enhanced comprehensive surveillance and diagnostics program for viral hemorrhagic fevers (CDC, 2019c)
From page 15...
... In the West Africa outbreak, the explosion occurred when the virus entered into the major population centers and overwhelmed the system's ability to respond in a timely way to control the outbreak through contact tracing, isolation, and other activities. It also required the international community to deal with the challenges involved in engaging with three different governments simultaneously.
From page 16...
... Towner commented that community engagement to develop "street cred" and to build trust is critical for the success of outbreak control, particularly in settings such as eastern DRC. Greg Armstrong, director, Office of Advanced Molecular Detection Program, CDC, asked if the innovation of emergency operations centers has been helpful in improving timeliness and completeness of response, bringing partners together for better coordination, and giving governments a degree of engagement and control that they would not otherwise have.
From page 17...
... Bandyopadhyay replied that surveillance for acute flaccid paralysis partly involves clinical surveillance, with reporting based on symptoms of sudden-onset flaccidity in people aged less than 15 years, but it does include laboratory testing for nonpolio enteroviruses. Testing is categorized by whether a sample has polio, and if so, intratypic differentiation is conducted to classify whether it is wild or vaccine derived, which serotype it is, and if it contains nonpolio enteroviruses.


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