Middle east respiratory syndrome coronavirus (MERS-CoV) infections in two returning travellers in the Netherlands, May 2014

Two patients, returning to the Netherlands from pilgrimage in Medina and Mecca, Kingdom of Saudi Arabia, were diagnosed with Middle East respiratory syndrome coronavirus (MERS-CoV) infection in May 2014. The source and mode of transmission have not yet been determined. Hospital-acquired infection and community-acquired infection are both possible

Follow-up of contacts of middle east respiratory syndrome coronavirus–infected returning travelers, the Netherlands, 2014

Notification of 2 imported cases of infection with Middle East respiratory syndrome coronavirus in the Netherlands triggered comprehensive monitoring of contacts. Observed low rates of virus transmission and the psychological effect of contact monitoring indicate that thoughtful assessment of close contacts is prudent and must be guided by clinical and epidemiologic risk factors

Appropriate Governance Responses to Infectious Disease Threats: Developing Working Hypotheses

Infectious diseases remain a threat to public health in today's interconnected world. There is an ongoing debate on how responses to threats of infectious diseases can best be coordinated, and the field remains nascent in understanding which specific structural governance arrangement will perform best. The present paper contributes to this discussion by demonstrating that it is possible to develop working hypotheses specifying the relationship between the type of infectious disease crisis and type of response to the crisis. For type of crises and type of response mechanisms there is still a lack of research, but the hypothesis combining these two provide a perspective for a future research and action agenda. It certainly prevents us from choosing between schism or hypes when it comes to crisis response. It provides instruments to realize that no single type of response is the most effective and that not all responses are equally effective in a concrete case

Ex ante knowledge for infectious disease outbreaks: Introducing the organizational network governance approach

The core question addressed is to what extent ex ante knowledge can be made available from a network governance perspective to deal with a crisis such as an infectious disease outbreak. Such outbreaks are often characterized by a lack of information and knowledge, changing and unforeseen conditions as well as a myriad of organizations becoming involved on the one hand but also organizations which do not become adequately involved. We introduce the organizational network governance approach as an exploratory approach to produce useful ex ante information for limiting the transmission of a virus and its impact. We illustrate the usefulness of our approach introducing two fictitious but realistic outbreak scenarios: the West Nile Virus (WNV), which is transmitted via mosquitos and the outbreak of a New Asian Coronavirus (NAC) which is characterized by human to human transmission. Both viruses can lead to serious illnesses or even death as well as large health care and economic costs. Our organizational network governance approach turns out to be effective in generating information to produce recommendations for strengthening the organizational context in order to limit the transmission of a virus and its impact. We also suggest how the organizational network governance approach could be further develope

Stakeholder Involvement in Outbreak Management: To Fear or Not to Fear?

Infectious diseases remain a threat to public health, requiring the coordinated action of many stakeholders. Little has been written about stakeholder participation and approaches to sharing information, in dynamic contexts and under time pressure as is the case for infectious disease outbreaks. Communicable-disease specialists fear that delays in implementing control measures may occur if stakeholders are not included in the outbreak-management process. Two case studies described in this article show how the needs of stakeholders may vary with time and that early sharing of information takes priority over shared decision-making. The stakeholders itemized their needs and potential contributions in order to arrive at the collective interest of outbreak management. For this, the results suggest the potential for improvement through development of “network governance” including the effective sharing of information in large networks with varying needs. Outbreaks in which conflicting perceptions may occur among the stakeholders require particular attention

Collaborative emergency preparedness and response to cross-institutional outbreaks of multidrug-resistant organisms: a scenario-based approach in two regions of the Netherlands

Abstract Background The likelihood of large-scale outbreaks of multidrug-resistant organisms (MDRO) is growing. MDRO outbreaks can affect a wide range of healthcare institutions. Control of such outbreaks requires structured collaboration between professionals from all involved healthcare institutions, but guidelines for cross-institutional procedures are, however, often missing. Literature indicates that such multi-actor collaboration is most promising when effective network brokers are present, and when the collaborative actors have clarity about the different roles and responsibilities in the outbreak response network, including collaborative structures and coordination roles. Studying these factors in an imaginary MDRO outbreak scenario, we gained insights into the expectations that health professionals in the Netherlands have in regard to the procedures required to best respond to any future cross-institutional MDRO outbreaks. Methods For exploration purpose, a focus group discussion with ten healthcare professionals was held. Subsequently, an online-survey was conducted among 56 healthcare professionals in two Dutch regions. The survey data was analysed using social network analyses (clique analysis and centrality analysis), which provided insights into the collaborative structures and potential brokers in the outbreak response networks. Additionally, respondents were asked which healthcare institutions and which professions they would prefer as coordinating actors in the collaborative network. Results Our results show a relatively high level of perceived clarity about the roles and responsibilities that healthcare professionals have during a joint outbreak response. The regional outbreak response networks which were studied appeared inclusive and integrated, with many overlapping groups of fully-connected healthcare actors. Social network analyses resulted in the identification of several central actors from different healthcare institutions with the potential to take on a brokerage role in the collaboration. Actors in the outbreak response networks also showed to prefer several healthcare professionals to take on the coordination roles. Conclusion Expected collaborative structures during an imaginary regional MDRO outbreak response are relatively dense and integrated. In regard to the coordination of an MDRO outbreak response, based on both the network analysis results and the preferred coordination roles, our findings support a governance structure with several healthcare institutions involved in responding to future cross-institutional MDRO outbreaks