The traces of a large number of recently known or emerging infectious agents and the re-emergence of infectious diseases with a global influence have been reported in recent decades. The framework for the immediate reaction of the hospital to the outbreak is being debated. Proper identification and isolation is the first step in treating any form of communicable illness, regardless of whether it is extremely widespread and recently diagnosed or spontaneously released. The value of designing and incorporating non-traditional monitoring techniques, as well as a framework that allows for broader and reliable sharing of knowledge and exchanging of views on risk assessment and risk control, is illustrated.

Case detection and testing skills and insulation techniques are core components of the initial hospital response. Worldwide outbreaks of extremely transmitted infectious diseases have shown the need for clinical preparation at-hospital and for recognition of patient isolation referral centers and labs with sufficient capabilities. In fact, hospitals will create a strategy to organize the elements of the hospital in order to respond to emergency circumstances resulting from the entry of extremely infectious patients. In recent decades, the signs of a small number of recently recognized or novel infectious agents and the re-emergence of infectious diseases with a global effect have been established.

Expanding international travel has expanded the mobility and speed of the transmission of infectious agents, as miraculously shown by the 2003 outbreak of the novel SARS-associated coronavirus.

Almost all of these infectious disorders have an significant connection to the hospital environment, which also indicates a case of significance with group outbreak events. Hospitals act as critical sites for identifying these disruptive entities and play a major role in combating these threats. Prompt diagnosis and detection is the primary step in combating any communicable disorder, irrespective of whether it is endemic, evolving or deliberately published. Whether in the neighborhood or in the hospital early recognition of any infectious illness is the responsibility of the primary health care provider who notices the first sick patients. Before any solution can be installed, the incident must be observed, recognized and identified as requiring urgent intervention. Detection includes professional knowledge, prompt monitoring, and sometimes smartness.

Whenever hospital staff professionals are interested in cases of serious injury, reporting to regional officials would be subject to local laws. Many controlled illnesses, including cholera and yellow fever, are subject to the monitoring requirements of the International Health Regulations. The primary report shall be referred by the local health agency to the nearest higher jurisdiction. A process that allows for the broad and immediate dissemination of information and sharing of opinions on risk assessment and risk control is critical to prompt intervention in the area of public health.

In this respect, an significant lesson arising from the multi-country epidemic of SARS. The disease arose in November 2002 in the province of Guandong, China, and appeared only after a few months when the World Health Organization (WHO) issued an international alert in February 2003. Shortly after the warning, a number of countries and regions were alerted of SARS cases as a direct result of globalization. A total of 8,500 cases and 916 deaths were recorded in the month of July 2003, when the WHO declared the containment of the epidemic; the largest impact was suffered by the countries of South East Asia and Canada.

The severe effects of the few months missed due to inadequate warning have been illustrated by the excellent outcomes obtained after the international community became aware of the danger of SARS.

Indeed, the timely identification of the Novel Coronavirus as an etiological agent of SARS and the introduction of hospital-based, regional and international control initiatives have demonstrated the importance of concerted coordination of resources and capabilities and shared intelligence. Once the first outbreak stopped, new infections were undoubtedly identified and a monitoring program introduced to quickly demonstrate the potential recurrence of the disease.

Proper Response & Steps to the Epidemic of the Hospital:

A) Acknowledgement and Supervision:

• Maintaining a system to detect and track cases of infectious diseases in the hospital.
• The Patient Health Public Awareness Program reports monthly infectious cases accordingly.
• Develop and enforce plans and practices for prevention.
• Reviewing existing clinical practices and best practice guidelines in partnership with public health departments to establish and periodically monitor disease response procedures.

B) Hospitalized Primordial Case Control - The case description created by the health authority at the start of the warning is the first resource that the hospital can use in order to enforce prompt and accurate medical, therapeutic and intuitive monitoring measures of primary significance in this regard is the position of the hospital emergency services, which can be the first contact where suspicious alarm-related patients may be re-founded. In addition, high-quality clinical microbiology laboratory capabilities should be available on-site as reference laboratories for timely diagnosis, and early detection of infectious disease outbreaks should be addressed. Proper selection, distribution, nucleic acid processing, molecular assay diagnostic reagent and equipment production, and standardization for the fast and effective identification of bio-agents in blood and other clinical samples should be discussed. The combination of suitable diagnostic technologies (culture, immunoassay, and molecular assay) will provide rapid diagnostic response capabilities to microbial threats to antimicrobial resistant bacteria, evolving infectious disease agents, and potential bioterrorism agents.

C) Reporting of an Outbreak- 

• Collaborate with the public health unit committee, once the warning requirement is exceeded, to review the details and determine when an epidemic will be announced.
• Identifying any places where assistance may be offered by the public health unit to extend the response to the outbreak.
• When an epidemic is reported, the hospital must report the infection and all associated reports to the public health agency.

D) Measures of Hospital Isolation- Finally, surveillance of health and laboratory workers exposed to highly communicable patients or specimens and post-exposure protocols must be provided as an essential component of hospital response. In this background, the WHO has proposed the introduction of a post-epidemic SARS warning program involving monitoring of clustered cases of pneumonia among healthcare workers. This suggestion is based on the belief that workplace communication amongst health workers was a striking aspect of the SARS outbreak. Disposable personal protective equipment ( PPE) consisting of masks or breathers, boots, shoes, hair and shoe covers and eyewear are available.

Tyvek tissue full-body suits with thermo-activated closure, full-face mask with P3 filtered respirators and latex obstetric gloves to be used in double gloves are recommended for the management of highly contagious patients. Multiple training sessions on adherence to infection control protocols have been developed for health care and laboratory personnel. The delivery, processing and storage of samples shall follow the WHO bio-security standard procedures.

Conclusion:

Defining roles and responsibilities for reporting and managing infectious diseases and outbreaks provides an important framework for facilitating the collaboration of hospitals, public health units and their support organizations. While an epidemic can be a daunting experience, a cooperative working partnership with both organizations, especially with hospitals and public health units, will improve its governance and reduce the burden of communicable disease in the province. Healthcare facilities provide the gateway to minimizing the prevalence and transmission of infectious diseases through the implementation of stringent infection prevention procedures, protection of patients and health staff and the availability of preventive measures.

Being healthcare professional, this is our pledge i.e. “We will make this world safe home: for a child; this is our strong commitment to the newborn before leaving from the beautiful Earth.”