Operation Mechanism of the Command Center of the Central Dengue Fever Command Center in Taiwan, 2010
Shu-Hua Huang1、Li-Jen Lin1、Yi-Chun Wu2、Wen-Yi Shih3
2011 Vol.27 NO.17
Correspondence Author： Shu-Hua Huang
The dengue clusters continually occurred in Baoshu village of Gushan District in Kaohsiung City and in Xiangyang village of Guanmiao Township in Tainan County since August 14, 2010, ignited the large-scale dengue epidemic in Kaohsiung and Tainan counties/cities. Up to mid-October, a total of 743 indigenous dengue cases were identified nationwide. The number of newly diagnosed cases in three consecutive weeks was even higher than 100 cases per week. The epidemic appeared an increasing trend in number of cases, with no signs of reversion. Therefore, in order to effectively control the epidemic, the Executive Yuan, based on Article 17 of the Communicable Disease Control Act, activated the Central Dengue Fever Command Center (CDFCC) during October 21-December 31, 2010, with a total of 72 days of operation. The CDFCC consists of Administration and Logistics Division, Epidemiological Investigation and Control Division, and Command Centers (FCC). The FCC resided in the Fourth and Fifth Branches of the Taiwan CDC and acted for combating dengue epidemics in Tainan and Kaohsiung areas, respectively. Since the epidemics were under control and presented in a stable situation, the FCC submitted a request for ending its operation on December 24. This report describes in detail the actions taken during the operation of the FCC initiated in response to the epidemics, including topics on classification of missions, epidemiology analysis and counselor, enforcement of government power, manpower scheduling and management of the Mobile Task Force, logistics and supply, health education, public complaints, response to public media, source reduction, and tracking the completion of monitored items. This report described the practical experience, faced problems, and recommendations in narrative style. The lesson we have learned from the activities includes that the occurred epidemic is the best scenario for practicing the team cooperation between central and local governments; to establish good channels for interior, exterior, horizontal, and vertical communication and coordination is helpful for ensuring consistence of orders and messages; the enforcement and implementation of government power can not be performed merely based on the Communicable Disease Control Act; to conduct mobile health dissemination with multiple channels and local language is more effective; we should keep sensitive to media news or public complaints that may occur at all times and carefully respond to each of them; and we should adjust the combat tactics along with the evolution of epidemic, define the “war zone” and aggregate experts experienced in dengue control for these areas, and establish indicators for evaluation of combat results. We recommend that the application of epidemiological analysis and determination of overall epidemic situations should be practiced with more advanced technology and provided in a more timely manner; the procedures for issuing Penalty Notice should be simplified and the time needed for approving of official documents should be decreased; source reduction program should be included as part of the dengue control activities at the usual time in the environmental protection unit, public health unit, and schools; special hotline should be set up in the CDFCC to provide public with a channel for making a complaint or raising a question about the issues of environment protection or public health.