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Capítulo 2. Políticas de salud pública. Políticas frente a los riesgos cotidianos
Amenazas para la salud y crisis sanitarias. Aproximación a la alerta y respuesta. Informe SESPAS 2008
Health threats and health system crises. An approach to early warning and response
Fernando Simón Soriaa,b,
Autor para correspondencia
fsimon@isciii.es

Correspondencia: Fernando Simón Soria. Centro Nacional de Epidemiología. Instituto de Salud Carlos III.
, Francisco Javier Guillén Enríquezc
a Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, España
b CIBER en Epidemiología y Salud Pública, (CIBERESP), España
c Servicio de Vigilancia Epidemiológica y Evaluación, Consejería de Salud de la Junta de Andalucía, Sevilla, España
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        "resumen" => "<p class="elsevierStyleSimplePara elsevierViewall">El mundo est&#225; cambiando m&#225;s deprisa que nunca&#46; Emergen enfermedades cada a&#241;o&#44; antiguas enfermedades reemergen como amenazas potenciales y desastres naturales o generados por el hombre afectan crecientemente a la salud&#46;</p><p class="elsevierStyleSimplePara elsevierViewall">El Reglamento Sanitario Internacional &#40;2005&#41; plasma la adaptaci&#243;n de la respuesta sanitaria a esta situaci&#243;n&#46; La vigilancia de enfermedades espec&#237;ficas y las respuestas predeterminadas cambian por la vigilancia de eventos de salud p&#250;blica de inter&#233;s internacional y medidas de control adaptadas a cada situaci&#243;n&#46; Los eventos de inter&#233;s se determinan por su gravedad&#44; previsibilidad&#44; potencial de diseminaci&#243;n e impacto en el movimiento de personas y mercanc&#237;as&#46;</p><p class="elsevierStyleSimplePara elsevierViewall">El desarrollo del sistema europeo de alerta y respuesta precoz desde 1998 y la creaci&#243;n del ECDC en 2005 muestran el compromiso pol&#237;tico en la Uni&#243;n Europea con la detecci&#243;n precoz&#44; evaluaci&#243;n y respuesta ante amenazas para la salud p&#250;blica&#46; Sin embargo&#44; para una evaluaci&#243;n de riesgos y una respuesta oportunas a escala nacional se debe iniciar el proceso de informatizaci&#243;n y accesibilidad a los datos&#44; la automatizaci&#243;n de la notificaci&#243;n&#44; el an&#225;lisis y la distribuci&#243;n de informaci&#243;n&#44; la combinaci&#243;n de informaci&#243;n de diferentes fuentes y la adecuaci&#243;n de servicios de salud p&#250;blica&#46; En Espa&#241;a&#44; las comunidades aut&#243;nomas han iniciado el proceso&#44; pero la interoperabilidad entre los sistemas desarrollados y la elaboraci&#243;n de gu&#237;as de actuaci&#243;n y coordinaci&#243;n deber&#237;a impulsarse desde el Consejo Interterritorial y coordinarse desde el Ministerio de Sanidad y Consumo&#46;</p><p class="elsevierStyleSimplePara elsevierViewall">Los sistemas de alerta y respuesta eficaces ante amenazas para la salud&#44; mejorando la oportunidad de las acciones y reduciendo la incertidumbre de la informaci&#243;n&#44; minimizar&#237;an el riesgo de crisis sanitarias&#46;</p><p class="elsevierStyleSimplePara elsevierViewall">Las amenazas sanitarias tienen un perfil inespec&#237;fico&#46; Su detecci&#243;n requiere un acceso a informaci&#243;n multidisciplinario y una correcta evaluaci&#243;n de riesgo&#46; El apoyo al desarrollo metodol&#243;gico y la investigaci&#243;n en salud p&#250;blica son fundamentales para mejorar la respuesta ante amenazas sanitarias&#46;</p>"
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      "en" => array:2 [
        "titulo" => "Abstract"
        "resumen" => "<p class="elsevierStyleSimplePara elsevierViewall">The world is changing more and faster than ever before&#46; New diseases are coming to light each year&#44; controlled diseases are reemerging as potential threats&#44; and natural or man-made disasters are increasingly affecting human health&#46;</p><p class="elsevierStyleSimplePara elsevierViewall">The &#8220;International Health Regulations &#40;2005&#41;&#8221; reflect the changes in the response of public health to this new situation&#46; Surveillance of specific diseases and predefined control measures have been replaced by surveillance of public health events of international concern and control measures adapted to each situation&#46; The public health events of international interest are characterized by their seriousness&#44; predictability&#44; the risk of international spread and potential for travel or trade restrictions&#46;</p><p class="elsevierStyleSimplePara elsevierViewall">The development of the European Early Warning and Response System in 1998 and the creation of the European Center for Disease Prevention and Control in 2005 demonstrate political commitment in Europe&#44; with early detection of and response to public health threats&#46; However&#44; timely risk evaluation and response at a national level requires improved data digitalization and accessibility&#44; automatic notification processes&#44; data analysis and dissemination of information&#44; the combination of information from multiple sources and adaptation of public health services&#46; The autonomous regions in Spain are initiating this adaptation process&#44; but interoperability between systems and the development of guidelines for a coordinated response should be steered by the National Interregional Health Council and coordinated by the Ministry of Health&#46;</p><p class="elsevierStyleSimplePara elsevierViewall">Efficient early warning systems of health threats that allow for a timely response and reduce uncertainty about information would help to minimize the risk of public health crises&#46;</p><p class="elsevierStyleSimplePara elsevierViewall">The profile of public health threats is nonspecific&#46; Early detection of threats requires access to information from multiple sources and efficient risk assessment&#46; Key factors for improving the response to public health threats are the development of surveillance methods and operational research in public health&#46;</p>"
      ]
    ]
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                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Emergent infectious diseases&#58; importance for public health&#44; epidemiology&#44; promoting factors&#44; and prevention"
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                        0 => array:2 [
                          "etal" => false
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                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Factors and determinants of disease emergence"
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                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Sci Tech"
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                  "referenciaCompleta" => "World Health Organisation&#46; Current WHO Phase of Pandemic Alert 2006&#46; Disponible en&#58; <a class="elsevierStyleInterRef" href="http://www.who.int/csr/disease/avian_influenza/phase/en/index.html">http&#58;&#47;&#47;www&#46;who&#46;int&#47;csr&#47;disease&#47;avian&#95;influenza&#47;phase&#47;en&#47;index&#46;html</a>"
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                  "referenciaCompleta" => "Hochedez P&#44; Hausfater P&#44; Jaureguiberry S&#44; Gay F&#44; Datry A&#44; Danis M&#44; et al&#46; Cases of Chikungunya fever imported from the islands of the South West Indian Ocean to Paris&#44; France&#46; Euro Surveill 2007&#59; 12&#40;1&#41; &#91;Epub ahead of print&#93;&#46; Disponible en&#58; <a class="elsevierStyleInterRef" href="http://www.eurosurveillance.org/em/v12n01/1201-227.asp">http&#58;&#47;&#47;www&#46;eurosurveillance&#46;org&#47;em&#47;v12n01&#47;1201-227&#46;asp</a>"
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                    0 => array:2 [
                      "titulo" => "Extensive drug-resistant TB&#58; a threat for Europe&#63;"
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                      "Revista" => array:4 [
                        "tituloSerie" => "Euro Surveill"
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                      "titulo" => "Smallpox and its eradication&#46; Ref Type&#58; Generic"
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                            0 => "F&#46; Fenner"
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                            4 => "I&#46; Ladnyi"
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                      "titulo" => "Bichat guidelines for the clinical management of smallpox and bioterrorism-related smallpox"
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                            4 => "J&#46; Hendriks"
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                0 => array:1 [
                  "referenciaCompleta" => "World Health Organization&#46; Revision of the International Health Regulations &#40;2005&#41;&#46; Disponible en&#58; <a class="elsevierStyleInterRef" href="http://www.who.int/csr/ihr/en/index.html">http&#58;&#47;&#47;www&#46;who&#46;int&#47;csr&#47;ihr&#47;en&#47;index&#46;html</a>"
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                  "referenciaCompleta" => "World Health Organization&#46; International Health Regulations &#40;1969&#41;&#46; 3rd annotated ed&#46; Geneva&#58; WHO&#59; 1983&#46;"
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              "identificador" => "bib11"
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                  "referenciaCompleta" => "Commission Decision of 22 December 1999 on the early warning and response system for the prevention and control of communicable diseases under Decision N&#46;&#176; 2119&#47;98&#47;EC of the European Parliament and of the Council &#40;2000&#47;57&#47;EC&#41;&#46;"
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                  "referenciaCompleta" => "Real Decreto de Vigilancia 28-12-1995&#44; n&#46;&#176; 2210&#47;1995&#46; BOE 24-1-1996&#44; n&#46;&#176; 21&#46;"
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              ]
            ]
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              "identificador" => "bib13"
              "etiqueta" => "13&#46;"
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                0 => array:1 [
                  "referenciaCompleta" => "Rodier G&#44; Hardiman M&#44; Plotkin B&#44; Ganter B&#46; Implementing the International Health Regulations &#40;2005&#41; in Europe&#46; Euro Surveill&#46; 2006&#59; 11&#58;208-11&#46; Disponible en&#58; <a class="elsevierStyleInterRef" href="http://www.eurosurveillance.%20org/em/v11n12/1112-222.asp">http&#58;&#47;&#47;www&#46;eurosurveillance&#46; org&#47;em&#47;v11n12&#47;1112-222&#46;asp</a>"
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                  "referenciaCompleta" => "Guglielmetti P&#44; Coulombier D&#44; Thinus G&#44; Van Loock F&#44; Schreck S&#46; The Early Warning and Response System for communicable diseases in the EU&#58; an overview from 1999 to 2005&#46; Euro Surveill&#46; 2006&#59; 11&#40;12&#41;&#46; Disponible en&#58; <a class="elsevierStyleInterRef" href="http://www.eurosurveillance.%20org/em/v11n12/1112-224.asp">http&#58;&#47;&#47;www&#46;eurosurveillance&#46; org&#47;em&#47;v11n12&#47;1112-224&#46;asp</a>"
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                  "referenciaCompleta" => "Rahamat-Langendoen J&#44; Van Vliet J&#44; Suijkerbuijk A&#46; Recognition of threats caused by infectious diseases in the Netherlands&#58; the early warning committee&#46; Euro Surveill 2006&#59; 11&#58;242-5 Disponible en&#58; <a class="elsevierStyleInterRef" href="http://www.eurosurveillance.org/em/v11n12/1112-230.asp">http&#58;&#47;&#47;www&#46;eurosurveillance&#46;org&#47;em&#47;v11n12&#47;1112-230&#46;asp</a>"
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                  "referenciaCompleta" => "Regulation &#40;EC&#41; N&#46;&#176; 851&#47;2004 of the European Parliament and of the Council of 21 April 2004 establishing a European Centre for disease prevention and control&#46; Official Journal L 142&#44; 30&#47;04&#47;2004 P&#46; 0001-0011&#46;"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "La Uni&#243;n Europea ante las crisis sanitarias"
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                          "etal" => false
                          "autores" => array:3 [
                            0 => "C&#46; Fern&#225;ndez de la Hoz"
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                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Rev Adm Sanit"
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                0 => array:1 [
                  "referenciaCompleta" => "Paquet C&#44; Coulombier D&#44; Kaiser R&#44; Ciotti M&#46; Epidemic Intelligence&#58; a new framwork for Strethening Disease Surveillance in Europe&#46; Euro Surveill&#46; 2006&#59; 11&#58;212-4&#46; Disponible en&#58; <a class="elsevierStyleInterRef" href="http://www.eurosurveillance.org/">http&#58;&#47;&#47;www&#46;eurosurveillance&#46;org</a>"
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                  "referenciaCompleta" => "Smith G&#44; Cooper D&#44; Loveridge P&#44; Chinemana F&#44; Gerard E&#44; Verlander N&#46; A national syndromic surveillance system for England and Wales using calls to a telephone helpline&#46; Euro Surveill 2006&#59; 11&#58;220-4&#46; Disponible en&#58; <a class="elsevierStyleInterRef" href="http://www.eurosurveillance.%20org/em/v11n12/1112-225.asp">http&#58;&#47;&#47;www&#46;eurosurveillance&#46; org&#47;em&#47;v11n12&#47;1112-225&#46;asp</a>"
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                0 => array:1 [
                  "referenciaCompleta" => "Josseran L&#44; Nicolau J&#44; Caill&#232;re N&#44; Astagneau P&#44; Br&#252;cker G&#46; Syndromic surveillance based on emergency department activity and crude mortality&#58; two examples&#46; Euro Surveill&#46; 2006&#59; 11&#58;225-9&#46; Disponible en&#58; <a class="elsevierStyleInterRef" href="http://www.eurosurveillance.org/em/v11n12/1112-226.asp">http&#58;&#47;&#47;www&#46;eurosurveillance&#46;org&#47;em&#47;v11n12&#47;1112-226&#46;asp</a>"
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                  "referenciaCompleta" => "Bork K&#44; Klein B&#44; M&#248;lbak K&#44; Trautner S&#44; Pedersen U&#44; Heegaard E&#46; Surveillance of ambulance dispatch data as a tool for early warning&#46; Euro Surveill&#46; 2006&#59; 11&#58;229-33&#46; Disponible en&#58; <a class="elsevierStyleInterRef" href="http://www.eurosurveillance.org/em/v11n12/1112-227.asp">http&#58;&#47;&#47;www&#46;eurosurveillance&#46;org&#47;em&#47;v11n12&#47;1112-227&#46;asp</a>"
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                  "referenciaCompleta" => "Schenkel K&#44; Williams C&#44; Eckmanns T&#44; Poggensee G&#44; Benzler J&#44; Josephsen J&#44; et al&#46; Enhanced Surveillance of Infectious Diseases&#58; the 2006 FIFA World Cup experience&#44; Germany&#46; Euro Surveill&#46; 2006&#59; 11&#58;234-8&#46; Disponible en&#58; <a class="elsevierStyleInterRef" href="http://www.eurosurveillance.%20org/em/v11n12/1112-228.asp">http&#58;&#47;&#47;www&#46;eurosurveillance&#46; org&#47;em&#47;v11n12&#47;1112-228&#46;asp</a>"
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                0 => array:2 [
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Información del artículo
ISSN: 02139111
Idioma original: Español
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