In this episode of EMS One-Stop, host Rob Lawrence welcomes back infectious disease expert Dr. Alexander P. Isakov, MD, MPH, founding executive director of the Office of Critical Event Preparedness and Response (CEPAR), and professor of emergency medicine at Emory University.
Rob begins by discussing his real-life experience with an H5N1 outbreak in the UK as an ambulance service leader, and Dr. Isakov discusses the current H5N1 emergence in the U.S.
The discussion covers the current U.S. H5N1 outbreak, bird and swine flus, and the spillover from bird to mammal populations. They also address three recent U.S. cases of H5N1 among agricultural workers. They go on to discuss signs and symptoms of H5N1, index of suspicion, the Hierarchy of Controls in infectious diseases, universal and standard precautions, and fit testing respirators. They also cover resources available at NETEC.
Dr. Isakov concludes with a roundup of other global issues, including viral hemorrhagic fever (VHF), Ebola, Marburg and smallpox.
| More: Quick-reference guide: Selecting the appropriate PPE
Top quotes from this episode
“While this virus has been tracked by public health authorities since 1997, what’s really different today that’s putting it in the news is this spillover into mammal populations.” — Dr. Alex Isakov
“The EMS clinicians in the field know how to apply the Hierarchy of Controls, including that PPE ensemble that we’ve described because they’ve gotten a tremendous amount of experience doing it during the COVID-19 pandemic.” — Dr. Alex Isakov
“It’s fairly non-specific for the EMS community. I think where this might be of greatest interest is if you are working in a service area or serving a population of people that are, you know, working on dairy cattle farms and working with your local public health department to understand what the risks are.” — Dr. Alex Isakov
Episode contents
00:45 – Introducing Dr. Alex Isakov
01:28 – H5N1 – Rob’s UK H5N1 origin story
04:30 – Original late 90s/2000s exposure rate
05:45 – The current U.S. H5N1 outbreak
06:15 – Bird flus and swine flus
08:00 – Spillover from bird to mammal populations
08:30 – Three recent U.S. cases amongst agricultural workers
09:45 – Signs and symptoms and index of suspicion
12:50 – If CDC says the risk to the human population is low, then why are we talking about this?
14:30 – Remembering the lessons of COVID
16:30 – The Hierarchy of Controls in infectious diseases
17:00 – Universal and standard precautions, and fit testing respirators
18:00 – Resources available at NETEC
19:00 – Is the EMS community ready to transport patients infected with H5N1?
20:30 – Other global issues to monitor
21:00 – Viral hemorrhagic fever, Ebola, Marburg and smallpox
22:40 – The role of call centers in surveillance monitoring
24:00 – Final thoughts
Additional resources on this topic
- National Emerging Special Pathogens Training and Education Center
- EMS Biosafety Transport - Viral Hemorrhagic Fevers: Ebola Virus Disease
- CDC A (H5N1) Bird Flu Response Update June 14, 2024
- Technical Report: June 2024 Highly Pathogenic Avian Influenza A(H5N1) Viruses
- Virulence differences of mpox (monkeypox) virus clades I, IIa, and IIb.1 in a small animal model
- NETEC: H5N1 Updates and Considerations for Health Care Personnel
ABOUT OUR GUEST
Alexander P. Isakov, MD, MPH, is the founding executive director of CEPAR and a professor of emergency medicine at Emory University. He oversees the development of the CEPAR office, providing oversight and leadership for numerous initiatives aimed at improving the disaster resilience of Emory and the broader community. His professional experience includes service as an officer in the United States Navy, consulting for the CDC, deploying with the National Disaster Medical System, and providing leadership in EMS and disaster preparedness. He is also the director for Emory’s Section of Prehospital and Disaster Medicine, whose faculty and staff provide medical oversight for 911 communications centers, first responders, air and ground ambulance services, and special events in the metropolitan Atlanta area.
Dr. Isakov has been active in programs to improve EMS and community disaster resilience locally, regionally and nationally. He led the Academic-Community Partnership for Sustainable Preparedness and Response Systems project of the Emory Preparedness and Emergency Response Research Center, which explored the relationship between academic institutions and the public health preparedness and emergency management communities. He previously served as a member of the Ad Hoc Committee on Strengthening the Disaster Resilience of Academic Research Communities and the Ad Hoc Committee on the Certification of Personal Protective Technologies for the National Academy of Science, Engineering and Medicine. He is currently the emergency medical services lead for the National Emerging Special Pathogens Training and Education Center. He is a member of the Epidemic Expert Panel of the American College of Emergency Physicians and a subject matter expert for the Assistant Secretary for Preparedness and Response, Technical Resources, Assistance Center and Information Exchange. Dr. Isakov was recently funded and tapped to lead a consortium to implement the latest Regional Disaster Health Response System (RDHRS) by the Department of Health and Human Services’ Office of the Assistant Secretary for Preparedness and Response (ASPR).
He is certified by the American Board of Emergency Medicine in both emergency medicine and emergency medical services. He practices clinically in the emergency department of Emory University Hospital and is also the medical director for Emory EMS, Sandy Springs Fire Department and Air Life Georgia.
