Western Pacific Surveillance and Response(WPSAR) was established to encourage countries in the Western Pacific Region to share information on the surveillance of and response to public health events specific to this Region. An important step in surveillance is the dissemination of results to stakeholders, and, in the current international environment, public health events in one country may be of interest to the Region or even globally. In recent years many countries in the Western Pacific Region have increased capacity in surveillance and response through the Asia Pacific Strategy for Emerging Diseases to meet the core capacity requirements of the International Health Regulations (2005), also known as IHR (2005).

Health security in the Asia Pacific Region is continuously threatened by emerging diseases and public health emergencies. In recent years, the Region has been an epicentre for many emerging diseases, resulting in substantial negative impacts on health, social and economic development. As the Region is home to more than 50% of the world population, true global public health security depends to a large degree upon how successful this Region is in developing and sustaining functional national and regional systems and capacities for managing emerging diseases and acute public health events and emergencies. Tremendous efforts have been made by individual countries and the international community to confront emerging disease threats in recent years, but the need for a common regional strategic framework has been recognized by countries and areas in the Asia Pacific, the World Health Organization, donors and partner agencies. To address this need, an updated Asia Pacific Strategy for Emerging Diseases, or APSED (2010), has been developed, aiming to strategically build sustainable national and regional capacities and partnerships to ensure public health security through preparedness planning, prevention, early detection and rapid response to emerging diseases and other public health emergencies. The Strategy calls for collective responsibility and actions to address the shared regional health security threat with a greater emphasis on preparedness-driven investments in health security. APSED (2010) serves as a road map to guide all countries and areas in the region towards meeting their core capacity requirements under the International Health Regulations (2005) to ensure regional and global health security.

After a devastating earthquake and tsunami struck north-eastern Japan in March 2011, the public health system, including the infectious disease surveillance system, was severely compromised. While models for post-disaster surveillance exist, they focus predominantly on developing countries during the early recovery phase. Such models do not necessarily apply to developed countries, which differ considerably in their baseline surveillance systems. Furthermore, there is a need to consider the process by which a surveillance system recovers post-disaster. The event in Japan has highlighted a need to address these concerns surrounding post-disaster surveillance in developed countries.

In May 2011, the World Health Organization convened a meeting where post-disaster surveillance was discussed by experts and public health practitioners. In this paper, we describe a post-disaster surveillance approach that was discussed at the meeting, based on what had actually occurred and what may have been, or would be, ideal. Briefly, we describe the evolution of a surveillance system as it returns to the pre-existing system, starting from an event-based approach during the emergency relief phase, a syndromic approach during the early recovery phase, an enhanced sentinel approach during the late recovery phase and a return to baseline during the development phase. Our aim is not to recommend a specific model but to encourage other developed countries to initiate their own discussions on post-disaster surveillance and develop plans according to their needs and capacities. As natural disasters will continue to occur, we hope that developing such plans during the “interdisaster” period will help mitigate the surveillance challenges that will arise post-disaster.

BACKGROUND: Pedicled flaps are useful for reconstructive surgery. Previously, we often used vascularized supraclavicular flaps, especially for head and neck reconstruction, but then shifted to using thoracic branch of the supraclavicular artery (TBSA) flaps. However, limited research exists on the anatomy of TBSA flaps and on the use of indocyanine green (ICG) fluorescence videoangiography for supraclavicular artery flaps. We utilized ICG fluorescence videoangiography to harvest reliable flaps in reconstructive operations, and describe the results herein. METHODS: Data were retrospectively reviewed from six patients (five men and one woman: average age, 54 years; range, 48–60 years) for whom ICG videoangiography was performed to observe the skin perfusion of a supraclavicular flap after it was raised. Areas where the flap showed good enhancement were considered to be favorable for flap survival. The observation of ICG dye indicated good skin perfusion, which is predictive of flap survival; therefore, we trimmed any areas without dye filling and used the remaining viable part of the flap. RESULTS: The flaps ranged in size from 13×5.5 cm to 17×6.5 cm. One patient received a conventional supraclavicular flap, four patients received a TBSA flap, and one patient received a flap that was considered to be intermediate between a supraclavicular flap and a TBSA flap. The flaps completely survived in all cases, and no flap necrosis was observed. CONCLUSIONS: The TBSA flap is very useful in reconstructive surgery, and reliable flaps could be obtained by using ICG fluorescence videoangiography intraoperatively.
Arteries ; Female ; Fluorescence ; Head ; Humans ; Indocyanine Green ; Male ; Neck ; Necrosis ; Perfusion ; Reconstructive Surgical Procedures ; Retrospective Studies ; Skin ; Surgical Flaps