The highly pathogenic avian influenza (HPAI) H5N1 virus was first detected in 1996 in Guangdong, China. Since 2003, H5N1 outbreaks have been reported in parts of Asia, Europe, the Middle East, and Africa. It is currently entrenched among poultry in parts of Asia and poses a major challenge to animal and human health. Singapore is free from HPAI. Given Singapore's need to import food, the Agri-Food and Veterinary Authority (AVA) has adopted a pro-active risk management system to prevent the introduction of HPAI. AVA's approach maybe described as a multi-layered control strategy for the prevention and control of HPAI. The strategy includes control measures at source, border control measures, local control measures and emergency preparedness.
Animals ; Birds ; Communicable Disease Control ; methods ; Disease Outbreaks ; prevention & control ; statistics & numerical data ; Global Health ; Health Planning ; Humans ; Influenza A Virus, H5N1 Subtype ; isolation & purification ; Influenza in Birds ; epidemiology ; prevention & control ; virology ; Poultry ; Singapore ; epidemiology

The main areas of emphasis in the Advanced Cardiac Life Support (ACLS) guidelines are: early recognition of cardiac arrest and call for help; good-quality chest compressions; early defibrillation when applicable; early administration of drugs; appropriate airway management ensuring normoventilation; and delivery of appropriate post-resuscitation care to enhance survival. Of note, it is important to monitor the quality of the various care procedures. The resuscitation team needs to reduce unnecessary interruptions to chest compressions in order to maintain adequate coronary perfusion pressure during the ACLS drill. In addition, the team needs to continually look out for reversible causes of the cardiac arrest.