As professionals in charge of public health and sanitation, our aim is the evaluation and management of the elements and devices that cause risks to public health and affect the quality of life.

Actions in the event of accidents and terrorism

PHD tasks are :

• to assist and advise first aid operators about public health, environmental and safety matters,
• to prevent or restrict diseases transmitted through the environment,
• to help emergency services to recover primary services and make their work easier.

Operating protocol for diseases transmitted by food and drinks

The PHD must adopt operating protocols providing appropriate action by the involved services and sectors.

Diseases transmitted by food include infections, toxic infections, infestations and intoxications caused by food. An outbreak of disease transmitted by food occurs when two or more disease cases appear after the same food has been eaten.

When a possible bioterrorism event is suspected, the PHD immediately activates the Regional Crisis Unit for bioterrorism and “SARS emergency”, which involves the Prefect and the Mayor of the concerned town.

All doctors must report suspected or confirmed cases of disease transmitted by food. Suspected cases of infective disease transmitted by food also have to be reported by head teachers of schools and by owners or holders of food production, preparation, handling and selling plants.

Aqueducts and Cisterns

Should an event deteriorate the aqueduct water quality, the PHD must carry out the following tasks :

• limit the use of aqueduct water for drinking, by suggesting that the Mayor adopts an urgent preventive decree,
• co-operate closely with the aqueduct managing body in taking every necessary step to identify the cause of the problem, its extent and its dangerousness for public health,
• sample the water in the aqueduct sectors and in the network of the concerned area, to analyse and identify the foreign substance.

Pathogenic agents transmitted by powders

If the police report finding a suspicious substance, the Fire Brigade and PHD intervene jointly according to their competence. The Police, the Emergency Department 118 and municipal guards of the concerned town also intervene, according to their institutional tasks. The PHD informs the regional crisis unit for bioterrorism and “SARS” emergency about the event.

Police seal off the area at risk and forbid people from entering or leaving, according to PHD and Fire Brigade indications.

All suspected cases of contamination must be taken to a Contagious Disease Hospital Ward. The first decontamination must be made on the actual site of contamination. However, the hospital must also provide decontamination facilities both for people who may have escaped the controls and in the event of logistic impossibilities for on-site decontamination. This is to be considered case by case.

PHD operators must start the epidemiological research in collaboration with non-contaminated persons in charge of the facility.

PHD operators give written instructions to managers or owners of premises to seal off rooms or areas polluted by the suspect substance, and encourage the Mayor to adopt a Preventive Health Decree until the results of the laboratory exams are known.

Pathogenic agents causing high sanitary impact transmissible diseases

PHD tasks are :

• Epidemiological surveillance :

The PHD maintains a high level of surveillance, and adopts a Notification System for contagious and rapidly spreading diseases and infections, toxic infections and food origin infestations, cooperating with the Regional Public Health Service, in order to be informed of unexpected events that may be connected with bioterrorism.

• Notification Receipt :

The Contagious Disease Prophylactics Dep. on working days and medical staff on duty on bank holidays and the days prior to bank holidays, receive notifications and all available information regarding the events.

• Notification of events is also communicated to other offices and epidemiological research bodies. Prophylaxis and quarantine measures are adopted. In cooperation with the Police, prophylaxis measures are applied in living and working environments.

Availability of PHD emergency teams (bioterrorism, toxic food infections, sars, avian influenza)

A team of operators is on permanent standby. The team is composed of 1 Technician, 1 Doctor and 1 Vet, who are provided with a car fitted with the necessary equipment.

The members of this team are each contacted by the Fire Department, the Emergency Department (118), the Police or the Prefect. On receiving a call, its is the team’s responsibility to reach the place indicated by the above-mentioned authorities as soon as possible.

Guidelines on Terrorist Threats to Food : Establishing and Strengthening Prevention and Response Systems

The intentional contamination of food by terrorists is a real and current threat, and deliberate contamination of food at one location could have global public health implications.

This document responds to increasing concern in Member States that chemical, biological or radionuclear agents might be used deliberately to harm civilian populations and that food might be a vehicle for disseminating such agents.

The guidelines state that :

• outbreaks of both unintentional and deliberate foodborne diseases can be managed by the same mechanisms,
• sensible precautions, coupled with strong surveillance and response capacity, constitute the most efficient and effective way of countering all such emergencies, including food terrorism,
• prevention is the first line of defence; the key to preventing food terrorism is establishment and enhancement of existing food safety management programmes and implementation of reasonable security measures,
• prevention is best achieved through a cooperative effort between government and industry, given that the primary means for minimizing food risks lie with the food industry,
• Member States require alert, preparedness and response systems that are capable of minimizing any risks to public health from real or threatened food terrorism. This document provides policy advice on strengthening existing emergency alert and response systems by improving links with all the relevant agencies and with the food industry.

The document provides guidance to Member States for integrating consideration of deliberate acts of food sabotage into existing programmes for controlling the production of safe food.

The role of the World Health Organization is to provide advice on the strengthening of national systems to respond to food terrorism. WHO is also in a unique position to coordinate existing international systems for public health disease surveillance and emergency response, which could be expanded to include considerations of food terrorism.