Friday, June 20, 2008

ERM-BC-COOP: On-going effort

Risk management, be it for an organization or for a government at any level MUST be an on-going effort.

Polio, we thought, had been eradicated - along with smallpox, measles, and other diseases which can maim or kill.

But, according to ProMed (, polio continues to be a threat, mostly in Africa and the Indian sub-continent, despite the availability of an easily acquired and easily distributed vaccine. Likewise smallpox and measles.

Tuberculosis, sometimes in very hard-to-treat forms, continues to make headlines, many years after a vaccine was developed.


Basically two reasons.

One: Some managements (governments) fail to immunize the populations.

Two: The illness was wiped out; we don't need to be concerned any more.

Obviously, Reason Two is false.

How do vaccinations relate to the non-government ERM-BC-COOP practitioner?

If people get sick, their production is reduced, sometimes to zero.

The illness can spread, so more people get sick, with another production "hit."

Lose enough people and there are two choices: shut down or hire new people (who probably also will become ill).

Now that everyone understands that people are an organization's most critical resource, consider how to protect that resource.

Preventive medicine.

When I was in the military, I often felt like a pin cushion as I made my way down the shot line. (Those were the days of needles.)

But I was protected from a host of maladies.

Today, about the only time an organization sponsors a preventive medicine event is just before flu season.

Perhaps we - risk management people - need to encourage management to reconsider implementation of a broader range of preventive medicine measures.

Understanding, of course, there are those who, for one reason or another, will spurn any preventive medical efforts. That's a problem "out of scope" for this day.

Northern Nigeria is currently affected by a new outbreak of wild poliovirus type 1 (WPV1), which has begun to spread internationally. In 2008, a 9-fold increase in new cases caused by this serotype has been reported compared with the same period in 2007. This outbreak in northern Nigeria has the potential to cause major international outbreaks, as occurred in 2003-2006. This year [2008], Nigeria accounts for 86 percent of WPV1 cases in the world.

This new outbreak in Nigeria has occurred because upwards of 20 percent of children remain unimmunized in key high-risk areas for polio in the north of the country. From 2003 to 2006, an outbreak in northern Nigeria led to national and international spread of the disease, eventually re-infecting 20 previously polio-free countries, causing outbreaks in places as far away as Indonesia and Yemen, and resulting in 1475 cases in these 20 countries.

New WPV1 genetically linked to viruses from northern Nigeria has now been confirmed in Benin (one case, onset 17 Apr 2008) and the western part of Niger (one case, in Tillaberry province, close to the borders with Burkina Faso and Mali; onset 11 Apr 2008). It is from these areas that WPV1 originating from Nigeria spread across west, central, and the Horn of Africa in 2003-2004, re-infecting -- among others -- Cote d'Ivoire, Ghana, Guinea, and Togo. In addition to international spread of WPV1 from northern Nigeria, wild poliovirus type 3 (WPV3) originating from northern Nigeria has been reported from Chad (onset of most recent case 13 Apr 2008).

The risk of renewed international spread of polio from Nigeria is increasing due to the intensity of the outbreak in northern Nigeria, the upcoming rainy season, which is associated with increased transmission of poliovirus, and the anticipated large-scale population movements for the Hajj (pilgrimage to Mecca, Saudi Arabia) in the 2nd half of 2008. Saudi Arabia has been notified of the increased risk of polio infection to Hajj pilgrims.

Nigeria has planned 2 large-scale rounds of emergency polio immunization in the northern states in July and August 2008. Large-scale emergency polio immunization campaigns were conducted on 13-16 June [2008] in high-risk and border areas of Benin, Burkina Faso, Mali, and Niger [see prior ProMED-mail posting Poliomyelitis (02): Africa, Asia 20080614.1882] , followed by additional campaigns in July. Disease surveillance is being heightened in 'at-risk' countries, including in those re-infected in 2003-2006.

Total cases: Year-to-date 2008 / Year-to-date 2007 / Total in 2007 Globally: 599 / 213 / 1313
- - in endemic countries: 560 / 179 / 1207
- - in non-endemic countries: 39 / 34 / 106

Case breakdown by country

Country: Year-to-date 2008 / Year-to-date 2007 / Total in 2007 / Date of onset of most recent case
India: 268 / 62 / 873 / 25 May 2008
Pakistan: 12 / 9 / 32 / 19 May 2008
Afghanistan: 8 / 3 / 17 / 14 May 2008
Angola: 16 / 1 / 8 / 12 May 2008
Nigeria: 272 / 105 / 285 / 9 May 2008
Ethiopia: 2 / 0 / 0 / 27 Apr 2008
Benin: 1 / 0 / 0 / 17 Apr 2008
Chad: 4 / 0 / 21 / 13 Apr 2008
Niger: 9 / 4 / 11 / 12 Apr 2008
Central African Republic: 1 / 0 / 0 / 6 Apr 2008
Democratic Republic of Congo: 2 / 13 / 41 / 24 Mar 2008
Sudan: 1 / 0 / 1 / 2 Mar 2008
Nepal: 3 / 0 / 5 / 16 Feb 2008
Myanmar: 0 / 8 / 11 / 28 May 2007
Somalia: 0 / 8 / 8 / 25 Mar 2007

Communicated by: ProMED-mail Rapporteur Marianne Hopp

[The figures cited in section [2] above represent an increase in 41 cases of polio reported to WHO in the past week -- (see prior ProMED-mail posting Poliomyelitis (02): Africa, Asia 20080614.1882 for cumulative cases reported as of 10 Jun 2008). Of these 41 newly reported cases, 25 were reported in Nigeria, 10 were reported in India, 4 were reported in Angola, one was reported in Pakistan, and one was reported in Ethiopia. The number of cases reported from Nigeria since the beginning of 2008 is 272 whereas in 2007, the total number of cases reported during the entire year was 285. - Mod.MPP]

Something to consider.

John Glenn, MBCI, SRP Enterprise Risk Management/Business Continuity Planner @

No comments: