INTRODUCTION

The spread of human influenza does not respect national boundaries and there could be simultaneous outbreaks in different parts of the world. Co-ordination of preparedness and response at the international, regional, and national level is therefore essential.

This research guide focuses on the law related to the efforts in preventing, detecting and containing human influenza on the international, regional and national level (focusing on the United States).

For resources on the broader topic of health law and bioethics, please consult:

• Health Law Guide
• Global Health Law Guide
• Bioethics Guide

BACKGROUND & CURRENT INFORMATION ABOUT PANDEMIC FLU

International / Regional

• Fighting the Flu With One Hand Tied, Washington Post Op-Ed by Lawrence Gostin
  
  
• Swine Flu Epidemic (WHO's Epidemic and Pandemic Alert Response)
  Updated periodically. It answers various questions about what strategic actions are recommended by WHO.
  
  
• Influenza (WHO's Epidemic and Pandemic Alert and Response, EPR)
  Maintained by the WHO Global Influenza Programme. It provides a comprehensive set of links to information such as the current situation around the world; and pandemic preparedness plans from countries around the world.
  
  
• Avian Influenza (World Organisation for Animal Health, OIE)
  Web site maintained by the World Organisation for Animal Health to help governments and the veterinary services of member countries which are affected by or which want to protect the territories from the disease.
  
  
• EISS Weekly Electronic Bulletin (European Influenza Surveillance Scheme, EISS)
  Published every Friday during the influenza season, EISS Weekly Electronic Bulletin provides the general public and concerned parties with information on influenza activity in Europe. It also publishes commentary written by experts from the EISS group.
  
  
• Swine Flu - Mapping the Outbreak (BBC News)
  Interactive map tracks the spread of swine flu.
  
  
• Bird Flu In Depth (BBC News)
  Collects news articles about bird flu situations across the world.
  
  
• The Swine Flu Outbreak and International Law, By David P. Fidler, American Society of International Law(ASIL) Insights, April 27, 2009
  

United States

• PandemicFlu.gov
  The official U.S. Government Web site for information on pandemic flu and swine influenza.
  
  
• Pandemic Influenza (National Vaccine Program Office)
  Explains how a pandemic starts, and the different phases of pandemics; presents a historical overview of pandemics that occurred in the 20th Century.
  
  
• Swine Influenza (Centers for Disease Control and Prevention)
  Provides background information about swine influenza, including recent outbreaks, the viruses, and the risk to human health.
  
  
• Swine Influenza, Avian Influenza and Pandemic Influenza (Center for Infectious Disease Research & Policy, CIDRAP, University of Minnesota)
  Includes latest news as well as journal articles and a resource list.
  
  
• Swine Flu Legal Preparedness and Response (The Center for Law and the Public's Health)

SOURCES OF LEGAL AUTHORITY

International / Regional

• The World Health Organization

  The World Health Organization is charged with the coordination and monitoring of disease outbreaks across the globe. Specifically, under the revised International Health Regulations, IHR (2005) (entered into force in June, 2007), deals with the public health response framework public health emergencies.

  International Health Regulations background information and FAQs of IHR.

  Influenza A (H1N1) Update Page with RSS feed for current alerts to spring 2009 outbreak.

  Phases of pandemic alert are posted here, with graphical representation,

  Influenza-like Illness in United States and Mexico is the overall page for WHO specific to the outbreak of spring 2009,

  Epidemic and Pandemic Alert and Response framework of best practices, disease list, and core functions of the alert and response system.

  The Food and Agriculture Organization confirms no link to pigs or the food chain but is under constant surveillance of the food supply and the health of the animal population.

• The European Union

  The Europa official EU web site is monitoring the coordination of control,

  The Extraordinary Council of EU Health Ministers will meet to consider further steps and coordination,

  EU legislation on coordinating response to threats to health is summarized under the European Commission‰s Health and Consumer Protection Directorate-General.

United States - Federal

Like police powers, most public health authority is based in the states (10th Amendment to the Constitution). However, federal public health recommendations significantly influence state public health practice. Besides, the federal government has authority to control entries of persons, goods and conveyances from other countries and impose quarantine. Moreover, emergency responses needed in Louisiana and Mississippi because of the devastating hurricane Katrina in 2005 have sparked debates over the role of the military in responding to disasters.

Below is a selected list of statutes that give the federal government authority to deal with large scale emergencies:

• National Emergencies Act (50 U.S.C. § 1601 et seq.) provides the President with the power to declare an emergency.
  
  
• Homeland Security Act (6 U.S.C. § 101 et seq.) creates the Department of Homeland Security and grants the Secretary of Homeland Security a broad leadership role in planning for and responding to emergencies.
  
  
• Stafford Act (Robert T. Stafford Disaster Relief and Emergency Assistance Act or Disaster Relief Act of 1974, 42 U.S.C. § 5121 et seq.) establishes provisions for federal assistance to states in the event of a disaster.

• Public Health Service Act (PHSA) (42 U.S.C. § 201 et seq.) "creates important vehicles for federal funding of public health activities in state and communities."
  
  
  • Section 319 of the Public Health Service Act (42 U.S.C. § 247d) authorizes the HHS Secretary to declare a public health emergency and "take such action as may be appropriate to respond" to that emergency consistent with existing authorities.
    
    
  • Section 361 of the Public Health Service Act (42 U.S.C. §264) gives the Secretary of Health and Human Services responsibility for preventing the introduction, transmission, and spread of communicable diseases from foreign countries into the US and within the US and its territories/possessions. The statute is implemented through regulations found at 42 C.F.R. Parts 70 and 71. Under its delegated authority, the Centers for Disease Control and Prevention (CDC) is empowered to detain, medically examine, or conditionally release individuals reasonably believed to be carrying a communicable disease. As of October 31, 2007, the CDC maintains 20 quarantine stations in the U.S.
    
    
• Federal Food, Drug and Cosmetics Act (FFDCA) (21 U.S.C. § 301 et seq.) "authorizes the FDA to regulate the safety of food and cosmetics, and the safety and effectiveness of pharmaceuticals, biologics, and medical devices." The HHS Secretary can authorize emergency use of unapproved products or approved products for unapproved uses under section 564 of FFDCA (21 U.S.C. §360bbb-3).
  
  
• Executive Order 13375 (April 1, 2005) amending the Executive Order 13295 by adding "influenza caused by novel or reemergent influenza viruses that are causing, or have the potential to cause, a pandemic" to the list of quarantinable diseases.
  For more information, check Questions and Answers on the Executive Order Adding Potentially Pandemic Influenza Viruses to the List of Quarantinable Diseases.
  

Appendix E: Legal Authorities to the HHS Pandemic Influenza Plan outlines key pandemic response issues (such as public sector vaccine or antiviral drug purchase, indemnification of manufacturers, compensation for persons injured by vaccine or antiviral medications, etc.) and legal authorities. For statutes not listed above or in Appendix E to the Plan, check the United States Codes (Title 21 - Food and Drugs, Title 24 - Hospitals and Asylums, and/or Title 42 - Public Health) available at:

• Official and Annotated Codes in print - Reading Room and 5th Floor
• Lexis (Legal > Area of Law - By Topic > Health Care > Find Statutes, Regulations, & Legislative Materials > USCS - Health - Titles 15, 21, 24 and 42)
• Westlaw (FHTH-USCA)
• United States Code http://uscode.house.gov/ or http://www.law.cornell.edu/uscode
• Health Care Law Sourcebook (Lexis: Legal > Area of Law - By Topic > Health Care > Find Health Care Analytical Sources > Matthew Bender (R) > Health Care Law Sourcebook) - Updated 3 times per year.

For proposed legislation, check:

• Thomas http://thomas.loc.gov (for the full text and status of pending and recently enacted health legislation, try a word search in the current Congress)
• Lexis (Legal > Legislation & Politics - U.S. & U.K.> U.S. Congress > Congressional Full Text Bills - Current Congress)
• Westlaw (CONG-BILLTXT)
• Health Care Law Sourcebook (Lexis: Legal > Area of Law - By Topic > Health Care > Find Health Care Analytical Sources > Matthew Bender (R) > Health Care Law Sourcebook) - Updated 3 times per year.
• Newsletters, such as BNA publications, and other current awareness tools (discussed later in this research guide) are also good sources of proposed federal legislation.

United States - States

Many state public health statutes were enacted in response to specific diseases or health threats. In 2000, the Turning Point Public Health Statutes Modernization Collaborative was formed to address the need to reform state statutes to improve the public health system. The Collaborative created and presented in September 2003 the Model State Public Health Act which is designed to serve as a tool for state, local, and tribal governments to use to revise or update public health statutes and administrative regulations. Other model state acts that relate to public health are:

• Model State Emergency Health Powers Act (MSEHPA)
  Developed by the Center for Law & the Public's Health at Georgetown and Johns Hopkins Universities which won the CDC contract for its development. States are encouraged to use the model act to revise their laws to ensure adequate response to public health emergencies. To find out more about whether states have recently adopted the model act, check "The Model State Emergency Health Powers Act State Legislative Activity Table" (as of July 15, 2006) and "The Model State Emergency Health Powers Act Legislative Surveillance Table (as of July 15, 2006)."
  
  
• Model State Public Health Privacy Act
  Also developed by the Center for Law & the Public's Health at Georgetown and Johns Hopkins Universities, it addresses privacy and security issues arising from the acquisition, use, disclosure, and storage of identifiable health information by public health agencies at the state and local levels.

• The Uniform Emergency Volunteer Health Practitioners Act (UEVHPA)
  Developed by the Uniform Law Commission (ULA) in the aftermath of Hurricanes Katrina and Rita, it "provides uniform legislative language to facilitate organized response efforts among volunteer health practitioners."
  
  
• State Quarantine and Isolation Laws
  Summary of state laws (does not include District of Columbia, or other territories) regarding quarantine and isolation. Created by the Health Policy Tracking Service (HPTS) at iNETSCAN Publishing (now part of Thomson) for Trust for America's Health (TFAH). The review was conducted from July to November 2004.
  • District of Columbia - D.C. Code Ann. §7-131 et seq. The Mayor may, upon the advice of the Commissioner of Public Health, issue rules to prevent and control the spread of communicable diseases...; D.C. Mun. Regs. tit. 22 §200 et seq.
  • Maryland - MD. Code Ann., [Health-Gen.] §18-905 et seq. The Secretary of Health may issue an isolation and quarantine order.
  • Virginia - VA. Code Ann. §32.1-43 et seq. The State Health Commissioner shall have the authority to require quarantine, isolation, immunization, decontamination, or treatment of any individual or group of individuals when he determines any such measure to be necessary; 12 VA. Admin. Code § 5-90-105, 5-90-110.Summary of state laws (does not include District of Columbia, or other territories) regarding quarantine and isolation.

Other resources for state public health statutes are:

• Cornell's Legal Information Institute's State Statutes by Topic: Health links to state health laws by state. The currency of the statutes varies by state.
  
  
• Westlaw's 50 State Surveys database ("SURVEYS") is a potential resource for a 50-state survey of statutes.
  
  
• Lexis/Nexis 50 State Surveys provides links to legislation and regulations in all 50 states.
  
  
• National Conference of State Legislatures (NCSL) [http://www.ncsl.org] has a page on Public Health.

EMERGENCY PREPAREDNESS & RESPONSE PLANS

Federal and state statutes give appropriate agencies and officials the legal authority to carry out their responsibilities in an emergency situation The following are emergency preparedness and response plans devised by health agencies of international/regional organizations and U.S. Federal and state governments. These plans provide the blueprints for preparing for and responding to a pandemic outbreak.

International / Regional Organizations

• WHO Global Influenza Preparedness Plan: The Role of WHO and Recommendations for National Measures Before and During Pandemics (WHO /CDS/CSR/GIP/2005.5) (WHO Department of Communicable Disease Surveillance and Response, Global Influenza Programme)
  The WHO global influenza preparedness plan has been prepared by staff from the WHO Secretariat after a 3-day consultation meeting in December 2004 in Geneva attended by representatives from national influenza centers from around the word. The plan was prepared to assist WHO Member States and those responsible for public health, medical and emergency preparedness to respond to threats and occurrences of pandemic influenza. It recommends actions for national authorities, and outlines measures to be taken by WHO during each phase of a pandemic. There are six WHO influenza pandemic phases (see page 11 of the report): Phase 0 (inter-pandemic phase) to Phase 5 (confirmation that the pandemic has ended).
  
  
• Global Strategy for the Progressive Control of Highly Pathogenic Avian Influenza (Food and Agriculture Organization (FAO, Rome), World Organization for Animal Health (OIE, Paris) in Collaboration with World Health Organization (WHO, Geneva) May 2005)
  A draft master coordination plan with a global vision defining the road map and time frames for the short, medium and long term priority activities, produced in response to the recommendation made during the 2nd FAO/OIE Regional Meeting on Avian Influenza Control in Asia (23-25 February, 2005) held in Ho Chi Minh City, Viet Nam. The strategy paper will be consolidated and complemented by more detailed country specific avian influenza control plans prepared for several countries in Southeast Asia.
  
  

United States - Federal

• HHS Pandemic Influenza Plan (November 2005)
  "[S]erves as a blueprint for all HHS pandemic influenza preparedness and response planning. Part 1, the Strategic Plan, describes a coordinated public health and medical care strategy to prepare for, and begin responding to, an influenza pandemic. Part 2, Public Health Guidance for State and Local Partners provides guidance on specific aspects of pandemic influenza planning and response for the development of state and local preparedness plans." (from the Executive Summary)
  
  
• Pandemic Influenza Response and Preparedness Plan (2005)
  The plan describes the role of the Department of Health and Human Services (HHS) in coordinating and collaborating with state and local levels during the different phases of an eventual pandemic. The draft plan has been criticized as skirting many essential decisions, such as how the military may be deployed.
  
  
• National Response Plan (Department of Homeland Security)
  "[E]stablishes a comprehensive all-hazards approach to enhance the ability of the United States to manage domestic incidents. The plan incorporates best practices and procedures from incident management disciplines - homeland security, emergency management, law enforcement, firefighting, public works, public health, responder and recovery worker health and safety, emergency medical services, and the private sector - and integrates them into a unified structure. It forms the basis of how the federal government coordinates with state, local, and tribal governments and the private sector during incidents." It is built on the template of the National Incident Management System (NIMS).
  
  
  
• Pandemic Influenza Preparation and Response Planning Guidance (Department of Defense, September 15, 2004)
  Planning guidance for the military during the Avian Flu outbreak.

United States - State

• Swine Influenza Home Page (California Department of Health Services)
  
  
• Pandemic Influenza Preparedness Plan (District of Columbia Department of Health, March 2005)
  
  
• Maryland Pandemic Influenza Preparedness Plan (Maryland Department of Health & Mental Hygiene)
  
  
• Virginia Pandemic Influenza Plan (Virginia Department of Health)
  
  
• 50 State Pandemic Plans

AGENCIES RESPONSIBLE FOR EMERGENCY PREPAREDNESS & RESPONSES

International

• World Health Organization's (WHO) Epidemic and Pandemic Alert and Response (EPR) [http://www.who.int/csr/en/]
  The overall framework for EPR's strategy is the International Health Regulations (IHR) (for more information about IHR, check "Sources of Legal Authority" below). EPR focuses on the leading epidemic and emerging diseases. It develops and strengthens specific global surveillance and response networks for diseases such as influenza, meningococcal meningitis, plague, SARS, viral haemorrhagic fevers (Ebola, Lassa) and yellow fever. EPR's epidemic intelligence system gathers and verifies outbreak information daily from around the world and coordinates international responses to outbreaks of global importance, under its operational arm, the Global Outbreak Alert and Response Network. EPR also supports the strengthening of national capacity for alert and response.
  
  
• WHO's Global Influenza Programme [http://www.who.int/csr/disease/influenza/mission/en/]
  Part of WHO's Epidemic and Pandemic Alert and Response (EPR).
  
  
• Emergency Prevention System for Transboundary Animal and Plant Pests and Diseases (EMPRES) [http://www.fao.org/ag/againfo/programmes/en/empres/home.asp]
  Established by the Food and Agriculture Organization of the United Nations (FAO) in 1994, the EMPRES-Livestock programme plays a major role in the fight against persisting and/or spreading transboundary animal diseases such as mad cow disease and avian flu at a global level, with emphasis on developing countries through international co-operation involving early warning, early reaction, enabling research, and coordination.
  
  

Regional

Europe

• European Union Centre for Disease Prevention and Control (ECDC)
  
  
  
• European Influenza Surveillance Scheme (EISS) [http://www.eiss.org/index.cgi]
  Funded by the Health and Consumer Protection Directorate-General, European Commission EISS collects and exchanges timely information on influenza activity; contributes to the annual determination of the influenza vaccine content, providing relevant information about influenza to health professionals and the general public and the general public and contributes to European influenza pandemic preparedness.
  

Latin America

• Pan American Health Organization
  Includes updates on the cases reported on a regional basis, featuring an interactive atlas (in Spanish).

United States - Federal

Many federal agencies are responsible for various aspects of emergency preparedness and response. The HHS Pandemic Influenza Plan (November 2005) prepared by the Department of Health and Human Services provides a summary of major pandemic preparedness roles of HHS officials, agencies and divisons (Table 3). The section on HHS Actions for Pandemic Influenza Preparedness and Response summarizes key actions and responsible agencies by pandemic phase. Roles played by other federal departments are not detailed in the plan, nor are the coordination and communication amongst departments and agencies. A brief description of the roles played by HHS officials, agencies and divisions is as follows. For a more detailed list, please refer to Table 3 of the HHS Pandemic Influenza Plan (November 2005):

• Department of Health and Human Services (HHS) [http://www.hhs.gov/]
  • Secretary of Health and Human Services
    Directs all HHS pandemic response activities.
    
    
  • Office of Assistant Secretary for Health (ASH) [http://www.hhs.gov/ash/]
    Coordinates HHS pandemic activities and monitors progress.
    
    
  • Office of the Assistant Secretary for Public Health Emergency Preparedness (OPHEP) [http://www.hhs.gov/ophep/index.html]
    Coordinates HHS response activities with other federal departments and agencies.
    
    
  • National Vaccine Program Office (NVPO) [http://www.hhs.gov/nvpo/pandemics/]
    Coordinates development and revisions of the pandemic preparedness and response plan; coordinates and monitors preparedness activities during the inter-pandemic period, reporting to ASH; coordinates HHS agencies on vaccine issues via the Interagency Vaccine Group (IAVG).
    
    
  • Office of the General Counsel (OGC) [http://www.hhs.gov/ogc/]
    Advises on law related to key pandemic response activities.
    
    
  • Office of the Assistant Secretary of Public Affairs (ASPA) [http://www.hhs.gov/aspa/]
    Develops communications plan including public messages and materials.
    
    
  • Office of Global Health Affairs (OGHA) [http://www.hhs.gov/ogha/]
    Oversees interactions with other governments and international organizations related to pandemic preparedness.
    
    
  • Centers for Disease Control and Prevention (CDC) [http://www.cdc.gov]
    Works with partners throughout the nation and the world to monitor health, detect and investigate health problems; develops, evaluates and modifies disease control and prevention strategies; stockpiles antiviral drugs and other essential materials; promotes and supports influenza vaccination programs. The Influenza Pandemic Operation Plan (OPLAN) is published by the CDC.
    
    
  • Food and Drug Administration (FDA) [http://www.fda.gov/]
    Regulates and licenses vaccines and antiviral agents through the Center for Biologics Evaluation and Research and the Center for Drug Evaluation and Research, respectively; develops influenza viral reference strains and reagents and makes them available to manufacturers for vaccine development and evaluation.
    
    
  • National Institutes of Health (NIH) [http://www.nih.gov/]
    Conducts and supports biomedical research, including vaccine research and development.
    
    
  • Health Resources and Services Administration (HRSA) [http://www.hrsa.gov/]
    Oversees the National Vaccine Injury Compensation Program; coordinates planning for health care and hospital surge capacity and emergency preparedness.
    
    
  • Centers for Medicare and Medicaid Services (CMS) [http://www.cms.hhs.gov/]
    Promotes and supports influenza vaccination for Medicare patients' fosters improved delivery of influenza vaccination to hospitalized pneumonia patients.
    
    
  • National Vaccine Advisory Committee (NVAC) [http://www.hhs.gov/nvpo/nvac/]
    The NVAC is made up of 15 members appointed for rotating four-year terms by the Director of the NVP in consultation with the National Academy of Sciences, from among individuals who are engaged in vaccine research or the manufacture of vaccines; or who are physicians, members of parent organizations concerned with immunizations, or representatives of state or local health agencies or public health organizations. The Committee advises the Assistant Secretary for Health (ASH) on pandemic preparedness from perspectives of the multiple stakeholders including in the committee membership.
    
    
  • Vaccines and Related Biological Products Advisory Committee (VRBPAC) [http://www.fda.gov/cber/advisory/vrbp/vrbpmain.htm]
    Advises the Commissioner of Food and Drugs in discharging his responsibilities as they relate to helping to ensure safe and effective biological products, and as required, any other product for which the FDA has regulatory responsibility.
    
    
    
• Department of Homeland Security (DHS) [http://www.dhs.gov/dhspublic/]
  Has the overall authority for emergency response activities and will coordinate interventions to maintain community services during a pandemic.
  
  
• Department of Defense (DoD) [http://www.defenselink.mil/] and Department of Veterans Affairs (VA) [http://www.va.gov/]
  Provides surge capacity of medical equipment, materials and personnel when needed during an emergency.
  
  
• Department of Agriculture (USDA) [http://www.usda.gov/wps/portal/usdahome]
  Conducts surveillance for influenza in domestic animals.
  
  
• Department of Energy (DOE) and Department of Transportation (DOT) [http://www.dot.gov/]
  Maintains infrastructure during a pandemic.
  
  
• Department of Interior (DOI) [http://www.doi.gov/]
  Responsible for ensuring public health on more than 500 million acres of land across the country.

United States - State

• California Department of Public Health
  • It is particularly important for California to have a strong influenza surveillance program as it has several ports of entry for flights and shipping from Asia. The California Influenza Surveillance Project (CISP) obtains and analyzes hospital, pharmacy and laboratory data year-round in an effort to determine the timing and impact of influenza activity and to determine how well circulating strains of the virus match those used in the current influenza vaccines. The Web site provides weekly surveillance updates during the flu season.
    
    
• District of Columbia Department of Health's Web site [http://doh.dc.gov/doh/site/default.asp]
  
  
• Maryland Department of Health & Mental Hygiene [http://www.dhmh.state.md.us/]
  • Responsibilities of organizations by pandemic phase in Maryland including the role of Federal Government and private and volunteer organizations are detailed in the Maryland Pandemic Influenza Preparedness Plan.
  • Maryland Flu Preparedness [http://flu.maryland.gov/]
    
    
• Virginia Department of Health [http://www.vdh.state.va.us/]
  • Emergency Preparedness & Response Programs [http://www.vdh.state.va.us/EPR/index.asp] includes the Pandemic Flu Plan which lays out the responsibilities of the federal government and the Virginia state government.

SECONDARY SOURCES

Books

• David P. Fidler, International Law and Infectious Diseases (1999)
  
  
• David P. Fidler, International Law and Public Health: Materials on and Analysis of Global Health Jurisprudence (2000)
  
  
• Law and the Public Dimension of Health (Robyn Martin and Linda Johnson ed., 2001)
  
  
• Preparedness against Bioterrorism and Re-emerging Infectious Diseases (Janusz Kocik, Marek K. Janiak and Marian Negut, ed., 2004)
  
  
• John M. Barry, The Great Influenza: the Epic Story of the Deadliest Plague in History (2004) Also available electronically.

To retrieve more publications on Pandemic Flu, consult the library's catalog and conduct a subject search for:

• Communicable Diseases
• Epidemics
• Epidemics -- United States -- Prevention
• Influenza
• Influenza -- United States -- Prevention

Journal Articles

Consult the Research Guide on Using Articles for Legal & Non-Legal Research for assistance in locating articles on pandemic flu.

Medical Journal Articles

• Medline
  This is the most important index for U.S. medical journals, and includes many international ones as well. Medline (Ovid), see below, is the best way for Georgetown students and faculty to use Medline, because the full text of some articles are available. Medline is also available for free on the Web (without full text) through the PubMed service at the National Library of Medicine. It is also available as a database on Lexis (Legal > Area of Law - By Topic > Medical > Medical Reference > Medline References) and Westlaw: MEDLINE (without full text of articles).
  
  
• Medline (Ovid) (1951- ) A version of Medline with access to the full text of many articles. Available to Georgetown faculty and students only through the Medical Center's Dahlgren Library. (Georgetown Law on-campus access only)

Public Health Journals

Below is an alphabetical list of leading public health journals and periodicals with a focus on infectious diseases.

• American Journal of Epidemiology (Georgetown Law on-campus access only)
  
  
• American Journal of Public Health [K1 .M57]
  
  
• Bulletin of the World Health Organization: the International Journal of Public Health [http://www.who.int/bulletin/en/index.html]
  Its mission is "[t]o publish and disseminate scientifically rigorous public health information of international significance that enables policy-makers, researchers and practitioners to be more effective and improves health, particularly among disadvantaged populations.
  
  
• Emerging Infectious Diseases: A Peer-Reviewed Journal Tracking and Analyzing Disease Trends (CDC) (1995-present)
  
  
• European Journal of Public Health [INTL, K5 .U728], also available online (Georgetown Law only)
  
  
• Eurosurveillance [http://www.eurosurveillance.org/]
  A joint project since 1995 of the Institut de veille sanitaire at Saint-Maurice, France, and the Health Protection Agency Centre for Infections in London, United Kingdom, funded by the European Commission's Directorate-General for Health and Consumer Protection (DG SANCO), Eurosurveillance is a free journal with monthly and weekly releases publishing "authoritative, peer-reviewed information on communicable diseases from a European perspective." Target readers are professionals and policy makers in the field of communicable diseases.
  
  
• The Milbank Quarterly [K13 .I385]
  A Multidisciplinary Journal of Population Health and Health Policy.
  
  
• Weekly Epidemiological Record [http://www.who.int/wer/en/] (World Health Organization)
  "[A]n essential instrument for the collation and dissemination of epidemiological data useful in disease surveillance on a global level. Priority is given to diseases or risk factors known to threaten international health."

Health Care Administration/Management Journals

• Health Business Elite Database (Georgetown Law on-campus access only)
  Covers topics such as hospital management, hospital administration, marketing, human resources, computer technology, facilities management and insurance. Contains full text content detailing all aspects of health care administration and other non-clinical aspects of health care institution management from more than 450 journals such as Harvard Business Review, Health Care Financing Review, Health Facilities Management, etc.

Government Reports

1. Major Government Reports (in reverse chronological order)

The following are non-partisan government reports on various aspects of influenza pandemic.

• The 2009 Influenza Pandemic: An Overview (CRS Report, September 10, 2009)

• The 2009 Influenza A (H1N1) Outbreak: Selected Legal Issues (CRS Report, May 21, 2009)

• Quarantine and Isolation: Selected Legal Issues Relating to Employment (CRS Report, May 11, 2009)
  
  
• Public Health and Medical Preparedness Response: Issues in the 111th Congress (CRS Report, February 25, 2009)
  
  
• Influenza Pandemic:: Sustaining Focus on the Nation's Planning and Preparedness Efforts (GAO Report 09-334, February 2009)
  
  
• Getting Beyond Getting Ready for Pandemic Influenza (House Committee on Homeland Security, January 2009)
  
  
• Assessment of States" Operating Plans to Combat Pandemic Influenza (Report to Homeland Security Council, January 2009)
  
  
• Would an Influenza Pandemic Qualify as a Major Disaster Under the Stafford Act? (CRS Report, October 20, 2008)
  
  
• Guidance on Allocating and Targeting Pandemic Influenza Vaccine (Departments of HHS and Homeland Security, August, 2008)
  
  
• Influenza Pandemic: Federal Agencies Should Continue to Assist States to Address Gaps in Pandemic Planning (GAO Report 08-539, June 2008)
  
  
• Pandemic Influenza: An Analysis of State Preparedness and Response Plans (CRS Report, September 24, 2007)
  
  
• The Pandemic and All-Hazards Preparedness Act (P.L. 109-417):Provisions and Changes to Existing Law (CRS Report, March 17, 2007)

2. Indexes/Databases

• PolicyFile (1990-) (Georgetown Law only)
  Indexes and abstracts public policy research and analyses originating from think tanks, university research programs, research organizations, and publishers (includes GAO Reports, but not CRS Reports). Where available, access to home pages and full text are made available within individual abstracts.
  
  
• PAIS International (1972-) (Georgetown Law On-campus access only)
  Indexes public policy and public affairs literature.
  
  
• CQ Researcher [http://www.law.georgetown.edu/connect/cq_researcher.cfm] Weekly publication covers the most current and controversial issues of the day with complete summaries, insight into all sides of the issues, bibliographies and more. It published a report on the Avian Flu Threat on January 13, 2006.
  
  
• Congressional Research Service Reports (CRS Reports)
  These are non-partisan and in-depth reports produced by the Congressional Research Service, the research arm of the Library of Congress, on a variety of topics for Congress. They are not widely available, but a few libraries have been collecting and making them accessible:
  • Thurgood Marshall Library, University of Maryland [http://www.law.umaryland.edu/marshall/crsreports/index.asp]
  • University of North Texas Library [http://digital.library.unt.edu/govdocs/crs/index.tkl]
  • Open CRS: Congressional Research Reports for the People [http://opencrs.cdt.org/]
    A project of the Center for Democracy & Technology that serves as a centralized location to learn about the Congressional Research Service and search for CRS reports that have been released to the public by members of Congress. Provides report summaries.
  • Wikileaks.org
  • The Law Library also has a collection of CRS Reports on microfiche. Check the index to this collection to find out if the CRS report you are looking for is in the collection. The index is called: A Guide to Major Studies and Issue Briefs of the Congressional Research Service [Media, JK1108 .M34 Index/Guide]

Current Awareness

• Health Law & Business Library (BNA)
  http://healthlaw.bna.com/ (Georgetown Law only); also available on Westlaw: All Databases > Tropical Materials by Area of Practice > Health & Medicine > BNA Health & Medicine Materials > BNA Health Portfolios
  
  
• Health Care Policy Report (BNA) [KF3821. M26]
  also available online from Westlaw: BNA-HCFR and from the Law Library Web site under BNA's publication http://pubs.bna.com/ip/BNA/HFR.NSF (Georgetown Law only)
  
  
• Health Law Report (BNA) [KF3825.5 .A15 B63]
  also available online from Westlaw: BNA-HLR and from the Law Library Web site http://pubs.bna.com/ip/BNA/HLR.NSF (Georgetown Law only)
  
  
• State Health Notes (National Conference of State Legislatures) [RA395 .A3 S7] [http://www.statehealthnotes.org/] (December 2003- ) is an eight-page biweekly publication designed to deliver health information to state legislators and legislative staff. It offers a national perspective on health care issues as well as a network of established key policy contacts in all 50 states. It also offers timely news concerning new bills, laws, proposals and programs. Username and password to full-text electronic access are available here. (Georgetown Law only)
  
  
• ProQuest Research Library [http://www.law.georgetown.edu/connect/proquest_lib.cfm] includes many weekly news magazine (both general, such as Newsweek, and specialized, such as World Disease Weekly) (Georgetown Law only)

Bibliographies

• Influenza Bibliography (National Institute for Medical Research, United Kingdom) [http://www.nimr.mrc.ac.uk/flu/]
  
  
• Selected Reading, Pandemic Flu (Center for Infectious Disease Research & Policy, CIDRAP, University of Minnesota)

WEB SITES

Blogs

• ,Top 10 Epidemiology and Flu BlogsŠ
  http://www.blogs.com/topten/top-10-epidemiology-and-flu-blogs/
  
  
• Wall Street Journal Health Blog
  http://blogs.wsj.com/health/
  
  
• Health LawProf Blog
  http://lawprofessors.typepad.com/healthlawprof_blog/
  
  
• Google Flu Trends (inc. new Experimental Flu Trends for Mexico)
  http://www.google.org/flutrends/
  
  
• New York Times Well Blog
  http://well.blogs.nytimes.com/
  
  
• Washington Post Swine Flu Update
  http://voices.washingtonpost.com/swine-flu-report/?hpid=topnews
  

Other International Organization Web Sites

• The Global Economic and Financial Impact of an Avian Flu Pandemic and the role of the IMF (Prepared by the Avian Flu Working Group of the International Monetary Fund in consultation with Departments and the Joint Bank-Fund Health Services Department), February 28, 2006. [http://www.imf.org/external/pubs/ft/afp/2006/eng/022806.htm]
  This document "discusses the Fund's role in helping members prepare their economic and financial systems for the possibility of an avaian flu pandemic." The document will be updated on a periodic basis.
  
  
• Transcript of a Conference Call on the Global Economic and Financial Impact of an Avian Flu Pandemic and the Role of the IMF (International Monetary Fund), March 13, 2006 [http://www.imf.org/external/np/tr/2006/tr060313.htm]

Other U.S. Government Web Sites

• Avian Influenza Response (U.S. Agency for International Development, USAID) [http://www.usaid.gov/our_work/global_health/home/
  News/news_items/avian_influenza.html]
  Provides information on USAID's response to Avian Flu.
  
  
• Division of Global Migration and Quarantine (CDC) [http://www.cdc.gov/ncidod/dq/]
  
  
• EPI-X: The Epidemic Information Exchange (CDC) [http://www.cdc.gov/mmwr/epix/epix.html]
  "The Center for Disease Control and Prevention's secure, web-based communications network that serves as a powerful communications exchange between CDC, state and local health departments, poison control centers, and other public health professionals. The system provides rapid reporting immediate notification, editorial support, and coordination of health investigations for public health professionals." This Web site provides the public with information about this secure network.
  
  
• Federal Emergency Management Agency (FEMA) [http://www.fema.gov/]
  
  
• Public Health Emergency Response Guide for State, Local, and Tribal Public Health Directors (CDC) [http://www.bt.cdc.gov/planning/responseguide.asp]
  "[A]n all-hazards reference tool for health professionals who are responsible for initiating the public health response during the first 24 hours (i.e. the acute phase) of an emergency or disaster. It provides useful information on the activation and integration of a jurisdiction's public health system into the existing overall emergency response structure during the acute phase of an incident."
  
  
• Strategic National Stockpile (CDC) [http://www.bt.cdc.gov/stockpile/] is a national repository of pharmaceuticals and medical material to supplement and re-supply state and local public health agencies in the event of a national emergency. The Web site provides general information such as what Strategic National Stockpile is, how and when it is deployed. The Web site also includes some training material for state and local health care providers, first responders, and governments.
  
  

U.S. Academic Institutes

• The Center for Law & the Public's Health at Georgetown & Johns Hopkins Universities [http://www.publichealthlaw.net/]
  
  
• Johns Hopkins Center for Public Health Preparedness [http://www.jhsph.edu/preparedness/]
  
  
• For a more comprehensive list of centers for public health preparedness, check this list on the Association of Schools of Public Health (ASPH)

U.S. Organizations & Associations

• American College of Emergency Physicians
  
  
• Assoication for Professionals in Infection Control and Epidemiology
  
  
• American Hospital Association
  
  
• American Medical Association's Center for Public Health Preparedness and Disaster Response
  
  
• American Public Health Association
  • State Public Health Associations
    
    
• Association of Public Health Laboratories
  
  
• Association of Schools of Public Health
  
  
• Association of State and Territorial Health Officials (ASTHO)
  • Pubilc Health Emergency Preparedness
  • States of Preparedness: Second Edition
  • Public Health Preparedness State News
  • Preparedness Planning for State Health Officials (November 2002) designed to help State Health Officials to design their preparedness plans.
    
    
• Council of State and Territorial Epidemiologists
  
  
• Infectious Disease Society of America
  
  
• Institute of Medicine (IOM)
  
• National Association of County and City Health Officials (NACHO)
  
  
• National Foundation for Infectious Disease
  
  
• Public Health Law Association
  
  
• Trust for America's Health
  
  • Pandemic Flu and the Potential U.S. Economic Recession: State-by-State Analysis (2007 Report)

 

Useful Web Sites from Other Countries

• National Influenza Pandemic Plans (WHO)
  
  
• Canadian Pandemic Influenza Plan (Public Health Agency of Canada)
  
  
• Prevention of Human Swine Influenza (Hong Kong)
  
  
• Department of Health (Government of Hong Kong Special Administrative Region)
  
  

Revised March 17, 2006 (LT)
Revised 05/09 (MR, CD & MK)