Early recognition and rapid initiation of infection control precautions are the most important strategies for controlling large-scale infectious disease outbreaks (24).
Whatever the role and impact of risk perception, there is a need for cognitive and perception- oriented studies of the exposed population in large-scale infectious outbreaks.
The technique has been applied in large-scale infectious disease outbreaks such as those caused by Escherichia coli O104:H4, Staphylococcus aureus, Streptococcus pyogenes, Enterococcus faecium, Pseudomonas aeruginosa, Vibrio cholerae, and mycobacteria (3 – 14 ).
Although healthcare work during the SARS outbreak and during an influenza pandemic will differ in key respects, SARS experience provides the most extensive information available about the effects on HCWs of a large-scale infectious outbreak.
Although it is not abundantly clear how well modern medicine will be able to prevent devastation during such a large-scale infectious disease disaster, it is widely recognized that advance planning holds promise to temper the extent of devastation.
Conventional disease surveillance mechanisms that rely on passive reporting may be too slow and insensitive to rapidly detect a large-scale infectious disease outbreak; the reporting time from a patient's initial symptoms to specific disease diagnosis takes days to weeks.
For example, Japan and Bulgaria consider school closure as routine during seasonal influenza epidemics; and in HK, closures are expected from the population and politicians during large-scale infectious disease outbreaks.
Understanding the physiology of pregnancy, the factors that influence the teratogenic potential of medications and vaccines, and the infection control measures that may stop an outbreak will aid planners in making recommendations for care of pregnant women during large-scale infectious disease emergencies.
Other large scale screening for infectious disease among neonates and pregnant women have also used dried blood spots [ 28, 49], which have been validated with good correlation with conventional serological tests [ 50].
It is well understood that conflict and population displacement on a large scale poses significant risks for infectious disease, combined with livelihood disruption and food and water shortages [ 4].
