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Emergency preparedness, resilience and response to a biological outbreak
  1. P Welby-Everard1,
  2. O Quantick2 and
  3. A Green3
  1. 1 Anaesthetics Department, Queen Elizabeth Hospital Birmingham, Birmingham, UK
  2. 2 Public Health, Royal Army Medical Corps, Camberley, UK
  3. 3 Research and Clinical Innovation, Royal Centre for Defence Medicine, Birmingham, UK
  1. Correspondence to Dr P Welby-Everard, Department of Anaesthetics, Queen Elizabeth Hospital Birmingham, Birmingham, B15 2TH, UK; pwelbyeverard{at}


Major disease outbreaks continue to be a significant risk to public health, with pandemic influenza or an emerging infectious disease outbreak at the top of the UK National Risk Register. The risk of deliberate release of a biological agent is lower but remains possible and may only be recognised after casualties seek medical attention. In this context the emergency preparedness, resilience and response (EPRR) process protects the public from high consequence infectious diseases, other infectious disease outbreaks and biological agent release. The core elements of the EPRR response are recognition of an outbreak, isolation of patients, appropriate personal protective equipment for medical staff and actions to minimise further disease spread. The paper discusses how high-threat agents may be recognised by clinicians, the initial actions to be taken on presentation and how the public health system is notified and responds. It draws on the national pandemic influenza plans to describe the wider response to a major disease outbreak and discusses training requirements and the potential role of the military.

  • infectious diseases
  • accident and emergency medicine
  • microbiology
  • public health
  • epidemiology
  • general medicine (see Internal Medicine)
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  • Contributors PW-E wrote the initial draft of the paper, with revisions and additions made by OQ and AG.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval Not required

  • Provenance and peer review Commissioned; internally peer reviewed.

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