65 -- Non-Pharmaceutical Public Health Interventions (NPPHIs)

The Division of Global Migration and Quarantine (DGMQ) of the Centers for Disease Control and Prevention (CDC) will oversee the awarding of extramural funds to identify, improve, and/or evaluate the effectiveness of non-pharmaceutical public health interventions (NPPHIs) to prevent or limit the international, national, or community spread of pandemic influenza. This Request for Information (RFI) is to solicit comments that will be used to determine the scope and content of DGMQ program announcements regarding applied research on the use of NPPHIs for pandemic influenza control. The purpose of this research is to identify optimal NPPHIs or combinations of NPPHIs that may be implemented during pandemic phases 4, 5, and /or 6, as defined by the World Health Organization. Since pandemic preparedness requires advance planning, this research would likely involve control of seasonal human influenza viruses or similar viruses that are spread predominantly by large respiratory droplets. However, a secondary benefit of this research will be to develop and pilot-test methodologies that could be used at the onset of a pandemic to rapidly assess effectiveness of interventions against the pandemic strain. This research will focus on experimental and field studies, including but not limited to surveys, observational studies, controlled trials, and laboratory studies, to help develop and/or evaluate effectiveness (including cost-effectiveness and practicality of implementation) of interventions or combinations of interventions. The research will not include mathematical modeling studies, although it could include studies to develop estimates for parameters used in modeling studies. This is not an RFI for comments related to the use of vaccines, antivirals, or other pharmaceutical agents for pandemic influenza control. This RFI is not for comments related to infection control in healthcare settings. There is no specified format or length for the responses to this RFI. Respondents should specify whether the information they provide is primarily applicable to developed countries such as the United States, to countries in other stages of development, or both. Respondents are encouraged to indicate useful research approaches, considerations that should be kept in mind in designing research studies, and opportunities available to them to add to the knowledge base on these issues. Submission of information in response to this RFI does not imply that subsequent submissions or protocols will be funded by DGMQ or CDC. It is expected that the funding of this research on NPPHIs for the control of pandemic influenza will be divided into three domains: Border containment. This domain includes strategies and interventions to prevent or delay the spread of a pandemic virus across international borders by inbound or outbound international travelers at airports, seaports, or land border crossings. Examples of interventions may include but are not restricted to: - Providing information to international travelers - Health questionnaires that request information on symptoms and exposures - Body temperature measuring devices such as thermal scanners - Point-of-contact, rapid tests to identify persons infected with pandemic influenza strains - Algorithms that include combinations of measures such as those listed above - Measures to prevent or reduce influenza transmission on conveyances (such as airplanes or ships) -end- Examples of studies that might provide data to support development and evaluation of new or existing methods might include but are not restricted to: - Providing data on influenza-like illness (ILI) in arriving passengers - Providing estimate of the proportion of influenza-infected arriving passengers who are in the incubation rather than symptomatic stage of the illness - Comparison of effectiveness of various methods of providing information to international travelers - Determining the knowledge, attitudes, and behaviors of international arrivals to the United States - Evaluation of enroute surveillance and reporting of persons with ILI by crews on incoming international flights; evaluation of contact locating strategies -end- Community containment. This domain includes strategies and interventions to contain or reduce transmission in communities. Information is particularly requested for program announcements regarding strategies and interventions in communities in the United States that are impacted by health disparities. Examples may include but are not restricted to: - Providing information to the public and relevant population subgroups. - Voluntary home isolation of ill persons and home quarantine of contacts. - Closure of schools, cancellation of mass gatherings - Workplace policies that require all symptomatic employees to stay home - Protective sequestration of communities to delay or limit introduction of a pandemic strain - Identification of high-transmission nodes (e.g., schools, workplaces, or buildings where increased rates of human-to-human transmission may occur -end- Personal protective measures. This domain includes strategies and interventions that may be used by individuals to protect themselves and possibly also to reduce spread at the community level. Examples may include but are not restricted to: - Providing information to the public - Respiratory hygiene/ cough etiquette. - Hand hygiene - Use of masks or respirators by well and ill people -end- Information must be submitted by February May 5, 2006. Responses should be limited to 20 pages, 12 Font, Times Roman, single space, one sided or equivalent in an electronic and hard copy formats and can be e-mailed to the attention of Jeff Miller, Contract Specialist, phone 770-488-2651, email afx2@cdc.gov. Please ensure that at least one electronic and TWO (2) HARD COPIES of all responses are submitted.