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Factors associated with preparedness of the US healthcare system to respond to a pediatric surge during an infectious disease pandemic: Is our nation prepared?

Christy Anthony, MD, Tito Joe Thomas, BS, Bridget M. Berg, MPH, Rita V. Burke, PhD, MPH, Jeffrey S. Upperman, MD, FAAP, FACS


Objective: Recent incidents have demonstrated that the US health system is unprepared for infectious pandemics resulting in a pediatric surge. Development of efficient plans and a structured and coordinated regional response to pediatric pandemic surge remains an opportunity. To address this gap, we conducted a literature review to assess current efforts, propose a response plan structure, and recommend policy actions.

Design: A literature review, utilizing MEDLINE and PubMed, through March 2017 identified articles regarding infectious disease pandemics affecting the US pediatric population. After review of current literature, a proposed response plan structure for a pediatric pandemic surge was designed.

Results: Inclusion and exclusion criteria reduced an initial screening of 1,787 articles to 162 articles. Articles ranged in their discussion of pediatric pandemic surge. Review of the articles led to the proposal of organizing the results according to 4 S's; (1) Structure, (2) Staff, (3) Stuff (Resources), and (4) Space.

Conclusion: The review has supported the concern that the US health system is unprepared for a pediatric surge induced by infectious disease pandemics. Common themes suggest that response plans should reflect the 4Ss and national guidelines must be translated into regional response systems that account for local nuances.


surge capacity, infectious disease, pandemic, Pediatric

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Filice CE, Vaca FE, Curry L, et al.: Pandemic planning and response in academic pediatric emergency departments during the 2009 H1N1 influenza pandemic. Acad Emerg Med: Off J Soc Acad Emerg Med. 2013; 20(1): 54-62.

Stalcup SA, Oscherwitz M, Cohen MS, et al.: Planning for a pediatric disaster—experience gained from caring for 1600 Vietnamese orphans. New Engl J Med. 1975; 293(14): 691-695.

Influx of patients with asthma-like symptoms strains resources in many pediatric EDs. ED Manage : Monthly Update Emerg Dept Manage. 2014; 26(11): 121-124.

Khan AS, Lurie N: Health security in 2014: Building on preparedness knowledge for emerging health threats. Lancet. 2014; 384(9937): 93-97.

Khabbaz RF, Moseley RR, Steiner RJ, et al.: Challenges of infectious diseases in the USA. Lancet. 2014; 384(9937): 53-63.

Nager AL, Khanna K: Emergency department surge: Models and practical implications. J Trauma. 2009; 67(suppl 2): S96-S99.

Care of children in the emergency department: Guidelines for preparedness. Pediatrics. 2001; 107(4): 777-781.

Barfield WD, Krug SE, Kanter RK, et al.: Neonatal and pediatric regionalized systems in pediatric emergency mass critical care. Pediatr Crit Care Med: J Soc Crit Care Med World Federation Pediatric Intens Crit Care Soc. 2011; 12(suppl 6): S128-S134.

Agolory SG, Barbot O, Averhoff F, et al.: Implementation of nonpharmaceutical interventions by New York City public schools to prevent 2009 influenza A. PloS one. 2013; 8(1): e50916.

Murray JS: A collaborative approach to meeting the psychosocial needs of children during an influenza pandemic. J Specialists Pediatr Nurs: JSPN. 2010; 15(2): 135-143.

Gupta R: Enhancing community partnerships during a public health emergency: The school-located vaccination clinics model in Kanawha County, WV during the 2009 influenza A (H1N1) pandemic. West Virginia Med J. 2011; 107(6): 28-34.

Cruz AT, Tittle KO, Smith ER, et al.: Increasing out-of-hospital regional surge capacity for H1N1 2009 influenza A through existing community pediatrician offices: A qualitative description of quality improvement strategies. Disaster Med Public Health Prep. 2012; 6(2): 113-116.

Kwan-Gett TS, Baer A, Duchin JS: Spring 2009 H1N1 influenza outbreak in King County, Washington. Disaster Med Public Health Prep. 2009; 3(suppl 2) : S109-S116.

Gausche-Hill M: Pediatric disaster preparedness: Are we really prepared? J Trauma. 2009; 67(suppl 2): S73-S76.

Burke RV, Ryutov T, Neches R, et al.: Health informatics for pediatric disaster preparedness planning. Appl Clin Informat. 2010; 1(3): 256-264.

Burke RV, Iverson E, Goodhue CJ, et al.: Disaster and mass casualty events in the pediatric population. Seminars Pediatr Surg. 2010; 19(4): 265-270.

Stamell EF, Foltin GL, Nadler EP: Lessons learned for pediatric disaster preparedness from September 11, 2001: New York City trauma centers. J Trauma. 2009; 67(suppl 2): S84-S87.

Krug SE, Needle S, Schonfeld D, et al.: Improving pediatric preparedness performance through strategic partnerships. Disaster Med Public Health Preparedness. 2012; 6(2): 94-96.

Sprang G, Silman M: Posttraumatic stress disorder in parents and youth after health-related disasters. Disaster Med Public Health Prep. 2013; 7(1): 105-110.

Remick K Snow S Gausche-Hill M: Emergency department readiness for pediatric illness and injury. Pediatr Emerg Med Pract. 2013; 10(12): 1-13 (Quiz 14).

Ginter PM, Wingate MS, Rucks AC, et al.: Creating a regional pediatric medical disaster preparedness network: Imperative and issues. Maternal Child Health J. 2006; 10(4): 391-396.

Siegel JD: Pandemic influenza planning in Texas: The pediatric perspective. Texas Med. 2007; 103(10): 48-53.

Tsai A, Kallsen G: Epidemiology of pediatric prehospital care. Ann Emerg Med. 1987; 16(3): 284-292.

Ortman SLCaJM: Projectsion fo the Size and Composition of the U.S Population: 2014-2060. In: Bureau USC, ed. Washington DC. 2015; 1125-1143.

Berger JT: Imagining the unthinkable, illuminating the present. J Clin Ethics. 2011; 22(1): 17-19.

Scarfone RJ, Alexander S, Coffin SE, et al.: Emergency preparedness for pandemic influenza. Pediatr Emerg Care. 2006; 22(9): 661-668 (Quiz 669-670).

Zhang X, Meltzer MI, Wortley PM: FluSurge - A tool to estimate demand for hospital services during the next pandemic influenza. Med Decis Making. 2006; 26(6): 617-623.

Prather E: Much ado about the flu. Texas Med. 2005; 101(12): 26-31.

Wong KK, Jain S, Blanton L, et al.: Influenza-associated pediatric deaths in the United States, 2004-2012. Pediatrics. 2014; 132(5): 796-804.

Cannava P, Cicillini D, Higgins M, et al.: Response to H1N1 influenza outbreak in a pediatric children's hospital: Challenges faced and lessons learned. J Pediatric Nurs. 2010; 25(5): 375-381.

Fieldston ES, Scarfone RJ, Biggs LM, et al.: Pediatric integrated delivery system's experience with pandemic influenza A (H1N1). Am J Manage Care. 2012; 18(10): 635-644.

Scarfone RJ, Coffin S, Fieldston ES, et al.: Hospital-based pandemic influenza preparedness and response: Strategies to increase surge capacity. Pediatr Emerg Care. 2011; 27(6): 565-572.

Strikas RA, Neff LJ, Rotz L, et al.: US Civilian Smallpox Preparedness and Response Program, 2003. Clinical Infect Dis: Off Publ Infect Dis Soc Am. 2008; 46(suppl 3): S157-S167.

Johnson EM, Diekema DS, Lewis-Newby M, et al.: Pediatric triage and allocation of critical care resources during disaster: Northwest provider opinion. Prehosp Disaster Med. 2014; 29(5): 455-460.

Christian MD, Devereaux AV, Dichter JR, et al.: Introduction and executive summary: Care of the critically ill and injured during pandemics and disasters: CHEST consensus statement. Chest. 2014; 146(suppl 4): 8s-34s.

Beigi R, Davis G, Hodges J, et al.: Preparedness planning for pandemic influenza among large US maternity hospitals. Emerg Health Threats J. 2009; 2: e2.

Howe EG: How can careproviders most help patients during a disaster? J Clin Ethics. 2011; 22(1): 3-16.

Waseem M, McInerney JE, Perales O, et al.: Impact of operational staging to improve patient throughput in an inner-city emergency department during the novel H1N1 influenza surge: A descriptive study. Pediatr Emerg Care. 2012; 28(1): 39-42.

Tollefsen WW, Brown CA, 3rd, Cox KL, et al.: Two hundred sixty pediatric emergency airway encounters by air transport personnel: A report of the air transport emergency airway management (NEAR VI: ‘A-TEAM’) project. Pediatr Emerg Care. 2013; 29(9): 963-968.

Laos CM, DiStefano MC, Cruz AT, et al.: Mobile pediatric emergency response team: Patient satisfaction during the novel H1N1 influenza outbreak. Acad Emerg Med: Off J Soc Acad Emerg Med. 2012; 19(3): 274-279.

Cruz AT, Patel B, DiStefano MC, et al.: Outside the box and into thick air: Implementation of an exterior mobile pediatric emergency response team for North American H1N1 (swine) influenza virus in Houston, Texas. Ann Emerg Med. 2010; 55(1): 23-31.

Antommaria AH, Powell T, Miller JE, et al.: Ethical issues in pediatric emergency mass critical care. Pediatr Crit Care Med: J Soc Crit Care Med World Federation Pediatr Intens Crit Care Soc. 2011; 12(suppl 6): S163-S168.

Fagbuyi DB, Brown KM, Mathison DJ, et al.: A rapid medical screening process improves emergency department patient flow during surge associated with novel H1N1 influenza virus. Ann Emerg Med. 2011; 57(1): 52-59.

Hutchins SS, Sulemana I, Heilpern KL, et al.: Performance of an algorithm for assessing smallpox risk among patients with rashes that may be confused with smallpox. Clin Infect Dis: Off Publ Infect Dis Soc Am. 2008; 46(suppl 3): S195-S203.

Erich J: START over. FDNY looks to patch cracks in a traditional triage system. EMS World. 2013; 42(5): I6-17.

Burt CW, Middleton KR: Factors associated with ability to treat pediatric emergencies in US hospitals. Pediatr Emerg Care. 2007; 23(10): 681-689.

Iwashyna TJ, Christie JD, Kahn JM, et al.: Uncharted paths: Hospital networks in critical care. Chest. 2009; 135(3): 827-833.

Staes CJ, Wuthrich A, Gesteland P, et al.: Public health communication with frontline clinicians during the first wave of the 2009 influenza pandemic. J Public Health Manage Pract: JPHMP. 2011; 17(1): 36-44.

Veenema TG: Diagnosis, management, and containment of smallpox infections. Disaster manage Response : DMR : Off Publ Emerg Nurses Assoc. 2003; 1(1): 8-13.

Martin SD: Code Flu: Common-sense steps to the development of an agency pandemic flu plan for home care. Home Healthcare Nurse. 2007; 25(9): 595-601.

Veenema TG: Safeguarding our nation's children: The diagnosis, management, and containment of smallpox in infants and children. Biologic Res Nurs. 2003; 4(4): 295-304.

Katharios-Lanwermeyer S, Holty JE, Person M, et al.: Identifying meningitis during an anthrax mass casualty incident: Systematic review of systemic anthrax since 1880. Clin Infect Dis: Off Publ Infect Dis Soc Am. 2016; 62(12): 1537-1545.

Rumoro DP, Bayram JD, Silva JC, et al.: The impact of alternative diagnoses on the utility of influenza-like illness case definition to detect the 2009 H1N1 pandemic. Am J Disaster Med. 2012; 7(2): 105-110.

Peacock E, Jacob VW, Fallone SM: Escherichia coli O157:H7: Etiology, clinical features, complications, and treatment. Nephrol Nurs J: J Am Nephrol Nurses' Assoc. 2001; 28(5): 547-550, 553-545 (Quiz 556-547).

Kumar S, Chusid MJ, Willoughby RE, et al.: Introduction of a Novel Swine-Origin Influenza A (H1N1) Virus into Milwaukee, Wisconsin in 2009. Viruses. 2009; 1(1): 72-83.

Schneider E, Hajjeh RA, Spiegel RA, et al.: A coccidioidomycosis outbreak following the Northridge, Calif, earthquake. JAMA. 1997; 277(11): 904-908.

Schrag SJ, Brooks JT, Van Beneden C, et al.: SARS surveillance during emergency public health response, United States, March-July 2003. Emerg Infect Dis. 2004; 10(2): 185-194.

Hinckley AF, Biggerstaff BJ, Griffith KS, et al.: Transmission dynamics of primary pneumonic plague in the USA. Epidemiol Infect. 2012; 140(3): 554-560.

Noah JW, Noah DL, Matalon S: Influenza exerts continued pressure in an era of modern medicine. Am J Respir Cell Mol Biol. Vol 41. United States. 2009: 3-7.

Karwowski MP, Meites E, Fullerton KE, et al.: Clinical inquiries regarding Ebola virus disease received by CDC—United States, July 9-November 15, 2014. MMWR Morb Mortal Wkly Rep. Vol 63. United States. 2014: 1175-1179.

Luby JP, Haley RW: Recurrent St. Louis encephalitis infection in residents of a flood plain of the Trinity River, Roosevelt Heights (Dallas, Texas). Am J Epidemiol. 1972; 96(2): 107-113.

Nolte KB, Lathrop SL, Nashelsky MB, et al.: ‘Med-X’: A medical examiner surveillance model for bioterrorism and infectious disease mortality. Human Pathol. 2007; 38(5): 718-725.

Jules A, Grijalva CG, Zhu Y, et al.: Influenza-related hospitalization and ED visits in children less than 5 years: 2000-2011. Pediatrics. 2015; 135(1): e66-e74.

McCormick JB, Yan C, Ballou J, et al.: Response to H1N1 in a U.S.-Mexico border community. Biosecurity Bioterrorism : Biodefense Strategy Pract Sci. 2010; 8(3): 233-242.

Stoto MA: The effectiveness of U.S. public health surveillance systems for situational awareness during the 2009 H1N1 pandemic: A retrospective analysis. PloS one. 2012; 7(8): e40984.

Barboza P, Vaillant L, Le Strat Y, et al.: Factors influencing performance of internet-based biosurveillance systems used in epidemic intelligence for early detection of infectious diseases outbreaks. PloS one. 2014; 9(3): e90536.

Monto AS, Comanor L, Shay DK, et al.: Epidemiology of pandemic influenza: Use of surveillance and modeling for pandemic preparedness. J Infect Dis. 2006; 194(suppl 2): S92-S97.

Centers for Disease Control and Prevention: Norovirus outbreak among evacuees from Hurricane Katrina—Houston, Texas, September 2005. MMWR Morb Mortal Weekly Rep. 2005; 54(40): 1016-1018.

Fleischauer AT, Silk BJ, Schumacher M, et al.: The validity of chief complaint and discharge diagnosis in emergency department-based syndromic surveillance. Acad Emerg Med: Off J Soc Acad Emerg Med. 2004; 11(12): 1262-1267.

Bristol N: US President releases long-awaited preparedness plan. Lancet (England). 2005; 366: 1683.

Moore ZS, Seward JF, Lane JM: Smallpox. Lancet. 2006; 367(9508): 425-435.

Ball K: The enigma of the H1N1 flu: Are you ready? AORN J. 2009; 90(6): 852-862 (Quiz 856-863).

Rebmann T: Preparing for pandemic influenza. J Perinatal Neonatal Nurs. 2008; 22(3): 191-202 (Quiz 194-203).

Zapata LB, Kendrick JS, Jamieson DJ, et al.: Prevention of novel influenza infection in newborns in hospital settings: Considerations and strategies during the 2009 H1N1 pandemic. Disaster Med Public Health Prep. 2012; 6(2): 97-103.

Jenkins PC, Modlin JF: Decision analysis in planning for a polio outbreak in the United States. Pediatrics. 2006; 118(2): 611-618.

Alexander L, Birkhead G, Guerra F, et al.: Ensuring preparedness for potential poliomyelitis outbreaks: Recommendations for the US poliovirus vaccine stockpile from the National Vaccine Advisory Committee (NVAC) and the Advisory Committee on Immunization Practices (ACIP). Arch Pediatr Adolesc Med. 2004; 158(12): 1106-1112.

Silvaggio JL, Van Otterloo J, Curran EA, et al.: Vaccine providers' perspectives on impact, challenges, and response during the California 2010 pertussis outbreak. Human Vaccines Immunother. 2014; 10(1): 199-207.

Moriarty LF, Omer SB, Seib K, et al.: Changes in immunization program managers' perceptions of programs' functional capabilities during and after vaccine shortages and pH1N1. Public Health Rep (Washington, DC : 1974). 2014; 129(suppl 4): 42-48.

Balbi DA, Calcagni K: Effects of the design and practice of points-of-dispensing on patient-reported satisfaction: Municipal H1N1 clinics in Rhode Island. Disaster Med Public Health Prep. 2011; 5(2): 106-111.

Klaiman T, O'Connell K, Stoto MA: Learning from successful school-based vaccination clinics during 2009 pH1N1. J School Health. 2014; 84(1): 63-69.

Cinti S: Pandemic influenza: Are we ready? Disaster Manage Response : DMR : Off Publ Emerg Nurses Assoc. 2005; 3(3): 61-67.

Davila-Payan C, Swann J, Wortley PM: System factors to explain 2009 pandemic H1N1 state vaccination rates for children and high-risk adults in US emergency response to pandemic. Vaccine. 2014; 32(2): 246-251.

Fishbane M, Kist A, Schieber RA: Use of the emergency Incident Command System for school-located mass influenza vaccination clinics. Pediatrics. 2012; 129(suppl 2): S101-106.

Seib K, Gleason C, Richards JL, et al.: Partners in immunization: 2010 survey examining differences among H1N1 vaccine providers in Washington state. Public Health Rep (Washington, DC: 1974). 2013; 128(3): 198-211.

Fauci AS: Race against time. Nature. 2005; 435(7041): 423-424.

Peacock G, Moore C, Uyeki T: Children with special health care needs and preparedness: Experiences from seasonal influenza and the 2009 H1N1 influenza pandemic. Disaster Med Public Health Prep. 2012; 6(2): 91-93.

Kemper AR, Davis MM, Freed GL: Expected adverse events in a mass smallpox vaccination campaign. Effective Clin Pract: ECP. 2002; 5(2): 84-90.

Bhanot KK: What defines a public health emergency? An analysis of the strategic national stockpile and the National Childhood Vaccine Injury Act: The need for prevention of nonterror national medical emergencies. J Contemporary Health Law Policy. 2004; 21(1): 137-167.

Chamberlain AT, Wells K, Seib K, et al.: Lessons learned from the 2007 to 2009 Haemophilus influenzae type B vaccine shortage: Implications for future vaccine shortages and public health preparedness. J Public Health Manage Pract: JPHMP. 2012; 18(3): E9-E16.

Gaglia MA, Jr, Davis MM: States' emergency orders regarding the 2004-05 influenza vaccine shortage. Human Vaccines. 2006; 2(1): 34-37.

Laurens MB: Common indications for pediatric antibiotic prophylaxis. Emerg Med Clinics North Am. 2013; 31(3): 875-894.

Goldstein E, Miller JC, O'Hagan JJ, et al.: Pre-dispensing of antivirals to high-risk individuals in an influenza pandemic. Influenza Other Respir Viruses. 2010; 4(2): 101-112.

Osterholm MT: How to vaccinate 30,000 people in three days: Realities of outbreak management. Public Health Rep (Washington, DC: 1974). 2001; 116(suppl 2): 74-78.

Wheeler CC, Erhart LM, Jehn ML: Effect of school closure on the incidence of influenza among school-age children in Arizona. Public Health Rep (Washington, DC: 1974). 2010; 125(6): 851-859.

Starbuck ES, von Bernuth R, Bolles K, et al.: Are we prepared to help low-resource communities cope with a severe influenza pandemic? Influenza Other Respir Viruses. 2013; 7(6): 909-913.

Wray RJ, Harris JK, Jupka K, et al.: Individual and community influences on adherence to directives in the event of a plague attack: Survey results. Disaster Med Public Health Prep. 2012; 6(3): 253-262.

Bauerle Bass S, Burt Ruzek S, Ward L, et al.: If you ask them, will they come? Predictors of quarantine compliance during a hypothetical avian influenza pandemic: Results from a statewide survey. Disaster Med Public Health Prep. 2010; 4(2): 135-144.

Miller G, Randolph S, Patterson JE: Responding to simulated pandemic influenza in San Antonio, Texas. Infect Control Hosp Epidemiol: Off J Soc Hosp Epidemiol Am. 2008; 29(4): 320-326.

Blendon RJ, Koonin LM, Benson JM, et al.: Public response to community mitigation measures for pandemic influenza. Emerg Infect Diseases. 2008; 14(5): 778-786.

From the Centers for Disease Control and Prevention. Acute hemorrhagic conjunctivitis—St Croix, US Virgin Islands, September-October 1998. JAMA. 1998; 280(20): 1737.

Rosoff H, John RS, Prager F: Flu, risks, and videotape: Escalating fear and avoidance. Risk analysis: Off Publ Soc Risk Anal. 2012; 32(4): 729-743.

Fung IC, Gambhir M, Glasser JW, et al.: Modeling the effect of school closures in a pandemic scenario: Exploring two different contact matrices. Clin Infect Diseases : Off Publ Infect Diseases Soc Am. 2015; 60(suppl 1): S58-S63.

Taylor-Clark K, Blendon RJ, Zaslavsky A, et al.: Confidence in crisis? Understanding trust in government and public attitudes toward mandatory state health powers. Biosec Bioterror: Biodefense Strategy Practice Science. 2005; 3(2): 138-147.

McKenna M: Pearls about swine how emergency departments are coping with the surge of H1N1. Ann Emerg Med. 2010; 55(1): A19-A21.

Marshall KM, Begier EM, Griffith KS, et al.: A population survey of smallpox knowledge, perceptions, and healthcare-seeking behavior surrounding the Iraq invasion—Connecticut 2002-03. Biosecurity Bioterrorism : Biodefense Strategy Practice Science. 2005; 3(3): 246-255.

Jehn M, Kim Y, Bradley B, et al.: Community knowledge, risk perception, and preparedness for the 2009 influenza A/H1N1 pandemic. J Public Health Manage Pract: JPHMP. 2011; 17(5): 431-438.

Savoia E, Testa MA, Viswanath K: Predictors of knowledge of H1N1 infection and transmission in the U.S. population. BMC Public Health. 2012; 12: 328.

Zun LS, Blume DN, Lester J, et al.: Accuracy of emergency medical information on the web. Am J Emerg Med. United States 2004; 22: 94-97.

TB crisis: A neonatal intensive care nurse may have the disease. Albany Medical Center Hospital, New York. Profiles Healthcare Market. 1993; 53: 24-35.

Powell T: Family participation in the care of patients in public health disasters. J Clin Ethics. 2010; 21(4): 288-293.

Kiltz L, Fonseca D, Rodriguez C, et al.: Assessment of pandemic preparedness in a socially vulnerable community in south Texas. J Health Human Serv Admin. 2013; 36(2): 164-207.

Kubicek K, Liu D, Beaudin C, et al.: A profile of nonurgent emergency department use in an urban pediatric hospital. Pediatr Emerg Care. 2012; 28(10): 977-984.

Del Beccaro MA, Brownstein DR, Cummings P, et al.: Outbreak of Escherichia coli O157:H7 hemorrhagic colitis and hemolytic uremic syndrome: Effect on use of a pediatric emergency department. Ann Emerg Med. 1995; 26(5): 598-603.

Brannen DE, Branum M, Pawani S, et al.: Medical allocations to persons with special needs during a bioterrorism event. Online J Public Health Informatics. 2016; 8(3): e200.

Witrago E, Perez MA: Preparing for an influenza pandemic: Policy implications for rural Latino populations. J Healthcare Poor Underserved. 2011; 22(suppl 3): 58-71.

Hutchins SS, Fiscella K, Levine RS, et al.: Protection of racial/ethnic minority populations during an influenza pandemic. Am J Public Health. 2009; 99(suppl 2): S261-S270.

Kayman H, Ablorh-Odjidja A: Revisiting public health preparedness: Incorporating social justice principles into pandemic preparedness planning for influenza. J Public Health Manage Pract: JPHMP. 2006; 12(4): 373-380.

Kim Y, Zhong W, Jehn M, et al.: Public risk perceptions and preventive behaviors during the 2009 H1N1 influenza pandemic. Disaster Med Public Health Prep. 2015; 9(2): 145-154.

Kids and the flu. State Legislatures. 2009; 35(9): 25.

Epson EE, Zheteyeva YA, Rainey JJ, et al.: Evaluation of an unplanned school closure in a Colorado school district: Implications for pandemic influenza preparedness. Disaster Med Public Health Prep. 2015; 9(1): 4-8.

Hinton CF, Griese SE, Anderson MR, et al.: CDC Grand Rounds: Addressing preparedness challenges for children in public health emergencies. MMWR Morbid Mortal Weekly Rep. 2015; 64(35): 972-974.

Miller A, Yeskey K, Garantziotis S, et al.: Integrating health research into disaster response: The New NIH Disaster Research Response Program. Int Journal Environ Res Public Health. 2016; 13(7), pii: E676.

Rebmann T, Elliott MB, Artman D, et al.: Missouri K-12 school disaster and biological event preparedness and seasonal influenza vaccination among school nurses. Am J Infect Control. 2015; 43(10): 1028-1034.

Dichter JR, Kanter RK, Dries D, et al.: System-level planning, coordination, and communication: Care of the critically ill and injured during pandemics and disasters: CHEST Consensus Statement. Chest. 2014; 146(suppl 4): e87S-e102S.

Courtney B, Hodge JG, Jr: Legal considerations during pediatric emergency mass critical care events. Pediatr Crit Care Med: J Society Crit Care Med World Federation Pediatr Intens Crit Care Societies. 2011; 12(suppl 6): S152-S156.

Buehler JW, Holtgrave DR: Who gets how much: Funding formulas in federal public health programs. J Public Health Manage Pract: JPHMP. 2007; 13(2): 151-155.

Silverman B, Chen B, Brener N, et al.: School district crisis preparedness, response, and recovery plans - United States, 2012. MMWR Morbid Mortal Weekly Rep. 2016; 65(36): 949-953.

Davis JP: Clinical and economic effects of pertussis outbreaks. Pediatr Infect Disease J. 2005; 24(suppl 6): S109-S116.

Heath BW, Coffey JS, Malone P, et al.: Pediatric office emergencies and emergency preparedness in a small rural state. Pediatrics. 2000; 106(6): 1391-1396.

Knowlton K, Rotkin-Ellman M, Geballe L, et al.: Six climate change-related events in the United States accounted for about $14 billion in lost lives and health costs. Health affairs (Project Hope). 2011; 30(11): 2167-2176.

Markenson D, Woolf S, Redlener I, et al.: Disaster medicine and public health preparedness of health professions students: A multidisciplinary assessment of knowledge, confidence, and attitudes. Disaster Med Public Health Preparedness. 2013; 7(5): 499-506.

Klein KR, Atas JG, Collins J: Testing emergency medical personnel response to patients with suspected infectious disease. Prehosp Disaster Med. 2004; 19(3): 256-265.

Sugerman D, Nadeau KH, Lafond K, et al.: A survey of emergency department 2009 pandemic influenza A (H1N1) surge preparedness—Atlanta, Georgia, July-October 2009. Clin Infect Diseases: Off Publ Infect Diseases Society Am. 2011; 52(suppl 1): S177-S182.

Eriksson CO, Uyeki TM, Christian MD, et al.: Care of the child with Ebola virus disease. Pediatr Crit Care Med. United States. 2015; 16: 97-103.

Wallace D, Gillett B, Wright B, et al.: Randomized controlled trial of high fidelity patient simulators compared to actor patients in a pandemic influenza drill scenario. Resuscitation. 2010; 81(7): 872-876.

Wood D, Kalinowski EJ, Miller DR, et al.: Pediatric continuing education for emergency medical technicians. The National Council of State Emergency Medical Services Training Coordinators. Pediatr Emerg Care. 2004; 20(4): 261-268.

Siddle J, Tolleson-Rinehart S, Brice J: Survey of Emergency Department staff on disaster preparedness and training for Ebola virus disease. Am J Disaster Med. 2016; 11(1): 5-18.

Chung S, Fagbuyi D, Lozon MM, et al. Going viral: adapting to pediatric surge during the H1N1 pandemic. Pediatr Emerg Care. 2013; 29(11): 1159-1165.

Fernandez JB, Glotzer DL, Triola MM, et al.: A unique role for dental school faculty: Telephone triage training and integration into a health departments' emergency response planning. Am J Disaster Med. 2008; 3(3): 141-146.

Burkle FM, Jr, Argent AC, Kissoon N: The reality of pediatric emergency mass critical care in the developing world. Pediatr Crit Care Med: J Society Crit Care Med World Federation Pediatric Intens Crit Care Societies. 2011; 12(suppl 6): S169-S179.

Mace SE, Jones JT, Bern AI: An analysis of Disaster Medical Assistance Team (DMAT) deployments in the United States. Prehosp Emerg Care : Off J National Assoc EMS Physicians National Assoc State EMS Directors. 2007; 11(1): 30-35.

Daugherty EL, Perl TM, Rubinson L, et al.: Survey study of the knowledge, attitudes, and expected behaviors of critical care clinicians regarding an influenza pandemic. Infect Control Hospital Epidemiol: Off J Soc Hosp Epidemiologists Am. 2009; 30(12): 1143-1149.

Stergachis A, Garberson L, Lien O, et al.: Health care workers' ability and willingness to report to work during public health emergencies. Disaster Med Public Health Prep. 2011; 5(4): 300-308.

Baron S, McPhaul K, Phillips S, et al.: Protecting home health care workers: A challenge to pandemic influenza preparedness planning. Am J Public Health. 2009; 99(suppl 2): S301-S307.

Cowden J, Crane L, Lezotte D, et al.: Pre-pandemic planning survey of healthcare workers at a tertiary care children's hospital: Ethical and workforce issues. Influenza Other Respir Viruses. 2010; 4(4): 213-222.

Qureshi K, Gershon RR, Sherman MF, et al.: Health care workers' ability and willingness to report to duty during catastrophic disasters. J Urban Health : Bulletin New York Acad Med. 2005; 82(3): 378-388.

Gershon RR, Magda LA, Canton AN, et al.: Pandemic-related ability and willingness in home healthcare workers. Am J Disaster Med. 2010; 5(1): 15-26.

Cone DC, Cummings BA: Hospital disaster staffing: if you call, will they come? Am J Disaster Med. 2006; 1(1): 28-36.

Watson CM, Barnett DJ, Thompson CB, et al.: Characterizing public health emergency perceptions and influential modifiers of willingness to respond among pediatric healthcare staff. Am J Disaster Med. 2011; 6(5): 299-308.

Grimes DE, Mendias EP: Nurses' intentions to respond to bioterrorism and other infectious disease emergencies. Nursing Outlook. 2010; 58(1): 10-16.

Charney RL, Rebmann T, Flood RG: Hospital employee willingness to work during earthquakes versus pandemics. J Emerg Med. 2015; 49(5): 665-674.

Santos CD, Bristow RB, Vorenkamp JV: Which health care workers were most affected during the spring 2009 H1N1 pandemic? Disaster Med Public Health Preparedness. 2010; 4(1): 47-54.

Goldsmith R, Stark F, Smith C, et al.: Orphan airlift. Enteric pathogens isolated from Vietnamese children immigrating to the United States. JAMA. 1976; 235(19): 2114-2116.

Douglas PK, Douglas DB, Harrigan DC, et al.: Preparing for pandemic influenza and its aftermath: Mental health issues considered. Int J Emerg Mental Health. 2009; 11(3): 137-144.

Carr BG, Addyson DK, Kahn JM: Variation in critical care beds per capita in the United States: Implications for pandemic and disaster planning. JAMA. 2010; 303(14): 1371-1372.

Gausche-Hill M, Schmitz C, Lewis RJ: Pediatric preparedness of US emergency departments: A 2003 survey. Pediatrics. 2007; 120(6): 1229-1237.

Gausche-Hill M, Ely M, Schmuhl P, et al.: A national assessment of pediatric readiness of emergency departments. JAMA Pediatr. 2015; 169(6): 527-534.

Bohn D, Kanter RK, Burns J, et al.: Supplies and equipment for pediatric emergency mass critical care. Pediatr Crit Care Med: J Society Crit Care Med World Federation Pediatr Intens Crit Care Societies. 2011; 12(suppl 6): S120-S127.

King JC, Ajao A, Lichenstein R, et al.: Surge in hospitalizations associated with mechanical ventilator use during influenza outbreaks. Disaster Med Public Health Prep. 2014; 8(2): 136-142.

Sobieraj JA, Reyes J, Dunemn KN, et al.: Modeling hospital response to mild and severe influenza pandemic scenarios under normal and expanded capacities. Military Med. 2007; 172(5): 486-490.

Kim KM, Cinti S, Gay S, et al.: Triage of mechanical ventilation for pediatric patients during a pandemic. Disaster Med Public Health Prep. 2012; 6(2): 131-137.

Gall C, Wetzel R, Kolker A, et al.: Pediatric triage in a severe pandemic: Maximizing survival by establishing triage thresholds. Crit Care Med. 2016; 44(9): 1762-1768.

Kanter RK: Pediatric mass critical care in a pandemic. Pediatr Crit Care Med: J Soc Crit Care Med World Federation Pediatr Intens Crit Care Societies. 2012; 13(1): e1-e4.

Kanter RK, Moran JR: Hospital emergency surge capacity: An empiric New York statewide study. Ann Emerg Med. 2007; 50(3): 314-319.

Graham J, Shirm S, Storm E, et al.: Challenges and solutions: Pandemic 2009 H1N1 influenza A in a pediatric emergency department. Am J Disaster Med. 2011; 6(4): 211-218.

Van Cleve WC, Hagan P, Lozano P, et al.: Investigating a pediatric hospital's response to an inpatient census surge during the 2009 H1N1 influenza pandemic. Joint Commission J Qual Patient Saf/Joint Commission Res. 2011; 37(8): 376-382.

Charney RL, Armbrecht ES, Kennedy BR, et al.: Pandemic influenza extension areas in an urban pediatric hospital. Prehosp Disaster Med. 2012; 27(1): 75-80.

Berg BM, Muller VM, Wilson M, et al.: Meeting children's needs: A mixed-methods approach to a regionalized pediatric surge plan—The Los Angeles County experience. Am J Disaster Med. 2014; 9(3): 161-169.

Clancy KA, Kacica MA: Ready for our children? Results from a survey of upstate New York hospitals' utilization of Pediatric Emergency Preparedness Toolkit guidance. Disaster Med Public Health Prep. 2012; 6(2): 138-145.

The Pediatric Emergency Care Applied Research Network (PECARN): Rationale, development, and first steps. Pediatr Emerg Care. 2003; 19(3): 185-193.



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