Veterinary medicine in disasters.

The evolution of the veterinary role in disaster management across the last 25 years is described, with particular attention to the Italian experience. Italy has a specific organisation of veterinary services which are integrated into the civil protection system as a component of the national health service. The Italian model is compared with USA and France. In USA a major role is played by the association of veterinarians (AVMA) while in France the veterinary response to disasters is based mostly on the activities of the Vetèrinaires Sapeur Pompiers (Veterinary Fire Brigades). Emerging issues arising after 9/11 attacks and SARS experience, as well as environmental emergencies, and the implication concerning the role of veterinary medicine in disasters are discussed.

Surveillance of summer mortality and preparedness to reduce the health impact of heat waves in Italy.

Since 2004, the Italian Department for Civil Protection and the Ministry of Health have implemented a national program for the prevention of heat-health effects during summer, which to-date includes 34 major cities and 93% of the residents aged 65 years and over. The Italian program represents an important example of an integrated approach to prevent the impact of heat on health, comprising Heat Health Watch Warning Systems, a mortality surveillance system and prevention activities targeted to susceptible subgroups. City-specific warning systems are based on the relationship between temperature and mortality and serve as basis for the modulation of prevention measures. Local prevention activities, based on the guidelines defined by the Ministry of Health, are constructed around the infrastructures and services available. A key component of the prevention program is the identification of susceptible individuals and the active surveillance by General Practitioners, medical personnel and social workers. The mortality surveillance system enables the timely estimation of the impact of heat, and heat waves, on mortality during summer as well as to the evaluation of warning systems and prevention programs. Considering future predictions of climate change, the implementation of effective prevention programs, targeted to high risk subjects, become a priority in the public health agenda.