Download Emerging and Zoonotic Infectious Diseases Updates

Emerging and Zoonotic
Infectious Diseases Updates
HICPAC Meeting
July 16, 2015
Beth P. Bell, MD, MPH
Director
National Center for Emerging and Zoonotic Infectious Diseases
Centers for Disease Control and Prevention
National Center for Emerging and Zoonotic Infectious Diseases
Office of the Director
NCEZID FY2015 Appropriations
$405 million for Emerging and Zoonotic Infectious
Diseases in FY2015
$352.99 million budget authority
$52 million Prevention and Public Heath Fund
Supports activities focused on:
Foodborne / waterborne illnesses
Infections that spread in hospitals and other healthcare settings
Infections that are resistant to antibiotics
Deadly diseases like anthrax and Ebola
Diseases caused by having contact with animals
Diseases spread by mosquitoes, ticks, and fleas
Illnesses that affect immigrants, migrants, refugees, and travelers
FY2016 President’s Budget Request
Budget Highlights Include:
• $264 million increase for
antibiotic resistance
• $10 million increase for
laboratory capacity and
safety
• $14 million increase for
the National Healthcare
Safety Network
Signature Programs
Laboratory Response
Network
The Yellow Book
PulseNet
National Healthcare Safety
Network
EIP
Emerging Infections
Program
EID Journal
Epidemiology and Laboratory
Capacity for Infectious Diseases
Strengthening State and Local Capacity
Epidemiology and Laboratory Capacity for Infectious
Diseases Cooperative Agreement (ELC)
• Supports 50 state health departments, 6
largest local health departments, and 8
territories or US affiliates
• Support >20 specific disease areas, e.g.,
influenza, foodborne disease, HAIs
• Provides cross-cutting support for infectious
disease epidemiology, laboratory and health
information systems
Responding to Outbreaks
In 2014, NCEZID received 37 requests from
states and other countries to assist
Blue Bell Ice Cream ~ Listeria
•
•
•
10 ill people in 4 states – 3 deaths
Recall of ALL products
Collaboration and data sharing
CRE ~ Duodenoscopes
Number of CRE outbreaks traced back to
duodenoscopes
NCEZID helped state assess duodenoscope
cleaning and disinfection practices;
developed an interim protocol for facilities
that want to test their duodenoscopes for
contamination with bacteria
Botulism
Many sickened, 1 death
Linked to a church potluck
CDC released anti-toxin from SNS
NCEZID sent 3 staff members to assist in
investigation
CDC’s Ebola Response
373 days of EOC activation as of July 16, 2015
27,564 Reported cases* in Sierra Leone, Liberia, and Guinea. Over 11,000
reported deaths
3000+ CDC staff involved in the response in the past year
6,800 communications products & 360 scientific documents cleared
35,000+ responses to Ebola-related inquiries
1,105 responses to calls from U.S. doctors and health departments
about patients with possible Ebola. Most did not require testing.
150,000 US healthcare workers trained via webinars and calls
Internet users have watched CDC PPE videos 445,849 times
* Suspected, probable, and confirmed cases as of July 4, 2015
• While the situation in West Africa has improved, there is more work to
be done
• New Ebola cases in Sierra Leone and Guinea, many of which have
unexplained chains of transmission
• On June 29, routine surveillance detected a new confirmed case of Ebola
in Liberia—the first since March 20. The person died on June 28 and
postmortem testing confirmed Ebola. Four subsequent cases have been
confirmed.
• CDC is committed to continuing to help the affected countries get to
zero new cases of Ebola by working with local ministries of health and
international partners
National Momentum on AR
AR Threat Report
FY 15 Detect and Protect Initative
National Strategy & PCAST Report
FY 16 AR Solutions Initiative
National Action Plan
WH Antibiotic
Stewardship Summit
National Action Plan for Combating
Antibiotic-Resistant Bacteria (CARB)
• Released March 27, 2015
• Outlines steps to implement
the National Strategy and
address policy
recommendations of the PCAST
report
• Significant outcomes expected
by 2020
• Activities are consistent with
investments in the FY 16
budget
• Companion TB Action Plan
under development
11
National Strategy for Combating Antibiotic-Resistant
Bacteria (CARB) Goals for the U.S. Government
1. Slow the Emergence of Resistant Bacteria and Prevent the
Spread of Resistant Infections
2. Strengthen National One-Health Surveillance Efforts to
Combat Resistance
3. Advance Development and Use of Rapid and Innovative
Diagnostic Tests for Identification and Characterization of
Resistant Bacteria
4. Accelerate Basic and Applied Research and Development for
New Antibiotics, Other Therapeutics, and Vaccines
5. Improve International Collaboration and Capacities for
Antibiotic Resistance Prevention, Surveillance, Control, and
Antibiotic Research and Development
12
FY16 AR Solutions Initiative:
New Chapter $264 Million
Comprehensive
Detect &
Respond
Protect
Innovate
Tracking
Rapid Detection
Faster Outbreak
• Regional Lab
• EIP
• NARMS
• State AR
Prevention
(Protect)
Programs
• Stewardship
• Microbiome
• Prevention
Epi-Centers
Response
Insights for Research
Innovation
Better Patient Care
Improved Prescribing
CDC’s proposed FY 16 AR activities will
also be supported through the FY 16
proposed increase to CDC’s National
Healthcare Safety Network (NHSN).
Chikungunya in the Western
Hemisphere
Countries and territories in the Americas where locally acquired chikungunya cases have been reported.
Cumulative CHIK in the Americas (July 2015)
•
44 countries or territories in the Caribbean,
Central America, South America, and North
America.
•
1,561,553 suspect/confirmed cases
•
The outbreak will likely continue to spread
to new areas in the Americas.
Cases in the Continental United States (2014)
• 47 states reporting cases, and the District of
Columbia
• 2,760 travel-associated cases
• 17% from FL
• 29% from NY
• 11 locally-acquired cases (FL)
Advanced Molecular Detection and
Response to Infectious Diseases
AMD combines
• Traditional epidemiology
• Genomic sequencing
• Bioinformatics
AMD projects
• Target specific pathogens and improve laboratory methods
• Span multiple CDC laboratories and many state and local
partner laboratories.
• Aim to develop innovations that will help CDC transform
public health and protect people from disease threats
Nationwide Listeriosis Surveillance Using WGS
• 1338 patient isolates and 1363 food and
environmental isolates sequenced as of Feb. 18,
2015
• Compared with PFGE, WGS
• Detected clusters faster and sped investigations
• Excluded cases from PFGE clusters
• Included isolates with different PFGE patterns in same
cluster
• Identified clusters not detected by PFGE
• Strongly linked patient isolates with food and
environmental isolates
• Successful pilot demonstrates WGS can eventually
replace PFGE
Supporting Global Health Security
3
3
Risks
Opportunities
• Emerging
organisms
• Drug resistance
• Intentional
creation
• Societal
commitment
• New
technologies
• Success leads to
success
3
© David Snyder/CDC Foundation
Priorities
• Prevent wherever
possible
• Detect rapidly
• Respond
effectively
Global Health Security
• CDC received $1.193 billion in FY2015 to build core public health
capacities around the world
– $597 million GHS appropriation
– $596 million in the Ebola Emerging Funding Request
• GHS focuses on 11 targets:
PREVENT
DETECT
RESPOND
Antimicrobial Resistance National Laboratory
Infection Control
System
Emergency Operations
Center
Zoonotic Diseases
Surveillance
Link Public Health and
Law Enforcement
Biosafety & Biosecurity
Information & Reporting Medical
Countermeasures
Immunization
Workforce Development
For more information please contact Centers for Disease Control and Prevention
1600 Clifton Road NE, Atlanta, GA 30333
Telephone, 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348
E-mail: [email protected]
Web: www.cdc.gov
The findings and conclusions in this report are those of the authors and do not necessarily represent the official
position of the Centers for Disease Control and Prevention.
Centers for Disease Control and Prevention
National Center for Emerging and Zoonotic Infectious Diseases