Download Outbreak Investigation and Response

Outbreak Investigation and Response
Program
Core Infectious Diseases
Healthcare-Associated
Infections/National Healthcare
Safety Network
CDC Food Safety
Advanced Molecular Detection
FY 14 Appropriation
$218,600,000
FY 15 President’s
Budget
$249,700,000
FY 15 ASTHO1
Recommendation
$249,700,000
$30,100,000
$40,100,000
$30,000,000
$32,100,000
$50,100,000
$30,000,000
$43,900,000
$54,400,000
$30,000,000
Outbreaks can be caused by known pathogens circulating every year, like the flu, or by new or emerging
diseases.2 Although no one can predict when and where the next outbreak will occur, we can support a
prepared public health workforce with the capacity to react quickly and limit disease spread. State
health agencies play this critical role.
Adequate Capacity Is Needed
State health agencies require effective and efficient systems to
prevent and control infectious disease. The Epidemiology and
Laboratory Capacity for Infectious Diseases (ELC) program provides
funding to all states to identify and monitor the occurrence of
known infectious diseases, identify newly emerging infectious
diseases, and identify and respond to outbreaks.
ELC funding has supported the actions of state public health in
virtually every major infectious disease outbreak in recent years,
while also building systems that work across multiple diseases and
can be leveraged according to conditions on the ground.
Importantly, the ELC program also enables states to adapt to
evolving health threats such as West Nile virus3, the emerging
Chikungunya threat, foodborne disease outbreaks, emerging strains
of flu such as H7N9 and H5N1, and MERS-CoV.




Selected Outbreaks in 2013
Serogroup B meningococcal disease
outbreaks: the outbreaks at Princeton
University (8 cases) and the University of
California, Santa Barbara (4 cases
Cyclospora cayetanensis infections: 631
cases and 49 hospitalizations across 25
states, representing more than one
outbreak.
Salmonella Heidelberg infections: 430
cases (38% hospitalized) across 23 states
with the outbreak strains linked to Foster
Farms brand chicken.
Hepatitis A infections: 162 cases and 71
hospitalizations across 10 states, linked to
pomegranate seeds.
Advanced Molecular Detection (AMD) Initiative Will Improve Capacity
The AMD Initiative provides the opportunity for a major modernization of current capacity to address
infectious disease outbreaks. With this initiative, CDC will adopt new technological approaches that can
provide huge amounts of detailed data about outbreaks faster and more cheaply than traditional
methods. Enhanced molecular sequencing tools, along with cutting-edge information technology and
bioinformatics experts, will allow CDC and states to identify outbreaks earlier and respond more
1
The FY 2015 ASTHO recommendation levels have been made comparable to FY 2014 and the FY 2015 president’s
budget to reflect implementation of the Working Capital Fund.
2
An emerging disease is one that appears in a population for the first time, such as SARS in 2004 or H1N1 influenza
in 2009, or one that existed previously but is rapidly increasing in incidence, range, or virulence.
3
Healthcare expenditures on West Nile virus top $770 million since 1999.
© March 2014 Association of State and Territorial Health Officials
2231 Crystal Drive, Suite 450, Arlington, VA 22202
202-371-9090 www.astho.org
Outbreak Investigation and Response
Outbreak Investigation and Response
effectively than they can today. Without these improvements, the important public health work to
protect people from infectious diseases will suffer.
Surveillance: Monitoring Infectious Disease
State health agencies systematically collect and analyze data to understand what infections are
spreading in the population and how best to prevent them. One example is surveillance for seasonal
influenza, which improves understanding of antiviral resistance in circulating influenza viruses and
provides the basis for seasonal influenza treatment recommendations. Detailed, quality surveillance
data is needed to inform response activities.
Response: Preventing and Controlling Infectious Disease
During an outbreak, time is of the essence. With adequate capacity, state health agencies can be ready
to quickly identify the cause of disease and communicate information about what steps to take. A timely
and complete public health response can save lives, avert illness, and restrain the growth of healthcare
costs.
2012 Multistate Meningitis Outbreak Case Count
In 2012, an investigation sparked by the Tennessee
Department of Health revealed cases of meningitis
associated with steroid injections. When evidence indicated
a link to a product from the New England Compounding
Center, the product was recalled. Prompt action got the
tainted product off shelves, and health departments and
providers worked together to inform and care for patients
who had already been injected.
Healthcare-Associated Infections (HAIs)
Other systems supported by CDC, such as the National Healthcare Safety Network, allow states to
monitor disease burden. HAIs in hospitals alone result in up to $33 billion in excess medical costs every
year. The area of HAI demonstrates the profound impact state health agencies can have when armed
with reliable data. In the relatively short time that state public health has been formally engaged,
infection rates have shown promising reductions.
Food Safety: Foodborne Illness
The United States needs an integrated national food monitoring system that has robust capacity at both
the federal and state levels to effectively prevent foodborne illness. Foodborne diseases sicken one in
six Americans each year, resulting in an estimated 128,000 hospitalizations and 3,000 deaths, with an
annual cost of $152 billion.
Surveillance programs such as CDC PulseNet are an important part of improving food safety. PulseNet
public health laboratories led the way in identifying an outbreak of Listeria in patients in Colorado and
connecting the outbreak DNA fingerprint to patients in 25 other states. Without CDC funding and
PulseNet, health officials might not have been able to collect the data needed to determine that the
illnesses in multiple states were related and linked to a common source.
© March 2014 Association of State and Territorial Health Officials
2231 Crystal Drive, Suite 450, Arlington, VA 22202
202-371-9090 www.astho.org
Outbreak Investigation and Response