CDC report highlights progress and challenges in emergency disease preparedness

Improvements noted in disease detection, investigation, and laboratory response.

An inaugural report on public health preparedness released by the Centers for Disease Control and Prevention (CDC) indicates states have made significant progress with respect to emergency preparedness, but that significant challenges remain.

"This assessment of public health emergency preparedness is a major step forward," said Dr. Julie Gerberding, CDC director. "It illustrates the many specific ways that the investments we've been making since 2001 have increased states' capacity to quickly and effectively respond to a wide range of health hazards and emergencies. Today, for example, all states have emergency response plans, improved ability to identify and confirm public health threats, and more consistent and effective collaboration and communication between the many entities involved in responding to public health threats and emergencies."

More than $5 billion of federal funding has been distributed to the nation by CDC to improve public health preparedness and response since 2002.

"As a nation, we are better prepared today to respond to public health threats but the reality is that these efforts must be ongoing," said Richard Besser, M.D., director of CDC's Coordinating Office for Terrorism Preparedness and Emergency Response.

The CDC report, Public Health Preparedness: Mobilizing State by State, presents data that illustrate the progress state health departments have made in disease detection and investigation; laboratory testing capabilities; and planning, exercising and responding to public health emergencies. Key improvements from the report include:

• Disease detection and investigation. All state public health departments can now receive urgent reports about disease 24 hours a day, seven days a week. In 1999, only 12 states could do so. In addition, all states share information using the Epidemic Information Exchange (Epi-X), a secure, CDC-based communications system that helps track disease outbreaks. The number of users of this network nationwide has increased from 1,366 in 2001, to 4,646 in 2006.
• Public health laboratories. The number of laboratories that can test and analyze samples has nearly doubled since 2001.
• Response plans. All states have developed detailed emergency response plans to address all hazards, including an influenza pandemic. All states also now have plans to distribute the Strategic National Stockpile's federal caches of pharmaceuticals, antidotes, and medical supplies used for an emergency.
• Training. All public health departments now systematically and routinely train their workers in a wide range of crucial emergency response areas.

Work needs to continue

According to Besser, CDC's preparedness report is an important part of the agency's focus on measuring and documenting results, systematically using data to continuously improve programs and increasing accountability regarding the country's investment in preparedness activities.

"We recognize that CDC's report presents important data on some preparedness activities but does not provide information on all areas of preparedness," said Dr. Besser. "The nation's public health preparedness information and measures need to improve and CDC continues to engage with states and others to identify and incorporate effective public health emergency preparedness systems that enhance the nation's ability to respond."

CDC's approach has been to support public health preparedness for all hazards, including natural, biological, chemical, radiological, and nuclear events. This work falls under one of the agency's overarching health protection goals: "People prepared for emerging health threats - people in all communities will be protected from infectious, occupational, environmental, and terrorist threats."

CDC's report also provides a better understanding of where the major national and state challenges lie, and the areas where more progress needs to be made. Preparedness challenges include:

• Improving the ability to quickly dispense medicines and vaccines in an affected community
• Increasing the use of electronic health data for preparedness and response by networking surveillance systems
• Improving legal preparedness by helping states and other jurisdictions implement public health mutual aid agreements, which enable sharing of supplies, equipment, personnel, and information during emergencies
• Exercising public health systems to continuously improve capability and demonstrate readiness

CDC released the report during the annual Public Health Preparedness Summit in Atlanta today. The summit is coordinated by the National Association of City and County Health Officials. The report and state specific information is available on CDC's Web site at http://emergency.cdc.gov/publications/feb08phprep.

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