Is Your State Ready For The Next Infectious Outbreak? Probably Not

By Nancy Shute

Published December 18, 2014 at 9:30 AM CST

Ebola may have slid off the nation's worry list, but that doesn't mean the United States is ready to handle an outbreak of Ebola or another infectious disease, an analysis says. That includes naturally occurring outbreaks like dengue fever, tuberculosis and measles, as well as the use of bioterrorism agents like anthrax.

The report issued Thursday gives half of the states and the District of Columbia failing grades on 10 measures of preparedness, which include maintaining funding for public health services from 2012; getting half the population vaccinated for flu; reducing the number of bloodstream infections caused by central lines for people in the hospital; testing the response time for emergency laboratory tests; and testing 90 percent of suspected E. coli 0157 infections within four days.

Maryland, Massachusetts, Tennessee, Vermont and Virginia did the best, scoring eight out of 10, while Arkansas, Idaho, Kansas, Kentucky, Louisiana, New Jersey, Ohio and Wyoming scored at or near the bottom.

That's not so good, considering that infectious diseases are the leading cause of death in people under age 60 worldwide, and cost the United States more than $120 billion a year. The list of diseases is long and growing, with old foes like tuberculosis and influenza, and newer threats like West Nile virus and Middle East Respiratory Syndrome.

It doesn't take rocket science to combat infectious disease; the public health strategies required have been used successfully for decades. But public health preparedness often loses out in state and federal budgets, unless there's been a recent Ebola outbreak or anthrax attack.

An up-to-speed public health system will be able to manage these challenges:

Quickly diagnosing outbreaks with laboratory testing and investigators who can trace contacts. Testing and contact tracing were used to contain the Ebola cases in Texas, and are used routinely by state and local health departments to combat outbreaks of foodborne illness.

Containing outbreaks with vaccines, medications and other countermeasures, including quarantine.

Train hospitals so they can respond quickly and safely when a novel infection presents itself, whether it's Ebola or the mysterious enterovirus D68, which sickened hundreds of children this fall.

Reporting systems that can help investigators quickly recognize an outbreak in the making, whether with everyday infections like flu and West Nile virus or rarer pathogens like Ebola and chikungunya.

Communicate swiftly and clearly among health workers, government agencies and the public.

Rapidly develop new vaccines or medical treatments, which multiple companies and countries are attempting now with Ebola.

The report was issued by the Trust for America's Health and the Robert Wood Johnson Foundation (which also provides funding to NPR.)

"Infectious disease control requires constant vigilance," the report concludes. "This requires having systems in place and conducting continuous training and practice exercises. The Ebola outbreak is a reminder that we cannot afford to let our guard down or grow complacent when it comes to infectious disease threats."