Report Reveals Gaps in U.S. Response to Infectious Disease Outbreaks

Half of all U.S. states and the District of Columbia meet no more than five of ten criteria related to the prevention, detection, diagnosis, and response to outbreaks of infectious diseases, a report from Trust for America's Health and the Robert Wood Johnson Foundation finds.

According to the report, Outbreaks: Protecting Americans From Infectious Diseases 2014 (112 pages, PDF), Maryland, Massachusetts, Tennessee, Vermont, and Virginia topped the state rankings for preparedness, meeting eight of the ten criteria, while Arkansas ranked at the bottom, meeting only two of the criteria. Although significant advances have been made in preparing for public health emergencies since 9/11 and the anthrax attacks later that fall, the new study found that only twenty-seven states and the District of Columbia met or exceeded the national average for the Incident and Information Management domain of the National Health Security Preparedness Index; that more than two million preschoolers, 35 percent of seniors, and a majority of adults do not get all recommended vaccinations; and that only ten states reduced the number of healthcare-associated infections between 2011 and 2012. The report also found the number of new HIV infections increased 22 percent among young gay men and 48 percent among young African-American men between 2008 and 2010, and that only thirty-seven states have the necessary reporting requirements in place to help prevent further transmission of HIV.

The report calls for stepped-up efforts to bolster states' core capabilities in a range of areas, including investigative capabilities, containment strategies, infection control and emergency preparedness, risk communication, surveillance, and research; better integration of efforts by healthcare systems, hospitals, and public health agencies; and a greater focus on strengthening leadership and accountability at the state and local level.

"Over the last decade, we have seen dramatic improvements in state and local capacity to respond to outbreaks and emergencies," said TFAH executive director Jeffrey Levi. "But we also saw during the recent Ebola outbreak that some of the most basic infectious disease control policies failed when tested. The Ebola outbreak is a reminder that we cannot afford to let our guard down. We must remain vigilant in preventing and controlling emerging threats — like MERS-CoV, pandemic flu, and enterovirus — but not at the expense of ongoing, highly disruptive and dangerous diseases — seasonal flu, HIV/AIDS, antibiotic resistance, and healthcare-associated infections."