Posts Tagged ‘Centers for Disease Control’

The Coronavirus

March 21st, 2013

There’s never a dull day in public health! Things are changing all the time– from new interventions to help folks stay or be more healthy to the discovery of a new virus. Recently, folks on the other side of the world documented a new Coronavirus that can be transmitted person to person. It was first discovered last September when doctors were looking into the death of a man in Saudi Arabia – since then, 15 cases have been laboratory confirmed. All the cases of this virus have ties to the Middle East – either through travel or contact with someone who travelled there. The CDC updated its treatment protocol to include questions about travel to the Mid-East for people who develop a severe, acute lower respiratory infection.

This Coronavirus causes a lower respiratory infection and is pretty strong, 9 of the 15 people who contracted it – died… but in general the Coronavirus is pretty fragile and many of us catch and defeat the virus in our lifetime. It only lives outside of a body for about 24 hours. Human Coronaviruses were first discovered in the 1960’s and they have their name because of the crown like spikes on the surface. One of the most notable Coronaviruses is SARS which hit the world with a splash when it first appeared in 2003. No documented SARS cases have been seen since 2004.

Solve the Outbreak

March 4th, 2013

Check out CDC’s new iPad App, Solve the Outbreak, which lets you pretend you’re a disease outbreak investigator in the world-class Epidemic Intelligence Service by solving outbreaks based on real-life.  When new outbreaks happen, disease detectives are sent in to figure out how they started, before they can spread.  You get to investigate the outbreak and make decisions about confirming cases and implementing public health interventions like isolation and quarantine, social distancing, vaccine prioritization etc.  

The better your answers, the higher your score – and the more quickly you’ll save lives. You’ll start out as a Trainee and will earn badges by solving cases, with the goal of earning the top rank: Disease Detective.  Post your scores on Facebook or Twitter and challenge your friends to do better.  Download the free app today!  

BTW: Dr. Frieden (the CDC Director) paid us a visit during our monthly Local Health Officers meeting on Wednesday afternoon.  Check out the pictures on the Facebook.

Strategic National Stockpile Readiness

February 27th, 2013

The CDC’s “Strategic National Stockpile” is a large quantity of medicine and medical supplies that are available to states in case there’s a public health emergency (flu outbreak, asteroid, etc.) severe enough to cause local health supplies to run out.  Once federal and local authorities agree that the stockpile is needed, meds and supplies are delivered to any state in time for them to be effective. Each state is responsible for receiving and distributing the stockpile assets to local communities fast. 

Our Public Health Emergency Preparedness shop is responsible for the overall planning and execution in AZ.  The Plan (which isn’t posted on-line for security reasons) provides a step by step approach to accessing and distributing pharmaceuticals, vaccines and other medical equipment and products stored by the Feds.  Our Plan is evaluated yearly by the CDC.  The review covers every aspect of our plan… including how we communicate with the public, work with our healthcare and Agency partners as well as how we plan to work with vulnerable populations should SNS assets be needed. 

This year we got a score of 93% from the CDC…  and our partner counties (Pinal and Maricopa) received similar scores- demonstrating that the plans work together effectively to serve the public when they need to be activated.  We’ll be testing these plans during a full-scale exercise this week.  Congratulations to our preparedness rock-stars Teresa Ehnert, Marcus Castle, Stacey Cain and the whole emergency preparedness team! 

By the way…  we received and executed stockpile assets (antiviral medications and other healthcare supplies) during the 2009 H1N1 Influenza pandemic.  Our turnaround time from the minute we received the first shipment until everything was at its local destination was less than 36 hours- an impressive testament to our ability to plan and execute during a public health emergency. 


Hearing and Vision Screening

February 19th, 2013

According to the CDC about 15% of school age kids have some hearing loss.  Children who are hard of hearing will find it harder to learn vocabulary, grammar, word order, and other parts of verbal communication.  Newborn hearing loss occurs in about 1 in 5,000 births- which is why it’s so important that AZ kids get a newborn hearing screening test.  IN AZ each school is supposed to conduct hearing screening for their students.   Last school year 574,361 children had a hearing screen and 1,484 children were identified as having some hearing loss- many of who moved on to interventions like ear tubes or hearing assist devices.  

But to be successful in school you need to see clearly too.  Vision Screening isn’t a mandated service at schools, but according to Prevent Blindness America vision problems affect 25% of school-aged kids.  In the US millions of kids in elementary schools have vision problems that go undetected and untreated.  Not being able to see clearly will slow a child’s ability to learn.  Without early detection and treatment, children’s vision problems can lead to permanent vision loss, learning difficulties, and of course missed learning opportunities.

Preventing Hospital Associated Infections in AZ: New Performance Data

February 15th, 2013

A new CDC report released this week gave a status update on the national Winnable Battle to reduce hospital associated infections.   Not all medical procedures carry the same risk of infection, so the report uses something called a standardized infection ratio to compare infection rates among hospitals. It’s a complicated statistic, but basically, it divides the number of infections that actually occurred in a hospital with the number of infections that were expected in the same time period.  The lower the score the better.  

Arizona’s 2011 overall score was less than 1… meaning we did well.  Our overall average (2011) score was 0.575, which was better than expected for Arizona, and better than the national average score of 0.592. The report also shows a decrease in scores since 2010, meaning that the work Arizona hospitals are doing to decrease infections and make care safer for their patients is making a difference. If you’re interested in seeing the score for your local hospital, you can check it out on Hospital Compare. Right now, this site only shows CLABSI scores, but it’ll soon display scores for catheter-associated urinary tract infections and some surgical site infections. 

We’re making it a priority to prevent hospital associated infections by maintaining our HAI Program and licensing and inspecting healthcare facilities across the state.  We also facilitate a multidisciplinary HAI Advisory Committee that identifies and addresses priority areas for Arizona. This dedicated group of partners has collaborated continuously since 2009 to coordinate prevention efforts across the state. The partnerships and open dialogue help us improve surveillance, report and prevent hospital associated infections, which support our Strategic Map goal of reducing healthcare associated infections and re-admissions.

Workin’ Out

February 11th, 2013

Student participation in PE and sports has lots of benefits like improved social skills, confidence, general health, well-being and healthier weight.  According to the CDC rates for obesity among students with disabilities are 38% higher than for students without disabilities.  Students who have intellectual disabilities, learning disabilities and mobility limitations have the highest obesity rates. Ensuring that students with disabilities are afforded their right to participate in physical education and sports can be an effective strategy in making progress toward achieving our winnable battles.  

Last week, in a letter to school districts, the US Department of Education provided sample scenarios and guidance for increasing participation of students with disabilities in PE and extracurricular activities, including sports. The guidance includes examples of reasonable modifications which may help schools in providing physical activities for all students.  Under section 504, of the Rehabilitation Act of 1973, students with disabilities are ensured access to educational and extracurricular activities available to other students; however sports opportunities have been limited.  For more information you may contact our Office for Children with Special Health Care Needs.

50 Years of Newborn Screening

January 29th, 2013

Last year we welcomed about 87,000 newborns to Arizona.  Our Newborn Screening Program (in our State Lab) ensures that each are tested for 28 inherited disorders and hearing problems.   The goal is to help kids avoid illness, developmental delays and even death.  Teamwork, communication and coordination are critical in making this program effective.  A quick look at the numbers reveals how monumental this screening task really is.

On any given day our newborn screening team receives and tests from 600 to 1,500 bloodspot samples for each of the 28 disorders. Our demographics team verifies the results and confirms all of the data associated with each sample as well as ensuring that lab results are sent out to the health care provider.  Our case management team follows up on about 140 potentially positive results (including hearing) each week, coordinates the confirmation test and works with pediatricians, clinical specialists and families.


The end result?  Because of the dedication and commitment of each member of the Team, hundreds of families have the opportunity for their newborn to receive the early treatment, intervention and support services that will allow them to lead normal lives.  Of course, none of this would be possible without the gasoline that runs the engine, the billing department brings in the money that keeps this effective machine helping families every day.

The first state-mandated newborn screening programs began in Massachusetts, Oregon, and Delaware 50 years ago this week.  Now, 97% of U.S. newborns are screened by state public health labs like ours.  The Association of Public Health Laboratories is partnering with the CDC to launch a year-long public awareness campaign to celebrate this milestone. The campaign website includes a calendar of events and informational resources for expectant parents, healthcare providers, and health decision-makers.

CDC’s Public Health Associate Program

January 28th, 2013

Do you know a young adult that might be interested in a career in the exciting field of public health?  If you do, they may be in luck.  The Public Health Associate Program administered by CDC is designed to identify future public health leaders with undergraduate degrees and a passion for public health. Throughout the 2 year program- associates get a hands-on frontline experience that will be the foundation of a solid public health career.  It’s a two-year, paid on-the-job training program for entry-level, frontline public health practitioners who are employed by CDC but work directly in state, tribal, local, and territorial public health departments. 

You can check out the eligibility requirements, and the application on the CDC’s website.  The application window opens this week- and candidates will have about 4 weeks to complete and submit the application and get supporting documents (transcripts, letters of recommendation).


Annual Preparedness “Reportcard”

January 15th, 2013

Every year a group called the Trust for America’s Health puts out a ‘Report Card” regarding what they believe is an assessment of each state’s readiness for a public health emergency.  They use various measurements that they can find and grade each state against each other.  The implication is that states that do poorly won’t be able to execute in a public health emergency and the ones that do well will do fantastic.  The problem is that they usually pick measuring sticks that have little to do with real public health readiness, things that public health systems have little control over, or both.  Sometimes the points are awarded for things that are cosmetic.  I don’t have any objection to outside entities scoring and passing judgment on states’ preparedness…  but I do object when the criteria they use has little to do with the conclusions they draw. 

For example- in this year’s report AZ lost 3 out of a total of 10 possible points because our whooping cough vaccination rates are 86% (rather than 90%), there’s a $5 co-pay for flu shots under the state Medicaid program, and the fact that AZ doesn’t have a comprehensive global warming action plan.  Using those criteria- are you ready to conclude that our state’s public health preparedness network is unable to effectively respond to a public health emergency?  (That’s a rhetorical question). 

Safeguarding the public’s health is more important than ever.  Whether the threat is a disease outbreak, environmental hazard or natural disaster, the public health system works 24 hours a day, 7 days a week to keep Arizonans safe.  Each year, the CDC evaluates state and local public health preparedness programs in a detailed report that measures what really matters.  This year’s installment is entitled 2012 State-by-State Report on Laboratory, Emergency Operations Coordination, and Emergency Public Information and Warning Capabilities.  This document outlines each state’s ability to perform key laboratory functions, engage in emergency operations, and develop and distribute public health messages.  While Arizona wasn’t perfect in this year’s CDC report- we did pretty darn good. 

For example, our Lab tests thousands of biological and chemical samples each year, and is a cornerstone of our public health system.  As a part of the Laboratory Response Network, we’ve consistently demonstrated its ability to detect high-threat biological agents like anthrax. Our lab team works long hours to test samples from suspicious packages and provide accurate results to our first responder community. As the report indicates, one area for improvement is our turn-around-times for pulsed-field gel electrophoresis testing- a technique used to identify organisms that commonly cause food borne illness.  We’re working to improve these turn-around-times by ensuring we have the right staffing and resources needed to meet these bench marks.  

Another capability addressed in this year’s CDC report is Emergency Operations Coordination.  ADHS has participated in dozens of exercises and drills over the past several years to prepare our staff for public health emergencies.  For the 3rd year in a row, our staff met the 60 minute target for Emergency Operations Center activation.  Similarly, our staff successfully demonstrated our ability to develop and distribute public health messages in a timely manner.  These examples illustrate our ability to manage public health emergencies and safeguard the public’s health during a disaster.  

For our employees that work in preparedness throughout Arizona’s public health system- the work is never done.  But I’m proud to say that we’ve achieved all of our emergency preparedness targets, and nearly all of the lab requirements for this year’s report.  Thanks to all of our preparedness staff for their hard work and dedication.  Well done.

Influenza Going Gangbusters in US and AZ

January 10th, 2013

During the 2009- 2010 influenza pandemic, we saw how influenza can be unpredictable in terms of who it affects most, when it occurs, and what strains will circulate. This season is no exception. While the circulating strains are exactly what we predicted, the peak of the flu season is hitting earlier than usual (now) and it’s really spreading fast.  In fact, this week’s new Influenza Activity Report moved us into the “Widespread” category along with just about all the other states.  The CDC Summary Site will probably be updated today with the latest US data.  I bet just about every state will be on widespread status. 

In AZ, a few of our licensed medical facilities are currently on “Divert or Caution” meaning that they are at or near capacity with sick folks.  Our Licensing team will be in contact with several hospitals today.  Many are managing patient flow by prioritizing medical procedures and postponing those that are optional in order to save space and staffing for acutely sick folks.  We’ve given a couple of facilities permission to make adjustments to their normal procedures to better serve sick patients.

Preparedness is working on bed polls and communication with the county health officers/counties and media. We’ll continue to reach out to facilities to find out about capacity issues and work with them on messaging for alternate care sites and transferring patients within their own facilities. 

It’s too late to get the flu shot for the folks that are sick with influenza right now.  But if you haven’t gotten sick yet and have been putting it off- you better get on the stick