MISSION: CRITICAL - 2014 Year in Review

Mission: New Infectious Disease Threats

Ebola

The ongoing Ebola outbreak in West Africa is among the most complex challenges ever to confront CDC.

The Ebola outbreak in West Africa is unprecedented in size and scope. Supported by highest-level activation of the Emergency Operations Centers, CDC staff surged into the region, setting up labs and emergency operations center, training contact-tracing and burial teams, providing leadership and communications support. The sudden appearance of an Ebola patient at a Dallas hospital – and the first-ever Ebola transmissions on U.S. soil – woke Americans to the truth of CDC’s oft-repeated mantra: a health threat anywhere is a health threat everywhere.

To protect Americans, CDC has helped affected nations perform exit screenings of hundreds of thousands of airline travelers and has helped establish entry screening for all people traveling from these countries to the U.S. By December, CDC had supported state health departments to make more than 30,000 contacts with these returning travelers to check for fever and other symptoms. Based on CDC guidance, states are now working to prepare hospitals to receive, isolate, and evaluate suspected Ebola cases. CDC Rapid Ebola Preparedness (REP) teams spread out across the nation to prepare hospitals for a possible Ebola threat while CDC Ebola Response Teams (CERT) stand ready to deploy to any hospital in the U.S. with probable Ebola cases.

Antibiotic Resistance

CDC has made important progress against antibiotic resistance, but it remains a serious threat. Combating antibiotic resistance and preventing healthcare-associated infections remains a critical initiative for 2015.

Every day, patients get infections in healthcare facilities while they are being treated for something else. These infections can be deadly, especially when they are resistant to antibiotics. While some progress was made in 2014 reducing common antibiotic resistant threats, thousands of patients in the United States continue to die from these infections. As a result of this ongoing threat the White House issued a Presidential Executive Order and the National Strategy to Combat Antibiotic-Resistant Bacteria. CDC has requested $30 million for CDC's Detect and Protect Initiative and $14 million for the National Healthcare Safety Network to combat resistant bacteria. These important initiatives are a down payment on the public health aspects defined in the national strategy.

An effort around the country to improve infection control to prevent spread of Ebola is an opportunity to protect patients from healthcare-associated infections, including antibiotic resistant infections. Fighting antibiotic resistance is both a public health and national health security priority. Improving antibiotic prescribing can save today’s patients from deadly infections and protect lifesaving antibiotics tomorrow. We must be diligent stewards of antibiotics, protecting this precious resource in doctor’s offices, homes, and farms, so it is available to help us, and our children, in the future.

Beth Bell, MD MPH

"Every day we don’t act to better protect antibiotics will make it harder and more expensive to address drug resistance in the future. Drug resistance can undermine both our ability to fight infectious diseases and much of modern medicine."

Beth Bell, MD MPH - Director, CDC’s National Center for Emerging and Zoonotic Infection

Domestic Response and EV D68

A disease threat mostly affecting American children, CDC and states have been investigating the 2014 surge in cases of this rarely reported type of enterovirus

Since late summer, CDC and states has been investigating a nationwide outbreak of severe respiratory illness in children caused by enterovirus D68 (EV-D68), affecting those with asthma most severely. In October 2014, CDC developed and started using a new, faster lab test for detecting EV-D68 in specimens from people in the United States with respiratory illness, allowing the ability to test and report results for new specimens within a few days of receiving them. From August to November, CDC received more than 2,600 specimens for enterovirus lab testing—more than six times the amount normally received in an entire year. CDC also sequenced the complete virus genomes from viruses representing the three known strains of EV-D68 that caused infection during 2014. About 40% of specimens tested by CDC and state public health labs—more than 1,100 cases—were positive for EV-D68. By the end of fall, reporting of EV-D68 infections to CDC began to decline. CDC continues to work closely with state and local health departments and clinical and state laboratories to monitor and assess the situation. For more information, visit http://www.cdc.gov/non-polio-enterovirus/.

Anne Schuchat, MD

"When rare or uncommon viruses suddenly begin causing severe illness, CDC works quickly to develop diagnostic tests to enhance our response and investigations."

Anne Schuchat, MD - Assistant Surgeon General and Director of CDC’s National Center for Immunization and Respiratory Diseases

MERS-Cov

New Global Outbreak Highlights the Need for Vigilance

Middle East Respiratory Syndrome (MERS), a new viral respiratory illness that was first reported in Saudi Arabia in 2012, showed a dramatic increase in cases during 2014. Centered in the Arabian Peninsula, cases have also appeared in other countries due to global travel. In May 2014, the US saw its first two confirmed cases, both imported by healthcare providers who acquired infection while working in Saudi Arabia. In response, CDC has improved lab-testing capacity for Middle East Respiratory Syndrome Coronavirus (MERS-CoV)—the virus that causes MERS, developed guidance for health departments to conduct investigations on suspected cases, and provided guidance for reporting and monitoring ill travelers. CDC also used Advanced Molecular Detection (AMD) to sequence the complete virus genome on specimens from the two US MERS cases, and sent disease detectives to the regions affected by MERS-CoV to assist the local investigation. CDC continues to closely monitor the MERS-CoV situation globally and work with partners to better understand the risks of this virus, including the source, how it spreads, and how infections might be prevented. For more information, visit http://www.cdc.gov/coronavirus/mers/.

Mission: Continued Fight Against Infectious Diseases

CDC Supports PEPFAR

The HIV/AIDS Pandemic continues to be one of the world’s most important public health challenges

 

The President’s Emergency Plan for AIDS Relief (PEPFAR) provides support to more than 60 countries to build capacity for their national HIV/AIDS programs, and CDC is a primary partner in this plan. Through PEPFAR, CDC has helped support life-saving antiretroviral treatment for 7.7 million people and supported HIV testing and counseling for more than 56.7 million people during fiscal year 2014. CDC will continue to work through PEPFAR to control the HIV epidemic and move closer to an AIDS-free generation. For more information, visit www.cdc.gov/globalaids.

Polio Eradication

The world is on the brink of eradicating polio, but we risk losing valuable ground

Since the launch of global polio eradication efforts in 1988, polio cases worldwide have decreased 99 percent, but the remaining 1 percent poses an enormous future risk. A resurgence of polio could paralyze more than 200,000 children worldwide every year within a decade. There were important milestones in this mission achieved during 2014: India and the other 10 countries of the South East Asia Region were certified polio-free. This year the CDC worked with Nigeria to improve immunization activities, develop outreach programs to underserved populations, and improve outbreak response and disease tracking in support of polio eradication. This vital infrastructure also played a critical role in the country’s response to their first Ebola case. The CDC will continue their efforts to eradicate polio globally, an achievement that once realized will rank among the greatest public health victories in history. For more information, visit http://www.cdc.gov/media/DPK/2014/dpk-polio.html.

Gregory Armstrong, MD

"If we eradicate polio in the next few years, we’ll not only eliminate a crippling disease for generations to come, but have an estimated global savings of 40-50 billion US dollars over the subsequent 20 years. The finish line is in sight and will be a gift to every generation to come."

Gregory Armstrong, MD - CDC’s Incident Manager for the Polio Eradication Response

Mission: Laboratory Safety

Laboratory incidents during 2014 raised national awareness of the importance of laboratory safety. CDC applied important lessons learned to ensuring its laboratories are safe and effective.

As a result of two incidents that occurred in CDC laboratories, CDC enacted a series of internal changes and targeted activities to improve laboratory safety and quality. These changes included establishing a CDC-wide single point of accountability for laboratory safety, establishing a high-level internal working group to accelerate improvements in laboratory safety, establishing an external advisory group for laboratory safety, and conducting intensive reviews of all BSL3 and BSL-4 laboratory facilities and protocols. A third incident involved the discovery of vials of smallpox in a storage room on the National Institutes of Health (NIH) campus. As a result of this incident, CDC and other federal agencies conducted comprehensive searches of their facilities to identify Biological Select Agents and Toxins and ensure their proper registration, safe stewardship, and secure storage or disposal. CDC will continue to work to change processes that allowed these incidents to happen, prevent an occurrence like these in other CDC laboratories, and to apply the lessons learned to inform biosafety and biosecurity procedures at other laboratories across the United States. For more information, visit http://www.cdc.gov/about/lab-safety/.

Leslie Dauphin, PhD

"Safety improvement is a continuous process. It is essential that we strive for the highest standards of safety to ensure that CDC labs are the most scientifically rigorous and the safest in the world."

Leslie Dauphin, PhD - Interim Director of Laboratory Safety, Centers for Disease Control and Prevention

Mission: Leading Causes of Death

Million Hearts® Campaign and Cardiovascular Deaths

Cardiovascular diseases account for one in every three deaths in the US. New ads provide practical strategies to improve cardiovascular health, enabling us to live healthier lives

Nearly 800,000 Americans die each year from cardiovascular diseases. Since launching, Million Hearts® has made progress in addressing preventable illness and deaths from heart attack and stroke by focusing on community and clinical prevention strategies. With the support of key partners, Million Hearts® encouraged widespread adoption and use of standard treatment protocols for improving blood pressure control. These simple steps help health care providers improve management of patients with high blood pressure, reducing their risk of heart attack and stroke. In addition, in 2014 Million Hearts® announced the launch of a new Healthy Eating and Lifestyle Resource Center that features lower-sodium, heart-healthy recipes and family-friendly meal plans, with an emphasis on managing sodium intake.

Janet S. Wright, MD, FACC

"Because sodium is a major contributor to high blood pressure, it is important to help people understand how they can manage sodium intake at home. This online resource offers practical, accessible eating and lifestyle-based solutions for people looking for ways to reduce sodium in their diet."

Janet S. Wright, MD, FACC - Executive Director of Million Hearts

Tips Campaign

Smoking remains the leading cause of preventable death in the US. New ads show the harms caused by smoking and encourage people to quit

Cigarette Smoking remains the leading cause of preventable death and disease in the United States, killing more than 480,000 Americans each year. In 2014, CDC continued its national tobacco education campaign- Tips From Former Smokers- with hard-hitting, new ads featuring health conditions people may not realize are related to cigarette smoking, like pregnancy complications and premature birth, gum disease and tooth loss, and stroke caused by smoking in people who have HIV. New ads with new participants and health conditions are being planned 2015. For more information, visit www.cdc.gov/tips.

Prescription Drug Overdose Kills Americans Everyday

A silent epidemic, opioid prescription drug overdose kills 44 people every day in the US. CDC joins with partners to improve prescription monitoring, reducing unnecessary prescriptions

 

Every day, 44 people die from an overdose of prescription opioids in the United States. In 2014, CDC issued a Vital Signs report describing the problem and what states and health care providers can do to more appropriately prescribe pain medicine. CDC is working with partners and states to improve prescription drug monitoring systems that collect and analyze prescribing data so that doctors and pharmacists are aware of other medications a patient may be taking before prescribing or dispensing opioids. These systems can help reduce the chance that a patient may receive multiple opioid prescriptions. For more information, visit www.cdc.gov/vitalsigns/opioid-prescribing.