Posted By Stephen Clay,
Friday, September 29, 2017
Updated: Tuesday, September 26, 2017
One of CSTE’s primary objectives is to increase epidemiology and surveillance capacity in state, local, tribal and territorial jurisdictions through various programmatic and workforce capacity building initiatives. The CSTE Vector-Borne Diseases Subcommittee facilitates peer to peer technical assistance consultations to support new and less established vector-borne disease surveillance coordinators and staff. These consultations may include an orientation to the surveillance system, guidance and program requirements and day-to-day systems management.
Michael Mudgett and Zoilyn Gomez, epidemiologists at the California Tribal Epidemiology Center (CTEC), recently participating in a peer to peer technical assistance consultation supported by CSTE with staff at the Louisiana Department of Health (LDH). CTEC is one of 12 Tribal Epidemiology Centers that provide epidemiological support to each Indian Health Service region and work directly with both tribes and Indian Health Programs. CTEC monitors the health status of American Indian/Alaska Natives (AIAN) in California to develop effective public health services for their respective AIAN populations.
To begin building a foundation for vector-borne disease (VBD) surveillance capacity, Michael and Zoilyn traveled to Louisiana to work with the Infectious Disease Epidemiology Section (IDEpi) within the LDH Office of Public Health in New Orleans. CTEC’s main goal was to gain a better overall understanding of VBD surveillance in order to increase surveillance capacity within tribal jurisdictions in California. Chrissie Scott-Waldron (Public Health Epidemiologist Supervisor), Julius Tonzel (Public Health Epidemiologist) and Sean Simonson (Public Health Epidemiologist) coordinated the technical consultation visit at LDH and they were all very gracious, accommodating and helpful in answering questions throughout the consultation.
Much of the consultation consisted of engaging on various aspects of VBD disease surveillance, ranging from orientations of databases and surveillance systems, demonstrations of integrated mosquito management including various traps, mosquito species identification, rearing rooms, biological control and adulticiding/larviciding equipment, touring laboratories for human and ecologic testing and other sites vital to the VBD program.
Pictured: A shot of downtown New Orleans. Photo credit: CTEC
We were quickly brought up to speed about IDEpi through introductions and key personnel presentations. Throughout our first day, we reviewed the various types of databases and surveillance systems utilized for VBD and visited the New Orleans Mosquito and Termite Control Board. At NOMTCB, we learned about the actual controlling and surveilling of the mosquito population, especially with the amount of standing water and high humidity in the area. Dr. Sarah Michaels demonstrated the various types of mosquito traps used around the city. Interestingly, we learned just how much Zika-virus potential is in the area since the mosquito Aedes aegypti is prevalent.
One of the biggest issues in the area with mosquitos breeding and standing water is that of disposed car tires. Many tires were simply dumped in areas like New Orleans East, which causes interesting problems for public health to handle. It was surprising that there were so many tires that needed to be disposed of in the area, and how the people contracted to dispose of the tires are finding it increasingly difficult to keep up with the demand.
The presentations given by the great staff at IDEpi provided a unique opportunity to see how VBD surveillance works behind the scenes with electronic lab reporting, database management, lab testing, interaction with providers and the Zika Pregnancy Registry.
Pictured (L-R): Randy Vaeth, Sean Simonson, Chrissie Scott-Waldron, Kyle Moppert, Zoilyn Gomez, Julius Tonzel and Mike Mudgett. Photo credit: Louisiana Department of Health.
One interesting conversation on Day 2 was the public perception of public health services. In recent years, the public has been debating whether they believe the risk of spraying is worth the reward of having a mosquito population controlled. We found this intriguing since the general public in California is no stranger to debating public health services and whether certain services are perceived to be more harmful than good. However, it was clear to see the vital role these entities play in controlling the mosquito populations.
Following the Mosquito Control facility tour, the group headed to the ecologic arboviral testing lab at the Louisiana Animal Disease Diagnostic Laboratory, where Dr. Alma Roy gave a tour of their facility and shared information on the comparable lab in California. She described in detail how they tested mosquitoes for endemic and important arboviral diseases via PCR, in addition to testing various animal reservoirs for these diseases.
Next, we visited the West Baton Rouge Mosquito Control District, a small yet impressive two-person operation, before rounding out the day at the Louisiana Office of Public Health State Laboratory. We toured the facility and saw how the lab conducts molecular and serologic testing to report out human results to IDEpi. It was inspiring to see the great relationships IDEpi had with all of these sites.
On our final day, we met with the CDC Epidemic Intelligence Service (EIS) Officer, Dr. Alean Frawley, where she provided insight on her role. Megan Jespersen, Surveillance Epidemiologist and Tribal Liaison, also gave us an overview of the Louisiana Early Event Detection System, which is Louisiana’s Syndromic Surveillance System, and the Louisiana Indian Health Surveillance.
Overall, the consultation was very valuable, as we received what we sought from the trip: foundational knowledge and technical guidance about VBD to support a younger public health entity. The consultation provided ample opportunity for us to bring back technical knowledge about VBD surveillance to CTEC. We hope to implement what we learned in our future work and thank CSTE and the Louisiana Department of Health for this opportunity.
Posted By Thuy Kim, MPH,
Friday, May 26, 2017
Updated: Friday, May 26, 2017
As summer approaches, many Americans will be searching for solace from the heat in recreational water. Each year, the week before Memorial Day is designated as Healthy and Safe Swimming Week (May 22-28). This year’s observance marks its 13th anniversary of promoting healthy and safe swimming practices for both swimmers and pool operators.
Whether it be in lakes, rivers, water parks, splash pads or neighborhood swimming pools – epidemiologists know that it is no coincidence there is an uptick of waterborne disease outbreaks during the hot summer months. The last major outbreak I investigated before I left the Alabama Department of Public Health (ADPH) in late 2016 to join the CSTE team happened to be a Cryptosporidum outbreak at a local water park. We were happy to have had cooperation from the water park owners and staff who voluntarily closed their facility for treatment. Unfortunately, we were not able to recover organisms from the water. That summer, other states also experienced waterborne disease outbreaks and our collective stories were published in a recently released MMWR.
Pictured: CSTE staff member Thuy Kim, MPH contributed to a CDC MMWR focused on a Crypto outbreak in Alabama, Arizona and Ohio in 2016.
In the spirit of this week, a few CSTE members have also written and created an educational music video on water safety. The video was written by Taishayla Mckitt and stars Miranda Daniels and Allison Roebling – all from ADPH. Please enjoy, like, comment, share and take some notes!
Thuy Kim, MPH is an Associate Research Analyst II at CSTE with a focus on Enteric Diseases.
Posted By Emily J. Holubowich ,
Friday, May 19, 2017
Updated: Friday, May 19, 2017
May 5 was filled with ups and downs on the public health funding front. On the upside, federal spending legislation for fiscal year (FY) 2017 was signed into law, bringing long overdue closure to public health funding—eight months into the fiscal year. All things considered, CSTE’s funding priorities fared well given that funding for the Centers for Disease Control and Prevention (CDC) was cut by $13 million. Funding for the National Center for Emerging and Zoonotic Infectious Diseases (NCEZID) increased by about $5 million, including a $3 million increase for the antibiotic resistance (AR) initiative and a $2 million increase for food safety. As always, we would expect much of NCEZID’s funding to support core infectious disease surveillance capacity at state and local health departments through Epidemiology and Laboratory Capacity (ELC) grants. This funding would be in addition to $40 million from the mandatory Prevention and Public Health Fund (PPHF) provided to ELC grants for the sixth consecutive year. Other NCEZID initiatives—vectorborne disease, advanced molecular protection, hospital acquired infections, National Healthcare Safety Network—were all flat funded.
On the downside, the Public Health Workforce program, through which the CDC/CSTE Applied Epidemiology Fellowship receives funding, was cut by $2 million. The appropriations bills do not specify how much funding would be dedicated to the Applied Epidemiology Fellowship program per se, but we should expect this cut to have an impact on future fellowships.
Photo credit: Emily J. Holubowich
While many were cheering the passage federal spending legislation and the avoidance of a government shutdown on May 5, the House of Representatives resurrected and passed by one vote the American Health Care Act (AHCA) as part of its efforts to “repeal and replace” the Affordable Care Act (ACA). If enacted, the legislation would terminate the PPHF beginning in FY 2019. The loss of the nearly $1 billion PPHF would result in a 12 percent cut to CDC’s total budget and a significant reduction or elimination of funding to many state and local public health programs—ELC, immunizations and the Preventive Health and Health Services Block Grant among them.
Upon its passage in the House, the Senate almost immediately rejected the AHCA, with leadership announcing their intentions to move forward in drafting their own ACA repeal legislation. A working group of 13 GOP Senators representing centrists and conservatives is working to craft a compromise, and another small group of Republicans and Democrats led by Senators Susan Collins (R-ME) and Bill Cassidy (R-LA) are simultaneously working to craft an ACA “repair” package that can garner support on both sides of the aisle. In sum, as the future of the ACA repeal is murky at best one thing is clear: don’t expect any swift action from the “World’s Greatest Deliberative Body.”
All eyes now turn to FY 2018, and the release of the President’s budget on May 23. The full budget will provide more information about the administration’s specific funding priorities—we’re anticipating cuts and consolidations galore! But of course, it will be up to Congress to ultimately decide how to prioritize spending. The budget resolutions that will emerge from the House and Senate Budget Committees in June will set the tone for ongoing discussions about public health funding and largely determine the fate of spending bills going forward. Deep cuts to spending in the budget resolutions will be rejected by Democrats, making it nearly impossible to move any appropriations legislation—legislation that will require bipartisan support to clear either chamber.
For more information about funding levels for your specific priorities, please click here for a copy of the omnibus spending legislation, and click here for a copy of the accompanying report that provides more detailed instructions about public health funding levels and intended purposes.
Emily Holubowichis Senior Vice President at CRD Associates and serves as CSTE’s Washington representative, leading our advocacy efforts in the nation’s capital.
Posted By CSTE Staff,
Friday, May 12, 2017
Updated: Thursday, May 11, 2017
CSTE is pleased to announce an exciting lineup of speakers at this year’s annual conference in Boise, Idaho with diverse professional backgrounds and insightful presentations to share. Our 2017 speakers will share their perspectives on applied public health epidemiology, with a focus on the 2017 conference theme - “Cultivating an Environment for Better Health.”
Keiji Fukuda , MD, MPH– Jonathan M. Mann Memorial Lecture
Keiji Fukuda is the Director and a Clinical Professor at the University of Hong Kong School of Public Health. He previously worked at the World Health Organization (WHO) in several capacities including Assistant Director-General (ADG) and Special Representative of the Director-General for antimicrobial resistance; ADG for the Health Security and Environment Cluster; and Director of the Global Influenza Programme. Before that, he worked at the U.S. Centers for Disease Control and Prevention (CDC) as the Epidemiology Section Chief, Influenza Branch and as a Medical Epidemiologist in the Viral Exanthems and Herpesvirus Branch, National Center for Infectious Diseases. Professor Fukuda has been a global public health leader in many areas including health security; emerging infectious diseases including seasonal, avian and pandemic influenza, SARS, MERS and Ebola; antimicrobial resistance; development of the Pandemic Influenza Preparedness Framework; implementation of the International Health Regulations; food safety; and chronic fatigue syndrome. He has considerable experience in epidemiological research and field investigations, media communications and international diplomatic negotiations including those held to establish a historic Heads of State level meeting on antimicrobial resistance at the United Nations in 2016. He has a BA in Biology, an MD; an MPH; was trained in the Epidemic Intelligence Service at CDC and is certified in internal medicine by the American Board of Internal Medicine.
Caleb Banta-Green, PhD, MPH, MSW
Caleb Banta-Green is a Principal Research Scientist at the Alcohol & Drug Abuse Institute, an Affiliate Associate Professor at the School of Public Health and Affiliate Faculty at the Harborview Injury Prevention & Research Center at the University of Washington. He conducts research and provides community and professional technical assistance on opioid use disorder treatment and opioid overdose interventions. He is currently analyzing data from an NIH funded clinical trial on opioid overdose prevention and has recently started at clinical trial to test an opioid use disorder treatment intervention for those released from prison. He is evaluating a HHS SAMHSA funded community based overdose prevention intervention and working with the Washington Department of Health on developing opioid overdose surveillance systems. He has been the Seattle representative to the NIH NIDA drug epidemiology workgroup since 2001. In 2012, he served as the Senior Science Advisory in the White House drug policy office working on opioid overdose prevention.
CAPT. Martin (Marty) Cetron, MD
Dr. Cetron is director of the Division of Global Migration and Quarantine (DGMQ) at the National Center for Emerging and Zoonotic Infectious Diseases (NCEZID). He previously served as director of DGMQ when it was within the National Center for Preparedness, Detection, and Control of Infectious Diseases. DGMQ’s mission is to prevent the introduction and spread of infectious diseases into the U.S. and to prevent morbidity and mortality among immigrants, refugees, migrant workers and international travelers. Dr. Cetron’s primary research interest is international health and global migration with a focus on emerging infections, tropical diseases and vaccine-preventable diseases in mobile populations.
Since coming to CDC in 1992, Dr. Cetron he has led a number of domestic and international outbreak investigations, conducted epidemiologic research and been involved in domestic and international emergency responses to provide medical screening and disease prevention programs to refugees prior to U.S. resettlement. He played a leadership role in CDC responses to intentional and naturally acquired emerging infectious disease outbreaks, including the anthrax bioterrorism incident, the global SARS epidemic, the U.S. monkeypox outbreak and the H1N1 pandemic. Dr. Cetron is also part of CDC’s Pandemic Influenza Planning and Preparedness Team. He holds faculty appointments in the Division of Infectious Diseases at the Emory University School of Medicine and the Department of Epidemiology at Rollins School of Public Health.
Dr. Cetron received his bachelor of arts degree from Dartmouth College in 1981 and his MD from Tufts University in 1985. He trained in internal medicine at the University of Virginia and infectious diseases at the University of Washington before becoming a commissioned officer in the U.S. Public Health Service in 1992.
Jacqueline MacDonald Gibson, PhD, MS
Dr. Gibson is currently an associate professor in the Department of Environmental Sciences and Engineering at the University of North Carolina, Chapel Hill. She had a 13-year career working for public policy research institutions before returning to school to earn a dual Ph.D. and entering academia.
As a senior engineer at the nonprofit RAND Corp., she served as liaison to the White House Office of Science and Technology Policy and conducted technical reviews of risk assessment methods adopted by government agencies. As associate director of the Water Science and Technology Board of the National Research Council, which advises Congress and the federal government on science policy matters, Dr. Gibson led a range of studies of issues at the interface between water science and public policy.
Studies included assessment of options for improving potable water service to small U.S. communities, evaluation of regulatory requirements for the remediation of contaminated groundwater, and assessment of research priorities for new environmental remediation technologies. She has also given briefings on these and other topics to a variety of federal officials, members of Congress and their staffs, and institutional advisory boards.
Christine Hahn, MD
Christine Hahn, MD, known for her common-sense approach to often challenging situations, has wanted to help as many people as possible since she finished her training as an Epidemic Intelligence Service Officer with the Centers for Disease Control and Prevention in 1995. She realized then she enjoys helping people live healthier lives now, as well as in the future. That led her to accept the position as Idaho’s state epidemiologist in 1996, and she continues to be the go-to authority for an array of healthcare professionals in the state, as well as the state’s public health districts. Her favorite part of the job is being able to help busy medical providers get the tools they need so they and their patients are successful. Her work overseeing the Idaho Refugee Health Screening Program has helped to provide better coordination and standardization of screening processes between clinics throughout the state in the last two years. She also has been instrumental in aligning Idaho’s immunization requirements with the CDC’s Advisory Committee on Immunization Practices, meaning that more children are starting school with the recommended panel of vaccines. As the state’s tuberculosis controller, she has advised and supported physicians treating and managing the disease.
Hahn attended Medical School at Michigan State University and completed a residency in Internal Medicine at the Mayo Clinic’s Graduate School of Medicine. She then completed a Fellowship in Infectious Diseases at Duke University Medical Center. After a two-year training program as an Epidemic Intelligence Service Officer with the CDC, she became the Idaho state epidemiologist. Hahn served on the CDC’s Advisory Committee for the Elimination of Tuberculosis until June 2012. She was recently named the Medical Director for the Division of Public Health with oversight of the Bureau of Communicable Disease Prevention and the Idaho Bureau of Laboratories. She served as president of the Council of State and Territorial Epidemiologists from 2004-2005, and remains active in that organization. She is the organization’s liaison to the CDC Advisory Committee on Immunization Practices, which sets national vaccination policy. Locally, Hahn serves on the infection prevention committees of Saint Alphonsus and St. Luke’s regional medical centers in Boise and is on the board of Idaho’s Immunization Policy Commission.
Debra Houry, MD, MPH
Dr. Houry is the Director of the National Center for Injury Prevention and Control (NCIPC) at CDC. In this role, Dr. Houry leads innovative research and science-based programs to prevent injuries and violence and to reduce their consequences. She joined the CDC in October 2014. She has previously served as Vice-Chair and Associate Professor in the Department of Emergency Medicine at Emory University School of Medicine and as Associate Professor in the Departments of Behavioral Science and Health Education and in Environmental Health at the Rollins School of Public Health. Dr. Houry also served as an Attending Physician at Emory University Hospital and Grady Memorial Hospital and as the Director of Emory Center for Injury Control. Her prior research has focused on injury and violence prevention in addition to the interface between emergency medicine and public health, and the utility of preventative health interventions and screening for high-risk health behaviors. She has received several national awards for her work in the field of injury and violence prevention.
Dr. Houry received the first Linda Saltzman Memorial Intimate Partner Violence Researcher Award from the Institute on Violence, Abuse, and Trauma and the Academy of Women in Academic Emergency Medicine’s Researcher Award. She is past president of the Society for Academic Emergency Medicine, Society for Advancement of Violence and Injury Research and Emory University Senate. Dr. Houry has served on numerous other boards and committees within the field of injury and violence prevention. She has authored more than 90 peer-reviewed publications and book chapters on injury prevention and violence. Dr. Houry received her MD and MPH degrees from Tulane University and completed her residency training in emergency medicine at Denver Health Medical Center.
Lyle R. Petersen, MD, MPH
Dr. Petersen is the director of the Division of Vector-Borne Diseases in the National Center for Emerging and Zoonotic Infectious Diseases (NCEZID). The division, located in Fort Collins, Colorado, supports CDC’s mission to protect the American public from exotic and domestic bacterial and viral pathogens transmitted by mosquitoes, ticks, fleas and other vectors.
Dr. Petersen earned his medical degree from the University of California, San Francisco. His career at CDC began in the Epidemic Intelligence Service (EIS) in 1985. During that time, he completed CDC’s Preventive Medicine Residency Program, received a Master of Public Health degree from Emory University, and served in several posts, including the Chief of the HIV Seroepidemiology Branch. In 1996, Dr. Petersen accepted an assignment in Germany, where he helped guide that country’s efforts in creating a new national infectious disease epidemiology program at the Robert Koch Institute in Berlin. In 2000, he returned to the United States to serve as the Deputy Director of Science of the Division of Vector-Borne Diseases, and he became the division’s Director in 2004.
Continuing Education through CDC
This year, CSTE has partnered with CDC to provide continuing education to Annual Conference attendees. We anticipate offering CE for doctors, nurses, health educators, veterinarians, certified in public health and general practitioners. Approval is pending with more details to come.
Posted By Liljana Baddour, MPH and Martin A. Kalis, MA,
Friday, May 5, 2017
Updated: Thursday, May 4, 2017
Mosquitoes are responsible for transmitting diseases to millions of people worldwide, with substantial morbidity and mortality. Epidemiologists know mosquitoes spread diseases such as West Nile virus, dengue, chikungunya and Zika. Preventing and reducing the spread of many of these diseases depends on controlling mosquito vectors or interrupting human-vector contact. Several factors, including the type and timing of mosquito control activities, are critical to reducing mosquito populations.
A new online training is now available for the public health workforce that focuses on vector control and pest management, and incorporates the 10 Essential Environmental Public Health Services and the Environmental Public Health Performance Standards developed by CDC’s National Center for Environmental Health (NCEH).
The online learning series Vector Control for Environmental Health Professionals (VCEHP) provides the knowledge and resources necessary to prevent and control vector-borne illnesses spread by insects, rodents, ticks and more. VCEHP provides resources on using an integrated pest management (IPM) approach.
The online curriculum of 11 courses geared toward environmental health professionals is:
Credible: It includes the latest science and evidence from vector control experts.
Practical: It addresses concrete principles, practices and resources for vector control.
Free and Flexible: Professionals can take the courses they want, when they want.
Available for Continuing Education Units: The National Environmental Health Association offers optional CEUs.
Pictured: VCEHP includes a subset of courses particularly helpful for understanding and addressing Zika virus and other mosquito-borne diseases. Photo credit: CDC/ Prof. Frank Hadley Collins, Dir., Cntr. for Global Health and Infectious Diseases, Univ. of Notre Dame
Performance assessment and improvement for vector control programs.
Biology and control of bedbugs, ticks, rodents, and mosquitoes.
Vector control and pest management in specific locations like schools, restaurants, and hotels.
We invite you to access or share VCEHP and get started today to prepare for mosquito season.
Texas Health Institute, Tulane University and the National Environmental Health Association.
VCEHP was developed by CDC, the National Network of Public Health Institutes, Liljana Baddour, MPH, is Senior Manager for Workforce and Education Initiatives at the National Network of Public Health Institutes (NNPHI), one of CDC’s core partners for VCEHP. Martin A. Kalis, MA, is a Public Health Advisor with CDC’s Environmental Health Services Branch and is the CDC lead for VCEHP.
Posted By Janet Hui , MPH,
Friday, April 7, 2017
Updated: Friday, March 31, 2017
This February, CSTE attended the 2017 HIMSS Annual Conference and Exhibition in Orlando, Florida. HIMSS – the Healthcare Information and Management Systems Society – is a global non-profit whose mission is to improve health through information technology. Their annual conference is one of the largest health IT conferences in the world, with over 40,000 representatives from health care and health IT attending this year. The enormous HIMSS exhibit hall featured some of the biggest names in health care and technology, such as Allscripts, Cerner, Epic IBM and many others.
This year, CSTE was invited by CDC to participate in the HIMSS Interoperability Showcase to demonstrate the Reportable Conditions Knowledge Management System (RCKMS). The Interoperability Showcase is a guided exhibit at HIMSS, where companies and organizations partner together and demonstrate how different technologies can work together to address a health problem. For our use case, CSTE partnered with the Association of Public Health Laboratories (APHL), Utah Department of Health, Epic and others to demonstrate how new technologies and standards can be used to enhance public health (PH) surveillance. Together, we demonstrated the electronic case reporting flow for a potential case of Zika virus infection.
During the Showcase, we simulated a patient visiting a clinic in Utah and receiving a positive PCR result for Zika virus, which triggered the process of PH reporting. The clinic’s EHR, represented by Epic, built and sent an initial electronic case report (elCR) to the APHL AIMS platform, which invoked the RCKMS decision support service to determine that this potential case should be reported to Utah Department of Health. AIMS routed the eICR and a Reportability Response (RR) to the Utah Department of Health and a RR to the Epic EHR system. Utah consumed the eICR and RR into their surveillance system, and Epic received and processed the RR.
Pictured: CSTE staff member Janet Hui leads a demonstration of the Reportable Conditions Knowledge Management System (RCKMS) during the 2017 HIMSS Conference in Orlando, FL.
Overall, CSTE’s participation in this year’s HIMSS Conference was very productive in educating attendees on CSTE’s role in the work of public health reporting, RCKMS and other technology currently being developed in the surveillance/reporting realm. The Conference presented a great opportunity to engage fellow public health professionals on the ongoing work of RCKMS, and I look forward to participation in future HIMSS Conferences.
Janet Hui is CSTE’s Associate Research Analyst on the RCKMS initiative. For more information about the ongoing RCKMS work or other projects in the Surveillance/Informatics area, contact Janet at email@example.com.
Posted By Jeremy Arieh and Emily Holubowich,
Thursday, March 23, 2017
Updated: Thursday, March 23, 2017
Each year, members of CSTE’s executive leadership team visit Washington, DC to meet with key Congressional offices on behalf of the applied epidemiology profession. Advocacy is one of CSTE’s integral functions, and the activity is a key component of the overall CSTE mission. On March 8-9, President Joe McLaughlin of Alaska, President-Elect Janet Hamilton of Florida, Secretary-Treasurer Sarah Y. Park of Hawaii, Senior Board Advisor Tim Jones of Tennessee and Executive Director Jeff Engel attended meetings with members of the U.S. House and Senate, and the Centers for Disease Control and Prevention’s (CDC) Washington office as part of the 2017 “Hill Day.”
Pictured (L-R): Janet Hamilton, Jeff Engel, Tim Jones, Sarah Park, Emily Holubowich and Joe McLaughlin attend CSTE Hill Day at the U.S. Capitol.
Led by CSTE’s Washington representative Emily Holubowich, advocacy efforts during this year’s Hill visits hinged upon the preservation of CDC’s Epidemiology and Laboratory Capacity for Infectious Diseases (ELC) funding, which in fiscal year 2016 awarded over $240 million to help states detect, prevent and respond to the growing threats posed by infectious diseases, including foodborne and vaccine-preventable diseases. In particular, CSTE’s meetings focused on proposed cuts to the Prevention and Public Health Fund (PPHF) as part of legislation to repeal and replace the Affordable Care Act (ACA). The loss of the PPHF would deal a $900 million blow to the CDC’s budget, and a $50 million blow to epidemiology capacity at the state and local level. This funding comprises around 12 percent of the CDC’s overall budget, and it is a vital aspect of our nation’s public health infrastructure. Cuts of this magnitude could severely hamper core CDC programs, such as immunization, workforce capacity, vector-borne disease management and more.
With the House’s introduction of the American Health Care Act (ACHA) to repeal the ACA earlier in the week, this year’s Hill visit was very well-timed, as CSTE leaders spoke to the proposed PPHF cut during meetings with Senate and House staff. Our packed March 8th agenda began with an ASTHO briefing at the Capitol Visitors Center. The briefing featured panel discussions on hot topic issues, such as Zika prevention and opioid addiction. CSTE Senior Board Advisor and Tennessee State Epidemiologist Tim Jones joined a panel of state health department experts from Georgia, Florida and Minnesota to convey his experiences during Tennessee’s Zika response.
Pictured: Tim Jones highlights Tennessee’s Zika response during an ASTHO panel, entitled Zika Response: State & Territorial Public Health Acting to Protect America’s Health.
From there, CSTE attended meetings with Senate and House staffers, including the offices of Sen. Lisa Murkowski of Alaska, Sens. Marco Rubio and Bill Nelson of Florida, Sen. Brian Schatz of Hawaii, Sen. Richard Burr of North Carolina, Sens. Lamar Alexander and Bob Corker of Tennessee and Sen. Chris Coons of Delaware. Meetings were held with staff of the Senate Health, Education, Labor & Pensions (HELP) Committee and Senate and House Appropriations Subcommittees on Labor, Health and Human Services, Education & Related Agencies. Our Hill visits concluded with a meeting with staff at the CDC Washington offices on March 9th.
Pictured: CSTE leadership met with staff in the offices of Sens. Richard Burr, Lisa Murkowski, Marco Rubio, Brian Schatz and several others.
As part of our ongoing advocacy efforts, CSTE once again partnered with the Association of Public Health Laboratories (APHL) in co-signing request letters to Senate and House appropriators urging support of CDC’s core epidemiology and laboratory programs in the FY 2018 federal budget. The letters emphasize the need for vital funding of Emerging and Zoonotic Infectious Disease prevention and Public Health Workforce and Career Development.
Our presence on Capitol Hill was more important than ever. Last week, President Trump provided a preview of his FY 2018 budget and proposed an 18 percent cut to HHS. The high-level budget summary does not specify the level of cuts to CDC, but one must assume that the full budget released in May will include deep cuts given the cuts proposed for the Department itself. CSTE will continue to educate lawmakers about the value of disease surveillance activities at the state and local levels, and work with our partners in the public health community to protect CDC from further cuts.
Click HERE to view a table of ELC and HAI funding for each state in FY 2016.
Posted By Jennifer Lemmings,
Friday, December 2, 2016
Updated: Thursday, December 1, 2016
On November 4, President Obama signed an Executive Order reinforcing the Global Health Security Agenda (GHSA) as a presidential-level priority and bolstering the United States as a major catalyst for supporting the GHSA and its promise. In his Executive Order, President Obama highlights the role of protecting global security as a key tenet of the United States’ national strategy to combat biological threats. He points out that in a globalized world, in order to protect ourselves, we must protect and bolster other nations’ health infrastructures.
The United States, joining the World Health Organization (WHO), Food and Agriculture Organization of the United Nations (FAO), World Organisation for Animal Health (OIE), Global Partnership Against the Spread of Weapons and Materials of Mass Destruction, the International Criminal Police Organization (INTERPOL), and other relevant organizations and stakeholders, will coordinate amongst governmental and non-governmental entities in order to advance the “global health agenda.” This will include the development of an inter-agency council to draft guidance for the agencies and support and track global health issues and how the United States can lead and participate in addressing them, among other things.
CSTE is pleased to support the President’s efforts, acknowledging that walls cannot stop the spread of disease, and therefore national health security can only be achieved through the protection of global health security. CSTE’s international role has accelerated rapidly within the last two years as we work to better support epidemiology surge capacity needs. Funding from the Centers for Disease Control and Prevention (CDC) and the CDC Foundation enabled CSTE to support international public health emergencies in Ebola, and now in Zika.
In January 2015, four French speaking senior epidemiologists traveled to four high risk Ebola Virus unaffected countries in Western Africa. As part of a comprehensive strategy to contain the regional Ebola epidemic, CDC and other international partners during this period were working in 18 unaffected high risk countries, with the aim of increasing capacity to detect and control any introduced Ebola Virus cases. The goal was to enhance the epidemiologic capacity in these countries and to provide:
Capacity building, technical assistance and guidance to the Ministries of Health/Health Departments surrounding Guinea, Sierra Leone and Liberia; and
Assessment of existing capacities and recommendations for improvement of policies and procedures
Funding for this work continued, and since August 2015 CSTE has supported an additional 40 deployments including those from the New York City Department of Health and Mental Hygiene, with an average deployment in Western Africa of 43 days.
As needs in the Zika response efforts have increased, CSTE is also supporting epidemiology work in Puerto Rico. Currently six deployments are completed or underway.
CSTE urges the new administration to continue support for these important efforts, and will continue to advocate for funding for epidemiologists to protect our nation’s health.
Posted By Emily J. Holubowich ,
Friday, November 4, 2016
Updated: Friday, November 4, 2016
Emily Holubowich, Senior Vice President at CRD Associates, is CSTE’s Washington representative and leads our advocacy efforts in the nation’s capital.
On September 28, Congress provided $1.1 billion in emergency supplemental funding to support epidemiologists and other public health professionals in the fight against the Zika virus—280+ days late and $800 million short of the President’s funding request. Despite the bill’s shortcomings, the funding is a welcome relief for those on the frontlines of the Zika response.
On October 26, the Department of Health and Human Services (HHS) provided its spend plan to Congress as required by the law, detailing how the Centers for Disease Control and Prevention (CDC) and other agencies will allocate resources for a range of Zika-related activities. As expected, CDC will rely heavily on state and local health departments to prevent, detect, and respond to the epidemic. Specifically, CDC will award at least $70 million of its $394 million in Zika supplemental funding to support epidemiology, laboratory surveillance, and vector control and surveillance. CDC has already provided Epidemiology and Laboratory Capacity (ELC) supplemental guidance to states (proposals are due November 20) and funds will be awarded before the end of the calendar year. In addition, CDC will restore $44 million that was redirected from the Public Health Emergency Preparedness (PHEP) grants to support Zika-related activities in the absence of new funding—funding that is already making its way back to state and local health departments.
With our attention now on the swift allocation of funding and ongoing response, it’s easy to forget how difficult it was to get here. The Council of State and Territorial Epidemiologists (CSTE) was actively engaged in efforts to secure Zika emergency funding during the last 8 months, first endorsing the administration’s request for $1.9 billion in emergency funding in February. Our vector-borne disease surveillance capacity assessment published in Mortality and Morbidity Weekly Report on the impact of budget cuts was a key pillar of our advocacy and education efforts, and was featured in a congressional hearing. CSTE actively participated in the “Zika Coalition” led by the March of Dimes, co-signing multiple letters to Congress and participating in meetings with key lawmakers. CSTE’s President-Elect Janet Hamilton of the Florida Department of Health took a break from her activities on the frontlines of the state’s Zika response to travel to Capitol Hill and share her experiences with a standing-room-only crowd of advocates, congressional staff, and lawmakers as part of the Coalition for Health Funding’s annual “Public Health 101” congressional briefing series, sponsored by the Congressional Public Health Caucus.
The challenge to the public health community now becomes keeping lawmakers’ short attention spans on the long-term Zika response and the needs of the public health infrastructure, more broadly. Some lawmakers think they have already “solved” the Zika problem with the appropriation of the $1.1 billion in emergency funding. Not only is this funding insufficient to support the immediate response, it will not address Zika’s long-term threat nor will it address the underlying weaknesses of the public health system after years of underinvestment that have been exposed by the virus.
Unfortunately, Zika is here to stay and will only get worse. As CDC Director Dr. Tom Frieden noted recently, “Zika and other diseases spread by [the Aedes aegypti mosquito] are really not controllable with current technologies. We will see this become endemic in the hemisphere." Meanwhile, the public health infrastructure will continue to buckle under the weight of mounting public health threats—both known and unknown. CSTE will continue to serve on the Zika Coalition’s steering committee to drive advocacy efforts around future funding needs for Zika response. CSTE will also continue to advocate for increased investment in ELC grants and the public health workforce. Only strong, stable, and sustained investment in the underlying public health infrastructure will ensure CSTE members and other public health officials are equipped and ready to combat all public health threats.
CSTE’s Executive Director Dr. Jeff Engel, President-Elect Janet Hamilton, and Washington Representative Emily Holubowich on Capitol Hill for a congressional briefing on the Zika response (Sept. 23, 2016).
Posted By Nicole Bryan,
Thursday, September 18, 2014
Over the past year, CSTE has worked with the National Foundation for Infectious Diseases (NFID) on a project to highlight the importance of the human papillomavirus (HPV) vaccine as a public health priority. This project has been a great way for CSTE to extend its relationships to other partners and organizations and to find different ways to impact public health. NFID and CSTE convened subject matter experts to talk about the long-term health impact of HPV and the role of immunization.
An environmental scan of existing resources was conducted in early 2014. This scan sought to enhance access to materials that would help healthcare providers improve vaccination rates. A summary of the environmental scan found many relevant and useful materials for healthcare providers. These materials range from resources for parents and teens to information for medical professionals. The summary emphasizes that key elements be included in communications materials to ensure the information provided is comprehensive and accurate. Key elements include information about the disease; the vaccine and its importance; the vaccine’s target age range, safety, and efficacy; and the benefit to men, among others. The NFID’s new HPV Resource Center includes many tools and resources for healthcare providers and public health professionals.
CSTE has acted as an advisory council to the project and conducted interviews with the states that have the highest and lowest HPV vaccination rates. CSTE members identified and conducted calls with State Epidemiologists and immunization program staff to discuss successes and barriers with regard to Vaccines for Children (VFC) and public clinics, HPV vaccination compared with other adolescent vaccination, and communication efforts toward healthcare practitioners and the public. Common themes were found among all states after having these conversations. Key messaging content focused primarily on cancer prevention, and funding playing a large role, as either a barrier or a success. All jurisdictions interviewed also stated that they would appreciate more helpful, easy-to-share resources in new formats for healthcare providers. There were also some key differences between jurisdictions with higher HPV vaccination rates and those with lower rates. Jurisdictions with higher or lower rates had different access to the vaccine, different cultures (particularly regarding perceptions of the HPV vaccine) and varying relationships with partners, such as pediatric hospitals and school nurses.
A virtual roundtable with several stakeholder organizations was conducted to discuss the importance of HPV vaccination and to develop a call to action document. The call to action urges healthcare providers to prioritize and actively promote HPV vaccination with parents and adolescents. The document lays out why HPV is an important issue, how vaccination addresses the burden of HPV, and how healthcare providers can help reduce the burden of HPV-related cancers in the U.S.
This work continues in the form of CSTE’s Vaccine-Preventable Diseases (VPD) Subcommittee. The subcommittee combines the work of the Adult and Child Immunization Subcommittees and will continue the work begun with CSTE’s partnership with NFID. The first VPD Subcommittee call will be September 23 at 2:00 pm ET via WebEx (login information below). It will include a presentation on the challenges and new directions for the pertussis case definition from Anna Acosta and Jeff Davis, an update on this Promotion of HPV Vaccination through Partnerships project, and an open forum to discuss future subcommittee projects.
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Associate Research Analyst
Council of State and Territorial Epidemiologists