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2014: A trying year for U.S. health agencies

Public health2014: A trying year for U.S. health agencies

Published 30 December 2014

2014 has been a trying year for U.S. health officials. Globalization and the movement of people from previously remote villages to large cities introduced diseases such as Ebola to places where the flu virus was once considered the most alarming public health scare. “If anyone still needed convincing, 2014 really showed that a disease threat anywhere is a disease threat everywhere,” said Dr. Tom Frieden, CDC director. A series of mishaps in handling deadly pathogens in CDC and NIH labs raised questions about the safety culture in U.S. biolabs.

2014 has been a trying year for U.S. health officials. Globalization and the movement of people from previously remote villages to large cities introduced diseases such as Ebola to places where the flu virus was once considered the most alarming public health scare. “If anyone still needed convincing, 2014 really showed that a disease threat anywhere is a disease threat everywhere,” said Dr. Tom Frieden, director of the U.S. Centers for Disease Control and Prevention (CDC).

U.S. health institutions — the CDC and the National Institute of Health (NIH) — were faced with incidents that questioned the storage and handling of deadly pathogens. This year, vaccines, which represent a breakthrough in curbing the spread of diseases, posed a challenge, while also giving hope to thousands of people at risk of being infected with the Ebola virus.

The last time U.S. health officials were this worried was during the 2009 flu pandemic, said Dr. Marci Layton of New York City’s health department, regarding concerns over the Ebola virus. Previous Ebola outbreaks had sickened a few hundred people at most, but as of today, at least 20,000 people have been infected with the virus and roughly 7,700 have died. The Free Lance-Star reports that healthcare systems in the most affected countries, Guinea, Liberia, and Sierra Leone were already weak before the virus struck, so public health officials had limited response options. Efforts by the World Health Organization to curb infection rates were hampered by budget cuts and bureaucratic bungles, according to a WHO internal report.

As the United States pledged to send supplies and troops to help countries suffering from the epidemic, CDC officials assured Americans that U.S. hospitals were equipped to handle Ebola should a case arrive in the country. Public confidence in U.S. Ebola prevention efforts was soon shaken after news that Ebola-infected Liberian national Thomas Eric Duncan was misdiagnosed at a Dallas hospital when he first reported his symptoms to hospital officials. Duncan, who died of the disease, infected two nurses who treated him at the Dallas hospital. Exactly how the nurses became infected remains unclear, but CDC officials admitted that a much larger team should have been sent to help hospital workers in Dallas care for Duncan. Today pharmaceutical firms, researchers, and public health agencies have teamed up to develop promising Ebola vaccines.

In January, months before the Ebola epidemic peaked, a CDC lab scientist accidentally mixed a deadly strain of bird flu with a weaker strain before sending it to workers at two other labs. In June, another CDC lab mistakenly sent active anthrax samples to two labs with fewer safeguards for containing the bacteria. Though no one fell ill from either incident, the anthrax lab director resigned. Then in July, Food and Drug Administration workers cleaning out a former storage room discovered forgotten sixty-year-old vials of smallpox virus at the NIH campus in Bethesda, Maryland.

This year, health officials in California discovered that the vaccine which has been used for over twenty years against whooping cough does a poor job of preventing spread of the disease. About 10,000 cases were reported in the state, but only 10 percent of the children sickened had not been vaccinated against pertussis, the bacteria which causes the disease.

Other public health incidents that alarmed U.S. health officials in 2014 included the 600 cases of measles sparked by a U.S. traveler who became infected in another country; the case of more than 1,100 people in forty-eight states infected with Enterovirus 68, a traditionally low profile respiratory virus; and a rare U.S. case of Middle East respiratory syndrome (MERS) identified in a doctor who traveled from Saudi Arabia to Indiana.

On what to expect in 2015, U.S. health and disease experts have pledged to be on high alert, noting that the Ebola epidemic is still alive in West Africa. “I think what we really hit is a new normal,” said Michael Osterholm, a University of Minnesota infectious disease expert.

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