Emerging Infections Programs
The Emerging Infections Programs (EIP) were established in 1995 in response to the Centers for Disease Control and Prevention's (CDC) 1994 strategy, Addressing Emerging Infectious Disease Threats: A Prevention Strategy for the United States [PDF - 23 pages]. An updated plan released by CDC in 1998, Preventing Emerging Infectious Diseases: A Strategy for the 21st Century [PDF - 19 pages], described the important role assumed by the EIPs in addressing emerging infections.
The EIP is a network of 10 state health departments (CA, CO, CT, GA, MD, MN, NM, NY, OR, TN) and their collaborators in local health departments, academic institutions, other federal agencies, and public health and clinical laboratories; infection preventionists; and healthcare providers (see map of EIP sites). The network comprises a catchment area of approximately 44 million people, though this varies by project. The EIP population is roughly representative of the U.S. population on the basis of demographic characteristics such as age, gender, race, and urban residence, as well as health indicators such as population density and percent at or below the poverty level.
The EIP network is a national resource for surveillance, prevention, and control of emerging infectious diseases. EIP activities go beyond routine functions of health departments by:
- Addressing the most important issues in infectious diseases and selecting projects that the EIP network is particularly suited to investigate
- Maintaining sufficient flexibility for emergency response and addressing new problems as they arise
- Developing and evaluating public health interventions and ultimately transferring what is learned to public health agencies
- Incorporating training as a key function of EIP activities
- Giving high priority to projects that lead directly to the prevention of disease
- Active Bacterial Core surveillance (ABCs): Active population-based laboratory surveillance for invasive bacterial disease. Pathogens included: groups A and B streptococcus, Haemophilus influenzae, Neisseria meningitidis, Streptococcus pneumoniae, and methicillin-resistant Staphylococcus aureus.
- FoodNet: Active population-based laboratory surveillance to monitor the incidence of foodborne diseases. Surveillance is conducted for seven bacterial and two parasitic pathogens: E. coli O157:H7, Campylobacter, Listeria, Salmonella, Shigella, Yersinia, Vibrio, Cryptosporidium, and Cyclospora.
- Influenza activities: Active population-based surveillance for laboratory confirmed influenza-related hospitalizations. EIP sites also conduct influenza vaccine effectiveness evaluations among groups for which ACIP recommends annual vaccination.
- Healthcare Associated Infections-Community Interface (HAIC) projects: Active population-based surveillance for Clostridium difficile infection and other healthcare associated infections caused by pathogens such as MRSA, Candida, and multi-drug resistant gram-negative bacteria. Sites also utilize the National Healthcare Safety Network (NHSN) to perform time-limited evaluations of HAIC data among NHSN facilities participating in the EIP NHSN network.
Surveillance efforts of these core EIP activities generate reliable estimates of the incidence of certain infections and provide the foundation for a variety of epidemiologic studies to explore risk factors, spectrum of disease, and prevention strategies.
- Evaluation of the HPV and rotavirus vaccines and their impact on disease burden
- A study to clinically validate diagnostics for pertussis
- Active and/or enhanced surveillance for acute and chronic viral hepatitis, unexplained deaths, encephalitis syndrome, Creutzfeldt-Jakob Disease, and tick-borne diseases (TickNET)
- Border Infectious Disease Surveillance for infectious diseases along the US - Mexico border
- Training opportunities for professionals through fellowship and international exchange programs, for partner organizations within the EIP area, and for states not participating in the network.
This complex network of active surveillance, applied research, and evaluation is currently conducting over 55 projects on a broad spectrum of infectious diseases.
The EIP network’s unique strength and contribution lies in its ability to quickly translate surveillance and research activities into informed policy and public health practice. For example, EIP work has been instrumental in the nation’s post-licensure evaluation of the 7-valent pneumococcal conjugate vaccine, evaluating and honing strategies for preventing severe disease in newborns caused by Group B Streptococcus, developing methodology to estimate ranges of 2009 H1N1 influenza cases and related hospitalization and deaths, and defining the rapidly changing epidemiology and growing burden of MRSA. The network has generated more than 510 publications since 1995 with data obtained from core EIP activities, Active Bacterial Core surveillance (ABCs), FoodNet, Influenza projects, and Healthcare Associated Infections - Community Interface projects, as well as other special studies.