Synopsis for May 13, 2005

The MMWR is embargoed until Thursday, 12 PM EDT.

1. Positive Test Results for Acute Hepatitis A Virus Infection Among Persons With No Recent History of Acute Hepatitis ― United States, 2002-2004
2. Assessment of Epidemiologic Capacity in State and Territorial Health Departments ― United States, 2004
3. Terrorism and Emergency Preparedness in State and Territorial Public Health Departments ― United States, 2004
4. Improvement in Local Public Health Preparedness and Response Capacity ― Kansas, 2002-2003

Positive Test Results for Acute Hepatitis A Virus Infection Among Persons With No Recent History of Acute
Hepatitis ― United States, 2002-2004

To avoid false positive results, health-care providers should limit use of IgM anti-HAV testing to persons with evidence of clinical hepatitis or to those who have had recent exposure to an HAV-infected person.

Hepatitis A blood tests generally work well to diagnose hepatitis A. However, health departments have received reports of adults who do not have symptoms of hepatitis A, but who test positive with an IgM anti-hepatitis A virus test. In this report, health departments working with CDC used several methods to show that most of these adults who have no symptoms of illness or recent exposure but who test positive for acute hepatitis A virus infection do not appear to be infected with the virus. Family and household members who have contact with these persons do not need treatment (immune globulin) to avoid infection. The investigators concluded that, in most situations, healthcare providers should limit use of IgM anti-HAV testing to persons with symptoms of hepatitis, or to those who have had recent exposure to a person with hepatitis A virus infection.

Assessment of Epidemiologic Capacity in State and Territorial Health Departments ― United States, 2004

National epidemiology capacity has improved since 2001 with more epidemiologists working who are also better trained but continued enhancement of epidemiology capacity should be a public health workforce priority.

The Council of State and Territorial Epidemiologists conducted a survey of states and territories in 2004 to assess epidemiology capacity following a similar 2001 survey. This recent survey revealed a total of 2580 epidemiologists working in state and territorial health departments representing increased capacity in terrorism preparedness and maternal child health epidemiology but decreased capacity in all other epidemiology program areas. The findings show a 27 percent increase in the number of epidemiologists working in public health although 29 percent of these epidemiologists had no formal training or academic coursework in epidemiology. Despite enhancements to epidemiology capacity resulting from federal bioterrorism funding, states estimate a 47 percent increase in the number of epidemiologists is needed to create a public health infrastructure capable of fully performing essential services.

Terrorism and Emergency Preparedness in
State and Territorial Public Health Departments ―
United States, 2004

National terrorism preparedness capacity and public health infrastructure have improved with significant federal funding investment but ongoing support for this area needs to continue to be a priority.

The Council of State and Territorial Epidemiologists assessed the impact of federal preparedness funding on epidemiologic capacity, including terrorism preparedness and response, in 2001 and again in 2004. These assessments revealed a rapid increase in the number of epidemiologists and increased capacity for preparedness at the state level. The overall proportion of epidemiologists working in terrorism preparedness programs increased the most of any epidemiology program area during this time. However, state public health officials estimate that nearly 200 additional epidemiologists, an increase of 45 percent, are needed nationwide to fully staff terrorism preparedness programs. The increase in state public health capacity reflects substantial investment in efforts to support state terrorism preparedness programs and the corresponding public health infrastructure.

Improvement in Local Public Health Preparedness and Response Capacity ― Kansas, 2002-2003

When attention and funds are allocated, preparedness capacity improves in specific and measurable ways. Investments in such a critical field as public health preparedness should be accompanied by consistent evaluation methods. The repeated use of measurable, meaningful indicators can help monitor progress towards preparedness goals and identify gaps.

The large investment in public health preparedness made in the past years has resulted in measurable improvement of preparedness capacity in the majority of counties in Kansas. Repeated assessments of preparedness using standardized tools can provide useful information to help guide federal, state, and local public health policies and investments. The need for standardized indicators to be used nationwide remains high.

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