Recent Work

Our Work - 2021

February COVID-19 updates

Toolkit helps epidemiologists better use genomic data to track COVID-19 variants

COVID-19 toolkit

Epidemiologists tracking variants of the virus that causes COVID-19 in states and localities have a new tool to help them stay on top of the latest scientific data. CDC’s Office of Advanced Molecular Detection recently released a COVID-19 Genomic Epidemiology Toolkit to teach epidemiologists how to optimize the use of whole genome data in their investigations. In infectious disease, molecular detection technology identifies important clues in germs. Identifying their genetic blueprints, or whole genomes, is among the most advanced available forms of molecular detection. The new toolkit consists of video training modules, audio transcripts, case studies, and more. The toolkit includes introductions to genomic epidemiology and concentrates on the genome of the virus that causes COVID-19. Sign up to receive email updates when new modules are added to the COVID-19 Genomic Epidemiology Toolkit.

Testing order for air travelers flying to the US from other countries

CDC has issued an Order requiring a negative COVID-19 test or documentation of recovery for all air passengers 2 years of age or older before boarding a flight to the United States from another country. The order took effect on January 26 and includes US citizens and legal permanent residents. Testing before and after travel is a critical step to slow the introduction and spread of COVID-19 in the United States. As variants of the virus that causes COVID-19 continue to emerge around the world, there is growing evidence that some of them are more contagious. With COVID-19 surging in the United States, the testing requirement for air passengers will help slow the spread of the virus as more people in the United States get vaccinated.

Serving as a COVID-19 vaccine hub for Alaska

When Alaska needed help distributing a vaccine to prevent COVID-19, it turned to its partners at CDC. The Alaska Department of Health and Social Services (DHSS) asked NCEZID’s Arctic Investigations Program (AIP) for assistance in receiving and redistributing the vaccine developed by Pfizer-BioNtech. AIP manages several ultracold freezers, the same type needed to store the vaccine, and agreed to serve as one of Alaska’s three vaccine hubs. AIP developed a database to track vaccine shipments, completed vaccine order redirects from Pfizer, and established a process to redistribute the vaccine to communities across the state. AIP helped distribute more than 23,000 doses of the vaccine to sites across the state, including to remote villages and smaller communities. AIP has since transitioned its vaccine hub responsibilities to the state.

Yellow fever vaccination campaigns continue safely during COVID-19 pandemic

Yellow fever, a disease transmitted by mosquitoes, kills an estimated 30,000 people annually. A WHO strategy aims to drive deaths down to zero by 2026, but COVID-19 has threatened prevention campaigns in countries at risk for yellow fever. For example, a vaccination campaign targeting 5.6 million people in Ghana was planned for November 2020, but personal protective equipment (PPE) and infection prevention and control (IPC) supplies were too low to adequately prevent the spread of COVID-19. Also, officials planned to use “yellow cards” to note who was vaccinated, but the country did not have supplies needed to create them. To purchase all necessary PPE, IPC, and yellow cards, CDC, in particular its Arboviral Diseases Branch, a close partner with WHO on insect-borne diseases, raised over $7 million internally, including from CDC Foundation. The vaccination campaign in Ghana was successfully carried out at the end of November 2020. The funding will also allow yellow fever vaccination campaigns to move forward in Nigeria and the Democratic Republic of the Congo.

Project Firstline launches video series for healthcare workers

Project Firstline Inside Infection Control Episode 1 screenshot

In December, Project Firstline launched a Facebook video series for frontline healthcare workers called Inside Infection Control. The videos range from three to five minutes and are designed to answer questions received from frontline healthcare workers. December’s episodes describe important infection control concepts and serve as a foundation for understanding infection control in healthcare. New Inside Infection Control videos are posted every Tuesday and Thursday. January videos focused on infection control actions that are important for healthcare workers to apply during this phase of the COVID-19 pandemic. To stay up to date on new video and infection control content from Project Firstline, follow along on Facebook and Twitter.

New data and tools

Report on the “food” in “foodborne” illness is packed with data


Illustration of Salmonella Typhi bacteria. Medical illustrator: Alissa Eckert

A report pdf icon[PDF – 15 pages] with NCEZID co-authors examines which foods are most commonly responsible for illnesses caused by the bacteria Salmonella, Campylobacter, E. coli O157, and Listeria. The report uses data collected over 21 years to mathematically estimate the major food sources of these illnesses during 2018. Combined with other analyses, this report pdf icon[PDF – 15 pages] could help shape measures to keep more people safe from foodborne illnesses. It was produced by the Interagency Food Safety Analytics Collaboration, which includes CDC, the US Food and Drug Administration, and the Food Safety and Inspection Service of the United States Department of Agriculture. The methods used in this and prior annual reports are detailed in an article in the journal Emerging Infectious Diseases.

Monitoring drug-resistant bacteria that can come from food or live animals

Some infectious bacteria that people catch from contaminated food or contact with animals are resistant to antibiotics. A new report, the 2018 NARMS Integrated Summaryexternal icon, summarizes data on the presence of antibiotic-resistant bacteria in raw retail meat, food-producing animals at slaughter, and infected people. The report also includes data on antibiotic-resistant bacteria from dogs collected through a pilot (new) surveillance system. The National Antimicrobial Resistance Monitoring System (NARMS), a collaboration between the Food and Drug Administration, the U.S. Department of Agriculture, and CDC, issued the 2018 report. It adds data on more antimicrobial drugs and expands the number of retail meat collection sites since the last reportexternal icon. The new report can also be viewed in an interactive formatexternal icon with convenient data charts.

Reducing the spread of infections in healthcare settings

The United States has continued to drive down several kinds of infections that spread in healthcare settings. But there is still room for improvement. Both aspects are highlighted in a recent CDC report, the 2019 National and State Healthcare-Associated Infections (HAI) Progress Report. The report’s findings show that HAI prevention is possible, which is good news for patient safety. Notably, there has been a decrease of about 18% in hospital-onset infections caused by Clostridioides difficile (C. difficile) in acute care hospitals. C. difficile can cause the colon to inflame and can be deadly. The 2019 Progress Report includes data from the National Healthcare Safety Network. The report’s data are also available in CDC’s Antibiotic Resistance & Patient Safety Portal. Continued collaboration with public health departments, healthcare professionals, and other partners is critical to sustain progress in eliminating HAIs and to ensure patient safety.

A call to end deaths from an HIV-related fungal meningitis by 2030

About 20 percent of people who die in connection with HIV/AIDS globally succumb to a fungal infection called cryptococcal meningitis. CDC researchers have co-authored an articleexternal icon in the medical journal The Lancet Infectious Diseases arguing for a global strategy to end these deaths by 2030. The article appeared in late November just before World AIDS Day on December 1, 2020. It highlights major gaps in access to diagnostics and treatment that need to be addressed for this goal to be achieved. CDC is supporting a global effort against the AIDS-related disease at a time when the strategic framework to fight HIV/AIDS is being updated.

Modeling a path to fewer rabies deaths around the world

A little girl waits in line to get her puppy vaccinated against rabies at a clinic in Haiti

A little girl waits in line to get her puppy vaccinated against rabies at a clinic in Haiti. Photo credit: Kelly Crowdis

About 59,000 people around the world die every year needlessly from rabies infections passed on by dogs. To combat the problem, NCEZID has produced RabiesEconexternal icon, an analytic tool that estimates the impacts of policy choices to reduce the spread of rabies. CDC has collaborated with stakeholders in Zambia, Mexico, Guatemala, Vietnam, and Haiti to model rabies cases and the human deaths that can be averted by expanding or continuing rabies vaccination programs for dogs. RabiesEcon models helped strongly persuade policymakers in Mexico to continue funding for the country’s successful 20-year rabies vaccination program for dogs.

Tracking down harmful pathogens

City water evaluated following a death from brain-eating amoeba

DFWED's Mia Mattioli and Travis Brown collect water from a water tower in Lake Jackson

DFWED's Mia Mattioli and Travis Brown collect water from a water tower in Lake Jackson. Photo credit: Jenna Kieser

CDC staff recently conducted water evaluations in the city of Lake Jackson, Texas, after disinfection of its drinking water pipes. In September, CDC had detected Naegleria fowleri, commonly called brain-eating amoeba, within the city’s water system after a child was exposed at a city splash pad. The child later died. The city treated its water distribution network for 60 days with a high dose of chlorine. Afterward, CDC staff took large water samples throughout the city from water towers, fire hydrants, and monitoring points which, before treatment, had shown low levels of chlorine. CDC detected no evidence of N. fowleri in drinking water samples after the treatment. Water testing results, along with the positive data about the disinfection levels, are helping restore the public’s and local authorities’ confidence in their drinking water.

Studying mosquitoes that transmit diseases in time to take action

Staff from CDC, US Virgin Islands Department of Health, and the Puerto Rico Vector Control Unit collect mosquito larvae.

Staff from CDC, US Virgin Islands Department of Health, and the Puerto Rico Vector Control Unit collect mosquito larvae and pupae from a cistern.

Outbreaks of Zika and other mosquito-borne diseases have highlighted the need to control a particular species of mosquito called Aedes aegypti. This requires a complex, layered approach that includes identifying places where mosquitoes lay eggs and detecting mosquitoes that are resistant to insecticide early enough to take effective action. A CDC team traveled to the US Virgin Islands in November to contribute knowledge and skills through an agreement that facilitates public health support in areas affected by hurricanes. On the island of St. Croix, the team worked with staff from the Virgin Islands Department of Health (VIDOH) and the Puerto Rico Vector Control Unit to collect mosquito larvae and pupae living in water-collecting containers like rain barrels or basins. In St. Thomas, the CDC team helped VIDOH colleagues collect Ae. aegypti eggs that will be tested for insecticide resistance.

On the trail of pneumonia caused by bacteria that make an anthrax toxin

A CDC disease detective and a colleague from the National Institute of Occupational Safety and Health traveled to Houston to help the Texas Department of Health investigate the source of an unusual pneumonia infection. It was caused by a rare strain of Bacillus bacteria that produces a toxin normally made by anthrax. (The infecting bacteria were not anthrax.) The team wanted to know where the patient, a welder, contracted the bacteria. This was the second time in six months that a welder came down with pneumonia caused by Bacillus bacteria containing DNA to make the anthrax toxin. It was the seventh known such case in total in the Southern United States.