Our Work - 2020
CDC is a year and a half into the second-largest Ebola outbreak on record. Weekly case counts in Democratic Republic of Congo (DRC) have been in the single digits for most of the year to date. Late this month, there was an entire week without a case for the first time since the outbreak began.
However, there needs to be six straight weeks with no new cases—a total of 42 days in a row—plus 90 days of enhanced surveillance to be able to call this outbreak over. The World Health Organization (WHO) recently reaffirmed the outbreak’s status as a Public Health Emergency of International Concern, warning that the security situation in the region leaves open the potential for new cases. WHO says it will revisit that decision within two months. In the meantime, CDC responders will keep working in Atlanta and with the DRC and its neighbors to support the response and preparedness efforts until the outbreak can definitively be declared over.
In January, the Making Dialysis Safer for Patients Coalition and the American Association of Kidney Patients released a video for dialysis staff and patients on dialysis about the importance of speaking up to prevent infections and improve patient safety. The video follows the journey of two patients on dialysis who feel empowered to speak up and share concerns about their treatment. The video also highlights ways dialysis staff can create an environment where patients feel safe speaking up. Along with the video, the group created a handout for staff with helpful tips and reminders about how to engage patients and caregivers. The video was released ahead of Patient Safety Awareness Week, which CDC observes from March 8-14.
CDC scientists and partners (including University of California-Davis and Sierra Leone’s Njala University and University of Makeni) have discovered active circulation of an Angola-like strain of Marburg virus in Egyptian rousette fruit bat colonies for the first time in Sierra Leone. Actively infected bats can potentially spread the virus to people who are in close contact with them, including when people prepare or eat fruit that’s been contaminated with the saliva, feces, or urine of an infected bat. Unfortunately, the bats eat a lot of the same fruit that we do. CDC has worked closely with partners in Sierra Leone to educate residents about conserving this ecologically beneficial bat species and the importance of avoiding the bats and their caves to prevent the spread of Marburg virus to people. Read more in the January 24 issueexternal icon of Nature.
CDC’s new video series, “Was It Something I Ate?,” presents stories of people who developed serious intestinal infections from food or animal contact. The stories are from families with children who developed Salmonella infection from eating contaminated chicken or contact with backyard poultry, and from a CDC veterinarian who investigated an outbreak linked to working with farm animals.
These stories highlight the importance of preventing infections from food or animal contact through efforts by industry, government, and the public. Check out all videos in the series (as well as free graphics, Medscape commentaries, and more) in the Resource Library section of CDC’s food safety website.
Nearly 400 representatives from across the country attended CDC’s first Vector Week, held March 25-28. CDC’s Division of Vector-Borne Diseases Director, Lyle Petersen, presented a collective vision and strategy to battle vector-borne diseases nationally. Other CDC senior scientists and experts from state and local public health programs and the Centers of Excellence presented on specific challenges and opportunities for vector-borne disease prevention and control. CDC and other public health programs are at a crucial juncture in our efforts to prevent and control vector-borne diseases, and we hope the deliberations at Vector Week 2020 will shape new directions in this important area.
CDC has been consulting with the National Aeronautics and Space Administration (NASA) on safety issues surrounding the Mars Sample Return missionexternal icon. The proposed mission will use rovers to sample Martian soil and bring back specimens to Earth for testing. A NASA team visited CDC earlier this month to discuss how to make sure that any pathogens that might be in the samples don’t pose a risk to people, agriculture, or the environment.
NASA staff also met with staff here at CDC about security and engineering of high-containment labs and biosafety for working with the samples. We talked about how to either contain or sterilize samples to prevent contaminants from getting in or out. Last week, representatives from CDC traveled to Salt Lake City, Utah, to meet with NASA’s Sterilization Workgroup, where they explained how CDC communicates about infectious disease risks and outbreaks. CDC shared examples of ways we have communicated about high-consequence but low-probability diseases.
On February 5, NCEZID released its 2019 Accomplishments highlighting everything from protecting domestic and global public health threats to collaborating with our partners to make an even bigger mark in saving lives and strengthening our preparedness to fight emerging and zoonotic infectious diseases. You can view NCEZID’s 2019 Accomplishments through a PDF – 16 pagespdf icon or on our website.
Since early January, CDC has been actively engaged in the international response to the rapidly escalating outbreak of respiratory infections linked to the 2019 novel coronavirus (2019-nCoV). CDC has activated its Emergency Operations Center under the leadership of National Center for Immunization and Respiratory Diseases (NCIRD), with support from NCEZID and other centers across the agency. Information about the outbreak has been changing daily. CDC and its public health partners have launched an aggressive preparedness and response effort. NCEZID’s response activities cut across programs throughout the center, as these examples show:
- Conducting enhanced health screenings at US airports, travel health notices, travel health alert messages in airports, and other travel- and quarantine-related activities, including analysis of travel data.
- Sharing infection control guidance.
- Providing expertise for pathology studies.
- Supporting efforts to develop and distribute laboratory diagnostic kits.
- Providing leadership and support for field deployments and CDC’s Emergency Operations Center.
On December 28, Puerto Rico experienced the first of a series of earthquakesexternal icon. On January 7, the island suffered a 6.4 magnitude earthquake. A 5.9 magnitude aftershock followed on January 11, and more than 2,300 tremors have occurred since December 28. We are communicating regularly with our staff in Puerto Rico to ensure that they are safe, and Dengue Branch facilities in San Juan have not been damaged. Metro areas currently have power, but southern Puerto Rico is still experiencing outages. Several CDC staff are participating in efforts to aid residents in this part of the island. CDC is actively engaged and monitoring quake activity and are on standby to provide support if needed.
Case counts have fallen from more than 100 a week at the worst of the outbreak to the single digits for many weeks. But the remaining hot spots are in places where surveillance and contact tracing are difficult, and recent violence has disrupted response work by some of our partner agencies.
Ebola vaccine receives FDA approval
In December, the US Food and Drug Administration (FDA) approvedexternal icon Ervebo, Merck’s Ebola vaccine, for use in the United States in people 18 and older. It’s the first FDA approval of a vaccine for Ebola virus, marking a historic milestone. The Democratic Republic of the Congo Ethics Review Committee and National Regulatory Authority have approved the Merck rVSV-ZEBOV vaccine in the DRC for this outbreak under “expanded access.” The existing vaccine supply in DRC and neighboring countries will remain investigational. This vaccine has been shown to be safe and protective against the Zaire ebolavirus species.
CDC, with state and federal partners, is investigating several multistate enteric disease outbreaks, including the following:
- Listeria infections linked to hard-boiled eggs produced by Almark Foods of Gainesville, Georgia. One death in Texas has been reported among seven total illnesses. On December 23, Almark Foods recalled all hard-boiled eggs produced at the Gainesville facility.
- Multidrug-resistant Campylobacter infections linked to contact with puppies in pet stores. Whole genome sequencing shows that the strain causing illness in 2019 is closely related genetically to the strain that caused a similar outbreak in 2016–2018.
- Salmonella infections linked to cut fruit. People in 11 states have gotten sick from eating contaminated cut honeydew melon, cantaloupe, or pineapple produced by Tailor Cut Produce.
- Salmonella infections linked to small pet turtles. People in 9 states have been infected with Salmonella typhimurim likely from contact with small pet turtles. The U.S. Food and Drug Administration bans the sale and distribution of turtles with shells less than 4 inches long as pets, but these animals can still be found for sale at flea markets, swap meets, and online.
CDC released a new interactive caseexternal icon assessment tool on Medscape to help healthcare providers learn more about preventing deadly Staphylococcus aureus (staph) infections in their patients. The tool was released in connection with a 2019 issue of Vital Signs that reported that 119,000 people suffered from bloodstream staph infections in the United States in 2017—and nearly 20,000 died. CDC called on healthcare facilities, providers, and administrators to protect patients from device- and procedure-related staph infections and promoted tools and resources to support those efforts. This case assessment tool is the latest resource created to help providers protect their patients against serious staph infections that can lead to sepsis or death.
CDC’s Arctic Investigations Program (AIP) recently published an articleexternal icon in Gastroenterology that summarizes the outcomes of a meeting that brought together international gastric cancer experts, Alaskan health providers, Alaska Native community and tribal leaders, public health officials, and representatives from other North American indigenous populations. The article describes the need for solutions designed to work in Alaska, where approximately 40% of Alaska Native people live in communities not connected to a road system. Participants identified the need for targeted screening and surveillance, clinical and community education, and additional research to uncover why gastric cancer rates are disproportionately high among Alaska Native people. AIP and its partners in Alaska have begun to address these needs, including designing a long-term screening study.