Strengthening Infection Control to Prevent and Contain the Next Outbreak

This post originally ran on NACCHO’s Healthy People, Healthy Places blog. For more environmental health news and information, visit 

By Sara Chang, Program Analyst, NACCHO

Zika-e1454344118331-300x202As the CDC and World Health Organization escalate their preparedness and response activities for Zika virus disease, it will be critical for public health preparedness and response systems, networks, and agencies to rapidly pivot from observing to applying lessons learned in the 2014 Ebola response. At a time when an outbreak is only a plane ride away, as seen in the quick spread of Zika to 22 countries, experts from various sectors and institutions have underscored the importance of maintaining a ready state of preparedness. This will help public health professionals and their partners to most effectively detect, investigate, respond to, and control outbreaks of emerging and reemerging infectious diseases.

A recent report by the Trust for America’s Health (TFAH) and the Robert Wood Johnson Foundation (RWJF) examines the current state of the nation’s preparedness, stating that “America’s investments in infectious disease prevention ebb and flow, leaving our nation challenged to sufficiently address persistent problems.” NACCHO and the Association of State and Territorial Health Officials (ASTHO) also identified this inconsistency and uncertainty in preparedness as a theme during a two-day meeting in August 2015 with representatives from over 50 organizations involved in the domestic response to Ebola. In response to these findings, NACCHO has continued to work with federal, state, and local organizations, as well as other partners, to improve future preparedness efforts and responses to infectious disease outbreaks.

Several events during the Ebola response in the United States exposed gaps in infection control, such as the transmission of Ebola from a patient to healthcare workers and delays in communicating and implementing personal protective equipment (PPE) measures. Infection prevention and control seeks to prevent the transmission of infectious diseases in healthcare settings to, from, and between healthcare providers and patients. A range of policies, procedures, and practices among healthcare facilities and their staff, such as hand hygiene and vaccination, advance this goal. As a cornerstone of CDC’s Framework for Preventing Infectious Diseases, infection prevention and control is integral to addressing antimicrobial resistance, healthcare-associated infections (HAIs), and other emerging threats.

Following the Ebola response, CDC intends to “build upon state and local health department infection control infrastructure to bolster infection control training and competency across the healthcare delivery system” as part of its efforts to strengthen institutionalization of domestic preparedness. Local health departments (LHDs) on are the frontlines of public health, protecting communities by identifying, investigating, and controlling emerging infectious diseases. They prevent the spread of infections in healthcare and other settings by functioning as conveners of partners, stewards of data and monitoring, and local experts for facilities. Although many LHDs are engaged in infection control efforts, challenges and barriers persist, including lack of resources, limited involvement in reporting and data collection activities, and a need for increased coordination with state health departments and other stakeholders. With adequate resources, more robust and interoperable public health information systems, and increased collaboration, LHDs can provide proactive leadership, coordination, and participation in infection prevention and control efforts.

NACCHO has received additional funding from CDC to further the work of LHDs and improve domestic infection control, preparedness, and response infrastructure and capacity. Part of this funding will support LHD demonstration sites in their efforts to improve both healthcare and community infection control and enhance coordination for preparing and responding to Ebola, HAIs, and other emerging infectious diseases. These sites will be supported through NACCHO’s Lessons in INfection Control (LINC) Initiative, which focuses on strengthening local public health organizational and administrative capacity, expertise, and partnerships with key stakeholders. This work builds off of NACCHO’s multi-year grant supporting LHD expertise and capacity building for antimicrobial resistance and stewardship and leverages preparedness initiatives to enhance LHDs’ readiness to respond to emerging infectious diseases.

The TFAH and RWJF report concluded that “the United States must redouble efforts to better protect the country from new infectious disease threats, such as MERS-CoV and antibiotic-resistant superbugs, and resurging illnesses like whooping cough, tuberculosis, and gonorrhea.” NACCHO remains committed to investing in infectious disease prevention and control efforts at the local level and will continue to partner with CDC and other stakeholders to observe and apply lessons learned from Ebola and other emerging infectious diseases.

Applications for the LINC Initiative funding opportunity are due this Friday, February 5; start your application now!

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