The Centers for Disease Control and Prevention (CDC)’s job is to detect health threats, stop outbreaks, and prevent illness and injury. As 2013 comes to a close America’s health protection agency looks back at the top health concerns in 2013 and previews the health threats that loom for 2014. The CDC’s most important achievements in 2013 are the outbreaks that didn’t happen, the diseases that were stopped before they crossed our borders, and the countless lives saved from preventable chronic diseases and injuries.
“While our biggest successes may be the bad things that did not happen, careful assessment of what we did well – and what we might do better – is essential for continued success,” says CDC director Tom Frieden, MD, MPH.
CDC’s top accomplishments included the life-saving Tips tobacco education campaign; a pilot study supporting the technologies and methods of the proposed Advanced Molecular Detection (AMD) initiatives; the Million Hearts® Initiative to prevent a million heart attacks; progress in curbing healthcare-associated infections; and contributions to the U.S. President’s Plan for Emergency AIDS Relief (PEPFAR), which prevented the one millionth baby from being infected with HIV.
However, much more needs to be done. The CDC sounded the alarm about the potential loss of antibiotic protection from bacterial infections, the slow uptake of the anti-cancer human papillomavirus (HPV) vaccine, the growing epidemic of prescription opiate addiction, the perfect storm of emerging infectious disease threats, and the final push for global polio eradication.
CDC’s 2013 accomplishments include:
•Demonstrations that new AMD technologies and methods can detect outbreaks sooner, stop them faster, and prevent them better. Through piloting AMD technologies and methods, the use of whole-genome sequencing allowed CDC to quickly track and trace a Listeria outbreak from contaminated cheese.
•More than 12,000 facilities now track healthcare-associated infections using CDC’s National Healthcare Safety Network (NHSN). CDC has found that bloodstream infections in patients with central lines have decreased by 44 percent and surgical-site infections have decreased by 20 percent since 2008. Following CDC protocols could cut some dialysis-related bloodstream infections in half.
•2013 marks the 10th anniversary of the U.S. President’s Plan for Emergency AIDS Relief (PEPFAR). In 2013, PEPFAR prevented the one millionth baby from being infected with HIV and has 6.7 million people on treatment, with HIV incidence falling in nearly all PEPFAR countries.
•CDC published its first estimates of which foods were causing foodborne illnesses in the United States, referred to as Attribution Estimates. These estimates help regulators, industry, and consumers more precisely target and implement effective measures to prevent food contamination, and allow people to use it to help guide their own food safety practices.
•CDC scientists traced the newly discovered Heartland virus that infected two men from northwestern Missouri to populations of lone star ticks in the region. This discovery helps CDC stay one step ahead of what could become another public health threat carried by ticks.
•In conjunction with public health officials in Eurasia’s Republic of Georgia, CDC helped identify a new poxvirus (related to smallpox) that sickened shepherds in Akhmeta, Georgia. The successful investigation shows that rapid detection saves precious time during response to emerging health threats.
•CDC researchers found that two new antibiotic regimens using existing drugs successfully treat gonorrhea infections. This is especially important given growing antibiotic resistance and dwindling treatment options for gonorrhea.
A major CDC priority in the year ahead is to improve America’s ability to detect diseases, both at home and abroad, before they become widespread outbreaks. AMD – the use of super computers and forensic DNA identification of infectious agents – is a key part of this effort. Improved AMD will enable faster and more effective infectious disease prevention and control.
“Investment in world-class technology is a wise investment in U.S. health security,” Frieden says. “American lives, and America’s economic stability depend on CDC quickly detecting and fighting superbugs.”
Technology is only one of the tools needed for global health security. The CDC and its partners are building a global health security infrastructure that can be scaled up to deal with multiple emerging health threats. Currently, only 1 in 5 countries can rapidly detect, respond to, or prevent global health threats caused by emerging infections. Improvements overseas, such as strengthening surveillance and lab systems, training disease detectives, and building facilities to investigate disease outbreaks can make the world -- and the United States -- more secure.
“There may be a misconception that infectious diseases are over in the industrialized world. But in fact, infectious diseases continue to be, and will always be, with us. Global health and protecting our country go hand in hand,” Frieden says.
Today’s health security threats come from at least five sources:
•The emergence and spread of new microbes
•The globalization of travel and food supply
•The rise of drug-resistant pathogens
•The acceleration of biological science capabilities and the risk that these capabilities may cause the inadvertent or intentional release of pathogens
•Continued concerns about terrorist acquisition, development, and use of biological agents.
“With patterns of global travel and trade, disease can spread nearly anywhere within 24 hours,” Frieden adds. “That’s why the ability to detect, fight, and prevent these diseases must be developed and strengthened overseas, and not just here in the United States.”
In addition to being crucial for global health security, AMD is a key element in one of CDC’s priority initiatives for 2014: combatting the spread of antibiotic-resistant bacteria. Several multidrug-resistant superbugs already threaten a throwback to the pre-antibiotic era.