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February 04
Working together for Flint: a personal perspective

Two weeks ago, President Obama asked me to head the federal response to the water crisis in Flint, Michigan. Since then, I’ve spent time in Flint, talking with community members, government officials, and technical experts about what’s going on there. Understandably, residents are worried, confused and angry about the situation; they want a solution they can count on so they so they can drink a glass of water or take a shower without a concern about their health and the health of their children. As part of the fix, they also want to be sure that their kids go forward with the best shot they can have at a healthy life. So do I.

As the Assistant Secretary for Preparedness and Response, I’m used to responding to various kinds of emergencies but this response is, for me, a particularly personal one. I’ve dedicated much of my career to addressing economic disparity and its impact on community health overall. Incredibly, it was lead that propelled me into a career in medicine and public health. As I flew out to Flint for my first visit, I flashed back to high school, when I met one of my first mentors, Dr. Martha Lepow. She’s an infectious disease pediatrician, and way back then she realized that lead was as critical an issue as infectious diseases in the kids she was seeing.

She got me – as a high school student – involved in her crusade to end lead poisoning in children. Instead of going to class, I got a different kind of education. I knocked on doors, collected blood and urine samples and paint chips, and using the results, mapped out lead in neighborhoods. Armed with those data, Dr. Lepow was assertive with policy makers and politicians, pushing to change standards and laws in order to better protect children’s health from the effects of lead. I’m proud to have been a part of her work and to have learned from her – and from later mentors and even from my patients – that being a doctor means improving the health of the entire community as well as the health of each patient.  

We’ve learned so much about lead since then. Today, we know that there is no really healthy lead level in a child’s blood. We also know now that there is a lot we can do to help kids who have been exposed to lead and especially to help their growing brains catch up on development. Quality health care, good parenting, early childhood education, and healthy food help counter some of the effects of lead; they are all part of the solution. I’m hopeful that working together, we can put these in place for the people of Flint.

We’ve already made progress. In the past two weeks, we’ve ramped up support for the people of Flint, bringing in technical experts from HHS, CDC, EPA, FEMA, USDA, HUD, SBA, and the Department of Education.  Not only are we supporting state and local officials in identifying the size and scope of the problem, but we also are assisting them in making and executing a plan to mitigate the short- and long-term health effects of lead exposure.

An EPA response team is on the ground working closely with Flint’s water-system operators to identify sources of contamination. Working with the community, they will help develop a plan to restore safe drinking water to all Flint residents and make sure the Flint water system is being maintained appropriately.

A comprehensive effort is underway to monitor the healing of the water system. This involves collecting samples that test the water supply from its intake all the way to the end of the line in homes and workplaces. EPA has already started to make this information available to the public so Flint residents know what’s in their water and can see progress. At the same time, EPA is inspecting Flint’s drinking water system to determine the locations of lead pipes. This information will help EPA understand where additional residential sampling may be needed.

To help meet the near-term physical and mental health needs of children, pregnant women and families impacted by lead, CDC scientists are working with county and state health departments to determine exactly how many people have been exposed to lead and how much they’ve been exposed to. At the same time, the USDA’s Food and Nutrition Services is working with families in the Special Supplemental Nutrition Program for Women, Infants, and Children to provide ready-to-feed formula which does not need to be mixed with water. This means moms and dads can worry a little less about having enough bottled water handy.

USDA also approved the Michigan Department of Education’s request for additional funds to expand the number of schools serving fresh fruit and vegetables. These funds will help affected schools purchase foods high in calcium, iron and Vitamin C because these types of fruits and vegetables can help children who have been exposed to lead. We’ve begun working with the health departments and community organizations to get this important information about nutrition to all Flint residents.

If you live in Flint, you can help your family by using your water filters until this is over, cleaning the aerator in your faucet, getting your kids tested for lead if they haven’t been, adding fresh fruits and vegetables to their diets, and doing the things we know will help them grow up healthy and strong. If you know someone who lives in Flint, spread the word to them about these important steps.

Finding a solution to the water crisis is the first part of rebuilding a healthier, more vibrant community. Doing so requires more than coordination and more than the resources of any single government agency – county, state or federal. Recovering as a stronger community will require that civic and faith-based organizations, businesses and neighbors rally and work together with government agencies and with families.

I imagine there are students in Flint who could benefit from getting out of the classroom and engaged in their community like I did as a high school student. They can get involved in Flint’s recovery, too. Drawing on the talent and energy of every member of the community can help end this crisis faster and have a lasting positive effect: building a stronger, more resilient city not just now but far into the future.

February 03
Influenza is for the birds…and dogs, pigs, horses, and humans

On the surface, it might seem like we had a really mild flu season.  As 2015 came to a close and most were making plans for the New Year, more than 13,000 people were tested for seasonal influenza A in a single week. Of those, 157 were positive, and one additional novel A infection was confirmed, reflecting an unusually low level of human influenza activity across the nation so far this season.

However, animals haven’t been quite so lucky.  Last year saw a number of influenza A outbreaks in several different species, including horses, dogs, birds and pigs. 

Outbreaks that start in an animal population might not stay there.   One Health, the concept that animal, human and environmental health are connected,  can help us work more effectively with partners across different disciplines, such as doctors, veterinarians, ecologists, and public health experts, to identify and address emerging threats to health that start in animal populations.  

Global ecologic research has confirmed that influenza A viruses are especially likely to make the jump from animal to human hosts.  Influenza A viruses are able to mutate easily causing large-scale or even global outbreaks. They are responsible for all six historical pandemics and the only flu strain with the capability to present such a threat in the future. 

In 2015, we saw three influenza A outbreaks in horses, and a canine influenza A strain was also introduced into the U.S.  Even in the face of all these threats to health, the veterinary community has been able to mitigate many of the potential impacts of these outbreaks.  Quarantine prevented the spread of the equine viruses.  A vaccine has been developed for the newly imported canine influenza, though the dogs have no natural immunity to the virus.  

The outbreak of highly pathogenic avian influenza (HPAI) is a more serious threat.  Avian-origin strains have traditionally been responsible for most prior pandemics and may cause severe disease in humans. The 2015 HPAI epidemic represents the single most devastating outbreak of an animal disease in US history. The first case was reported from a mixed poultry flock in Oregon in December 2014, and eventually identified as H5N8. Another subtype, H5N2, was also later identified from a backyard flock in Kansas in March 2015. The two viruses eventually spread to the Midwest where they decimated commercial chicken and turkey populations, exhibiting a mortality rate between 90-100% and resulting in the loss of approximately 48 million birds. Surveillance has been ongoing in preparation for a possible reintroduction this season, which recently occurred with the report of highly pathogenic H7N8 in a single commercial turkey flock in Indiana Eight other positives have been reported in the area; however, all are low pathogenic.

No human infections of HPAI have been reported as a result of these outbreaks.

Influenza A outbreaks in animals may foreshadow similar outbreaks in humans and available animal health countermeasures could have later implications for people too. As we consider a comprehensive approach to preparedness, remember that the broader One Health approach can help us bring together different kinds of expertise. Knowledge fuels preparedness and helps mitigate the impacts of health emergencies on businesses and, in turn, on our nation’s critical infrastructure.

Interested in learning more?  Contact the Critical Infrastructure Protection staff with your questions at cip@hhs.gov or leave a comment on this blog post.

January 20
The chaos before the storm

Anniston, Alabama, recently became the scene of controlled chaos: waves of patients needing urgent medical care, a steady rotation of helicopters performing medical evacuations, and medical personnel scrambling to decontaminate people affected by an incident. This time the patients were actors, but this degree of realism is what drives ASPR to send National Disaster Medical System (NDMS) personnel to train at FEMA’s Center for Domestic Preparedness (CDP) in Anniston. At CDP, the nation’s premier, all-hazards training facility, members of the National Disaster Medical System become better prepared to respond to real-life disasters.

Image of two people practicing emergency care on a mannequin 
 

Nearly 5,000 medical, public health, and emergency management professionals from across the country comprise the NDMS, led by the U.S. Department of Health and Human Services’ Office of the Assistant Secretary for Preparedness and Response’s (ASPR) Office of Emergency Management (OEM). These professionals have the necessary medical training and credentials to treat the types of injuries they might see during a disaster. However, disasters present challenges that can be quite different from what these experts encounter during a normal day in their non-federal professional occupations.

To make the training as realistic as possible, NDMS teams participate in hands-on mass casualty exercises at the CDP in which actors and sophisticated patient simulators are the disaster survivors triaged and treated by NDMS personnel. During the week-long training sessions, responders operate medical facilities similar to field hospitals and effectively manage medical needs arising from the disaster scenario. These scenarios can range from mock nuclear incidents to natural disasters, and the teams don’t know what scenario they’ll face until they encounter and treat their “patients.”

The training is intense, much like what they would face in the field when called into service.

ASPR/OEM launched its full training program at the CDP for NDMS team members in 2014, and approximately 600 members are slated to train there in 2016.

The intensive training helps them hone their triage skills; become more familiar with equipment they would use during disaster responses, and establish working relationships with NDMS members they may not have met but with whom they could be working in a disaster.

When disasters and public health emergencies overwhelm state and local resources, ASPR/OEM looks to the expertise within NDMS teams across the nation to help with the medical response. Through ASPR/OEM’s partnership with FEMA’s CDP, we are making sure NDMS team members have the most realistic training available to ensure the best possible response for those who need medical care in a disaster.

CDP’s emergency response training is low-cost for state and local agencies and health care coalitions. It’s worth checking out.

December 30
Preparing for a happy, healthy year

I don’t usually make New Year’s resolutions at the beginning of each calendar year. Mostly because they involve some sort of “getting in shape,” and the gyms are too crowded. However, this January I’m coming up on my one-year anniversary with ASPR, and I realize now more than ever just how important preparedness is – so I am resolving to be ready.

When my family first moved to the Washington, D.C. area almost six years ago, we kinda made an emergency plan. If something happens, husband grabs the kid and the cats from the house and heads to his home state of Ohio. I catch up when I can. Before you start thinking my family is really squared away, let me say there are no “go bags” packed, the cats’ supplies are all over the house, and my daughter just went off to college last summer.

So where does that leave us now? A useless plan with a cool name (Operation Get Out of Dodge, if you’re curious) that doesn’t fit our needs anymore. So this year, we’re resolving to be ready. If you are thinking of doing the same, start by asking yourself a few questions:

  • Are you ready to safely shelter in place at your home during an emergency? If not, there are things you need to do to make your home a safe place to stay. Plan to have at least three days’ of food and water for everyone in the house. And with the holidays approaching, consider stocking up on extras if you will be hosting. You’ll be glad you have it if you need it.
  • How easy will it be to leave work and get home if disaster strikes? Several cities – including Washington, D.C. – are notorious for their horrible traffic. If you might need to stay at work for a while before you can head home, think about having a small emergency kit under your desk. A change of clothes and some extra snacks and water are a great place to start here. Also think about the needs of the people who rely on you and have a plan for contacting them and getting them help if you can’t reach them. Remember that phone lines are often jammed in an emergency, so texting is best.
  • What is the make-up of your family? If you have small children, what do you want to put in their emergency kit? Obviously clothes and medications are important, but consider putting in a special toy that will provide comfort and some books or games they can play. And I’m sure I don’t have to remind you that kids grow like weeds. Mark it on your calendar to periodically change out their kits to ensure clothing fits and is seasonally appropriate. Do you have elderly family members living with you? How will you accommodate their special needs?
  • Where are the people you care for most? Like I mentioned, my daughter went off to college last summer. Now she needs a plan of her own. What kind of items could you put together for kids in dorms knowing that space is a premium? Does she know about the emergency alerts on campus or in her new neighborhood? How will they contact you to let you know they are safe during an emergency? How will you contact them to let them know you are safe in an emergency?
  • Do you have special needs that might make preparing for an emergency more challenging? Talk with your doctor, pharmacist, or insurance company about how you will get access to care or medications during an emergency. Make sure you have a stash of important documents and medications to take with you in a hurry so you can continue to get the care you rely on every day.

I know this is a lot of information that can quickly become overwhelming, but taking all these things into consideration in small bites can help you make sure your family is prepared. If you aren’t sure where to get started making your emergency kit and plan, check out Emergency Preparedness and You from CDC.

I hope your family will resolve to be ready this year as well and will take the time to sit down and prepare your plans. Resolving to be ready might not get you into your skinny jeans, but it could get you and your loved ones out of a disaster safely – which is even better.

December 21
Better protecting our nation against future anthrax attacks

Almost 15 years ago, an attacker mailed three letters containing a deadly form of anthrax, killing five people and sickening 17 others. At the time, people who were exposed or who may have been exposed had few treatment options available and no vaccine at-the-ready to prevent illness. Today, that’s changed. On November 23, FDA announced licensure of a vaccine to prevent illness after exposure to anthrax. After a bioterrorism incident, a licensed vaccine could save countless lives.

The vaccine, BioThrax® (also called Anthrax Vaccine Adsorbed or AVA), had been licensed only for use before people were exposed. The military has used BioThrax® successfully for decades to protect people going into war zones where they could come in contact with anthrax. However, civilians’ greatest risk of exposure is after an anthrax attack, so they need a vaccine that can be used safely and effectively after being exposed to anthrax bacteria.

Reaching this milestone required collaboration across the federal government and industry. BARDA provided technical assistance and funding for phase 2 and 3 studies, which were needed for the vaccine developer, Emergent Biosolutions, to request FDA licensure of BioThrax® for community-wide post-exposure use.

Other federal agencies also had important roles in the vaccine’s advances. BARDA and Emergent built on previous development work sponsored by DoD for pre-exposure use and on long-term safety studies sponsored by CDC. In addition, progress the National Institute of Allergy and Infectious Diseases (NIAID) made in developing non-clinical models, research concepts, and in working with FDA on a clear regulatory path for post-exposure prophylaxis anthrax vaccines ultimately provided the roadmap for BioThrax’s successful licensure.

Based on additional studies sponsored by BARDA, this vaccine is expected to be effective as part of a larger treatment regimen of antibiotics and antitoxins. BARDA-supported studies, for example, demonstrated that BioThrax® would not interfere with antibiotics likely to be used for treatment of anthrax exposure.

This vaccine joins other medical products – including four antibiotics and two antitoxins – approved for use after an anthrax attack. Yet our work is not complete. BARDA is continuing to develop new treatments should anthrax become resistant to current antibiotics; a new antitoxin is in the works. BARDA also is pushing to improve BioThrax and develop other vaccines so that people are protected with the fewest possible doses of vaccine. Currently, BioThrax must be administered in three doses. To protect people faster in large-scale vaccination efforts, BARDA is working with NIAID and private industry on anthrax vaccine formulations that use dose- or antigen-sparing techniques so that only one or two doses of vaccine would be needed in short succession instead of three doses over a month after exposure. These programs have transitioned to BARDA from earlier development at NIAID and highlight the coordination across the Public Health Emergency Medical Countermeasures Enterprise.

Threats to public health constantly evolve, and along with these come ever-growing challenges in protecting our nation’s health security. Working together across federal agencies and with private industry, we can meet the challenge and provide a full range of approved products available to protect health in future bioterrorism incidents.

December 15
REMM redesigned

If a large mass casualty radiation incident were to occur in the U.S., local health care professionals would deliver most of the medical care initially, supported by surge capacity from Healthcare Coalitions developed under ASPR’s Hospital Preparedness Program grants, surrounding states, the National Disaster Medical System (NDMS), and the Radiation Injury Treatment Network. The local providers could have to evaluate large numbers of individual patients, and then triage, transport, and treat many kinds of radiation-induced injuries. Unfortunately, most providers at hospitals and in the community know little about radiation medicine, but HHS provides a resource that can help them better understand radiation and treat patients if an incident occurs in their area.

The Radiation Emergency Medical Management (REMM) web site, released by HHS’ Office of the Assistant Secretary for Preparedness and Response in 2007, offers health care providers key clinical information about the various types of radiation incidents and injuries, and how to recognize, triage and treat these injuries. It also provides instructional and training material about radiation itself and the federal assets available to help with the response. The REMM web site was recently redesigned to make it more user-friendly and have a more modern navigation system. REMM information also is available for health care professionals through the REMM Mobile app for Apple, Android, and Blackberry devices.

Fortunately, the U.S. has not seen many major radiation incidents. So, up to the present, U.S. health care responders and planners have mainly used REMM extensively to learn more about radiation, participate in formal exercises, and develop response plans. However, during Japan’s Fukushima nuclear reactor incident in 2011, REMM had a huge spike in visitors. REMM was accessed more than 170,000 times in the first day following the Fukushima disaster and hundreds of thousands of times throughout the incident. REMM has also been used extensively during formal radiation incident exercises of various kinds.

Since understanding radiation is complex, the site includes a Multimedia Library to explain the basics of radiation and radiation incidents, injuries, and treatment. In addition, the REMM YouTube channel, provides videos from HHS and other government entities about radiation issues. REMM has many interactive tools that assist with diagnosing and managing radiation injuries in a mass casualty setting.

For users who want to dive deeper into a topic, REMM has an extensive, easy to access bibliography of the key studies that support clinical recommendations for managing radiation injury. If those who want to learn even more, REMM’s training page aggregates many federal and state training opportunities available for those seeking additional information, skills, and credentials. Health care professionals and health physicists have used REMM assets extensively to teach and prepare their students and peers.

During radiation mass casualty incidents in the U.S., state, local, tribal and territorial governments would interact with the national government using plans published in the U.S. government’s Nuclear/Radiological Incident Annex, one of seven Federal Response Framework Incident Annexes. Radiation incidents of concern include a nuclear detonation, a dirty bomb, a nuclear facility incident, and a transportation incident involving radiation, among others.

The National Health Security Strategy and Implementation Plan outlines the strategy for how the U.S. can help protect communities from disasters and support them during emergencies and REMM is one piece in that strategy. Another part of this strategy is maintaining medical countermeasures and supplies in the Strategic National Stockpile (SNS) to help with the treatment of patients affected during a radiological or nuclear incident. In March 2015, the FDA approved the Neupogen (filgrastim) for the treatment of patients with radiation-induced myelosuppression. ASPR purchased Neupogen for the SNS in 2013. In November, Neulasta (pegfilgrastim) also was approved for this indication.

The REMM Team includes subject matter experts and information technology specialists from ASPR, the National Cancer Institute and the National Library of Medicine. Users can contact the REMM Team with comments and/or general questions.

December 11
Including Mental Health Resilience in your Disaster Plan

Did you know that the ACA can help you be healthier and more resilient? It helps by ensuring all of your healthcare needs, including your mental health care needs, are taken care of.

Even people who are otherwise psychologically healthy may experience mental distress that can affect day-to-day functioning and overall health in response to a disaster or emergency. Research suggests that upwards of 35 percent of individuals who go through a distressing or traumatic event will experience symptoms such as grief, anxiety about safety, feeling of hopelessness, and physical symptoms. It is even common for experienced emergency workers or first responders to be overwhelmed emotionally by an unusual or particularly upsetting event.

Some groups are more at risk of psychological disruption after emergencies. Children and older adults are known to be more vulnerable to extreme stress reactions after a disaster. People with preexisting mental health disorders are at greater risk for new or renewed problems. Most disaster survivors will recover psychologically on their own over time by connecting to their normal coping mechanisms and social supports. Some, however, may find their psychological conditions worsen or additional concerns, such as substance abuse, develop if they don’t get help.

Most of us already know that mental health and wellbeing is an essential part of overall health. Even if you have never had a mental health disorder yourself, you probably know or have been close to someone who has.

Statistics show that about one in five Americans experience some sort of mental illness every year. Conditions may include mild to moderate depression, stress disorders, or temporary adjustment disorders. Five percent of Americans suffer from chronic mental health conditions such as severe anxiety disorders like PTSD, bi-polar disorder and chronic depression.

Anyone suffering symptoms of mental illness is more vulnerable to stress brought on by traumatic or highly stressful events like disasters.

The prevalence of mental health disorders in our country, day-to-day and due to disasters, translates into big costs for our communities in terms of lost productivity and social connectedness. It also carries significant economic impacts due to the higher medical care costs associated with unaddressed mental illness.

Yet, in spite of how common and how costly mental health concerns are, only about 60 percent of people who are experiencing mental illness get treatment. A big reason for this in the past has been a lack of accessibility due to limits on insurance benefits to pay for mental health and substance use treatment.

The ACA has changed that; now most plans are required to provide behavioral health benefits as part of their essential benefits. This means that people who are currently experiencing mental health disorders can get the care they need so that they can be healthier every day, and more resilient if a disaster happens. It also means that anyone struggling with mental health or substance use concerns following a disaster can access professional support and recover more quickly.

Make sure you have comprehensive healthcare that includes mental health, or enroll in a plan that does during Open Season and visit Healthcare.Gov to learn more about your options and sign up for a plan. December 15 is the deadline to sign up for coverage that starts on January 1. The final deadline for enrollment is January 31. Take some time today to find a plan that is right for you. You will be taking important steps to improve your personal preparedness and build your foundation of individual resilience.

December 07
Protecting Our Community From the Flu While Practicing Our Response Plans: Annual Drive-Thru Point of Distribution Exercise in Onondaga County, New York

How do you practice mass prophylaxis/point of distribution (POD) plans, keep Medical Reserve Corps (MRC) volunteers actively engaged, and ensure that first responders are protected against seasonal influenza? The Onondaga County Health Department combines all three in an annual drive-thru influenza vaccination exercise.

Why use a drive thru POD? A drive through model helps us do a few very important things. Social distancing, the practice of keeping the sick people away from the healthy people, is critical during a real outbreak. Using a drive-thru POD helps us protect our staff while they dispense medicine. For Onondaga County, the drive-thru model also helps reduce personnel requirements —one large POD is easier to manage than several smaller, simultaneous PODs. How do you meaningfully test your plans to deploy a POD in an emergency with enough people to assess key components of the operation? By involving your partners!

First response organizations helped connect us with a manageable number of clients each year so that we can test the plan. The Onondaga County Health Department focuses on first responders as key partners because we want our responders to remain healthy and protect those they serve – the public and their families. The drive-thru POD provides us the perfect opportunity to do both. Now many of our county first responders receive their flu shot at this exercise each October because it is so convenient.

When most health departments practice their POD plans, it is usually for a few hours. We know that in reality, a POD response would require multiple shifts. Very few health departments have the personnel to maintain a POD operation while still continuing to deliver essential services. That’s why partnerships with MRC units and community organizations are crucial. OCHD recognizes the need for our local MRC unit—Central New York MRC—to provide the additional staff that we need to successfully run the POD. This MRC provides roughly 20-25 percent of the personnel needed for the drive-thru exercise and in all roles: traffic, medical screening, and prophylaxis and they help us make this event a success.

Involving our local MRC unit in the exercise benefits everyone. The health department can pull less staff from their daily duties, the volunteers get to practice alongside health department staff to more seamlessly fit into the operation, and the MRC is able to demonstrate its capabilities. MRC volunteers can see how important they are to our health department and are excited about their involvement. Many come back each year and some even get involved in other POD activities.

Practicing and testing our plans is essential to strengthening operations—you never know how it will work out and when and where it may go wrong. Successfully working with partners, getting volunteers actively involved, and having enough resources to meaningfully test the plan are our outcomes. The icing on the cake is when we can also protect the health of our public!

Your community may not have a POD set up in your neighborhood, but there are probably many places in your neighborhood where you can get a flu shot. Vaccination only takes a few minutes and it is the best way to protect against the flu. To find a vaccine location in your area, check out the HealthMap Vaccine Finder

Nurse checking in drive-up flu vaccine participant
People in cars lined up to receive flu vaccine
Nurse giving flu vaccine to a person in a car
 

December 03
Join the Conversation on Meeting Next-Generation Challenges in Medical Countermeasures

Safe and effective drugs, vaccines, therapeutics and diagnostics help us tackle a wide range of public health threats from emerging infectious diseases to terrorist threats. As we saw during the recent Ebola outbreak, developing next-generation medical countermeasures to respond rapidly to these threats takes a many smart people who are committed to working together to solve tough problems.

To meet these challenges, we need the commitment of experts from the pharmaceutical industry, hospitals and healthcare coalitions, the first responder community, as well as federal, state and local partners.

If you are interested in helping the nation prepare for these threats, register today for the Public Health Emergency Medical Countermeasures Enterprise (PHEMCE) Stakeholders Workshop on January 6-7, 2016. This free, two-day workshop will highlight future directions in developing, stockpiling and effectively utilizing medical countermeasures that may be required during public health emergencies.

Given the broad interests of the workshop attendees, plenary sessions and in-depth breakout sessions are organized along four tracks:

  • Track 1 – End User Considerations focuses on operational capacity and effectively utilizing medical countermeasures. During this workshop first responders, emergency room physicians, hospital directors and state and local emergency planners will be asked to provide their input into medical countermeasure needs, designs and utilization policies. You will also learn about the PHEMCE’s preparedness goals, clinical guidance for more effective use of medical countermeasures and the Strategic National Stockpile.
  • Track 2 – Federal Initiatives and Progress highlights federal advancements and progress of the PHEMCE partner agencies and other issues of interest to policy makers. Much has happened since the last workshop was held five years ago, and topics covered for this group will help them get up-to-speed about current medical countermeasures technology, policy and planning efforts. During these sessions, you will learn more about science preparedness and the importance of collecting critical data during crises; how to meet the needs of people with special needs; and how biosafety and biosecurity issues are evolving.
  • Track 3 – Industry Partnerships focuses on issues of interest to industry partners. These breakout sessions will include discussion of how PHEMCE federal agencies can help private sector partners advance products through federal support for development, and the history and future of the U.S. Food and Drug Administration’s medical countermeasure initiative. Medical countermeasure manufacturers also will learn about resources available to help them develop medical countermeasures.
  • Track 4 – Emerging Infectious Diseases and Pandemic Influenza will be of interest to members of the health care industry. These sessions will focus on how to deal with emerging infectious diseases, lessons learned during the response to the Ebola outbreak and an update about influenza and other respiratory pathogens. You will gain a better understanding of how these real-world responses have helped improve overall public health. Health care partners also will learn how more effective communication with the public can result in better health care utilization and health outcomes during crises.

You can learn more about the workshop and find the track that best suits your needs and interests at www.phe.gov/phemceworkshop. Space is limited, so register today.

November 25
Your Thanksgiving bird flu the coop?

More than seven million turkeys were culled during a bird flu outbreak this year, and you might be wondering about the one that’s going to serve as the centerpiece for your Thanksgiving dinner. The good news is the bird you’re eating on Thanksgiving didn’t get the flu, but what about the people you’re gathering around the table with?

Influenza affects humans and many other animals. Birds, pigs, ferrets, horses and even ocean mammals can get the flu, but not all of these strains can be transmitted to humans.

To help make sure these strains don’t cross over to people, federal agencies are focused not only on preventing humans from getting flu, but also on controlling disease in animals when they are experiencing an outbreak of a strain that has the potential to make us ill.

After the highly pathogenic H5N2 avian influenza broke out earlier this year, the U.S. Department of Agriculture culled millions of infected and exposed birds, primarily chickens and turkeys, to help prevent the spread of the flu and prevent it from entering the food supply. Last summer ASPR’s Biomedical Advanced Research and Development Authority (BARDA) along with the Centers for Disease Control and Prevention began development of new H5 vaccines that may protect humans and birds.

According to the USDA’s Animal and Plant Health Inspection Service (APHIS), more than 32 million egg-laying chickens – almost 10 percent of the total U.S. flock – were culled during the outbreak, which started in January 2015 and wasn’t brought under control until June. By September the average price of eggs nationally had climbed by more than 50 percent compared to the price a year before.

At present, most flu vaccines for humans use are grown in eggs, so you might think the egg shortage could lead to shortages and/or higher prices for flu vaccines. Fortunately, this is not the case. To prevent such outbreaks from threatening the vaccine supply, hens providing eggs for flu vaccines are kept separate from those producing eggs for food. The heightened sanitary and biosafety precautions used to protect these hens worked to keep our seasonal influenza vaccine supply secure.

It was with just such a scenario in mind that more than 10 years ago, HHS’ Office of Research and Development Coordination (the predecessor office to today’s BARDA) established a program to ensure a secure, year-round supply of embryonated eggs for manufacturing influenza vaccines. In subsequent years, ASPR/BARDA also supported the development of new egg-free influenza vaccines. Two of the egg-free vaccines that BARDA has supported, one grown in a cell culture system, the other produced using recombinant technology, have now been licensed by the U.S. Food and Drug Administration (FDA).

To help further protect our nation against a potential pandemic flu outbreak, BARDA announced in September that it is supporting the development of the first monoclonal antibody treatment for flu. It is helpful to know the shape of influenza viruses to better understand how drugs target them.

Influenza viruses are roughly spherical and their outer coats are studded with proteins called the hemagglutinin (the H in a virus’s name) and neuraminidase (the N). Think of the hemagglutinin as one of the pieces of broccoli on your Thanksgiving table. Flu vaccines elicit an immune response that targets the flower heads at the tip of the broccoli and these frequently change, which is why public health officials have to try and predict which flu strains vaccines should target each year. The monoclonal antibody BARDA is supporting targets a conserved region on the stem of the broccoli, which changes much more slowly than the flower heads and could allow the drug to be effective against a broader range of flu viruses. If this drug’s efficacy is proven, it will give us another weapon against seasonal and pandemic flu. At the same time, BARDA is also seeking to develop improved influenza vaccines that more effectively target the conserved region of the hemagglutinin stem. The ultimate goal is to develop a vaccine that protects against all or nearly all subtypes of influenza A – a so-called “universal vaccine” that would protect against both seasonal and pandemic influenza.

Even though we aren’t facing a pandemic right now, seasonal flu can be a real threat to you and your family. If the flu strikes in your home this holiday season, it could ruin your family’s gathering or worse. The consequences of the flu can be very serious, even life-threatening, especially for children, pregnant women, the elderly and people with compromised immune systems. If you are getting together with anybody in one of those groups this holiday season, it is especially important to get your flu vaccine.

It takes about two weeks for a flu vaccine to take effect, so get your vaccine today. Not sure where to go? The Flu Vaccine Finder can help you find a pharmacy in your area where you can get the vaccine.

We hope that you have a safe, happy holiday season full of great memories. You can help make that happen by taking a few minutes to get your flu shot.

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