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April 22
The link between our planet’s health and our own wellbeing

Earth day is a day to celebrate our amazing planet and to take time to pay attention to its inhabitants’ health and wellbeing. On April 4, 2016 the White House released its findings on the intersection of environment and human health in its new report, The Impacts of Climate Change on Human Health in the United States: A Scientific Assessment.  Many people already knew that climate change brings with it increased sea level rise, extreme weather events, vector-borne illness, extreme temperatures and more. 

But did you know that climate change also affects your mental health?

The things that impact our physical health, including climate change, also affect our mental health and wellbeing. The report includes a chapter on  Mental Health and Wellbeing that identifies four key findings which may help health and emergency management professionals plan for the mental health consequences of climate change, especially for individuals in communities with more frequent severe weather or climate-related events.

Exposure to Disasters Results in Mental Health Consequences
Key Finding 1:
Many people exposed to climate-related or weather-related disasters experience stress and serious mental health consequences. Depending on the type of the disaster, these consequences include post-traumatic stress disorder (PTSD), depression, and general anxiety, which often occur at the same time. The majority of affected people recover over time, although a significant proportion of exposed individuals develop chronic psychological dysfunction.

Specific Groups of People Are at Higher Risk
Key Finding 2:
Specific groups of people are at higher risk for distress and other adverse mental health consequences from exposure to climate-related or weather-related disasters. These groups include children, the elderly, women (especially pregnant and post-partum women), people with preexisting mental illness, the economically disadvantaged, the homeless, and first responders. Communities that rely on the natural environment for sustenance and livelihood, as well as populations living in areas most susceptible to specific climate change events, are at increased risk for adverse mental health outcomes.

Climate Change Threats Result in Mental Health Consequences and Social Impacts
Key Finding 3:
Many people will experience adverse mental health outcomes and social impacts from the threat of climate change, the perceived direct experience of climate change, and changes to one’s local environment. Media and popular culture representations of climate change influence stress responses and mental health and well-being.

Extreme Heat Increases Risks for People with Mental Illness
Key Finding 4:
People with mental illness are at higher risk for poor physical and mental health due to extreme heat. Increases in extreme heat will increase the risk of disease and death for people with mental illness, including elderly populations and those taking prescription medications that impair the body’s ability to regulate temperature.

So, as you consider the best way to celebrate Earth Day, take a moment to reflect on how you can take action to support your own mental health and the mental health of other people in your family or community. Research indicates that the more engaged you are with your community, the more resilient you and your community will be when faced with challenges.

April 08
Young, Creative Producers Show How They Prepare! Cast your ballot for the best video!

The entries are in and now it’s your time to choose.  Who’s got the best preparedness story?  You tell us!

Students across the country are helping to make the nation more prepared for disasters.  They are encouraging their families and communities to make healthier, safer and smarter choices.   Many of them told us how as part of the My Preparedness Story: Staying Healthy and Resilient Video Challenge.

Over the course of the last three months, over 75 students have answered the challenge by making their own shorts – 60 second videos – showing how they help protect health during disasters and every day. Now, we need your help to decide who has the best story!

Students have so many compelling stories to share about preparing themselves and their communities to stay healthy when disaster strikes.  They help their families make emergency kits and plans.  They organize emergency drills and blood drives.  They volunteer with great organizations like the Medical Reserve Corps. They choose career paths that can give them the skills that they will need to act when seconds count.

You can check out their stories on your computer, tablet or smart phone – just visit challenge.gov, and click on Solutions to view all entries.

Who you think has the best preparedness story?  Whose story was most engaging?  Most exciting? Most original?  Who inspires others to take action?  Who should win best picture for preparedness?

Voting is easy.  Visit challenge.gov and once on the main page, click on the Solutions tab on the left hand side to view all entries. Once there, you will see 5 grayed out stars for voting – simply move your cursor over the stars and select 1-5.

Let us know what you decide and help a young producer – or team – win the challenge.  In addition to bragging rights, the top prize winner will receive a $2,000 prize and the video could be used to inspire others take actions to prepare themselves and their communities so that they are ready when disaster strikes.

Don't delay!  Cast your ballot by April 22, 2016!

April 06
Want a more resilient community?  Start by improving public health in your neighborhood.

Think about all of the things that go into making our nation more secure and enhancing our well-being.  What do you think is at the foundation?  For President Obama, it’s public health.  And, you don’t need to be in the medical community to be active in your community and play a vital role in enhancing public health outcomes following disasters.

Healthy communities – the ones where people get outside, know their neighbors, and work together toward common goals – bounce back more effectively when disaster strikes.  They have strong systems to promote health every day and the community relies on those same systems when a disaster strikes.

You are a part of that system – whether you think about it or not.  For example, do you know your neighbors?  When the lights go out, do you check on the people that you know might need some extra help, like people with disabilities, elderly neighbors, or pregnant women?  If your neighbor has a child in your son or daughter’s class, have you talked about ways that you might help each other if a disaster strikes during the day and someone is unable to pick up their kids? And does your child’s school know about that plan? Every time you reach out and to help or plan to help people in your community before, during or after a disaster, you are helping to make your community healthier and more secure. If you haven’t already discussed “what ifs” with friends and neighbors, this week is National Public Health Week, and it’s a good time to start those conversations.

Knowing your neighbors, planning with them, and being willing to help is really important.  But if you want to do more to strengthen health in your community, there are many great volunteering opportunities that can help you do just that.  By giving your time, bringing your perspective of your community, and being willing to work as part of a team, you can help make your community healthier and more secure.

There are many great organizations that work in your community to promote health and others that focus on community connectedness and resilience.  Find one that feels right to you and think about ways that you can work with them to make your community healthier during disasters and every day.

Having trouble deciding?  The Medical Reserve Corps probably has some great options in your community.  The Medical Reserve Corps is a national network of local groups of volunteers engaging local communities to strengthen public health, reduce vulnerability, build resilience, and improve preparedness, response and recovery capabilities.  MRC volunteers promote everyday health through projects like vaccination clinics, training community members in CPR/first aid, and even providing psychological first aid training.

Many MRC units find really creative ways to combine preparing for the next disaster with keeping their communities safe today.  For example, the New Mexico Medical Reserve Corps supported the Annual Bataan Memorial Death March as a “planned mass casualty event.”  Because the 26.2 mile march is so tough, the MRC knows that many people will need medical attention in a setting that bears a striking resemblance to a disaster – and so they help the community while testing their disaster plans. Another MRC in New York partnered with their local government to test their mass vaccination plans using a drive-thru point of distribution exercise.

MRC volunteers also step in to help when their communities need them most.  MRC volunteers in Puerto Rico are teaching people in the community about the risks posed by Zika virus.  MRC volunteers have helped respond to natural disasters and disease outbreaks in communities across the country.

Building healthy communities helps strengthen us all.  Healthy communities are places where we can come together to grow stronger – physically and mentally.  They are places where people support each other.  There are many ways that you can help to make your community stronger – getting to know your community and volunteering are just a couple of them. 

Have you found other ways to make your community healthier and more secure during disasters and every day?  Share your stories in a comment on the blog.

March 21
PHEMCE-supported drug achieves FDA approval

Today, the FDA licensed the monoclonal antibody drug Anthim, developed by Elusys Therapeutics of Pine Brook, New Jersey, to treat inhalational anthrax. This drug’s approval not only diversifies our available medical countermeasures for use after an anthrax attack but also further demonstrates the effectiveness of partnering among federal agencies through the Public Health Emergency Medical Countermeasures Enterprise (PHEMCE) and the success of BARDA’s model of partnering with private industry.

Bridging the “Valley of Death” in Drug Development

HHS established the coordinated interagency PHEMCE group to define and prioritize requirements for the countermeasures our nation needs, focus research and development activities to address those needs, and procure and establish strategies to deploy and use the medical countermeasures that are in the Strategic National Stockpile.

Before BARDA existed, companies with drugs identified as promising countermeasures in early research often lacked the necessary funding, technical support and services necessary to advance the products through the development pipeline to FDA licensure.

Unlike drugs for common medical conditions, many drugs developed as medical countermeasures do not have a commercial market. Companies with promising medical countermeasures in early development often lacked the needed funding to push their products through late-stage development, which sometimes is referred to as the “valley of death” in drug development, to FDA licensure.

In 2006, Congress recognized that to have medical countermeasures available in a disaster meant the federal government needed to bridge this gap, and created BARDA to do it. The National Institutes of Health (NIH) supports studies of potential medical countermeasures in the earlier stages of development, and BARDA picks up the baton to support products as they move into clinical studies, develop commercial scale manufacturing, and make regulatory submissions. The agencies coordinate through the PHEMCE to transition products smoothly between agencies.

Anthim stands as the twenty-third medical countermeasure BARDA has supported to achieve FDA approval. The support the manufacturer received from PHEMCE partners proved vital reaching this milestone.

Partnerships lead to greater national health security

We continue to collaborate with private sector partners to advance the development of promising drugs, vaccines and other medical products to help ensure our nation is better protected during a disaster or public health emergency.

Companies seeking to further the development of countermeasures for chemical, biological, radiological and nuclear agents can apply for BARDA funding through one of our broad agency announcements, or BAAs. We also provide funding to advance medical countermeasures for pandemic influenza through a separate BAA.

We also provide funding to private partners to help develop new and innovative medical countermeasure technologies.

BARDA created the TechWatch program to help companies, private organizations and academic institutions determine whether they have products or technologies that could qualify for funding. Through TechWatch, participants have an opportunity to meet with scientific subject matter experts as well as project management staff. During TechWatch meetings, participants present their products and development plans, and receive feedback about their products or technologies, suggestions about techniques and strategies to meet technical and regulatory challenges, insight on how a product or technology might address BARDA's objectives, and information about BARDA’s mission and programs.

To learn whether BARDA could help advance the development of a medical countermeasure or innovative technology that your company or organization is working on, request a TechWatch meeting to present your ideas to medical countermeasure development experts.

March 17
Would old vaccine work if needed during a pandemic?

One of ASPR’s goals is to protect our nation against future flu pandemics. Even before ASPR was created in 2006, our nation started stockpiling millions of doses of flu vaccine to protect Americans against the H5N1 avian flu that spread in Asia beginning in 2004.

But, would the vaccine that was stockpiled more than a decade ago still be safe and effective to use if this pandemic flu strain spread in the U.S. today?

We believe so, but this aged vaccine has not been tested in humans, so we’re going to find out.

Unknown Shelf Lives

Most seasonal flu vaccine is stored for less than one year, so we lack data on how well flu vaccines hold up over time – basically, how long their shelf lives are. We know the potency of most vaccines diminishes over time. A recent study found that the active ingredient (antigen) of one of the stockpiled flu vaccines stored for five years remained safe and elicited an immune response in people, but was only about half as potent as it was when it was produced. In the world of vaccines, the difference between five and ten years is significant.

The active ingredients (in bulk) for strains of H5N1 flu vaccines maintained in the National Prepandemic Influenza Vaccine Stockpile undergo laboratory testing several times a year since they have been produced, and have been found to be within 60 to 90 percent of their original potency from when they were first stockpiled seven to nine years before. While this monitoring by testing in the laboratory has suggested they should still be effective, what we don’t know is whether they would still elicit a comparable immune response if they were to be used today.

Finding the answer to this question will help inform us about the national prepandemic influenza vaccine stockpiling strategy, including how long some antigens might be stored and still be usable.

BARDA Paving a Path to Find the Answers

BRITE is important in that it will answer this vital question. It is also a historic study in that it represents the first clinical trial that BARDA has sponsored and supported completely on its own.

The clinical study will seek to determine not only whether the stockpiled A/Vietnam/2004 (H5N1) lots of vaccine antigen produced in 2004 and 2005 still elicit immunity, but also whether the adjuvant produced in 2009 and 2013 has maintained its safety and potency. An adjuvant is an ingredient of a vaccine that helps create a stronger immune response in the patient’s body.

The study is expected to include more than 400 participants at six locations across the U.S., and the first 65 participants enrolled on March 15. After following the participants for a year, BARDA will know whether this vaccine passes the real world performance test by Fall 2017.

Additional Post-Study Benefits

BARDA could see benefits from managing this clinical trial beyond simply providing the answers it is designed to yield.

Clinical trials are required to assess the safety and efficacy of new medical countermeasures. By expanding our in-house expertise within BARDA to manage clinical trials, then this increased capacity could be tapped during an emergency to help develop new countermeasures when a third party might not be available to respond to those immediate needs.

Having this high level of proficiency within BARDA will help us more effectively engage with partners to conduct clinical studies, improving our ability to respond quickly to emergencies and better protect our nation.

March 11
Volunteering in tough conditions to protect health today and promote disaster preparedness for tomorrow

The Annual Bataan Memorial Death March is tough. The 26.2 mile march through hot, rugged terrain lasts for 14 hours. Hundreds or even thousands of the 5,800 marchers are likely to need medical attention during the march – making this a “planned mass casualty” event. The New Mexico Medical Reserve Corps is an important part of the team that gets participants the help they need.

For the past five years the New Mexico Medical Reserve Corps (MRC) has worked with other volunteer disaster teams and the military to provide medical care during the Bataan Memorial Death March. As part of the event, MRC volunteers face some challenges of their own: they provide medical care in austere conditions, work long hours, and learn to work with new partners on the spot. In short, they face many of the same challenges that are common in disasters.

Runners in the Annual Bataan Memorial Death March Busy tent during the Bataan Memorial Death March
Robert Perry Acute Care Tent

The Bataan Memorial Death March commemorates the World War II heroes from the Army, Army Air Corps, Navy and Marines who were captured and forced march to prisoner of war camps by Japanese forces. Some of the members seized were from the 200th Coast Artillery, New Mexico National Guard. Participants march in this event for many reasons: personal challenge, the spirit of competition, to honor a family member or particular veteran, or to honor those that were taken a prisoner of war by the Japanese in the Philippines.

And there are many reasons for MRC to participate in this event as well. For the New Mexico MRC, this is one of their best full-scale field exercises because of how closely it mirrors being deployed in a real world disaster response. The march is an excellent training opportunity for MRC volunteers to learn about collaboration, medical care in an austere environment, and integration under one incident command structure toward a common goal.

For the past several years the New Mexico MRC and the University of New Mexico University Health Emergency Response Team have collaborated with Colorado, Utah, Arizona and Texas to come together as one volunteer team to provide medical and logistical support in each of the ten medical tents along the 26.2 mile march. Knowing that we are a part of a bigger team has helped us develop respect for what each organization has to offer, foster positive attitudes and instill a strong working relationship that we can rely on during a public health emergency or disaster.

Just like in a disaster, there are a wide range of medical needs during the march. During past events, we have seen between 980 - 2,000 patients in a 14 hour period presenting with medical needs ranging from blister care or dehydration to orthopedic issues or even cardiac events. And just like in a disaster, it’s a very long day for our volunteers. Volunteers work late into the night and get up at 3:00 AM to start the next day.

The New Mexico MRC is in the final stages of gearing up for the 27th Annual Bataan Memorial Death March, which begins on March 20, 2016. During the event, MRC is looking forward to building on partnerships that we have made and adding to the lessons we’ve learned so that we can better protect health when we are called on to help.

Interested in finding a way that you can serve your community? Check out the Medical Reserve Corps and find a unit near you!

February 25
Putting Patients First: Reforming Emergency and Acute Care Delivery in the U.S.

Meet 22-year-old John. He’s visiting his older sister, Ann, on Monday evening when he starts to throw-up and develops severe abdominal pain. John is in pain and Ann is scared. At around 7 p.m., Ann takes him to the urgent care center a block from her apartment.

Due to his persistent vomiting and history of kidney stones, John is sent to the closest emergency department (ED). He typically goes to a different hospital in town closer to his apartment and had a CT scan there last week. There is no health information exchange shared by the competing hospitals. Phone calls to the other hospital result in a faxed medical record release form that will sit in medical records until the daytime clerk’s next shift. Without the ability to access John’s recent imaging studies, the emergency physician orders another CT scan, increasing cost and radiation exposure.

As John’s case demonstrates, emergency and acute care touches Americans’ lives, and the way this care is delivered is ripe for change. We need a more integrated and patient-centered way to deliver care during our most vulnerable moments.

So, how can we help John get the individualized care he needs?

Challenges facing the healthcare system are being addressed by the delivery system reform initiative announced by Health and Human Services’ (HHS) Secretary Burwell last year. The Secretary outlined a vision to ensure all healthcare delivery components are patient-centered by supporting better care, smarter spending, and healthier people through:

  1. Incentives: Bringing proven payment models to scale, aligning quality measures, and promoting value-based payment systems by testing new alternative payment models (APMs) and increasing the linkage of Medicaid, Medicare fee-for-service, and other payments to value. HHS announced that 30% of Medicare payments will be tied to quality through APMs by the end of 2016 and 50% by the end of 2018. By the end of 2016, 85% of all Medicare fee-for-service payments will be tied to quality or value, reaching 90% by the end of 2018.
  2. Care Delivery: Bolstering the integration and coordination of clinical care services throughout the healthcare continuum of care, improving population health, and promoting patient engagement via shared decision making.
  3. Information: Creating transparency on cost and quality information, bringing electronic health information to the point of care for meaningful use, and supporting joint consumer and clinical decision making.

Many important factors will shape healthcare delivery in the future, and medical success stories are integral in advancing healthcare to be patient-and community-centered. Key among these are changes in population demographics such as an aging population, an increased proportion of the population who lives with multiple chronic medical conditions, rapidly evolving innovation in technology, and the extension of a consumer culture into the healthcare marketplace. Many of these factors are relevant in the emergency and acute care setting as chronically ill and medically complex patients with fragmented healthcare seek outpatient solutions that don’t yet exist when they get sick.

Changes in healthcare delivery and payment models are shifting from volume-based care to value-based care. This is a critical time for the acute care system to connect the dots between providers, be the just-in-time solution when patients are sick, injured, and scared, and deliver on the promise of a better, smarter, and healthier U.S. healthcare system.

Stay tuned to read about the evolving role of acute and emergency care reform as part of this three-part series.

This blog post is the first part of a three-part series that discusses how the emergency and acute care system can be reformed to ensure patient-centeredness, integration into the broader healthcare system, high-quality, and the ability to respond to public health emergencies and disasters. To stay up-to-date as new blog posts are published, subscribe to the ASPR Blog RSS feed, follow @PHEgov on Twitter, Like us on Facebook or follow us on LinkedIn.

February 19
BARDA seeks to launch a novel partnership, a product accelerator to address antimicrobial resistance

Today the Biomedical Advanced Research and Development Authority (BARDA), in collaboration with our colleagues at the National Institutes of Allergy and Infectious Disease (NIAID) released a Funding Opportunity Announcement to establish the Combating Antibiotic Resistant Bacteria (CARB) Biopharmaceutical Accelerator.  The Accelerator represents a novel public private partnership that will support research and development to accelerate candidate products (drugs, vaccines, and diagnostics) into clinical development.

Infections with bacteria that are resistant to existing antibiotics kill 23,000 Americans per year and cost the U.S. healthcare system an estimated $2B annually.  Penicillin-resistant bacteria were first identified in 1947, just four years after mass production of the drug began, and over the last several decades, resistance has emerged to every class of marketed antibiotic.  Bacteria resistant to one of the last drugs to treat certain types of hospital acquired infections are now widespread and transmission of this resistance factor between bacteria has been observed, further raising concern. 

Many observers are concerned that the current pipeline of candidate antimicrobial products is insufficient to counter the threat of antimicrobial resistance.  Compared with other drug product classes, the pipeline is far from robust.  For example, as of May 2015, there are 28 antibiotics in Phase II/III clinical development (Pew Charitable Trusts 2015).  To put that in perspective, in March of 2015 there were over 500 candidates in Phase II/III clinical development for oncology indications (HemOnc today 2015).

To rectify this shortfall, we need to spur innovation and investment in new antimicrobial products to repopulate the early development pipeline. In 2014 United States released it National Strategy to Combat Antibiotic Resistant Bacteria. The National Strategy calls for BARDA to form new public private partnerships to incentivize antibacterial drug development.  Specifically, it calls for BARDA to establish a Biopharmaceutical Incubator/Accelerator to expand the current insufficient pipeline of antibacterial drug candidates.

Through this funding announcement, BARDA and NIAID will identify and select an existing Industry, non-profit organization, incubator or life science accelerator to lead this effort and leverage Industry experience performing the functions of an accelerator. The Accelerator will fund research and development (R&D) activities to help progress candidate products from the proof-of-concept stage through pre-clinical development. Candidates that graduate from the Accelerator will be better positioned for follow on R&D investment and clinical development.

There are various Accelerator models in the marketplace. The Accelerator will be a non-equity accelerator that provides non-dilutive funding to product developers for R&D activities and enables the product developers to retain full ownership and control of their company.  The Accelerator will be focusing only on antibacterial products.

The Accelerator that will focus on 1) funding development of antimicrobial products to further enhance the pipeline, 2) offering a suite of capabilities to rapidly shuttle successful product candidates through early development, 3) providing business and drug development guidance, and 4) decreasing the risks and barriers that impact further R&D investment by pharmaceutical companies, private investors and government partners.

The FOA can be found at: EP-IDS-16-001

Interested parties should plan on attending a Pre-Application workshop on March 3, 2016 from 3:00PM – 5:00PM EST at the Hubert H. Humphrey Building, in the Auditorium, located at 200 Independence Ave SW, Washington, DC 20201.

For this program to be successful, BARDA needs your help! BARDA looks forward to engaging the antibacterial community through another novel public private partnership and re-inventing how government is able to partner with industry to address the urgent problem of antimicrobial resistance.

February 04
Working together for Flint

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, talking with your doctor about whether your kids should be tested for lead, 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.

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