CDC Investing $110 Million in Disease Surveillance and Detection

Public health laboratories could get a boost from a large infusion of federal funds for testing. That would come from $110 million being provided by the Centers for Disease Control and Prevention (CDC) to help states and communities track and respond to infectious diseases. The funding is intended primarily to increase surveillance of vaccine-preventable-diseases, foodborne-disease prevention and the use of advanced molecular testing for disease detection. Of that total sum, $51 million is being provided through the mandate of the Affordable Care Act. “In the last year alone, states were hit with emerging diseases, like chikungunya and respiratory infections from enterovirus D-68, while also responding to outbreaks of measles, foodborne illness, and other threats. These awards lay the foundation for those on the front lines—state and local health departments—to act quickly to prevent illness and deaths,” said Beth P. Bell, M.D., director of the CDC’s national center for emerging and zoonotic infectious diseases, in a statement. The funding breaks down along these lines:

• $6 million to establish local, state, and territorial health coordinators to track vaccine-preventable diseases like measles and pertussis, the rates of which have been increasing in recent years due to a growing resistance by some parents to vaccinate their children
• $17.4 million for foodborne disease prevention and tracking—up $4 million from fiscal 2014. This will include support for the existing CDC surveillance system called PulseNet, and to establish a new regional center in the Northeast for the CDC’s Food Safety Centers of Excellence
• More than $2 million to help states build their capacity for advanced molecular detection
• About $1.5 million to better monitor and prevent the spread of Lyme and other diseases spread by ticks. Lyme disease has been spreading in recent years, according to the agency
• $9.2 million to state and local health departments to build and maintain disease detection, surveillance, and prevention programs to reduce infections of West Nile virus and other mosquito and tick-borne viruses.
• More funding to help U.S. States on the Mexico border prepare for and respond to potential outbreaks of the mosquito-borne chikungunya virus, which infected more than 1.5 million people throughout the Caribbean, Mexico and Central America last year.

The money comes at a time when many labs—particularly those based in hospitals—are struggling to convert from paper-based information gathering that would speed up identification of potential serious outbreaks. According to data released earlier this year by the CDC, 67 percent of the 20 million or so reportable conditions submitted by laboratories were sent electronically last year. That compares to 62 percent in 2013. But only 20 percent of hospital-based labs are reporting electronically—a significant leap in recent years, but still far behind the rates of commercial labs. And smaller rural labs are also far less likely to report data electronically, officials said. Moreover, changing technologies are also creating issues. The use of pulsed-field gel electrophoresis to test certain bacterias can help spot outbreaks of serious diseases such as cryptosporidiosis more rapidly. But it also means slides and stool samples that can be sent to public health agencies for inspection are vanishing.

Takeaway: The Affordable Care Act and Medicaid expanded eligibility have increased the number of insured but overall the rate of growth in health care cost remains slower than historical averages.