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Agencies release report card on states’ ability to fight infectious diseases :

December 17, 2015

A report issued today from the Trust for America’s Health (TFAH) and the Robert Wood Johnson Foundation says the nation needs to “redouble efforts” to protect against infectious disease threats and resurging illnesses including pertussis.

The 2015 report “Outbreaks: Protecting Americans from Infectious Diseases” looked at how well the states are doing in regard to vaccinations, syringe exchange programs, disease surveillance, climate change and food safety.

The states were graded on their ability to prevent and control infectious disease outbreaks. More than half of the states scored a five or lower on 10 key indicators related to preventing, detecting, diagnosing and responding to outbreaks.

Five states tied for the top score, achieving eight of 10 indicators: Delaware, Kentucky, Maine, New York and Virginia. Seven states tied for the lowest score at three of 10: Idaho, Kansas, Michigan, Ohio, Oklahoma, Oregon and Utah.

One indicator addressed childhood immunization school requirement policies. States received a point if they excluded philosophical exemptions altogether or required a parental notification or affidavit to achieve a religious or philosophical exemption. Twenty states met that threshold.

Other findings included the following:

  • In 2014, more than 600 cases of measles and about 33,000 cases of pertussis were reported.
  • Although more than 90% of all U.S. kindergarteners received all recommended vaccinations, rates were lower in a number of communities and states.
  • More than 28% of preschoolers failed to receive all recommended vaccinations.

“Infectious diseases ─ which are largely preventable ─ disrupt the lives of millions of American and contribute to billions of dollars in unnecessary health care costs each year,” said Jeffrey Levi, Ph.D., executive director of TFAH.

In a telebriefing, Dr. Levi highlighted the lack of predictability in federal funding for states, which makes it difficult for them to “hire appropriate people and build the systems that really make a difference.”

Coping with infectious disease threats “requires constant vigilance,” added Dan Hanfling, M.D., a contributing scholar at UPMC Center for Health Security, a Baltimore-based nonprofit.

Past successes have been dramatic “but have contributed to a lack of urgency” to adequately deal with the inevitable continuing threats, Dr. Hanfling said.

Among the report’s recommendations are the following:

  • Increase resources to ensure every state can maintain and modernize basic capabilities needed to respond to outbreaks.
  • Update disease surveillance to be real-time and interoperable across communities and health systems.
  • Incentivize the development of new medicines and vaccines, and ensure systems are in place to distribute them when needed.
  • Decrease antibiotic overuse and increase vaccination rates.
  • Improve and maintain the ability of the health system to be prepared for a range of potential threats, such as an influx of patients during an outbreak.

Read the third annual report, with state-by state rankings, at

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