Pandemic Preparedness and Response at CDC

Carol Rubin DVM, MPH Senior Advisor for Zoonotic Influenzas

National Center for Zoonotic, Vector-Borne and Enteric Diseases, Centers for Disease Control and Prevention

Things this audience should know about CDC and AI response

• Recent reorganization-where to find the people you need

• On-going pandemic influenza activities • Research regarding the AI Animal:Human

interface • One Medicine perspective

The content of this presentation is the opinion of the author and is not necessarily representative of the Centers for Disease Control and Prevention

Re-organization

• The National Center for Infectious Disease became four separate centers under the umbrella of the Coordinating Center for Infectious Diseases

• Officially accepted by HHS in May, 2007

Coordinating Center for Infectious Dis eas es

COORDINATING OFFICE FOR

GLOBAL HEALTH

COORDINATING OFFICE

FOR TERRORISM PREPAREDNESS &

EMERGENCY RESPONSE

CDC OFFICE OF THE DIRECTOR

National Center for Health Marketing

National Center for Birth Defects and

Developmental Disabilities

National Center for Health Statistics

National Center for Chronic Disease

Prevention and Health Promotion

National Center for Public Health Informatics

National Office of Public Health Genomics

National Center for Environmental

Health/Agency for Toxic Substances &

Disease Registry

National Center for Injury Prevention and

Control

National Center for Immunization and

Respiratory Diseases

National Center for Zoonotic, Vector-Borne and Enteric Diseases

Prevention

National Center for HIV/AIDS, Viral

Hepatitis, STD, & TB Prevention

COORDINATING CENTER FOR

ENVIRONMENTAL HEALTH AND

INJURY PREVENTION

COORDINATING CENTER FOR INFECTIOUS

DISEASES

COORDINATING CENTER FOR HEALTH PROMOTION

COORDINATING CENTER

FOR HEALTH INFORMATION AND SERVICE

April 2005

National Institute for Occupational Safety And Health

National Center for Preparedness, Detection, &

Control of Infectious Diseases

Influenza BranchInfluenza Branch

… a multidisciplinary strategy to prevent, control, and, where possible, eliminate infectious diseases within a larger ecological context that includes humans, animals, and plants interacting in a complex, ever-changing natural environment.

AnimalAnimal HealthHealth Human HealthHuman Health

Ecosystem HealthEcosystem Health

Who does flu at CDC?...everybody

• Influenza Division – NCIRD,seasonal influenza, seed strains for

vaccines, labs, research, Dr.Nancy Cox

• Influenza Coordination Unit – CCID, permanent unit, funding, decision-

makers, Dr. Steve Redd • Influenza Task Force

– Core representatives from 18 CIOs • NCZVED

CDC Pandemic PreparednessCDC Pandemic Preparedness

llllllllllll~~. l lllPIAINlolilEIMl1lclOllPILAlllllllllllllllllllllllCllDICllNllFILIUIEINIZA llN•-~ 20 MAReM 2007•

CDC INFLUENZA PANDEMIC

OPERATION PLAN (OPLAN)

20 MARCH 2007

D E P A RTM E NT O F H EALTH AND HUMAN SERVICES

CENTERS FOR DISEASE CONTROL AND PREVENTION

S AFER • HEA L.THIER• PEOPLE~

OPLAN:OPLAN : (selected)(selected) planning assumptionsplanning assumptions

�� Initial responsibility is localInitial responsibility is local �� Gaps in PH s ervicesGaps in PH services �� DEOC activatedDEOC activated �� Usual CDC activities suspendedUsual CDC activities suspended �� SN S and PPE moved to states when humanSN S and PPE moved to states when human--

toto--human transmission verifiedhuman transmission verified �� Increased anxiety nationallyIncreased anxiety nationally

Research and LaboratoryResearch and Laboratory

Developing and Improving Diagnostic Tests and

Countermeasures � Supporting the development of improved

diagnostic tests, including point-of-care tests

� Developing and distributing modified avianinfluenza viruses for the use in manufacturing pre-pandemic vaccines

� Conducting research to improve ourunderstanding of influenza virulence and transmission

ExEono

l a sistance, andl

panding and Enhancingxpanding and Enhancing Surveillance and Resp seSurveillance and Resp nse

�� Providing training, technica sProviding training, technica assistance, and diagnostic reagents to improve lab capacitydiagnostic reagents to improve lab capacity domestically and internationallydomestically and internationally

�� Conducting training programs for rapidConducting training programs for rapid response t eams in Africa, Asia, Central Asia,response teams in Africa, Asia, Central Asia, Latin America, and the US (including CDCLatin America, and the US (including CDC ssttaaff)ff)

FY 2006 International Activities and Support International Activities and Support FY 2006

DeD

al gencies and travela

ati na

veloping and Implementingeveloping and Implementing Disease ContainmentDisease Containment

and Mitigation Strategiesand Mitigation Strategies �� Working with other feder aWorking with other feder l agencies and travel

industry regarding border and travelindustry regarding border and travel--relatedrelated interventionsinterventions

�� Issued interim guidance on community mitig oIssued interim guidance on community mitig tion strategiesstrategies

�� Supporting studies of nonSupporting studies of non--pharmaceutical,pharmaceutical, communitycommunity--level measures to decreaselevel measures to decrease transmissiontransmission

�� Assisting with provision of antivirals and vaccinesAssisting with provision of antivirals and vaccines

US Pandemic Influenza Checklists • State and Local Agencies • Business • Preschool • Schools (K-12) • Colleges & Universities • Faith-Based & Community

Organizations • Physician Offices and

Ambulatory care • Home Health • Emergency Medical Services • Travel Industry • Individuals and Families

http://www.cste.org/influenza/avian.asp

• …a standardized curriculum to state and local public-health responders about how to identify and control human infections and illness associated with avian influenza A (H5N1).

• Users are encouraged to download and use these free materials including presentations, case studies, and tabletop exercises and adapt the materials to meet the training and preparedness needs of individual state health agencies.

Workforce Protection

www.hi-tm.com/Documents/Image4.gif

Centers for Disease Control and Prevention

Pandemic Workforce Protection Plan

DRAFT January 19, 2007

What’s Included in the CDC Workforce Protection Plan?

• Personal and Family Readiness • Keeping the Workplace Safe • Assuring the Safety of CDC

Deployments • Managing Illness within the Workplace

• Guidance for Supervisors and Managers

• Mental Health and Resiliency During Pandemic

Director’s Emergency Operations Center

Research that addresses the AI animal human interface

• CDC – Cooperative agreements with U of MN, CO

State, National Institute of PH-The Netherlands, UGA, Maihidol U-Thailand

• NIH, NIAID – Centers of Excellence at St. Judes, UCLA, U

of MN, Emory, Mt. Sinai, U of Rochester NY

ONE MEDICINE

• A priority for AVMA and AMA • 60% of current infectious diseases are

shared by humans and animals • 80% of emerging infectious diseases are

zoonotic • If HPAI H5N1 doesn’t cause a pandemic,

another zoonotic agent probably will

We need to work together