Responding to Emerging and Zoonotic Infectious Disease Threats in 2017

Montage of photos. From left: a photo of different raw foods, including salmon, fruits and vegetables. A photo of a boy taking an oral vaccine. A photo of bacteria growing in petri dish.

Photo of Rima F. Khabbaz, MD, Director, National Center for Emerging and Zoonotic Infectious Diseases
Rima F. Khabbaz, MD, Director, National Center for Emerging and Zoonotic Infectious Diseases

The fungal superbug Candida auris causes serious and often fatal infections. It can strike people in the places where they seek care—hospitals and other healthcare facilities. In early 2016, we knew about outbreaks of C. auris infections on multiple continents, but we were not sure whether C. auris was in the United States. Fast forward to 2017: C. auris is a priority for public health workers in the United States, and CDC, along with state and local health departments, has tracked more than 200 cases of C. auris infection in the country. Our experts have worked with healthcare facilities across the nation to implement infection control measures and stop transmission.

The progress to track and prevent C. auris is just one example of the important work experts from CDC’s National Center for Emerging and Zoonotic Infectious Diseases (NCEZID) tackled in 2017. Some of the other highlights from the NCEZID 2017 Accomplishments report are described below.

A tremendous year for public health

Summarizing last year’s major efforts was a difficult task. The numbers alone depict a tremendous year for public health. Here are just a few examples.  CDC sequenced nearly 45,000 DNA samples by using Advanced Molecular Detection (AMD) technologies. The agency identified more than 1,100 illnesses that were associated with backyard flocks—the highest number ever recorded by CDC in a single year. And the Antibiotic Resistance Lab Network performed more than 12,000 tests to contain the spread of resistant infections, just to name a few accomplishments.

Tracking new and evolving threatsCDC’s National Center for Emerging and Zoonotic Infectious Diseases (NCEZID) focuses on emerging diseases and diseases spread between animals and people. Our experts work around the clock to identify, track, control and prevent some of the deadliest diseases on the planet. This work includes tracking diseases across the globe and at home, developing innovations, investigating disease outbreaks in extreme conditions, and helping experts prepare for infectious disease threats.

Every day we are learning more about antibiotic resistance, which continues to be among the biggest health concerns in our country. In 2017, CDC took several important steps to combat antibiotic resistance, including rolling out a containment strategy to slow the spread of drug-resistant diseases in healthcare facilities—starting with a single case—and supporting 25 innovators through a CDC pilot project to develop solutions to antibiotic resistance crises.

Understanding the impact

We are also learning more about Zika virus. Zika was often in the headlines in 2016 and 2017, and the mosquito-borne virus continues to be a threat, especially for pregnant women and their fetuses. Last year, CDC experts shed light on a lesser-known effect of Zika virus infection: a link with Guillain-Barré syndrome (GBS), an uncommon illness of the nervous system. In 2017, CDC and partners conducted the first case-control study in the Americas that showed evidence linking Zika virus infection and GBS. This was just one of many vector-borne diseases CDC tackled in 2017.

Responding to new outbreaks

As we continued to work on lingering threats like antibiotic resistance and Zika, CDC also responded to new outbreaks in 2017, both at home and abroad. In the United States, we saw a range of illnesses connected to food products—from Salmonella infections linked to papayas to an Escherichia coli outbreak from soy nut butter. For the first time, scientists linked an outbreak of Seoul virus infections to pet rats in the United States, and AMD lab techniques proved critical in tracing this and other outbreaks. CDC scientists traveled across the globe in 2017 to investigate a myriad of outbreaks, including an outbreak of anthrax infections in animals in Namibia that posed a threat to human health. Experts helped respond to yellow fever outbreaks in countries including Brazil, and we continue that work today as the yellow fever outbreak in Brazil has expanded over the past two years and could affect US travelers.

Like CDC’s response to yellow fever outbreaks, much of last year’s work continues in 2018. We are closely tracking emerging infections like C. auris, continuing to study the effects of unusual diseases like Zika, and investigating and containing outbreaks of infections caused by a wide range of microbes such as Salmonella bacteria, monkeypox virus, and hemorrhagic fever viruses.

Want to learn more? Read the full NCEZID 2017 Accomplishments report, and follow NCEZID on Twitter @CDC_NCEZID.

Pursuing Preprints, Preventing Pandemics: How pre-peer-review posting can accelerate outbreak science | PLOS Research News

0000-0002-8715-2896 Preprints – scientific papers posted online prior to peer review – offer opportunities to share and discuss research rapidly and openly, and Michael Johansson, infectious disease expert and founder of the nonprofit Outbreak Science,

Evaluating Communication Campaigns

Black man holding belly of his pregnant wife making heart. Pregnant woman and loving husband hugging tummy at home. Heart of hands by multiethnic couple on pregnant belly.

Health communication and marketing campaigns that promote positive behavior change are a cornerstone of public health and behavioral science. Designing and implementing quality campaigns on a tight budget and in an urgent timeframe is a challenge that most health communication professionals share. Research and evaluation are critical for a successful campaign. CDC is using leading research and evaluation methods to develop quality campaigns, while keeping costs low and sticking to tight timelines.

A great example is CDC’s design and implementation of The Domestic Readiness Initiative on Zika Virus Disease, also Domestic Zika Campaign: By the Numbers. Since its launch in early summer 2016, the campaign has generated over 350 million impressions and nearly 555,000 clicks across search, social, and display in the United States. In Puerto Rico, the campaign got over 10 million impressions, and 26,000 clicks on a range of media buys that covered the entire island.known as the Domestic Zika Campaign. This bilingual digital campaign sought to increase Zika awareness among the general population and expectant parents in the United States and its territories. Campaign messages were also developed to change knowledge and attitudes regarding Zika transmission, beliefs about the risks of Zika, and the perceived ability (self-efficacy) to protect oneself against Zika.

CDC identified several methods to get tailored messaging to our target audiences. Based on the work for this campaign, there are 10 methods that can help you reduce costs and improve the efficacy of your communication or health marketing campaign.

Formative Research

  1. Use “mixed” methods or alternative approaches. When feasible, mixed assessment techniques can enhance and complement different types of data collection. Your budget may not allow you to conduct in-depth formative research, but you can use one primary research or evaluation method and then supplement with other methods that are less costly. For example, conducting qualitative focus groups might not account for all of your audience segments, but you could perform a literature search to complement your qualitative data. Additionally, when circumstances dictate, sometimes substituting one evaluation activity for another may be just as effective (or close to it). During the Domestic Zika Campaign we used “triad” interviews, which only involved three participants, when we did not have the time or the budget to conduct a full suite of focus groups, and this was supplemented with previous survey data on closely related topics.
  2. Invest in market data. Public, non-proprietary market data, such as data from the US Census, PEW, and Gallup, allow you to get to know your audience at no cost. Outside marketing firms may also be willing to share “older” proprietary data that may be from a year or two ago at little or no cost. During the Domestic Zika Campaign, secondary data donated from Annenberg surveys(?) were key to our analysis of each of our target demographics’ media habits and informed the mass media and digital media strategies and plans. The cost is your time in building relationships with like-minded partners and analyzing the data for a specific purpose.
  3. Identify alternative data. When traditional surveying of knowledge, attitudes, and behaviors is not feasible, sometimes you can use alternative data (usually less expensive). During the Domestic Zika Campaign, we did not have sufficient time to get approval for our survey from the Office of Management and Budget (OMB) and field a traditional campaign evaluation survey. Instead, to meet our tight timeline, we acquired data about our audiences’ insecticide purchasing behavior in the stores where our advertisements had been placed, and compared them to similar product purchasing data from stores that did not display our advertisements. Building partnerships with organizations who have data, even from related issues, that can offer insights to you is a great long-term investment in both implementing and evaluating programs—especially when we have a shared commitment to protecting people from diseases.

Monitoring & EvaluationDigital Media in an Emergency. During a public health emergency or disease outbreak, even a small number of strategically placed, paid digital media spots can deliver messages to those who need them most. This type of message can often be placed within 24 – 48 hours. During the Zika response, CDC developed and executed behavioral intent studies using data collected by Google Health and Nielsen to study the effect of media exposure on audiences’ intent to take action to protect themselves from Zika. • We monitored exposure to digital campaign banners on the Google Display Network and compared those exposures to an increase in internet search for specific Zika-related terms. • We employed channel-targeted messaging, which helped to amplify CDC’s weekly Zika theme content on Facebook to reach audiences beyond the people who were already following the CDC page. This cost-efficient strategy extended the reach of posts to tens of thousands more people within the specific geographic areas.

  1. Take advantage of social media analytics. Social media platforms like Facebook, Twitter, Instagram, and Google AdWords allow you to target specific geographic areas and have built-in analytics tools that the user has access to at no additional cost. The Domestic Zika Campaign used data analytics to look at the performance of specific advertisements and the corresponding click-through rate to Zika-related campaign websites. Using social media platforms as a primary channel for the campaign allowed for more precise audience targeting, rapid message modifications, and real-time metrics. Using the data, we developed tailored advertisements that engaged key audiences and encouraged them to take preventive actions. For example, one of our treatments, the “carousel advertisement format” on Facebook, had the highest engagement with our target audience and provided a platform to communicate in-depth information about actions people could take to prevent Zika infection. Most organizations have access to someone who specializes in web analytics who can offer their insight.
  2. Conduct A/B testing. A/B testing is a way to compare two versions of something to figure out which performs better. A/B testing is used to assess different options of campaign messages or creative concepts in real time and measures which one people actually use more among different channels, such as Facebook and Twitter. The Domestic Zika Campaign tested messages and materials on a number of social and digital platforms to determine which channels our audience preferred. For example, we conducted an A/B test of an existing “Cover Your Body and Use Repellent” advertisement against two new advertisements that presented the “Cover” and “Repellent” content as two separate messages. We conducted a qualitative analysis of user comments on the advertisements and found that users had a negative reaction to the “Cover” action step given the high temperatures in areas with risk of Zika.
  3. Refresh your materials. Build in regular measurements to track and observe public response and evaluate public complacency towards your campaign to avoid a decrease in behavioral change outcomes. This can occur for two reasons: 1. Message fatigue, when the attention of your target audience is reduced because they have had repeated exposures to the campaign messages; or 2. Risk fatigue, when your audience no longer receives or responds to messages about the health threat.  You can refresh and adjust your campaign messages without creating new messages from scratch. During the second phase of the Domestic Zika Campaign we revised materials that were targeted towards men by adding images of males with their pregnant partners because we were informed by both women and men that they had become complacent about behaviors men could perform to protect both themselves and their partners from Zika virus infection and transmission.

General Rules of Thumb

  1. Do not reinvent the wheel. Know what is available in your organization.  Do you have existing contracts in place to purchase things quickly.  If you have to get permissions to do research, do you have processes in place to navigate them efficiently? As a federal agency, anytime we want to ask more than 9 people a question, we have to get approval from the Office of Management and Budget, which typically takes many months. Knowing this, CDC set up a process called the Health Message Testing System, which is generic request set up in advance with OMB that programs can use to quickly get permission to test a specific message with a specific audience. These approvals can be obtained in days instead of months.
  2. Track current events. Scan and track prominent news and social media. Be aware of current events and issues that arise over the course of your campaign. The news media will cover what is timely, and you can take advantage of this coverage to enhance your campaign efforts. During the initial phase of the Domestic Zika Campaign, the proposed use of the chemical pesticide Naled in Puerto Rico created a controversy for public health and government officials on the island. Tracking the controversy allowed us to address this issue by adding a media relations effort to the campaign and provided more opportunities to disseminate the most effective prevention messages.
  3. Partner with influential bloggers. Influential bloggers can help enhance and further disseminate your campaign messages, increasing the reach to and saturation of your target audience. One of the main goals of the Domestic Zika Campaign was to amplify CDC’s Zika prevention messages. We worked with a well-known television news celebrity who was pregnant and chose not to attend the summer Olympics in Rio de Janeiro, Brazil. We pitched the story to mom and parenting bloggers and packaged it with CDC-branded messaging and the opportunity for an interview with a CDC subject matter expert. The cost of working with a blogger can vary, and you need to vet them carefully, but there can be great benefits by partnering with someone who is a natural fit for your cause and/or message content AND who is already reaching your target audience.
  4. Welcome donated media. Opportunities may arise for you to take advantage of “value-added” or donated media, which can help extend your communication efforts and increase the number of measurement points to evaluate. If you purchase a large number of services, the outside vendor might be willing to add additional advertising or other activities so the campaign will not incur any additional costs. For instance, we acquired donated time for the public service announcements developed by the Domestic Zika Campaign to run in movie theaters in Puerto Rico.

Do you have any other suggestions to improve the quality and timeliness of health marketing and communication campaigns on a budget? Please leave a comment below.

Fred Fridinger is a Senior Health Communications Specialist in the Office of the Associate Director for Communication (OADC). During his 22- year career at CDC, he has worked on various campaigns and communication efforts, including those addressing moderate physical activity and healthy eating, genetics, chronic fatigue syndrome, and Zika prevention. In his current position, he oversees the market research function for OADC, which involves the Porter Novelli Styles and Nielsen Scarborough syndicated data bases.

The Communication Research and Evaluation blog series highlights innovative research and evaluation methods used at CDC to improve behavior change campaigns.

Responding to Emergencies One Behavior at a Time

A group of Ebola response volunteers in Nigeria.

To improve the health and safety of people in the United States and around the world, we have to influence and change behaviors. It can be difficult to try new things, or stop old things as behaviors range from simple to complex, but one way to consider behavior change is to think of any change as a passive or active choice.

Public health practitioners must think about interventions in terms of the behaviors they are asking people to adopt, stop or continue. What would encourage someone to change what they are currently doing? Before you can influence someone’s behavior or change their choices about a behavior (risky or protective) you need to know how their judgments and decisions are made about that behavior in the first place.

Behaviors are rooted in traditions

During the Ebola response behavior change was critical to prevent people from getting sick and ultimately stop a disease threat. In the wake of the outbreak, communities in West Africa were encouraged to give up or change their traditional burial practices. Some of these longstanding rituals, like washing the body, proved dangerous because the virus can live on the skin of a victim after death. Communicators developed public health messaging to help change social norms and customs for burials. It was important to understand behavioral science and anthropology in order to communicate about safe burial practices in a way that would make people choose to change a behavior that was ingrained in their culture.

Behaviors are rooted in social 7 Things to Consider When Communicating About Health. Trust: Will people trust the information? Who is the best source to put the information out? Information: What information is necessary, and how will people find it? How much is enough, or too much? Motivation: How relevant is the information to the people we’re trying to reach? Environment: What are the conditions that surround and affect the audience? Capacity: What is people’s ability to act on the information? Are there barriers? Perception: What will the audience think about the information? What will inspire them to act on it? Response: How will people respond? What can we do to stay engaged with them and give them support as they take action?norms

The 2016 Zika virus outbreak is the first time in more than 50 years that a virus has been linked to serious birth defects. Due to the impact of Zika virus infection during pregnancy, social norms and perceptions around provider visits had to be addressed to alleviate concerns about the cost of screening. Clinicians were educated about the risks associated with Zika virus, how to prevent infections, and reporting suspected cases to their state, local, or territorial health departments and women were offered free clinical services, education, and access to Zika prevention kits.

Behaviors are rooted in beliefs

The fight to eradicate polio teaches us the importance of beliefs in behavior change during a response to a public health threat. Creating an effective polio vaccine was only the first step in the effort to eradicate polio. Of course an effective vaccine was necessary to prevent polio virus infections, but getting communities to accept the vaccine was equally important. Public health practitioners created messages that build on cognitive, developmental, and social psychology to persuade parents to bring their children into clinics to get vaccinated.

Behaviors inform preparedness and response

Responding to emergencies effectively requires combined expertise in many fields, including behavioral science. Epidemiology, for example, allows us to understand how many people have a disease and characterize the disease, while behavioral science identifies the role of human behavior and psychosocial factors. Behavioral science expertise can identify methods to communicate and design campaigns to change behavior that are culturally and socially acceptable.

It is important that we maintain humility when we try to understand why people do or think what they do. We often assume that we understand human behavior, but we must remain open-minded when working with people from all different backgrounds and cultures. Who’s to say that what our culture considers right and true necessarily translates to the same belief systems elsewhere? Thus public health ethics is also an important consideration when suggesting behavioral change interventions. When we are in situations that are particularly dangerous or stressful, our assumptions about other people’s behavior can lead to recommendations or actions that seem counterintuitive or wrong to them. Careful application of behavioral science is critical to any mission that seeks to improve public health and safety, here and around the world.

The Communication Research and Evaluation blog series highlights innovative research and evaluation methods used at CDC to improve behavior change campaigns.

New Lab Matters: Sharing the value of public health laboratories

New Lab Matters: Sharing the value of public health laboratories | www.APHLblog.org

The need for a laboratory voice in budgetary discussions has become more urgent recently, and “human-to-human relationships” are as critical as technical knowledge. So how does a public health laboratory raise its profile within the community? By telling a good story…over and over again.

In the summer issue of Lab Matters, our feature article examines how laboratories are sharing their value, one interview, photo or outreach moment at a time.

Here are just a few of this issue’s highlights:

Subscribe and get Lab Matters delivered to your inbox, or read Lab Matters on your mobile device.

The post New Lab Matters: Sharing the value of public health laboratories appeared first on APHL Lab Blog.

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Battling Biting Mosquitoes and Jumping Genes in 2016

NCEZID microbiologist Jane Basile shows how to use the new yellow fever test kit that in less than 4 hours yields results that are as accurate as the older 2-day test.

Last year, an expert from the CDC National Center for Emerging and Zoonotic Diseases (NCEZID) found himself in an unlikely position: guest starring on a popular Navajo language radio program to field questions about hantavirus infection. Hantavirus is caused by contact with mouse droppings and can sometimes be fatal.

This is just one example of how NCEZID has worked over the past year to confront a wide range of infectious disease concerns. From antibiotic resistance to Zika, last year’s threats required rapid and innovative responses, and CDC experts stepped up to the plate. Below are just a few of highlights from 2016.

Fighting the bite

In 2016, the mosquito was a major culprit. Zika virus became the first known mosquito-borne virus that can cause major birth defects, and we continue to learn about Zika virus every day. The Zika virus outbreaks in the Americas and other parts of the globe required a massive response, which is hands-down a top accomplishment for 2016. The consequences of Zika can be devastating, and stopping the epidemic has been anything but simple. It has involved expertise from many fields, including mosquito control, pregnancy and birth defects, laboratory, epidemiology, blood safety, communication, and the list goes on. NCEZID led that effort and, by the end of the year, more than 2,000 CDC staff members had been part of the Zika response.

Confronting an imminent threat

Imagine a post-antibiotic world where bacteria no longer respond to the drugs designed to kill them. It’s a real threat, and many consider it the most concerning challenge to our country’s health. CDC has made the fight against antibiotic resistance a priority, and our transformative investments nationwide can be seen using the interactive AR Investment Map. This work includes establishing a new lab network in 2016 with expanded lab capacity in all 50 states.

Tackling illnesses caused by food

What do packaged salads and raw flour have in common? In 2016, both made dozens of people sick. For the first time, NCEZID experts conclusively showed that these foods were linked to specific bacteria that caused outbreaks. Whole genome sequencing helped connect the dots by showing that flour was the cause of an E. coli outbreak that made 60 people in 24 states sick, a third of whom were hospitalized. Some reported eating raw dough or raw batter. Whole genome sequencing also helped determine that an outbreak of listeriosis, which resulted in at least one death and 30 hospitalizations in the United States and Canada, was caused by eating packaged salads. As a result, the company that produced the salads recalled all brands produced at a single US facility.

Responding to rare infections

The jumping gene. A fungus that can cause bloodstream infections. A rare bacteria found in water. These are brief descriptions of three new or rarely seen emerging infectious threats that caused heightened concern in 2016. We worked to identify and contain the mcr-1 – or “jumping” – gene, which can make bacteria resistant to an antibiotic that is a last resort for some infections. A report by our experts also detailed the first US cases of Candida auris, an emerging fungus that is resistant to drugs and can cause serious – and sometimes deadly – blood infections. And, after the first cases of the rare Elizabethkingia infection were reported in Wisconsin, our scientists assisted the Wisconsin and Michigan state health laboratories in investigating the outbreak that would sicken almost 60 people and cause 20 deaths.

Assisting the response to hantavirus in Navajo Nation

NCEZID’s Craig Manning (left) fields a question about hantavirus from KTNN-AM radio host Navajo Bob during the live call-in program.

When a young woman from Navajo Nation in western United States died from an uncommon respiratory infection in early 2016, CDC experts stepped in to help. The problem was hantavirus which is spread by deer mice and causes a serious, sometimes lethal, respiratory infection. NCEZID experts worked with Navajo leaders to share information about hantavirus and create messages on preventing infection, including messages broadcast on a popular Navajo language radio station.

For more on the top infectious threats of 2016 and how we confronted them, please see the NCEZID 2016 Accomplishments.

10 Ways CDC Gets Ready For Emergencies

Dr. Stephen Redd, Director, Office of Public Health Preparedness and Response
Dr. Stephen Redd, Director, Office of Public Health Preparedness and Response

One of the best parts of my job is the opportunity to learn from a wide range of experiences. We have an obligation to not only respond to emergencies today, but to prepare for tomorrow by learning from the past. Our work extends to households affected by disease, communities ravaged by disasters, and U.S. territories battling new and changing threats. In fact, all over the world – we try to get ahead of, and manage, complex responses that touch many lives through ever changing circumstances. In an ideal world the health in every community would be at a level that would make recovery and reliance easier. The reality is that emergencies happen in all kinds of environments and populations.

The Public Health Preparedness and Response National Snapshot is our annual report that gives us an opportunity to showcase the work that we and our state partners do. The report reminds us that no matter how big the emergency, we need to work together to respond to the best of our ability—with the cards we are dealt.

Here are 10 ways CDC’s Office of Public Health Preparedness and Emergency Response worked to keep people safer in 2016 that can inform our work going forward.

1) Four Responses at Once: An Unprecedented Challenge

CDC experts continue to provide 24/7 monitoring, staffing, resources, and coordination in response to natural disasters, terrorist attacks, and infectious disease threats. In early 2016, CDC managed four public health emergencies at the same time through our Emergency Operations Center :

  • Ebola
  • Flint, Michigan, Water Quality
  • Zika Virus
  • Polio Eradication

See us in action:

2) A Complex Threat: Zika Hits the U.S.

CDC scientists and responders were activated in CDC’s Emergency Operations Center, where they combed through research, developed and distributed diagnostic tests, and provided on-the-ground mosquito control and education to protect people at higher risk for the virus, including pregnant women and infants.

3) Right Resources, Right Place, Right Time

CDC’s Strategic National Stockpile is ready to send critical medical supplies quickly to where they are needed most to save lives. The stockpile is the nation’s largest supply of life-saving pharmaceuticals and medical supplies that can be used in a public health emergency if local supplies run out.

Last year, we helped conduct 18 full-scale exercises and provided training for 2,232 federal and state, local, tribal, and territorial emergency responders to ensure that systems for delivering medicines are functioning well before they are needed in an actual emergency. We continue to work with our federal, state, local, and commercial partners to make sure every step of the medical supply chain – from manufacture to delivery – is coordinated.

4) State and Local Readiness

CDC connects with state and local partners to provide support and guidance, helping every community get ready to handle emergencies like floods, hurricanes, wildfires, or disease outbreaks.

This year, we created a new process to evaluate how well state and local jurisdictions can plan and execute a large-scale response requiring the rapid distribution of critical medicines and supplies. Through this program, we conducted assessments of 487 state and local public health departments. The information from these assessments will be used to help improve the ability to get emergency supplies quickly to those who need them most.

5) Cutting-Edge Science to Find and Stop Disease

To protect lifesaving research, CDC experts in biosafety and biosecurity conducted approximately 200 laboratory inspections and thousands of assessments of those who handle dangerous select agents and toxins like anthrax, plague, and ricin to keep these materials safe, secure, and out of the hands of those who might misuse them.

CDC’s Laboratory Response Network (LRN)l also develops and deploys tests to combat our country’s most pressing infectious and non-infectious health issues, from Ebola to Zika virus to opioid overdose. The network connects over 150 labs to respond quickly to high priority public health emergencies.

6) Protecting Our Most Vulnerable

CDC supports efforts all across the country to help those who may not be able to help themselves when a crisis strikes. Some populations, like children, older adults, and others with functional and access needs may need extra help during and after an emergency.

From planning for the 69 million children who may be in school when disaster strikes to the millions of Americans who need to make sure prescriptions are filled, medical equipment is working, and help arrives even if power is out and roads are blocked, it’s up to us to protect our most vulnerable in emergencies.

7) Emergency Leaders: The Future of Incident Response

When every minute counts, we need people who have the knowledge to step in and take immediate action. Learning and using a common framework like the CDC Incident Management System helps responders “speak the same language” during an event and work more seamlessly together.

CDC experts train leaders from around the world—25 countries in 2016—through an innovative, four-month fellowship based at our Atlanta headquarters. Lessons learned from this course were put to work immediately to head off an outbreak of H5N1 influenza in Cameroon.

8) The Power of Preparedness: National Preparedness Month

Throughout September, CDC and more than 3,000 organizations—national, regional, and local governments, as well as private and public organizations— supported emergency preparedness efforts and encouraged Americans to take action.

The theme for National Preparedness Month 2016 was “The Power of Preparedness.” During our 2016 campaign , we recognized the successes of countries and cities who have seen the direct benefits of being prepared, looked at innovative programs to help children and people with disabilities get ready for emergencies, and provided tips for home and family on making emergency kits.

9) Health Security: How is the U.S. Doing?

As part of the Global Health Security Agenda, teams of international experts travel to countries to report on how well public health systems are working to prevent, detect, and respond to outbreaks. In May, a team made a five-day visit to the U.S. to look at how well we’re doing.

In the final report, the assessment team concluded that, “the U.S. has extensive and effective systems to reduce the risks and impacts of major public health emergencies, and actively participates in the global health security system.” They recognized the high level of scientific expertise within CDC and other federal agencies, and the excellent reporting mechanisms managed by the federal government.

10) Helping YOU Make a Difference

Get a flu shot. Wash your hands. Make a kit. Be careful in winter weather. Prepare for your holidays. Be aware of natural disasters or circulating illnesses that may affect you or those you care about. There are many ways to prepare, and in 2016 we provided the latest science and information to empower every one of us to take action.

Every person needs knowledge to prepare their home, family, and community against disease or disaster before an emergency strikes. Whether it’s how to clean mold from a flooded home, how to wash your hands the right way, or how to use your brain in emergencies, our timely tips and advice put the power of preparedness in your hands. From the hidden dangers of hurricanes to the heartbreaking dangers of flu, there are steps we can all take to stay safe every day as we work toward a healthy and protected future.

For more ways we are helping protect America’s health, check out the new National Preparedness Snapshot.

To find out more about the issues and why this work matters, visit our website.