Create Co(i)mmunity. Get Vaccinated.

August is National Immunization Awareness Month, an annual observance highlighting the importance of vaccination for people of all ages.

Life has been anything but routine lately. A sometimes overlooked result of the COVID-19 pandemic is that many people have missed routine medical checkups, routine screenings, and recommended vaccinations.

Recommended vaccines

Vaccines aren’t just for children. Adults need them to avoid getting and spreading certain serious diseases that can result in missed work, medical bills, and problems taking care of others, as well as serious illness, or even death.(1)

Vaccines for adults are recommended based on different factors like a person’s age, health, lifestyle, jobs, and travel. All adults need:

  • Flu vaccine. An annual flu vaccine is recommended for everyone but is especially important for adults with certain chronic health conditions, pregnant people, and those who are 65 years and older.
  • Tdap vaccine: If they have never gotten one before, a Tdap vaccine helps protect against pertussis (whooping cough). Pregnant people should get a Tdap vaccine during each pregnancy, preferably at 27 through 36 weeks.
  • Td vaccine:(tetanus, diphtheria) or Tdap shot every 10 years.(1)
  • Pneumococcal polysaccharide vaccine (PPSV23): If they are 65 years and older or 19–64 years old and have certain health conditions or smoke cigarettes. In addition, adults 65 years and older may discuss and decide, with their clinician, to receive a pneumococcal conjugate vaccine (PCV13). Pneumococcal vaccines help protect against serious illnesses like meningitis, bloodstream infections, and pneumonia.
  • Shingles vaccine: Two doses of shingles vaccine for everyone 50 years of age and older. Your risk of shingles and complications increases as you age. Shingles vaccine provides strong protection from shingles and long-term nerve pain.
  • HPV vaccine: HPV vaccination is also recommended through age 26, if they did not get vaccinated when they were younger. For adults aged 27 years and older, talk with your doctor about HPV vaccine.
  • COVID-19 vaccine: CDC recommends vaccination for all adults and children of certain ages.(2)

Take this quiz to find out what other vaccines may be recommended for you. Then talk with your doctor to make sure you get the vaccines that are right for you. Some adults with specific health conditions should not get certain vaccines or should wait to get them.(1)

Staying up to date on vaccinations helps protect you and others in your family and community. Every year, tens of thousands of Americans get sick and some die from diseases that could be prevented by vaccines.(3)

Vaccine records

Today, people move, travel, and change healthcare providers often. This can make it hard to keep an accurate vaccination record. If you don’t have copies of your vaccination records, ask for help from:

  • Your current or previous doctor or medical provider
  • Your parents or caregivers
  • Your high school or college health services group
  • Previous employers (including the military) that may have required vaccinations
  • Your state health department to see if they can direct you to their immunization registry

It’s a good idea to try and keep track of your own vaccinations. Ask your doctor, pharmacist, or vaccination provider for a vaccination record form or download one. Take it with you to health visits. Ask your vaccination provider to sign and date the form for each vaccine you receive.(4)

After getting a COVID-19 vaccine, you should get a small, white card with information about which vaccine you received, when you received it, and where you received it. This card is a vaccination record.(5). As such, it is important that you take steps to check and protect it:

  1. Check your card to make sure everything is correct.
  2. Take a picture of the front and back of the card with your cellphone or a camera.
  3. Use plastic envelopes for vaccine cards. Lamination is not recommended in case future shots are recommended. A photocopy can be laminated.
  4. Store your card in a secure, fireproof, and water-resistant bin or safe.

Vaccination records are examples of important paperwork that you need to collect and protect. Keeping a record and storing it in a safe place can save you time and unnecessary hassle later.

Important paperwork

The term “important paperwork” applies to any documents and personal data that you might need in an emergency or disaster.

What to collect

How to protect

Once you’ve collected your important paperwork, take steps to proofread and protect it. Store paperwork someplace that is a) easily accessible and b) safe from theft, fire, flood, and other emergencies.

Some ways to keep your important paperwork safe and secure include:

  • Scanning or saving to your computer important paperwork and personal items, like family photos. Creating digital duplicates of originals makes it easier to share the information, helps preserve the original, and serves as a backup in case the original is destroyed
  • Storing external drives and hardcopies of important papers in a fireproof and water-resistant file organizer, container, or storage bag with a trusted friend or relative or in a safety deposit box
  • Telling family members, friends, or trusted neighbors where you keep your important paperwork

Learn more ways to prepare your health for emergencies.




Thanks in advance for your questions and comments on this Public Health Matters post. Please note that the CDC does not give personal medical advice. If you are concerned you have a disease or condition, talk to your doctor.

Have a question for CDC? CDC-INFO ( offers live agents by phone and email to help you find the latest, reliable, and science-based health information on more than 750 health topics.


Five Good Reasons to Get a Flu Vaccine This Season

Flu vaccine: We all have a role in protecting each other.

The National Influenza Vaccination Week (NIVW) is a national awareness week focused on highlighting the importance of influenza vaccination.

As flu viruses and the virus that causes COVID-19 can spread this season, getting a flu vaccine is more important than ever. Here are five reasons why you should:

1. Helps Keep You Healthy

Flu can cause signs and symptoms; such as fever, cough, and body aches, that can keep a healthy person home from work, school, and errands for a few days to a week or more.

The best way to prevent seasonal flu is to get vaccinated every year. Flu vaccination helps prevent millions of illnesses and flu-related doctor visits each year. CDC estimates that influenza vaccination during the 2019–2020 influenza season prevented 7.52 million illnesses, 3.69 million medical visits, 105,000 hospitalizations, and 6,300 deaths associated with influenza.(1)(3)

2. Beat the Bug

Flu vaccination can reduce doctor visits due to flu. Several studies have shown flu vaccination can reduce the severity of illness in people who get vaccinated but still get sick. And during seasons when the flu vaccine viruses are similar to circulating flu viruses, flu vaccine was shown to reduce the risk of having to go to the doctor with flu by 40% to 60%.(2)

3. Care for Each Other

You may think of flu vaccine only as a way to protect yourself from flu. But getting vaccinated also may protect the people around you. Many people in the U.S. are at higher risk of getting very sick from flu because of their age, or because they have one or more of certain health conditions, like asthma, diabetes, or heart disease. Also, some people in your family or community may not be able to get vaccinated due to their age (children younger than 6 months, for example).(4) They rely on you to help prevent the spread of disease. When you get a flu shot, you help protect them.

Help CDC promote flu vaccination in conversations with friends, family, and neighbors, and post to followers on social media using resources available in this year’s #SleeveUp to #FightFlu digital media toolkit.

4. Help the Health Care System

Getting a flu vaccine is more important than ever during the 2020-2021 season. A flu vaccine this season can help protect you and the people around you from flu, reduce the burden of flu on our health care systems during the COVID-19 pandemic, and save medical resources for the care of COVID-19 patients.

Since health care workers are needed to care for people sick with COVID-19 and may care for or live with people at high risk for influenza-related complications, it is especially important for them to get vaccinated.(5)

5. It’s Not Too Late

National Influenza Vaccination Week (December 6-12) is focused on highlighting the importance of influenza vaccination. It’s not too late for anyone 6 months and older to get a flu vaccine. Laboratory-confirmed flu activity is low now, according to the Weekly U.S. Influenza Surveillance Report (or FluView).

CDC has worked with vaccine manufacturers to have extra flu vaccine available this flu season. Manufacturers have distributed 197.4 million doses of flu vaccine this season so far. Use the VaccineFinder to find yours.




Thanks in advance for your questions and comments on this Public Health Matters post. Please note that the CDC does not give personal medical advice. If you are concerned you have a disease or condition, talk to your doctor.

Have a question for CDC? CDC-INFO ( offers live agents by phone and email to help you find the latest, reliable, and science-based health information on more than 750 health topics.

Curves for the 1918 flu pandemic

For National Geographic, Nina Strochlic and Riley D. Champine look back at the 1918 pandemic for clues about the future:

The 1918 flu, also known as the Spanish Flu, lasted until 1920 and is considered the deadliest pandemic in modern history. Today, as the world grinds to a halt in response to the coronavirus, scientists and historians are studying the 1918 outbreak for clues to the most effective way to stop a global pandemic. The efforts implemented then to stem the flu’s spread in cities across America—and the outcomes—may offer lessons for battling today’s crisis.

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Some of my favorite books about infectious disease, viruses, bioweapons in relation to #Coronavirus #COVID19

I posted some pics of my books I brought home from work to look over in relation to the current coronavirus outbreak and some people asked if I could post a list. So here is a collection. I will update with other books.

I used Amazon links here b/c, well, that was really simple.

Infectious Diseases


Biological Warfare


General Information about Viruses


Lab Culture Ep. 18: Alaska state virology lab — Freezing temps, wild animals, and extremely dedicated staff

Lab Culture Ep. 18: Alaska state virology lab -- Freezing temps, wild animals, and extremely dedicated staff |

Every area of our country is unique in ways that make public health laboratory work vary from one state or locality to another. But just as Alaska is different from the lower-48 states in most ways, their public health lab’s work is too. Have you ever considered all the ways it might be different to work in the Alaska state lab in Fairbanks? This episode of Lab Culture reveals some of the many ways in which working in Alaska is unlike anywhere else.

Listen here, in iTunes or wherever you get your podcasts.

Jayme Parker
Manager, Virology Unit, Alaska State Public Health Laboratory (Fairbanks)

Nisha Fowler
Microbiologist, Alaska State Public Health Laboratory (Fairbanks)


Virology Unit of the Alaska State Public Health Laboratory

Alaska Department of Transportation and Public Facilities — FAQs

Alaska’s permafrost/ice lenses



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Pandemic preparedness has been a boon for US flu surveillance, but it won’t maintain itself

Pandemic preparedness has been a boon for US flu surveillance, but it won’t maintain itself. |

by Kim Krisberg

At the peak of the 2009 H1N1 flu pandemic, the Wisconsin state public health lab was routinely testing up to 300 specimens every day. On one day, the lab hit a record of nearly 500.

To generate results within 24 hours of receiving a specimen and keep up with its duties outside of flu surveillance, the lab added a second shift of flu testing on the weekdays and worked through the weekends. H1N1 definitely stressed the lab’s capacities, said Peter Shult, PhD, associate director of the Wisconsin State Laboratory of Hygiene, but it also demonstrated the value of years of investing in pandemic preparedness and response. In fact, Shult said that if the lab had received 300 flu specimens in a day only a few years before the H1N1 pandemic, “we’d have been backlogged immediately — it would have taken us weeks to catch up.”

As one might expect, years of preparing for another worldwide flu pandemic has also boosted the lab’s seasonal flu response. During the 2017-2018 flu season — one of the most severe in recent memory with an estimated 80,000 U.S. deaths — Shult said the Wisconsin lab was easily able to keep pace with a surge in testing demands, which while much lower than peak pandemic levels, were still about 30% higher than the average flu season.

“We were busy, but we could comfortably handle the specimen load without expanding testing hours or impacting turnaround times, and we could still carry out all of our other routine testing responsibilities,” said Shult, who also serves as director of the lab’s Communicable Disease Division. “All that speaks to the capacity we’ve developed regarding testing platforms and our staff being able to do this flu testing. …But funding is still needed to maintain this kind of capacity.”

That capacity building goes back more than 20 years when global health officials detected the first human infections of H5N1 avian influenza; a few years later in 2003, the virus re-emerged, spreading from Asia to Europe and Africa. While the virus very rarely spread from person to person, fears that H5N1, which has a mortality rate of about 60%, could evolve to easily transmit between people sparked a new chapter of pandemic preparedness that included billions in federal funding support and a key focus on improving flu surveillance and detection. By the time H1N1 hit in 2009, public health labs had transformed their flu capacities.

Just a few years before the H1N1 pandemic, for example, most public health labs relied on the traditional viral culture to gather data on the flu. Viral cell culture is a reliable way to identify flu strains and monitor which antivirals work best to treat infections, but getting results can take more than a week, which is hardly ideal in any disease outbreak, let alone a flu pandemic. By 2009, however, most labs had built the capacity to use and quickly deploy highly sensitive molecular assays — in particular, a technique known as real-time reverse transcription-polymerase chain reaction (RT-PCR) — that could turnaround flu results in less than a workday.

With a week shaved off testing times, as well as years of cross-training and drilling lab staff in pandemic response, it’s little surprise that investments in pandemic preparedness have also been a boon for seasonal flu surveillance.

“The last flu season was a high-volume one for public health labs, but it was also considered business as usual at this point,” said Stephanie Chester, MS, manager of APHL’s Respiratory Disease Program. “That’s a capacity that labs had been working toward for years, but you do need to maintain that warm base. If funding went down, it could certainly erode that capacity.”

In New Hampshire, the state public health lab tested more than 4,000 flu specimens during the 2009 pandemic. During a more typical year, it tests between 300 and 500 flu specimens from sentinel sites across the state, such as hospital labs and long-term care facilities, according to Carol Loring, MS, supervisor for the Virology and STD Laboratory at the New Hampshire Department of Health and Human Services’ Public Health Laboratories. Compared to clinical flu testing, which typically determines if a patient has influenza A or B, the state lab performs genotyping and subtyping to identify the specific strains circulating in the community, including potential pandemic strains, and to help monitor the effectiveness of each year’s flu vaccine. All that data, Loring said, helps clinicians make better diagnostic and prescribing decisions and helps public health workers more precisely target their prevention resources.

During the 2017-2018 flu season, Loring said the lab didn’t experience a significant increase in testing volumes, but it was prepared to face a surge.

“In my experience, our surge capacities evolve with each event,” she said. “We’re constantly training, drilling and preparing for the next pandemic.”

Loring noted that routine flu surveillance isn’t especially different from pandemic response — “the day-to-day tasks are the same, the only difference often is that there’s less interest from the public,” she said. Still, both capacities are heavily reliant on funding from CDC’s Epidemiology and Laboratory Capacity for Infectious Diseases Cooperative Agreement (ELC), which is scheduled to begin a new five-year funding cycle in August 2019. A substantial portion of ELC funding, about $40 million a year comes from the Affordable Care Act’s Prevention and Public Health Fund, which the law established as the nation’s first mandatory funding stream dedicated to improving the public health system. If the ACA were repealed and those funds not replaced, it would be a major blow to the country’s flu surveillance system.

Inside the New Hampshire state lab, Loring said at least two instruments that the lab needs to perform nucleic acid extraction, a key step in the RT-PCR process, are slated for retirement by their manufacturers in the next few years. Replacement costs could run up to $100,000 and that’s just for the initial purchase, not the costs of regular maintenance.

“ELC funding is critical to enable us to purchase instruments,” she said. “If I don’t have the financial resources to maintain our instrumentation or update it, we’ll be that much less prepared for a pandemic.”

Also on Loring’s lab wish list: its own courier system for getting flu specimens into the lab. Right now, the lab depends on its clinical partners across the state to send in specimens for surveillance. Some send in their samples via US mail, others use courier services and some drive their samples over and drop them off. The hodgepodge of delivery methods makes it hard to predict when specimens will show up, and many don’t arrive within the recommended three days of being collected.

“A better specimen transport system would definitely help improve our efforts,” Loring said.

In Wisconsin, the state’s public health lab is also one of the country’s three National Influenza Reference Centers (NIRCs), which serve as extensions of the CDC Influenza Division’s Virology, Surveillance and Diagnosis Branch and allow the federal agency to focus on more advanced testing and global flu monitoring. As a state lab, the Wisconsin State Laboratory of Hygiene subtypes every flu specimen it receives, testing samples for flu as well as 18 other respiratory pathogens. As a NIRC, the flu specimens it receives from around the country have already been subtyped ; the center’s job is to conduct genetic sequencing and grow the specimen up with the traditional viral culture. The sequencing, in particular, is key to detecting signs of evolving genetic change and antiviral resistance.

Data generated by public health laboratory testing helps form the basis of CDC’s FluView, the agency’s weekly flu surveillance report. Data and specimens coming out of the three NIRCs — also located in New York and California — go onto CDC for additional study, inclusion in FluView and are fundamental to planning each year’s flu vaccine composition.

Shult, the Wisconsin lab’s associate director, said it’s critical to maintain the ability to quickly detect both novel and seasonal flu viruses across the public health system if responders hope to stay one step ahead of a potential outbreak.

“In 2009, H1N1 went across the country and the globe in a matter of weeks,” he said. “That’s how quickly a novel virus can emerge and spread globally.”

In 2009, at the peak of the pandemic’s first wave, the Wisconsin lab was routinely testing up to 300 specimens a day; in a more typical flu season, it receives a couple-hundred of specimens in a week. In the early days of the pandemic, the lab was the only one in the state that could perform real-time RT-PCR on H1N1 samples. Now, Shult said nearly 50 labs in the state use real-time RT-PCR in their flu testing.

“It was game-changing in terms of how we were able to respond,” said Shult of the shift to RT-PCR. “The results were reliable and the turnaround time was remarkably quicker. …If we had received 400 specimens in a day (like we did in the H1N1 pandemic) and we were still depending on viral culture, we’d have been immediately behind.”

To further illustrate how far flu surveillance has come, Shult noted that only about 15 years ago — before the influxes of federal pandemic and preparedness funds — a flu season as severe as the 2017-2018 one would have significantly strained the lab’s capacities. Instead, Shult said the Wisconsin lab was “able to take on a season like the past one more or less in stride.”

Like his colleague in New Hampshire, Shult is concerned about sufficient federal funding to both preserve the country’s investment in flu surveillance and response and ready the system for the future.

“We’ve had a lot of funding to build this capability and capacity, and slightly less funding to maintain it,” he said. “We have staff to pay and train, we have equipment that ages out and needs maintenance … there are considerable ongoing costs.”

Shult’s laboratory wish list? Enough funding to keep getting better and faster at chasing the flu.

“My wish is having enough dollars to maintain what we’ve built and keep on top of new technologies that will help us respond even quicker,” he said. “Right now, if we were to face a severe pandemic, we’d be stressed but we’d still be in the game. But if funding were severely cut? Then we’d be in trouble.”


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Partnerships Help Save Lives When Disaster Strikes

Emergency responders gathered in a circle.

Public health emergencies occur every day across the United States. Tornadoes, hurricanes, wildfires, floods, infectious disease outbreaks, terrorist attacks, and other emergencies have all occurred within the past few years and likely will happen again. Communities must be ready in the event of a public health emergency – both those they expect and those that come without warning.

Since 2002, CDC’s Public Health Emergency Preparedness (PHEP) program has provided funding and guidance to 50 states, four cities, and eight territorial health departments across the nation to protect communities. Planning and exercising plans help ensure that health departments are ready to respond and save lives when emergencies occur.

While we all hope that emergencies never happen, they are inevitable and the true test of any preparedness system. The following stories are examples of how CDC’s PHEP program works with states and local communities to ensure they are ready to respond to any emergency. Some of CDC’s partners include health departments, community organizations, national public health organizations, and private companies.

Restoring California Communities after Devastating Wildfires

A fire truck responds to a brush fire.In 2017, nearly 9,000 fires, almost double the average annual number, burned 1.2 million acres in California. The fires destroyed more than 10,800 structures and killed at least 46 people. However, thanks to years of planning for such events and building a public health infrastructure through the PHEP program, state and local health departments were ready to respond immediately and help their communities recover over the following months.

Through partnerships and support provided by the PHEP program in and around Sonoma County, local officials evacuated more than 1,160 patients from area hospitals and many other healthcare facilities. Additionally, because of the relationship the state built with the California National Guard through the PHEP program, more than 100 volunteer troops cleaned the Sonoma Developmental Center in one day. More than 200 patients with disabilities were then able to return safely to the facility.

Ensuring Access to Medication during an Influenza Outbreak in Maine

Package of Oseltamivir (i.e., Tamiflu) capsulesIn March 2017, an influenza outbreak on Vinylhaven, a remote island off the coast of Maine with a population of about 1,165, sickened half of the island’s residents. The outbreak depleted the medical center’s Tamiflu® supply. Tamiflu® can greatly lessen the severity of influenza but it must be taken early in treatment.

Because of a partnership agreement established under PHEP with the Northern New England Poison Center, local pharmacies, and other organizations, and the Maine Department of Health staff quickly delivered 100 treatment courses of Tamiflu®. As a result, the state successfully reduced the impact of the influenza outbreak on the island.

Responding to a Water Contamination Incident in Illinois

Bottles of water on a conveyor belt.On May 2017, a water main break under a river contaminated water in Cumberland County, Illinois, and left some residents without water entirely. Health department staff funded through PHEP established water distribution sites with bottled water donated by private partners such as Walmart, Coca-Cola, and Anheuser-Busch. Staff also went door-to-door to check on residents and distribute materials about safe water.

The PHEP program ensures public health emergency management systems and experts are ready to respond when emergencies occur. Preparedness efforts throughout the years have saved lives and helped communities return to normal operations as quickly as possible.

From natural disasters to infectious diseases, the PHEP program protects America’s health, safety, and security to save lives. Check out the PHEP Stories from the Field to find out more about how the PHEP program has helped communities prepare for, respond to, and recover from public health emergencies.

Influenza prevention and response requires a One Health approach

Influenza prevention and response requires a One Health approach |

By Jill Sutton, respiratory diseases intern, APHL

Did you know there’s no known influenza A subtype that’s only found in humans? That makes influenza a perfect example of why a One Health approach is critical to disease prevention and response.

One Health is about breaking down the silos between human, animal and environmental health and adapting a synergistic approach for planning and responding to threats. When it comes to influenza, this multi-disciplinary approach can make us better prepared to evaluate, predict and respond to infections in both humans and animals.

Toward the end of last year’s flu season, I decided I wanted to delve deeper into One Health. I registered for my first One Health Academy talk, which covered the 1918 influenza pandemic and ended with a discussion around the adjacent possibilities in 2018. As I learned more about influenza, I realized the flu wasn’t just a disease infecting humans each winter, but rather a year-round burden causing severe disease in animals too. Eight months later, here I am as the respiratory diseases intern at APHL, and I haven’t missed a single One Health talk yet. If there’s one thing I’ve learned thus far in my career in public health, it’s that we can’t control the future, but we can control how we respond to try and shape the future.

What are some implications of influenza for human & animals?

Influenza prevention and response requires a One Health approach | www.APHLblog.orgZoonotic diseases, such as avian influenza, can infect and cause severe disease in both animals and humans. According to the CDC, 60% of known infectious diseases in humans are of animal origin and 75% of new and emerging infectious diseases are spread from animals. Not only does the flu infect humans, influenza also infects a number of other animals (both domesticated and wild) and can cause severe disease.

The primary threat, of course, is the spread of new influenza strains. Influenza pandemics occur when a novel influenza virus emerges in an animal host, changes to the point where it is able to infect humans, and then changes further so it can continue to spread from one person to another.

Once the virus can be transmitted from human to human, a pandemic becomes possible. Global population movement directly influences the spread of influenza pandemics. Looking back to the 1918 influenza pandemic, troop movement during World War I was a major factor in the spread of the virus between continents. Today, international trade and travel has connected every region of the world. Transportation of humans, animal and goods increases the risk of exposure to pathogens. Did you know the influenza virus can remain infectious on surfaces for up to 48 hours? And when airborne, viral particles from a cough or sneeze can remain suspended in the air for up to 30 minutes. That is, if someone who is infected with the flu sneezes while on an elevator or in the bathroom of an airplane and 10 minutes later you enter that elevator or bathroom, you could become infected from those particles.

Aside from humans moving around the globe, animal travel is capable of spreading influenza too. Each year, birds such as ducks, swans and geese migrate between continents. If the any of those birds are infected with avian influenza, the virus can be carried and transmitted. If agricultural operations, domesticated animals or other potential hosts come in contact with infected birds or their feces, new influenza infections can be sustained.

Because we live in a shared environment where global travel is fast, global trade is easy and plenty of opportunities for inter-species transmission of influenza viruses exist, it’s important that experts work collaboratively. Within the veterinary community, areas of knowledge exist that can complement existing areas of knowledge in human health, and vice versa. One Health allows for an easier exchange of information and support between those professional communities.

In addition to the risk of transmission, influenza pandemics can have serious economic impacts. Societies around the world depend on the health of humans, animals and the environment for food, income and health security. Influenza is a major threat to animal agriculture as it can be fatal to chickens, turkeys and pigs. When a new influenza strain emerges, the livelihood for global communities, especially those who are largely dependent on agriculture cultivation, is put at risk. For example, live poultry markets have been identified as significant risk factors for transmission of avian influenza. Because many people who sell poultry at live bird markets are dependent on their operation for income, they are less likely to implement measures of prevention especially if it means closure of the market even temporarily and are at higher risk for exposure to avian influenza. Their poultry can continue to transmit the virus and, if they themselves become infected, they might also transmit the virus to other customers, their families or community members. In these cases, it’s important to include and understand all stakeholders such as farmers, consumers, market operators, supply chain transporters, and human and animal health professionals by taking a One Health approach to implement long term management for control and prevention of avian influenza.

What gaps exist?

The health of our ever-changing world depends on breaking down the walls between animal, human and environmental sectors. To effectively detect, respond to and prevent outbreaks of pandemic potential, epidemiological and laboratory data needs to be shared across sectors.

Integrated human, animal and environmental health/management systems promotes communication and collaboration among human-animal-eco sectors, thus optimizing success. Multi-sector coordination helps address joint issues and opens discussion on what to anticipate, what gaps exists, how to reduce duplication of efforts and enhances risk reduction. We need harmonized human and animal surveillance and research efforts that compliment and build upon one another. This is important because it can help human and animal health professionals identify the determinants that affect disease transmission such as pathogenicity, infectivity, antigenicity and resistance. By capitalizing on existing systems and infrastructure and by investing in capacity building, we can enhance our understanding of circulating viruses within animals, and better predict when and where a spillover could occur. Increasing laboratory and data sharing capacity at both the human and animal levels so that they’re equally capable to diagnose both human and animal influenza can help prevent knowledge gaps and identify where intervention is needed to prevent exposure. Furthermore, this can increase surge capacity so that more laboratories are able to provide the necessary help for when an outbreak occurs.

As we move forward, we must use a One Health approach to prevent multi-disciplinary threats like influenza pandemics. By collaborating between professionals with a range of experience and expertise, we can better address the unanswered questions around the risks for pandemic influenza at human-animal-environmental interface.


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A Little Girl and a Deadly Virus

A Little Girl and a Deadly Virus |

By Linette Granen, director, Marketing & Membership, APHL

This story begins as many others. A young lady met a young man, got married and had a baby, whom they adored. They were children of immigrants — her family was from Germany and his from Italy. They began their lives together in the early part of the 20th century in New Orleans, Louisiana. He worked for the New Orleans Park Service — he always had a green thumb and immensely enjoyed working outdoors — while she settled down as a housewife, raising a variety of animals on their small property. One room of their shotgun-house was devoted to a small flock of canaries, and outside they had a plethora of chickens, geese, rabbits and guinea pigs. They shared their double shotgun-house with her brother, a chief in the New Orleans Fire Department. In 1916 they had a baby girl.

A Little Girl and a Deadly Virus | www.APHLblog.orgYes, they were happy — until October 1918, when their only child, nearly three years old, got very sick. She had influenza, although at the time they didn’t know what was wrong. This disease spread quickly through New Orleans, and it became suddenly clear that it was spiraling out of control. On October 7, just one week before the young girl’s untimely death, the New Orleans Board of Health made this then-unknown illness a mandatory reportable disease in order to understand the impact on their population and to track the epidemic’s progress. Two days later, at the recommendation of health officials, the mayor closed all schools, churches, theaters, movie houses and anywhere else people might congregate. Quickly, additional actions were taken to prevent crowding and gathering in the hopes of slowing or stopping the epidemic.

As was mandated, case reports of influenza began to flood the New Orleans Board of Health. On October 12 and 13 alone, there were 4,875 cases reported in the city. At that point, the US Surgeon General instructed the health department to secure additional hospital space for ill military personnel from nearby military installations. Within days, 17 wards of the city’s Charity Hospital were totally dedicated to influenza care. The newly appointed medical advisor, Dr. Gustave Corput, began working with the Red Cross to convert another facility, the Sophie Gumbel building on the Touro-Shakespeare almshouse property, into a 300-bed emergency hospital. At that time, the health department did not employ nurses, so the Red Cross began recruiting nurses and physicians for the emergency facility — some volunteering time and some working part-time. Through funding from the Red Cross and the Public Health Service, the facility was opened and maintained, along with smaller facilities at the Southern Yacht Club on Lake Pontchartrain and a Knights of Columbus hall across the river.

The little girl died on October 15, 1918.

By the end of October, two weeks after the little girl’s death, Tulane University scientists developed and produced a vaccine for local use against a bacteria called Bacillus influenzae (now known as Haemophilus influenzae). Despite being untested, deploying this type of vaccine was worth any risks because of the large number of cases in a city desperate for relief. Laboratories at local hospitals began manufacturing the Tulane vaccine and more than 4,000 city government employees and factory workers were immunized. Medical and nursing students were deployed all over the state: third-year nursing students staffed the emergency hospitals and fourth-year Tulane medical students were appointed as assistant US Public Health Service surgeons. Later that month, it appeared that the tide was beginning to turn, perhaps due to the actions taken by the health department and the Tulane vaccine.

By the spring, the devastating epidemic in New Orleans was finally declared over. Between October 1918 and April 1919, the city experienced over 54,000 cases of influenza and almost 3,500 deaths. The case-fatality rate was 6.5%; only Pittsburgh and Philadelphia had higher death rates.

This story is very personal to me. Not only am I a career public health scientist from New Orleans, that little girl who died on October 15, 1918 was my aunt, Gladys Mary Cucinello. Her parents – my grandparents – later had four sons, one of whom was my father who recently passed away at the age of 95. Born in 1922, he was not alive for the epidemic and never met his sister, but he remembered the heartache my grandmother expressed whenever she talked about that time. The only picture of my Aunt Gladys lives in a place of honor in my house. Such a tiny girl was no match for such a deadly virus.


*Much of the historical information about New Orleans during the 1918 influenza pandemic came from the Influenza Encyclopedia.

The post A Little Girl and a Deadly Virus appeared first on APHL Lab Blog.

3 Reasons Why Handwashing Should Matter to You

Unseen woman washing her hands with soap in a sink.

Most of us are familiar with the parental-like voice in the back of our minds that helps guide our decision-making—asking us questions like, “Have you called your grandmother lately?” For many that voice serves as a gentle, yet constant reminder to wash our hands.

Handwashing with soap and water is one of the most important steps you can take to avoid getting sick and spreading germs to loved ones. Many diseases are spread by not cleaning your hands properly after touching contaminated objects or surfaces. And although not all germs are bad, illness can occur when harmful germs enter our bodies through the eyes, nose, and mouth. That’s why it is critical to wash hands at key times, such as after a flood or during a flu pandemic, when germs can be passed from person to person and make others sick.

Washing hands with soap and water is the best way to reduce the number of germs on them, however during a disaster clean, running water may not be available. If soap and water are not available, use an alcohol-based hand sanitizer that contains at least 60% alcohol. Alcohol-based hand sanitizers can quickly reduce the number of germs on hands in some situations, but sanitizers do not eliminate all types of germs.

Here are three key reasons why you should always care about handwashing:Your hands carry germs you can't see. Wash your hands.

  1. Handwashing can keep children healthy and in school. Handwashing education can reduce the number of young children who get sick and help prevent school absenteeism.
  2. Handwashing can help prevent illness. Getting a yearly flu vaccine is the most important action you can take to protect yourself from flu. Besides getting a flu vaccine, CDC recommends everyday preventive actions including frequent handwashing with soap and water.
  3. Handwashing is easy! Effective handwashing is a practical skill that you can easily learn, teach to others, and practice every day to prepare for an emergency. It takes around 20 seconds, and can be done in five simple steps:
    1. Wet your hands with clean, running water, turn off the tap, and apply soap
    2. Lather your hands by rubbing them together with the soap
    3. Scrub your hands for at least 20 seconds. Need a timer? Hum the “Happy Birthday” song from beginning to end twice
    4. Rinse your hands well under clean, running water
    5. Dry your hands using a clean towel or air-dry them

Promote Handwashing in Your Community

Global Handwashing Day is celebrated annually on October 15 to promote handwashing with soap as an easy and affordable way to prevent disease in communities around the world. This year’s theme, “Clean Hands—A Recipe for Health,” calls attention to the importance of handwashing at key times, such as before eating or feeding others, and before, during, and after preparing food.

Learn how you can get involved and promote handwashing at home, your child’s school or daycare, and your local community: