By DAN MARGOLIES
A new report says that the U.S. needs to redouble its efforts to protect Americans from the threats of infectious disease threats like MERS-CoV, pictured above on camel epthelial cells.
CREDIT NIAID IN COLLABORATION WITH COLORADO STATE UNIVERSITY
Kansas is one of seven states that rank in the bottom tier in a newly released report measuring states’ readiness to deal with infectious disease outbreaks.
The report, “Protecting Americans from Infectious Diseases,” was produced by the Trust for America’s Health and the Robert Wood Johnson Foundation. It finds that most states are ill-prepared to deal with the threat of antibiotic-resistant superbugs, resurgent illnesses like whooping cough, tuberculosis and gonorrhea, and other bacterial, viral and parasitic diseases.
“The overuse of antibiotics and underuse of vaccinations along with unstable and insufficient funding have left major gaps in our country’s ability to prepare for infectious disease threats,” Jeffrey Levi, executive director of the Trust for America’s Health, said in a statement.
Kansas – along with Idaho, Michigan, Ohio, Oklahoma, Oregon and Utah – scored on only three of 10 key indicators measuring states’ efforts at outbreak prevention, detection, diagnosis and response. The indicators collectively offer a snapshot of state health systems’ strengths and weaknesses.
Kansas got credit for having public health laboratories with a biosafety professional and providing biosafety training; and for meeting the national performance target of testing 90 percent of reported E. coli cases within four days.
On the seven remaining indicators it received no credit. Those indicators measure whether states:
Increased or maintained public health funding over the last two fiscal years.
Vaccinated at least half of their population ages six months and older for seasonal flu.
Excluded philosophical exemptions to childhood immunization or required parental notification or an affidavit for such exemptions.
Met certain reporting requirements for HIV/AIDS surveillance.
Authorized syringe exchange programs.
Completed climate change adaptation plans.
Reduced central line-associated bloodstream infections between 2012 and 2013.
Sara Belfry, a spokeswoman for the Kansas Department of Health & Environment, said that while there was always room for improvement, “we aren’t as bad as this report makes us out to be.”
Belfry said that 48 percent of the state’s population got flu vaccinations in 2014-2015, falling just short of the report’s 50 percent target. She said that 55.5 percent of children up to 17 years of age got their flu vaccinations, compared with only 45.6 percent for adults 18 years and older.
“Adults sometimes forget to get their flu vaccinations,” she said.
She also said that Kansas doesn’t have a statewide policy excluding children who don’t get childhood immunizations from school. Instead, local school boards set their own policies.
“And a lot of local school boards do have policies that say if you haven’t gotten up to date on your vaccinations within 90 days of entering school, then you’re not able to come until you get those vaccinations,” Belfry said. “So it’s just because we don’t have a statewide policy that we didn’t reach that measure.”
Finally, she said that public health spending was up in the current fiscal year, albeit by only about $100,000.
“I think the important thing for Kansans to know is that we are prepared to make sure that we’re able to respond in the event of an infectious disease outbreak,” she said.
The state had no cases of measles this year, compared with six last year, and cases of whooping cough have also fallen, Belfry said.
“So we know we’re doing a better job and we can always do a better job making sure we’re getting immunizations and making sure adults are getting immunizations as well,” she said.
Lougene Marsh, director of the Johnson County Department of Health and Environment, said it was “disappointing to see that the state was in the lowest tier” on core functions of public health, namely “control of infectious disease and protecting Americans from that.”
But she pointed out that public health funding in Johnson County was in much better shape than the state as a whole. The county’s public health budget, which largely comes from county property taxes, has increased from $6 million in fiscal 2014 to $7.8 million in the upcoming fiscal year.
“So I think that’s a very strong commendation for our local board of health and their recognition that they do have responsibility around protecting the health of the public and that they are taking that responsibility seriously,” she said.
In contrast, in Sedgwick County, the second largest county in Kansas by population after Johnson County, funding for public health programs, including initiatives aimed at improving the county’s immunization and infant mortality rates, have been cut. Also cut was $48,634 earmarked for a county health assessment.
Statewide, public health funding fell by 1.1 percent between fiscal 2013 and fiscal 2015, according to the infectious disease report. Kansas was one of 16 states that saw such funding decrease. Missouri increased its public health funding during the same period by 1.9 percent.
Missouri met five of the report’s 10 indicators, placing it in the middle of the pack. The Show Me state got credit for the same indicators that Kansas did as well as for HIV/AIDS surveillance and public health funding.
Missouri was among 28 states that scored a five or lower. No state received 10 points. Five states – Delaware, Kentucky, Maine, New York and Virginia – scored on eight of the indicators. Six – Alaska, California, Maryland, Massachusetts, Minnesota and Nebraska – scored on seven.
The report makes several recommendations. Among them: increasing resources for epidemiology and laboratories to deal with outbreaks; updating disease surveillance systems; incentivizing the development of new medicines and vaccines; decreasing antibiotic overuse and increasing vaccination rates; taking measures to contain rising hepatitis C outbreaks and other sexually transmitted infections, particularly among young adults; and adopting strategies to end AIDS in every state and city.
Dan Margolies, editor of the Heartland Health Monitor team. You can reach him on Twitter @DanMargolies.