Outbreaks: Texas receives bad grade on infectious disease protections

Published on Saturday, 21 December 2013 18:08 - Written by By Coshandra Dillard cdillard@tylerpaper.com

The majority of states, including Texas, received bad grade for policies that protect the public against infectious disease threats in a report released last week.

In “Outbreaks: Protecting Americans from Infectious Disease,” a report by Trust for America’s Health and the Robert Wood Johnson Foundation, it found that Texas scored four out of 10 on key indictors used to judge capabilities to prevent and control possible infectious disease outbreaks.

However, there is one indicator that the state said was erroneously excluded, which would have raised Texas’ score to a five. It is the coverage of routine HIV screening under the Texas Medicaid program. According to documents provided by the Texas Department of State Health Services, Texas does, in fact, cover routine HIV screening under the Medicaid program.

Texas Department of State Health Services health officials said, in a written statement, they “respect the authors’ efforts and welcome the discussions these kinds of reports generate.”

”The report finds that the country’s ability to prevent and control infectious disease outbreaks is “hampered by outdated systems and limited resources.”

“There’s been a widespread mistaken belief that infectious disease in this country is under control,” said Dr. Tom Inglesby, chief executive officer and director of the UPMC Center for Health Security during a teleconference Tuesday. “It has led to complacency and letting our guard down. … Unfortunately, a number of issues revealed by this report show why we remain vulnerable.”

Dr. Jeff Levi, Ph.D., executive director of Trust for America’s Health, said Tuesday that infectious disease costs the country $120 billion each year.

“From antibiotic-resistant superbugs to salmonella to the seasonal flu, infectious diseases disrupt lives and communities,” Levi said. “Fighting these diseases requires constant vigilance. The bad news is that we found major gaps in the country’s ability to prevent, control and treat outbreaks, leaving Americans at an unacceptable level of unnecessary risk.”

Thirty-four states scored five or lower out of the 10 indicators in the report. New Hampshire was alone at the top, scoring eight out of 10. Georgia, Nebraska and New Jersey all tied for the lowest score, achieving only two out of 10 indicators.

Indicators include: state vaccination rates for young children, state mandates that health care facilities report health care-associated infections and the capability to handle a significant surge in testing over a six- to eight-week period in response to an outbreak that increases testing more than 300 percent.

The four indictors Texas was credited for include: increased or maintained level of funding for public health services for 2011-12 and 2012-13, requires HPV vaccine or funds HPV vaccination efforts, state mandates that health care facilities in their state report health care-associated infections, and from July 1, 2012, to June 30, 2013, a public health lab evaluated the functionality of continuity of operations plan via a real event or an exercise.

Indicators Texas fell short on include the state’s ability to handle a significant surge in testing in response to an outbreak and the capacity to assure the timely transportation of samples to public health labs 24/7.

“We’ve long had plans in place to handle testing surges and always assure timely transportation of samples,” said Carrie Williams, media relations director with DSHS. “That said, we’re gathering information from other states about how they handle specimens from hospitals on major holidays. We’re also looking at our internal processes to ensure surge testing capability for the full six to eight weeks. Right now our plans allow us to handle four to six weeks at surge levels.”

While Texas received a point for increasing or maintaining funding for public health services during the past two years, about two-thirds of the country has not.

“We have also lost a serious number of scientists and public health professionals due to budget cuts,” Inglesby said, noting that 40,000 public health jobs were lost in the past five years.

Locally, NET Health, which receives about 90 percent of its funding from state grants, has actually had their grant funding increased for some vaccination programs, tuberculosis care and preparedness.



Officials with Trust for American’s Health said there has been a resurgence of diseases that were once eradicated and Americans are vulnerable to outbreaks occurring globally.

They attribute recent outbreaks of whooping cough and measles to low vaccination rates. They’ve also included the flu vaccines as a weak spot. According to the report, only 12 states have vaccinated at least half of their population for the seasonal flu during the 2012-13 season. According to the report, 20 percent of Americans get the flu each year. Locally, East Texas has also seen declines with certain vaccinations.

“We are starting to see a little bit of a dip,” said George Roberts, chief executive officer with Northeast Texas Health District. “It’s my sense that it’s, not because the vaccines are not available. A number of people still, for example, flu vaccines, will not take the vaccine.”

He added, “(This report is) a good reminder that we need to be vigilant and continue to educate the public and encourage the public to get their vaccines.”

Roberts added that everyone has a responsibility in public health.

“It requires each individual to maintain their own vigilance,” he said.

DSHS officials also addressed vaccination rates.

“We work with our partners to promote regular immunizations as well as the seasonal flu vaccine,” Ms. Williams said.

She said strategies to boost immunization rates include: promoting that adolescents receive full vaccination services in a medical home, educating health care providers and the public, promoting immunization reminder and recall systems in provider offices, and increasing public and private collaborations to improve each of the aforementioned strategies.

The outbreaks report looked at the impact that antibiotic overuse has on public health, citing antibiotic resistance in the population. The report also considers the impact of climate change on human health, such as dengue fever, a disease carried by mosquitoes as they migrate. According to the Centers for Disease Control and Prevention, dengue fever is an emerging disease affecting 40 percent of the world's population. The CDC notes that nearly all of the 48 cases in the U.S. have been acquired by travelers or immigrants. 

To view the report, visit www.healthyamericans.org/reports/outbreaks2013 .