Half of the states in the U.S. and Washington, D.C., are ill-equipped to prevent, detect, diagnose and respond to an outbreak of an infectious disease, according to a report from Trust for America's Health and the Robert Wood Johnson Foundation.
The report scored every state and Washington, D.C., on 10 key indicators of their ability to manage severe infectious disease threats, receiving one point for achieving an indicator and zero points if they did not.
The 10 indicators were:
- Public health funding commitment: Increased or maintained level of funding for public health services from fiscal year 2012-13 to FY 2013-14
- Incident and information management: Scoring equal to or higher than the national average on the Incident & Information Management domain of the National Health Security Preparedness Index
- Childhood vaccinations: Met the Healthy People 2020 target of 90 percent of children ages 19 to 35 months receiving the recommended doses of HBV vaccine
- Flu vaccination rates: Vaccinated at least half of their populations for the flu for the 2013-14 season
- Climate change and infectious disease: Currently completed climate change adaptation plans, including the impact on human health
- HAI control: Performed better than the national SIR for central line-associated bloodstream infections
- HAI control: Reduced the number of central line-associated bloodstream infections between 2011 and 2012
- Public health lab capabilities during emergencies: Public health lab reports conducing an exercise or utilizing a real event to evaluate the time for sentinel clinical labs to acknowledge the receipt of an urgent message, from July 1, 2013 to June 30, 2014
- HIV/AIDS surveillance: Requires reporting of all CD4 and HAIV viral load data to their state HIV surveillance program
- Food safety: Met national performance target of testing 90 percent of reported E. coli 0157 cases within four days
While no state received a perfect score and 25 "failed," five states stood out among their peers by receiving eight points. Those states are:
- Maryland
- Massachusetts
- Tennessee
- Vermont
- Virginia
"Infectious disease control requires constant vigilance," the report concludes. "This requires having systems in place and conducting continuous training and practice exercises. The Ebola outbreak is a reminder that we cannot afford to let our guard down or grow complacent when it comes to infectious disease threats."