Search Results for: outbreaks

Sep 9 2014
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The Ebola Response: Q&A with Laurie Garrett, Council on Foreign Relations

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Almost every day brings reports of new cases of Ebola, the often-fatal virus now impacting multiple countries in West Africa. According to the U.S. Centers for Disease Control and Prevention (CDC), the 2014 Ebola outbreak is the largest Ebola outbreak in history. Spread of the disease to the United States is unlikely—although not impossible—and efforts are underway to find vaccines and cures, including scale-ups of drug development and manufacturing, as well as human trials for vaccines both in the United States and around the world. However, in West Africa the epidemic is impacting lives, economies, health care infrastructure and even security as countries try a variety of methods—including troop control—to get citizens to obey quarantines and other potentially life-saving instructions.

Late last week, NewPublicHealth spoke with Laurie Garrett, senior fellow for global health at the Council on Foreign Relations. Garrett has written extensively on global health issues and was on the ground as a reporter during the Ebola outbreak in Zaire in 1995.

NewPublicHealth: What are your key concerns with respect to the current Ebola outbreak?

Laurie Garrett: My main concern has been about the nature of the international response, which could be characterized as non-response until very recently. And now that the leadership of the international global health community has finally taken the epidemic seriously, it’s too late to easily stop it. We’ve gone through the whole list of all the usual ways that we stop Ebola and every single one of them was initiated far too late with far too few resources and far too few people—and now we’re in uncharted territory. We’re now trying to tackle a problem that has never reached this stage before and we don’t know what to do. The international response is pitiful, disgusting and woeful.

NPH: How do you account for such a poor response?

Garrett: First of all, the World Health Organization (WHO) is a mere shadow of its former self. When I was involved in the Ebola epidemic in 1995 in Kikwit, Zaire, the WHO was recognized worldwide as the leader of everything associated with outbreaks and infection, and it acted aggressively. It didn’t have a huge budget, but it still was able to take the problem very seriously and the resources that were needed were available, and more importantly a very talented leadership team combining the resources of the U.S. Centers for Disease Control and Prevention; WHO; Medicin San Frontiers (Doctors Without Borders); and the University of Kinshasa, Zaire, came together. They respected each other. They were on board together. They worked very closely with the local Red Cross, and they were able to conquer the problem pretty swiftly. 

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Aug 28 2014
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Public Health News Roundup: August 28

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EBOLA UPDATE: Death Toll Passes 1,500 as Outbreak Accelerates
(NewPublicHealth is monitoring the public health crisis in West Africa.)
The West African Ebola outbreak continues to accelerate, according to the World Health Organization (WHO), which today announced there have so far been 3,069 probable and confirmed cases; 1,552 people have died. While most cases remain concentrated in only a few localities, WHO estimates that more than 40 percent of the total cases have occurred within the past 21 days.

In other Ebola news:

  • Earlier this week, IDV Solutions released an infographic showing how this Ebola outbreak—the largest in history—compares to previous outbreaks of the disease.
  • The National Institute of Allergy and Infectious Diseases, part of the National Institutes of Health, will begin initial human testing of an Ebola investigational vaccine next week.

Read more on Ebola.

Teens Who Don’t Get Enough Sleep Are at Increased Risk of Obesity
Teenagers who don’t get enough sleep are at increased risk of being obese by age 21, according to a new study in Journal of Pediatrics. Researchers at Columbia’s Mailman School of Public Health analyzed health information on more than 10,000 teens and young adults at the ages of 16 and 21, finding that the 16-year-olds who reported less than six hours of sleep per night were 20 percent more likely to be obese by age 21. Potential reasons for the link include appetite changes and cravings due to daytime sleepiness and fatigue. The U.S. Centers for Disease Control and Prevention recommends nine to ten hours of sleep per night for teenagers. Read more on pediatrics.

Study: ‘Rules of Thumb’ on Pouring Help Reduce Excessive Drinking
Curbing a person’s excessive drinking may be as simple as thinking about how much is poured into each glass, according to a new study in the International Journal of Drug Policy. Researchers from Iowa State University and Cornell University had 74 college students pour red or white wine in a variety of settings, finding that those students who use a “rule of thumb” to dictate their pours—such as only filling half the glass or leaving space equivalent to two fingers at the top—poured less, regardless of their BMI or gender. “About 70 percent of the people in the sample used the half-glass rule, and they poured significantly less by about 20 percent,” said Laura Smarandescu, lead author and an assistant professor of marketing at Iowa State, in a release. “It’s a big difference. We would suggest using a rule of thumb with pouring because it makes a big difference in how much people pour and prevents them from overdrinking.” Read more on alcohol.

Jul 11 2014
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Public Health News Roundup: July 11

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CDC: 60 Percent of Diners Will Use Menu Calorie Counts When Available
Approximately 6 in 10 U.S. adults will choose their restaurant meals in part because of menu label information when it’s available, according to the U.S. Centers for Disease Control and Prevention’s (CDC) latest Morbidity and Mortality Report. Researchers analyzed the self-reported usage of 118,013 adults in 17 states in 2012 to determine that about 57 percent will look to the provided calorie information. New York had the highest rate, with 61.3 percent, while Montana had the lowest, at 48.7 percent. Federal law requires calorie information be provided by any restaurant with 20 or more locations; while the regulations are not yet final, many establishments already voluntarily provide menu labeling, according to the CDC. Read more on nutrition.

Depression, Stress, Hostility Tied to Higher Stroke Risk
Depression, stress and hostility may be linked to a higher risk for stroke, according to a new study in the journal Stroke. Using information provided by approximately 7,000 adults who did not have heart disease or a history of stroke at the beginning of the study, researchers followed up nearly nine years later and determined that depression was associated with an 86 percent increased chance of a stroke or a transient ischemic attack, stress was associated with a 59 percent increase and hostility doubled the risk. “[C]hronic stress and negative emotions are important psychological factors that affect one's health, and findings from this study link these factors to brain health in particular," said the study's lead author, Susan Everson-Rose, an associate professor of medicine at the University of Minnesota, according to HealthDay. "Patients and their health care providers should be aware that experiences of chronic stress and negative emotional states can increase risk for stroke.” Read more on heart health.

Washington State Sees Most Measles Cases Since 1996
A slight decline in Washington State’s mumps and rubella vaccination rate has coincided with the state’s highest number of measles case in 18 years, according to officials. Washington has reported 27 cases so far this year and is currently in the midst of its third outbreak. While homegrown measles was declared officially eliminated from the United States in 2000, infections from people who have travelled overseas remain a threat. There were 554 total cases of measles and 17 outbreaks reported in the United States between Jan. 1 and July 3 of this year. Read more on infectious diseases.

Jul 2 2014
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Public Health News Roundup: June 2

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Report: Food Sodium Levels at Many Top Chains Continue to Be Unhealthily High
From 2009 to 2013, the nation’s top restaurant chains reduced the sodium in their foods by an average of only 1.5 percent annually, according to a new report from the nonprofit Center for Science in the Public Interest (CSPI). In a review of 136 meals from 17 chains, researchers determined that approximately 79 percent of the 81 adult meals contained more than 1,500 milligrams (mg) of sodium—or one mg more than the U.S. Centers for Disease Control and Prevention recommends as a full day’s limit. The study also found efforts to reduce sodium to be inconsistent, with some chains actually increasing the amounts over the studied time period. CSPI Executive Director Michael F. Jacobson said the findings indicate that the U.S. Food and Drug Administration’s “wait-and-see” approach to sodium in packaged and restaurant food doesn’t work and that a new approach is needed. Read more on nutrition.

CDC: Antibiotic-resistant Foodborne Germs Remain a Serious Public Health Issue
New data from the U.S. Centers for Disease Control and Prevention (CDC) indicates both positive and negative trends in the ongoing public health fight against antibiotic-resistant foodborne germs, which contribute to an estimated 430,000 U.S. illnesses every year. According to the data, multi-drug resistant Salmonella—which causes approximately 100,000 U.S. illnesses annually—decreased over the past decade, but Salmonella typhi resistance to certain drugs increased by 68 percent in 2012, meaning one of the common treatments for typhoid fever may not be effective. “Our latest data show some progress in reducing resistance among some germs that make people sick but unfortunately we’re also seeing greater resistance in some pathogens, like certain types of Salmonella,” said Robert Tauxe, MD, MPH, deputy director of CDC’s Division of Foodborne, Waterborne, and Environmental Diseases. “Infections with antibiotic-resistant germs are often more severe. These data will help doctors prescribe treatments that work and to help CDC and our public health partners identify and stop outbreaks caused by resistant germs faster and protect people’s health.” Read more on food safety.

Four Communities to Share $120M in HUD Grants for Community Revitalization
Four U.S. communities will split nearly $120 million in U.S. Department of Housing and Urban Development (HUD) grants earmarked for the redevelopment of severely distressed public or HUD-assisted housing and their surrounding neighborhoods. "HUD's Choice Neighborhoods Initiative supports local visions for how to transform high-poverty, distressed communities into neighborhoods of opportunity," said HUD Secretary Shaun Donovan. "By working together, with local and state partners we will show why neighborhoods should always be defined by their potential—not their problems. Together, we will work to ensure that no child's future is determined by their zip code and expand opportunity for all."

The four communities are:

  • Columbus (Ohio) Metropolitan Housing Authority — Columbus, Ohio
  • Housing Authority of the City of Norwalk/Norwalk (Conn.) Redevelopment Agency
  • City of Philadelphia, Office of Housing & Community Development/Philadelphia Housing Authority
  • Housing Authority of the City of Pittsburgh/City of Pittsburgh

Read more on housing.

Jul 1 2014
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Public Health News Roundup: July 1

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Study: New Requirements Needed for Hand Hygiene for Anesthesia Providers
Anesthesia providers frequently miss identified opportunities to clean their hands during surgical procedures, with the points immediately before patient contact and immediately after contact with the patient’s environment the times when they are least likely to practice proper hand hygiene, according to a new study in the American Journal of Infection Control. However, the findings also point to a larger problem: Complete compliance with all hand hygiene guidelines would take so much time that there would be no time to actually perform any procedures. The findings indicate “a need to create more practical—but still effective—methods of controlling bacterial transmission in anesthesia work environments.” Read more on prevention.

HHS: $840M to Help State, Local Agencies Improve Disaster Preparedness
The U.S. Department of Health and Human Services (HHS) has awarded approximately $840 million in grants to help state and local public health and health care systems improve their emergency response preparedness. Distributed through the Hospital Preparedness Program (HPP) and the Public Health Emergency Preparedness (PHEP) program, the funds will ensure that communities are prepared to respond to an array of emergencies, including infectious disease outbreaks, natural disasters, or chemical, biological, or radiological nuclear events. “Community and state preparedness is essential to the health security of all Americans,” said Nicole Lurie, MD, assistant secretary for preparedness and response (ASPR), in a release. “Events in the last few years have demonstrated how critical it is for health systems across the country to be ready and able to respond quickly and effectively.” Read more on disasters.

ACP: Annual Pelvic Exams Not Needed for Asymptomatic Women
Annual pelvic exams for women do more harm than good and should not be a routine part of health care for women who are not pregnant or who show no other signs of pelvic problems, according to new guidelines from the American College of Physicians (ACP). In a review, researchers found no studies on the effectiveness of pelvic exams in identifying cancers, infections and other health issues that they are commonly used to find. Researchers stressed that their findings only apply to pelvic exams and that women should still undergo recommended cervical cancer screening. Read more on prevention.

 

Jun 3 2014
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Public Health News Roundup: June 4

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Study: Medicaid Patients Receive Poorer Cancer Care
People on Medicaid receive poorer cancer care than people with private insurance, according to three new studies presented at the American Society of Clinical Oncology annual meeting in Chicago. Researchers determined that Medicaid patients are less likely to have their cancer caught at an earlier, more treatable phase, as well as far more likely to die from cancer. One of the factors contributing to this disparity is the fact that Medicaid patients have less experience navigating the health care system. "Research has shown that we can screen more patients, but that they get dropped along the way to treatment. We don't give them full access into curative therapy," said Jyoti Patel, MD, an oncologist at the Robert H. Lurie Comprehensive Cancer Center of Northwestern University in Chicago, who's also a spokeswoman for the American Society of Clinical Oncology. "We need to do a better job to make sure that people who aren't savvy or can't advocate for themselves have that helping hand." Read more on health disparities.

CDC: Norovirus is the Leading Cause of Disease Outbreaks from Contaminated Food
Norovirus is the leading cause of disease outbreaks from contaminated food in the United States, according to the latest Vital Signs report from the U.S. Centers for Disease Control and Prevention (CDC). Approximately 20 million people in the United States are sickened by norovirus annually. According to the CDC, because infected workers are often the source of these outbreaks, the food service industry can help prevent outbreaks by enforcing safety practices, including:

  • Making sure food service workers practice proper hand washing and use utensils and single-use disposable gloves to avoid touching ready-to-eat foods with bare hands
  • Certifying kitchen managers and training food service workers in food safety practices
  • Establishing policies that require food service workers to stay home when sick with vomiting and diarrhea and for at least 48 hours after symptoms stop

Read more on food safety.

N.C. Program Successful in Expanding Dental Care to Young, Low-income Children
A North Carolina program to reduce cavities in young, low-income children, has significantly increased the number of children under the age of four receiving preventive dental care  since the program began in 2000, according to a new study in the journal Pediatrics. The program works to train physicians in basic dental screening and preventive techniques that can be provided quickly and effectively during regular office visits. “Evaluation studies conducted since the initiation of the program in 2000 have found it to substantially increase access to preventive dental services for young, high-risk children who otherwise would be unlikely to use these services in dental offices, reduce caries-related treatments and costs, avert hospitalizations and improve oral health status,” said study was co-author R. Gary Rozier, DDS, MPH, professor of health policy and management at the UNC Gillings School of Global Public Health, in a release. Read more on pediatrics.

May 5 2014
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Public Health News Roundup: May 5

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CDC Confirms First U.S. Case of MERS Virus
The U.S. Centers for Disease Control and Prevention (CDC) has confirmed the first U.S. case of MERS, a respiratory virus first identified in the Middle East two years ago. The virus was diagnosed in a U.S. patient who recently traveled from Saudi Arabia. The patient is being treated at a hospital in Indiana and people who traveled with the patient on an airplane from the Middle East are being contacted and told to see a doctor if respiratory symptoms develop. In some Middle Eastern countries, the virus has spread from person to person through close contact, but the CDC says there is no evidence of the sustained spread of the virus in general settings. "The virus has not shown the ability to spread easily in a community setting," said Ann Schuchat, MD, director of CDC's National Center for Immunization and Respiratory Diseases, during a telephone press conference on Friday.

"In this interconnected world we live in, we expected MERS to make its way to the United States....We have been preparing since 2012 for this possibility,” said Tom Frieden, MD, director of the CDC in a statement.

The CDC says that anyone who experiences respiratory illness within 12 weeks of traveling to Saudi Arabia, or becomes ill after contact with someone who recently traveled to Saudi Arabia, should contact their doctor. The CDC has not recommended that anyone change their travel plans based on the MERS virus. So far there have been 401 confirmed cases of the MERS virus in twelve countries, including the United States; 93 people have died of the virus. Camels have been identified as carriers of MERS, but it's not known how the virus is being spread to people. Read more on infectious disease.

WHO: World Polio Threat an ‘Extraordinary Event’ That Requires a Coordinated International Response
Despite the near cessation of the international spread of wild polio virus in the low transmission seasons (January to April) from January 2012 through 2013, a new report from the World Health Organization (WHO) finds that the current international spread of polio can now be considered an “extraordinary event.” WHO experts say the public health risk—the WHO Emergency Committee unanimously agreed that the conditions for a Public Health Emergency of International Concern (PHEIC) have been met—requires a coordinated international response. So far in 2014 there has already been international spread of wild polio virus from 3 of the 10 States that are currently infected: in central Asia (from Pakistan to Afghanistan), in the Middle East (Syrian Arab Republic to Iraq) and in Central Africa (Cameroon to Equatorial Guinea). Pakistan, Cameroon and the Syrian Arab Republic pose the greatest risk in 2014, according to the WHO. Read more on global health.

Study: Even Outbreaks May Not Change the Minds of Parents Opposing Childhood Vaccines
Parents who choose not to have their children receive mandatory immunizations may not change their minds even in the face of outbreaks of childhood illnesses, according to a new study. Researchers studied a pertussis outbreak in Washington State from October 2011 through December 2012, finding “no significant increase” in the vaccination rates of approximately 80,000 infants ages 3 to 8 months, according to HealthDay. Paul Offit, MD, chief of the division of infectious diseases at the Children's Hospital of Philadelphia, said parents using “personal belief” exemptions to not have their children vaccinate is likely beyond the resurgence of diseases that were once all but eradicated in the United States. "The problem is not theoretical,” he said. "You are starting to see eroding of herd immunity with outbreaks of measles and pertussis. The main reason is people are choosing not to vaccinate their children. It's becoming a more dangerous world from the standpoint of infectious diseases. Measles and pertussis are back. These are serious diseases that before vaccine caused a lot of death.” Offit was not a part of the recent study. Read more on vaccines.

Apr 25 2014
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Public Health News Roundup: April 25

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CDC: Long-term Measles Vaccines Program Will Save Millions from Disease
Two decades ago, in 1994, the United States launched the Vaccines for Children program (VFC) as a direct response to rising cases of measles cases across the country.  The U.S. Centers for Disease Control and Prevention (CDC) now estimates that vaccinations will prevent more than 21 million hospitalizations and 732,000 deaths among children born in the twenty years since the VFC program was launched. "Thanks to the VFC program,  children in our country are no longer at significant risk from diseases that once killed thousands each year,” said CDC Director Tom Frieden, MD, MPH, in a release. “Current outbreaks of measles in the U.S. serve as a reminder that these diseases are only a plane ride away. Borders can’t stop measles, but vaccination can.” A reported 129 people in the United States have been diagnosed with measles in 13 outbreaks so far this year. Read more on vaccines.

FDA Approves DNA Test to Improve Early HPV Detection, Assess Later Cancer Risk
The U.S. Food and Drug Administration (FDA) has approved a DNA test to help women age 25 and older, along with their physician, determine whether they need additional diagnostic testing for cervical cancer. The test can also help assess the patient’s risk of developing cervical cancer later in life. The new HPV test detects DNA from 14 high-risk HPV types. Women who test positive for HPV 16 of HPV 18 would then be advised to undergo a colposcopy, while women who tested positive for 12 other high-risk HPV types would be advised to undergo a Pap test to determine whether a colposcopy was needed. While the FDA previously approved the cobas HPV Test in 2011, this new approval expands the use of the test, allowing it to be either a co-test or to be used as a primary cervical cancer screening testing. Read more on cancer.

 

Study: Drinking More Coffee Linked to Reduced Risk for Type 2 Diabetes
Drinking more coffee may be tied to a reduced risk for type 2 diabetes, according to a new study in the journal Diabetologia. In a study of 123,000 adults over four years, researchers determined that the participants who increased their coffee intake by more than one cup saw a reduction in risk, while those who drank less saw an increase. "It looks like there is a dose-response relationship between increasing coffee consumption and a lower risk of diabetes," said lead researcher Frank Hu, MD, professor of nutrition and epidemiology at the Harvard School of Public Health, according to HealthDay. "Basically, the more coffee, the lower the risk of diabetes. People who drink three to five cups of coffee a day enjoyed a significant reduction in type 2 diabetes risk." Researchers noted that while the study determined a correlation it did not determine causation, so further study is needed to explain the link. Read more on diabetes.

Apr 18 2014
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Faces of Public Health: Esther Chernak, Drexel University School of Public Health

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The Center for Public Health Readiness and Communication (CPHRC) at the Drexel University School of Public Health in Philadelphia recently re-launched DiversityPreparedness.org, a clearinghouse of resources and an information exchange portal to facilitate communication, networking and collaboration to improve preparedness, build resilience and eliminate disparities for culturally diverse communities across all phases of an emergency. The site had originally been developed by Dennis Andrulis, now at the Texas Health Institute, and Jonathan Purtle, who co-writes a blog on public health for the Philadelphia Inquirer.

>>Bonus Links:

NewPublicHealth recently spoke with Esther Chernak, MD, MPH, the head of CPHRC, about the re-launched site and her work in preparedness.

NewPublicHealth: Tell us a little bit about your background and how you came to lead the Center for Public Health Readiness and Communication.

Esther Chernak: I’m an infectious disease physician by training and pretty much have been working in public health since I finished my infectious disease fellowship in 1991 at the University of Pennsylvania. I started working in the Philadelphia Department of Public Health in its city clinic system doing HIV/AIDS care, and then became the Clinical Director of HIV Clinical Programs for the health centers back in the early ’90s when the epidemic was obviously very different. I then moved to working in infectious disease epidemiology as a staff doctor in the acute communicable disease control program and was involved in infectious disease surveillance and outbreak investigations for a number of years.

Then in 1999, I took a job with the City Health Department in what was then called bioterrorism preparedness. That was the time when major cities in the country were just beginning to be funded to do bioterrorism response plans. Groups that were involved in bioterrorism preparedness recognized relatively quickly that despite the fact that we were dealing with planning for novel strains of influenza and pandemic preparedness and SARS and smallpox, we were also dealing with many, many really significant infectious disease outbreaks, and then ultimately non-infectious disease related issues that had huge impacts on public health, such as earthquakes and hurricanes. Those links helped prepare me for my role at the Center.

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Apr 9 2014
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FDA’s Role in Disaster Preparedness: Q&A with Brooke Courtney

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The U.S. Food and Drug Administration (FDA) was a partner agency for last week’s Preparedness Summit in Atlanta. NewPublicHealth spoke with Brooke Courtney, Senior Regulatory Counsel in the FDA Office of Counterterrorism and Emerging Threats, about how the agency plans for disasters it hopes never occur. Previously, Courtney was the Preparedness Director at the Baltimore City Health Department and in that role oversaw all of the public health preparedness and response activities for Baltimore City.

NewPublicHealth: What did you speak about at the Summit last week?

Brooke Courtney: FDA views the summit as an unparalleled opportunity each year to engage with stakeholders at the state, local and federal levels—to share with them updates from the federal side and also for us to get feedback from them about challenges and successes. We engage with stakeholders on a regular basis, but this is really the meeting where the largest number of people involved in preparedness come together, and it’s a great opportunity to see people face-to-face.

We feel really fortunate to have been able to take part in the summit for the past few years. For this year’s summit FDA served on the Planning Committee and also participated in the medical countermeasure policy town hall with federal colleagues from the Office of the Assistant Secretary for Preparedness and Response, the U.S. Department of Homeland Security and the national security staff, all of whom we work with closely.

Another thing that we like to do at the summit each year is to give a more in-depth update through a session with the U.S. Centers for Disease Control and Prevention (CDC) and the U.S. Department for Health and Human Services (HHS) legal counsel on the authorities that we have that we use related to the emergency use of medical countermeasures during emergencies. This year’s session was especially exciting for us because it was an opportunity for us to discuss with stakeholders some new authorities that were established in 2013 to enhance preparedness and response flexibility.

For example, we can now clearly issue emergency use authorizations in advance of emergencies, which is really a critical medical countermeasure tool for preparedness purposes. Through these flexibilities, for example, we’ve issued three emergency use authorizations in the past year for three different in-vitro diagnostic tests to address the emerging threats of H7 and 9 influenza and MERS-CoV.

NPH: What are the key responsibilities the FDA has in helping to prepare the United States for possible disasters?

Courtney: As an agency of the U.S. Department of Health and Human Services, the FDA, at its core, is a public health agency. FDA’s mission is to protect and promote public health in a number of critical ways. We’re responsible for regulating more than $1 trillion in consumer goods annually, ranging from medical products such as drugs and vaccines to tobacco and food products.

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