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MMWR Supplements

Nicole J Cohen, Clive M Brown, Francisco Alvarado-Ramy, Heather Bair-Brake, Gabrielle A Benenson, Tai-Ho Chen, Andrew J Demma, N Kelly Holton, Katrin S Kohl, Amanda W Lee, David McAdam, Nicki Pesik, Shahrokh Roohi, C Lee Smith, Stephen H Waterman, Martin S Cetron
During the 2014-2016 Ebola virus disease (Ebola) epidemic in West Africa, CDC implemented travel and border health measures to prevent international spread of the disease, educate and protect travelers and communities, and minimize disruption of international travel and trade. CDC staff provided in-country technical assistance for exit screening in countries in West Africa with Ebola outbreaks, implemented an enhanced entry risk assessment and management program for travelers at U.S. ports of entry, and disseminated information and guidance for specific groups of travelers and relevant organizations...
July 8, 2016: MMWR Supplements
Jeffrey C Hageman, Carmen Hazim, Katie Wilson, Paul Malpiedi, Neil Gupta, Sarah Bennett, Amy Kolwaite, Abbigail Tumpey, Kristin Brinsley-Rainisch, Bryan Christensen, Carolyn Gould, Angela Fisher, Michael Jhung, Douglas Hamilton, Kerri Moran, Lisa Delaney, Chad Dowell, Michael Bell, Arjun Srinivasan, Melissa Schaefer, Ryan Fagan, Nedghie Adrien, Nora Chea, Benjamin J Park
The 2014-2016 Ebola virus disease (Ebola) epidemic in West Africa underscores the need for health care infection prevention and control (IPC) practices to be implemented properly and consistently to interrupt transmission of pathogens in health care settings to patients and health care workers. Training and assessing IPC practices in general health care facilities not designated as Ebola treatment units or centers became a priority for CDC as the number of Ebola virus transmissions among health care workers in West Africa began to affect the West African health care system and increasingly more persons became infected...
July 8, 2016: MMWR Supplements
Beth P Bell, Inger K Damon, Daniel B Jernigan, Thomas A Kenyon, Stuart T Nichol, John P O'Connor, Jordan W Tappero
During 2014-2016, CDC, working with U.S. and international partners, mounted a concerted response to end the unprecedented epidemic of Ebola virus disease (Ebola) in West Africa. CDC's response, which was the largest in the agency's history, was directed simultaneously at controlling the epidemic in West Africa and strengthening preparedness for Ebola in the United States. Although experience in responding to approximately 20 Ebola outbreaks since 1976 had provided CDC and other international responders an understanding of the disease and how to stop its spread, the epidemic in West Africa presented new and formidable challenges...
July 8, 2016: MMWR Supplements
Tara K Sealy, Bobbie R Erickson, Céline H Taboy, Ute Ströher, Jonathan S Towner, Sharon E Andrews, Laura E Rose, Elizabeth Weirich, Luis Lowe, John D Klena, Christina F Spiropoulou, Mark A Rayfield, Brian H Bird
The 2014-2016 Ebola virus disease (Ebola) epidemic in West Africa highlighted the need to maintain organized laboratory systems or networks that can be effectively reorganized to implement new diagnostic strategies and laboratory services in response to large-scale events. Although previous Ebola outbreaks enabled establishment of critical laboratory practice safeguards and diagnostic procedures, this Ebola outbreak in West Africa highlighted the need for planning and preparedness activities that are better adapted to emerging pathogens or to pathogens that have attracted little commercial interest...
July 8, 2016: MMWR Supplements
Lucy A McNamara, Ilana J Schafer, Leisha D Nolen, Yelena Gorina, John T Redd, Terrence Lo, Elizabeth Ervin, Olga Henao, Benjamin A Dahl, Oliver Morgan, Sara Hersey, Barbara Knust
Developing a surveillance system during a public health emergency is always challenging but is especially so in countries with limited public health infrastructure. Surveillance for Ebola virus disease (Ebola) in the West African countries heavily affected by Ebola (Guinea, Liberia, and Sierra Leone) faced numerous impediments, including insufficient numbers of trained staff, community reticence to report cases and contacts, limited information technology resources, limited telephone and Internet service, and overwhelming numbers of infected persons...
July 8, 2016: MMWR Supplements
Jennifer C Brooks, Meredith Pinto, Adrienne Gill, Katherine E Hills, Shivani Murthy, Michelle N Podgornik, Luis F Hernandez, Dale A Rose, Frederick J Angulo, Peter Rzeszotarski
Establishing a functional incident management system (IMS) is important in the management of public health emergencies. In response to the 2014-2016 Ebola virus disease (Ebola) epidemic in West Africa, CDC established the Emergency Management Development Team (EMDT) to coordinate technical assistance for developing emergency management capacity in Guinea, Liberia, and Sierra Leone. EMDT staff, deployed staff, and partners supported each country to develop response goals and objectives, identify gaps in response capabilities, and determine strategies for coordinating response activities...
July 8, 2016: MMWR Supplements
Lucy Breakwell, A Russell Gerber, Ashley L Greiner, Deborah L Hastings, Kelsey Mirkovic, Magdalena M Paczkowski, Sekou Sidibe, James Banaski, Chastity L Walker, Jennifer C Brooks, Victor M Caceres, Ray R Arthur, Frederick J Angulo
In the late summer of 2014, it became apparent that improved preparedness was needed for Ebola virus disease (Ebola) in at-risk countries surrounding the three highly affected West African countries (Guinea, Sierra Leone, and Liberia). The World Health Organization (WHO) identified 14 nearby African countries as high priority to receive technical assistance for Ebola preparedness; two additional African countries were identified at high risk for Ebola introduction because of travel and trade connections. To enhance the capacity of these countries to rapidly detect and contain Ebola, CDC established the High-Risk Countries Team (HRCT) to work with ministries of health, CDC country offices, WHO, and other international organizations...
July 8, 2016: MMWR Supplements
Thomas R Frieden
The 2014-2016 Ebola virus disease (Ebola) epidemic in West Africa required a massive international response by many partners to assist the affected countries and tested the world's readiness to respond to global health emergencies. The epidemic demonstrated the importance of improving readiness in at-risk countries and remaining prepared for Ebola and other health threats. The devastation caused by Ebola in Guinea, Liberia, and Sierra Leone is well recognized; what is less widely recognized is that in these countries more people probably died because of Ebola than from Ebola...
July 8, 2016: MMWR Supplements
Benjamin A Dahl, Michael H Kinzer, Pratima L Raghunathan, Athalia Christie, Kevin M De Cock, Frank Mahoney, Sarah D Bennett, Sara Hersey, Oliver W Morgan
CDC's response to the 2014-2016 Ebola virus disease (Ebola) epidemic in West Africa was the largest in the agency's history and occurred in a geographic area where CDC had little operational presence. Approximately 1,450 CDC responders were deployed to Guinea, Liberia, and Sierra Leone since the start of the response in July 2014 to the end of the response at the end of March 2016, including 455 persons with repeat deployments. The responses undertaken in each country shared some similarities but also required unique strategies specific to individual country needs...
July 8, 2016: MMWR Supplements
Marc-Alain Widdowson, Stephanie J Schrag, Rosalind J Carter, Wendy Carr, Jennifer Legardy-Williams, Laura Gibson, Durodami R Lisk, Mohamed I Jalloh, Donald A Bash-Taqi, Samuel A Sheku Kargbo, Ayesha Idriss, Gibrilla F Deen, James B W Russell, Wendi McDonald, Alison P Albert, Michelle Basket, Amy Callis, Victoria M Carter, Kelli R Clifton Ogunsanya, Julianne Gee, Robert Pinner, Barbara E Mahon, Susan T Goldstein, Jane F Seward, Mohamed Samai, Anne Schuchat
In October 2014, the College of Medicine and Allied Health Sciences of the University of Sierra Leone, the Sierra Leone Ministry of Health and Sanitation, and CDC joined the global effort to accelerate assessment and availability of candidate Ebola vaccines and began planning for the Sierra Leone Trial to Introduce a Vaccine against Ebola (STRIVE). STRIVE was an individually randomized controlled phase II/III trial to evaluate efficacy, immunogenicity, and safety of the recombinant vesicular stomatitis virus Ebola vaccine (rVSV-ZEBOV)...
July 8, 2016: MMWR Supplements
Edward N Rouse, Shauna Mettee Zarecki, Donald Flowers, Shawn T Robinson, Reed J Sheridan, Gary D Goolsby, Jeffrey Nemhauser, Sachiko Kuwabara
From the initial task of getting "50 deployers within 30 days" into the field to support the 2014-2016 Ebola virus disease (Ebola) epidemic response in West Africa to maintaining well over 200 staff per day in the most affected countries (Guinea, Liberia, and Sierra Leone) during the peak of the response, ensuring the safe and effective deployment of international responders was an unprecedented accomplishment by CDC. Response experiences shared by CDC deployed staff returning from West Africa were quickly incorporated into lessons learned and resulted in new activities to better protect the health, safety, security, and resiliency of responding personnel...
July 8, 2016: MMWR Supplements
Martin I Meltzer, Scott Santibanez, Leah S Fischer, Toby L Merlin, Bishwa B Adhikari, Charisma Y Atkins, Caresse Campbell, Isaac Chun-Hai Fung, Manoj Gambhir, Thomas Gift, Bradford Greening, Weidong Gu, Evin U Jacobson, Emily B Kahn, Cristina Carias, Lina Nerlander, Gabriel Rainisch, Manjunath Shankar, Karen Wong, Michael L Washington
To aid decision-making during CDC's response to the 2014-2016 Ebola virus disease (Ebola) epidemic in West Africa, CDC activated a Modeling Task Force to generate estimates on various topics related to the response in West Africa and the risk for importation of cases into the United States. Analysis of eight Ebola response modeling projects conducted during August 2014-July 2015 provided insight into the types of questions addressed by modeling, the impact of the estimates generated, and the difficulties encountered during the modeling...
July 8, 2016: MMWR Supplements
Chris A Van Beneden, Harald Pietz, Robert D Kirkcaldy, Lisa M Koonin, Timothy M Uyeki, Alexandra M Oster, Deborah A Levy, Maleeka Glover, Matthew J Arduino, Toby L Merlin, David T Kuhar, Christine Kosmos, Beth P Bell
In response to the 2014-2016 Ebola virus disease (Ebola) epidemic in West Africa, CDC prepared for the potential introduction of Ebola into the United States. The immediate goals were to rapidly identify and isolate any cases of Ebola, prevent transmission, and promote timely treatment of affected patients. CDC's technical expertise and the collaboration of multiple partners in state, local, and municipal public health departments; health care facilities; emergency medical services; and U.S. government agencies were essential to the domestic preparedness and response to the Ebola epidemic and relied on longstanding partnerships...
July 8, 2016: MMWR Supplements
Sara R Bedrosian, Cathy E Young, Laura A Smith, Joanne D Cox, Craig Manning, Laura Pechta, Jana L Telfer, Molly Gaines-McCollom, Kathy Harben, Wendy Holmes, Keri M Lubell, Jennifer H McQuiston, Kristen Nordlund, John O'Connor, Barbara S Reynolds, Jessica A Schindelar, Gene Shelley, Katherine Lyon Daniel
During the response to the 2014-2016 Ebola virus disease (Ebola) epidemic in West Africa, CDC addressed the disease on two fronts: in the epidemic epicenter of West Africa and at home in the United States. Different needs drove the demand for information in these two regions. The severity of the epidemic was reflected not only in lives lost but also in the amount of fear, misinformation, and stigma that it generated worldwide. CDC helped increase awareness, promoted actions to stop the spread of Ebola, and coordinated CDC communication efforts with multiple international and domestic partners...
July 8, 2016: MMWR Supplements
Brita Roy, Joel Stanojevich, Paul Stange, Nafisa Jiwani, Raymond King, Denise Koo
With the passage of the Patient Protection and Affordable Care Act, the requirements for hospitals to achieve tax-exempt status include performing a triennial community health needs assessment and developing a plan to address identified needs. To address community health needs, multisector collaborative efforts to improve both health care and non-health care determinants of health outcomes have been the most effective and sustainable. In 2015, CDC released the Community Health Improvement Navigator to facilitate the development of these efforts...
February 26, 2016: MMWR Supplements
Leandris C Liburd, Karen E Bouye, Ana Penman-Aguilar
In 1985, the Report of the Secretary's Task Force on Black and Minority Health was published after the federal government convened the first group of health experts to analyze racial/ethnic health disparities among minorities. This analysis, also known as the Heckler report, revealed higher illness and death rates among minorities. The year 2015 marks the 30th anniversary of the Heckler Report and presents an opportunity to evaluate and continue to improve minority health at the national, state, tribal, territorial, and local levels...
February 12, 2016: MMWR Supplements
Greta M Massetti, Corinne David-Ferdon
Youth violence is preventable, and the reduction of health disparities is possible with evidence-based approaches. Achieving community-wide reductions in youth violence and health disparities has been limited in part because of the lack of prevention strategies to address community risk factors. CDC-supported research has resulted in three promising community-level approaches: Business Improvement Districts (BIDs) in Los Angeles, California; alcohol policy to reduce youth access in Richmond, Virginia; and the Safe Streets program in Baltimore, Maryland...
February 12, 2016: MMWR Supplements
Scott D Rhodes, Jami S Leichliter, Christina J Sun, Fred R Bloom
Hispanics/Latinos in the United States are affected disproportionately by human immunodeficiency virus (HIV) infection, acquired immunodeficiency syndrome (AIDS), and other sexually transmitted diseases (STDs); however, few effective evidence-based prevention interventions for this population exist. This report describes the Hombres Manteniendo Bienestar y Relaciones Saludables (Men Maintaining Wellbeing and Healthy Relationships) (HoMBReS) intervention, which was developed by a community-based, participatory research partnership in North Carolina and initially implemented during 2005-2009...
February 12, 2016: MMWR Supplements
Dawn Satterfield, Lemyra DeBruyn, Marjorie Santos, Larry Alonso, Melinda Frank
Type 2 diabetes was probably uncommon in American Indian and Alaska Native (AI/AN) populations before the 1940s. During 2010-2012, AI/AN adults were approximately 2.1 times as likely to have diabetes diagnosed as non-Hispanic white adults. Although type 2 diabetes in youth is still uncommon, AI/AN youth (aged 15-19 years) experienced a 68% increase in diagnosed diabetes from 1994 to 2004. Health disparities are related to biological, environmental, sociological, and historical factors. This report highlights observations from the Traditional Foods Project (2008-2014) that illustrate tribally driven solutions, built on traditional ecological knowledge, to reclaim foods systems for health promotion and prevention of chronic illnesses, including diabetes...
February 12, 2016: MMWR Supplements
Ana Penman-Aguilar, Karen Bouye, Leandris Liburd
In 2011, CDC published the first CDC Health Disparities and Inequalities Report (CHDIR). This report examined health disparities in the United States associated with various characteristics, including race/ethnicity, sex, income, education, disability status, and geography. Health disparities were defined as "differences in health outcomes and their determinants between segments of the population, as defined by social, demographic, environmental, and geographic attributes". Among other recommendations, the 2011 CHDIR emphasized the need to address health disparities with a dual intervention strategy focused on populations at greatest need and on improving the health of the U...
February 12, 2016: MMWR Supplements
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