State and Local Public Health Department Healthcare Outbreak Response Capacity Self-Assessment—United States 2016

Abstract

Background. Timely and appropriate investigation of potential outbreaks involving medical care is needed to prevent the spread of healthcare-associated infections (HAIs) and antimicrobial-resistant (AR) pathogens. While the ability to detect and respond to outbreaks represents a core public health function, health department (HD) capacities vary and have not been well described. Methods. CDC funded 55 HD HAI Programs to complete an interim Outbreak and Response Capacities Self-Assessment Tool as part of the Epidemiology and Laboratory Capacity Infection Control Assessment and Response Ebola Supplement. HAI outbreaks were defined as clusters of infections involving healthcare settings or medical care. Response activities were defined as efforts on the part of public health authorities to assist with investigation of specific HAI risks, including outbreaks, sentinel cases and serious infection control breaches. Results. HDs recorded 6,381 HAI outbreaks and related response activities during 2015 (median = 58 per jurisdiction; Figure 1). HD participation was reported for 71% of these events; HD laboratory support for 44%; and HD on-site visits for 16%. Eightyfour percent of HDs specified clusters or suspected outbreaks and 84% specified a single case of a novel-resistant pathogen were reportable by jurisdictions' statutes or regulations. Resource limitations to conduct HAI response activities included staff and expertise in infection control (44%), laboratory (40%), and data management/analytics (38%). Areas in need of additional investigation tools and training for HD staff included equipment reprocessing errors (58%), AR pathogens (49%), dialysis centers (47%), and outpatient settings (37%). HDs reported plans to engage HAI advisory committees (76%), state hospital association (51%), APIC chapters (56%), and partners in long-term care (60%), acute care (59%), ambulatory surgery (24%), and dialysis (7%) to improve response capacity. Conclusion. HDs indicated a high background level of HAI response activity. Additional expertise and resources could increase HD capacity to support investigations of HAI/AR outbreaks. Planned partner outreach could further enhance outbreak detection, reporting, and investigation. (Figure Presented).