Section II Epidemiology and Laboratory - WORD

PIRA_Section II: Epidemiology and Laboratory_TEST - Final
Form Approved
OMB Number: 0920-0879
Expiration Date: 03/31/2018

Introduction
Background
The 2009 H1N1 influenza pandemic underscored the importance of communities
being prepared for potential threats to public health security. Because of its
unique abilities to respond to infectious, occupational, or environmental incidents,
the Centers for Disease Control and Prevention (CDC) plays a pivotal role in
ensuring that state and local public health systems are prepared for these and
other public health incidents.
The identification of the novel influenza A (H7N9) virus illnesses in China in 2013
highlights the importance of influenza pandemic preparedness. To date, the
reported case fatality ratio from human H7N9 infections is more than 30%.
Should the H7N9 virus mutate to allow for sustained human-to-human
transmission, it appears capable of causing severe disease in all ages. To better
prepare for such a scenario, it is important to understand the collective ability of
our nation to prepare for and respond to a pandemic of substantially different
epidemiology than the 2009 H1N1 pandemic.
State and local public health departments are first responders for public health
incidents. To better prepare these agencies to respond, CDC provides funding
and technical assistance for state, local, and territorial public health departments
through the Public Health Emergency Preparedness (PHEP) cooperative
agreement. CDC’s Public Health Preparedness Capabilities: National Standards
for State and Local Planning provide national standards that help state and local
public health departments strengthen their ability to respond to all hazards,
including influenza pandemics, and build more resilient communities. Consistent
with this approach, the following Pandemic Preparedness Readiness
Assessment for State and Local Public Health Planners specifically aligns with 11
public health preparedness capabilities and administrative preparedness
planning goals.
Overview
The Pandemic Preparedness Readiness Assessment for State and Local Public

Health Planners promotes state, local, and territorial public health preparedness
and immunization program collaboration through the administration of a selfassessment designed to measure jurisdictional readiness to respond to an
influenza pandemic. Although the content of this assessment does not
encompass every contingency or element necessary to effectively respond to an
influenza pandemic, CDC technical experts in differing programs have helped to
arrange content within the following seven priority planning areas:
1.

Vaccination Planning

2.

Epidemiology and laboratory

3.

Medical Care and Countermeasures

4.

Healthcare Systems

5.

Community Mitigation

6.

Public Information and Communication

7.

Public Health and Immunization Workforce

Information collected from the assessment will not be used to score or
competitively rank public health emergency preparedness or immunization
programs. Rather, this assessment is designed to identify preparedness gaps,
as well as promising state, local, and territorial preparedness practices.
Assessment results will be used by the CDC to inform technical assistance and
future program improvement initiatives.
Definitions
Allocation: Amount of pandemic influenza vaccine available for ordering.
Allocating: Process of dividing available vaccine among CDC’s PHEP awardees
or among registered pandemic influenza vaccine providers and facilities within an
awardee’s jurisdiction.
Critical infrastructure personnel (CIP): The full list of CIP is defined in Guidance
on Allocating and Targeting Pandemic Influenza Vaccine; U.S. Department of
Health and Human Services (HHS)/U.S. Department of Homeland Security
(DHS); 2008 Guidance on Allocating and Targeting Pandemic Influenza Vaccine
Distribution: The process of transporting pandemic influenza vaccine from one
location to another.
Enrollment: The process of enabling registered healthcare providers and facilities

to legally provide pandemic influenza vaccine.
Ordering: Process of requesting pandemic influenza vaccine from either the
federal, state, city, or local government. Orders can be placed against an
allocation or independent of allocation.
Non-pharmaceutical interventions (NPIs): Those interventions that can mitigate
transmission of influenza and do not involve medical countermeasures. NPIs
include voluntary home isolation, school closures, respiratory etiquette, hand
hygiene, and routine cleaning of frequently touched surfaces and objects.
Peak vaccine administration capacity: The highest rate at which a jurisdiction is
able to provide pandemic influenza vaccine to its population; CDC recommends a
peak vaccine administration capacity of at least 10% of the population per
week.
Point of dispensing (POD) / mass vaccination clinic: Location for dispensing
medical countermeasures, specifically for vaccine, during an influenza pandemic
response. Located in a public or private space, this clinic is designed to
vaccinate a large group of persons over a short time period. The POD or clinic
might target the entire population or people in specific priority or high-risk groups.
Public and/or private entities can manage a POD or clinic.
Closed POD: Point of dispensing/vaccination clinic closed to the general public
and open only to a specific group (e.g., staff of a participating business or
healthcare personnel in a specific hospital).
Open POD: Point of dispensing/vaccination clinic open to the general public,
specifically to provide vaccine, during an influenza pandemic response.
Recruitment: The process of soliciting healthcare providers and facilities
interested in and willing to provide pandemic influenza vaccine.
Registration: The submission of required information, similar to an application, by
healthcare providers or facilities interested in providing pandemic influenza
vaccinations.
Retail-based clinics: Non-pharmacy businesses that sell retail products (e.g.,
Walmart, Target) and serve as PODs/mass vaccination clinics.
School-located vaccination clinics: Vaccination clinics that target students and
are typically held on school grounds.
Public reporting burden of this collection of information is estimated to average 30 minutes per
response, including time for reviewing instructions, searching existing data sources, gathering
and maintaining the data needed, and completing and reviewing information. An agency may not
conduct or sponsor, and a person is not required to respond to a collection of information unless it

displays a currently valid Office of Management and Budget control number. Send comments
regarding this burden estimate, or any other aspect of this information collection, including
suggestions for reducing this burden to CDC/Agency for Toxic Substance and Disease Registry
Information Collection Review Office, 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333;
Attention: PRA (0920-0879).

(End of Page 1)

Section II: Epidemiology and Laboratory
Goal: Each awardee will have the capability to detect the start of an influenza
pandemic, track pandemic activity, and monitor response effectiveness in the
jurisdiction. Please work with the Influenza Surveillance Coordinator in your
jurisdiction to address these questions.
Assumptions:
• Each awardee will conduct pandemic influenza surveillance using established
seasonal influenza surveillance systems
• Each awardee will have the ability to detect influenza viruses using CDC realtime PCR (RT-PCR) methods
(End of Page 2)

Section II: Epidemiology and Laboratory
Please select your jurisdiction:

mAlabama
mAlaska
mAmerican Samoa
mArizona
mArkansas
mCalifornia
mChicago
mColorado
mCommonwealth of the Northern Mariana Islands
mConnecticut
mDelaware
mFederated States of Micronesia
mFlorida
mGeorgia
mGuam
mHawaii
mIdaho
mIllinois
mIndiana
mIowa
mKansas

mKentucky
mLos Angeles County
mLouisiana
mMaine
mMaryland
mMassachusetts
mMichigan
mMinnesota
mMississippi
mMissouri
mMontana
mNebraska
mNevada
mNew Hampshire
mNew Jersey
mNew Mexico
mNew York
mNew York City
mNorth Carolina
mNorth Dakota
mOhio
mOklahoma
mOregon

mPennsylvania
mPuerto Rico
mRepublic of Palau
mRepublic of the Marshall Islands
mRhode Island
mSouth Carolina
mSouth Dakota
mTennessee
mTexas
mU.S. Virgin Islands
mUtah
mVermont
mVirginia
mWashington
mWashington, DC
mWest Virginia
mWisconsin
mWyoming

Please select your position:
mPHEP Director
mState Epidemiologist
mState Lab Director

mOther (please specify) ____________________

(End of Page 3)

Section II: Epidemiology and Laboratory
Please answer the following questions on a scale of 1 to 5, with 1 being “no
capacity” and 5 being “full capacity.”

1. Does your jurisdiction have the capacity to conduct comprehensive contact
tracing and epidemiologic investigations of initial (for example 40 cases or initial
clusters) confirmed cases of novel influenza with epidemic/pandemic potential?

No Capacity

Please select
capacity

m

2

m

3

m

4

m

2. Does your jurisdiction have the capacity to collect basic epidemiologic data,
such as demographic data, hospital admission data, admission to ICU,
mechanical ventilation, and laboratory-confirmed influenza-positive
hospitalizations in your jurisdiction?

No Capacity

Please select
capacity

m

2

m

3

m

3. Does your jurisdiction have the capacity to investigate influenza-associated
deaths in children (note that influenza-associated death in children is a nationally
notifiable condition)?

4

m

No Capacity

Please select
capacity

m

2

m

3

m

4

m

4. Does your jurisdiction have the capacity to conduct surveillance for influenzaassociated mortality in adults?

No Capacity

Please select
capacity

m

2

m

3

m

4

m

5. Does your jurisdiction have the capacity to investigate a systematic subset of
influenza-associated deaths in adults?

No Capacity

Please select
capacity

m

2

m

3

m

4

m

6. Does your jurisdiction have the capacity to collect detailed epidemiologic and
clinical case information, such as onset date, symptoms, contacts, hospitalization
or death, on a subset of initial cases identified during a large epidemic or
pandemic?

No Capacity

Please select
capacity

m

2

m

3

m

4

m

7. Would your jurisdiction be willing to use CDC protocols and questionnaires
developed at the onset of the pandemic for this purpose?
mYes
mNo

8. Does your jurisdiction have the capacity to transfer electronic death records to
CDC in a reliable and timely fashion (within 2 weeks)?

No Capacity

Please select
capacity

m

2

m

3

m

4

m

9. Is your jurisdiction willing to follow a common protocol to transfer laboratory,
surveillance, and case-investigation data electronically to CDC in a reliable and
timely fashion (TBD)?
mYes
mNo
mWill do for some type of data, but not all (please specify)
____________________

10. Is your jurisdiction able to test and differentiate novel influenza A viruses, for
example influenza A(H7), A(H5), A(H3v), from seasonal influenza viruses?
mYes
mNo, but in development
mNo

11. Does your jurisdiction have the capacity to transport specimens to CDC on a
regular basis during a pandemic, given the expected surge in lab testing?
mYes
mNo, but in development
mNo

(End of Page 4)