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December 21, 2015: Outbreak Report Finds Over Half of U.S. States Lacking in Preparedness

On December 21, 2015, the Trust for America’s Health in conjunction with the Robert Wood Johnson Foundation published the “Outbreaks: Protecting Americans from Infectious Diseases” report, a study which rated each state with a numbered ranking in accordance with that state’s ability to prevent and control infectious disease outbreaks. The outbreak report yielded disappointing results, with more than half (28) of states scoring a five or lower out of 10 in issues related to preventing, detecting, diagnosing and responding to outbreaks.

Categories and Findings of the Outbreak Report


The ranking was determined by several categories, including each states’ rates of childhood vaccinations, flu vaccinations, Hepatitis C and HIV/AIDS, and policies regarding Food Safety, preparation for emergency threats, healthcare-associated infections. The report’s overall findings in each category can be found below:

Childhood Vaccinations:
• 20 states have laws that either exclude philosophical exemptions entirely or require a parental notarization or affidavit to achieve a religious or philosophical exemption for school attendance.

Flu Vaccinations:
• 18 states vaccinated at least half of their population (ages 6 months and older) for the seasonal flu from Fall 2014 to Spring 2015. The national average is 47.1 percent. Rates are lowest among young and middle age adults (only 38 percent of 18- to 64-year-olds are vaccinated).

Hepatitis C and HIV/AIDS
• 16 states and Washington, D.C. explicitly authorize syringe exchange programs.
• 43 states and Washington, D.C. require reporting all (detectable and undetectable) CD4 cell count (a type of white blood cell) and HIV viral load data to their state HIV surveillance program.

Food Safety
• 39 states met the national performance target of testing 90 percent of E.coli O157 cases within four days (in 2013).

Preparing for Emerging Threats:

• 36 states have a biosafety professional in their state public health laboratories – which are responsible for helping detect, diagnose and contain disease outbreaks.
• 15 states have completed climate change adaption plans that include the impact on human health.

Healthcare-associated Infections:
• Only nine states reduced the standardized infection ratio (SIR) for central line-associated blood stream infections (CLABSI) between 2012 and 2013.”


If you or a loved one have been harmed in connection with an infectious disease outbreak, and have a question regarding your legal options, please call The Weinberg Law Firm toll free at 1-877-934-6274. Our phones are answered 24/7. You can also contact our personal injury lawyers online by using the easy-to-use “Free Legal Case Evaluation Form” found on this page.

Outbreak Report Scores by State

8/10: DE, KY, ME, NY, VA

7/10: AK, CA, MD, MA, MN, NE

6/10: AR, IL, NH, NJ, NM, NC, ND, WV, WI

5/10: AZ, CO, CT, GA, HI, MS, MO, MT, PA, RI, TX, WA

4/10: AL, DC, FL, IN, LA, NV, SC, SD, TN, WY

3/10: ID, KS, MI, OH, OK, OR, UT

Outbreak Report Conclusions and Recommendations

According to Jeffrey Levi, PhD, executive director of TFAH, “The overuse of antibiotics and underuse of vaccinations along with unstable and insufficient funding have left major gaps in our country’s ability to prepare for infectious disease threats,” said . “We cannot afford to continue to be complacent. Infectious diseases – which are largely preventable – disrupt the lives of millions of Americans and contribute to billions of dollars in unnecessary healthcare costs each year.”

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