State Health Departments Race to Respond to Meningitis Outbreak Despite Budget Cuts and Looming Sequester

ARLINGTON, Va., Oct. 26, 2012 /PRNewswire-USNewswire/ -- Despite recently sustaining $2.5 billion in federal public health spending cuts and facing billions more in cuts under sequestration, public health departments across the nation are racing to detect cases of meningitis associated with the ongoing widespread outbreak and ensure at-risk patients are contacted, properly counseled, and offered proper treatment, as well as monitoring the removal of any tainted vials of the steroid believed to be behind the outbreak. The Tennessee Department of Health was the first organization to identify the outbreak and its source. As of October 25, the outbreak has resulted in 328 cases of fungal meningitis and 24 deaths spanning 18 states, with up to 14,000 individuals at risk in the 23 states where the contaminated steroids were distributed.

"Getting a handle on this outbreak is a top priority for state and local health departments right now, but it's challenging given the tens of thousands of public health jobs lost to budget cuts over the past few years," says Paul Jarris, MD, executive director of the Association for State and Territorial Health Officials (ASTHO). "It's a massive undertaking, with potentially thousands of lives at stake, but there's very little funding for it and there will be even less if sequestration occurs."

A sequester is scheduled to take effect on January 2, 2013—resulting in automatic across-the-board budget cuts to federal government programs—unless Congress reaches an agreement to pass legislation to postpone it or finds other ways to reduce the federal deficit. If sequestration takes place, Tennessee, which is also the state hit hardest by the meningitis outbreak, will lose more than $18 million in core public health funding in 2013 alone.

Under sequestration, all 18 states affected by the outbreak would lose a total of more than $568 million in public health funding for FY 2013. The Coalition for Health Funding, a nonprofit working to preserve and strengthen public health investments, estimates that sequestration would also result in state and local health departments losing 2,500 specialized disease detectives—workers who have been on the front lines fighting the meningitis outbreak.

"The net effect of additional budget cuts to state and local public health agencies equates to the devastation of vital public health programs," says Jarris. "Sequestration's cuts will put the public at greater risk for infectious disease outbreaks, foodborne illnesses, and life-threatening infections from routine hospital stays. As we continue to deal with this terrible outbreak, we need to remember that health departments must be kept whole to ensure that all Americans are safe."

State and local public health agencies engage in the following activities, all of which are part of the response needed in outbreaks such as this:

  • Active surveillance to identify infected individuals
  • Laboratory testing to help confirm infection
  • Providing guidance to physicians to make the most appropriate decision for the care and treatment of patients
  • Conveying timely and accurate information to the concerned public through call centers and hotlines
  • Working with key federal and state regulatory agencies to ensure that contaminated and potentially harmful medications are removed from use and properly disposed of

Since 2008, both state and federal funding for public health has declined. Forty-eight state and territorial health agencies report budget cuts since 2008, and more than 45,000 state and local public health jobs have been lost. At the federal level, public health funding has declined from $31.4 billion in 2010 to $28.9 billion in 2012. After sequestration, funding would plummet to $26.5 billion. These cuts could have severe implications for how effectively public health agencies can respond to future emergencies.

ASTHO is the national nonprofit organization representing the public health agencies of the United States, the U.S. territories, and the District of Columbia, as well as the more than 100,000 public health professionals these agencies employ. ASTHO members, the chief health officials of these jurisdictions, are dedicated to formulating and influencing sound public health policy and to ensuring excellence in state-based public health practice. Web:; Twitter: @ASTHO.

SOURCE Association of State and Territorial Health Officials