In Our Scope: 2022 & Beyond
As we continue to work toward ending the COVID-19 pandemic in the year ahead, NCEZID is poised to advance infectious disease preparedness for the broad spectrum of diseases we cover. While keeping an ever-watchful eye on challenges that new variants of SARS-CoV-2 may present, we aim to apply many of the lessons learned from the largest infectious disease response in CDC history to fortify preparedness for future outbreaks and pandemics. As we move forward into what we hope soon will be a post-pandemic world, it is with keen understanding that we need to be ready to take swift action against all future outbreaks and public health threats.
What’s Happening
NCEZID is spearheading the National Strategy for Vector-Borne Disease Prevention and Control in Humans. Under the direction of HHS and led by CDC, the strategy will be developed by five federal departments, the US Environmental Protection Agency, the National Aeronautics and Space Administration, and the National Oceanic and Atmospheric Administration.
Why We Need It
Everyone in the US is at risk from endemic and emerging diseases transmitted by ticks, mosquitoes, fleas, and other blood-feeding vectors. Certain groups, such as people who live in homes without air conditioning or window screens, are at even greater risk of contracting or experiencing adverse consequences from specific vector-borne diseases. Cases of tickborne diseases reported to CDC doubled from 2004 to 2018; epidemic mosquito-borne viruses, such as dengue viruses, are increasing; and the geographic habitat of disease-causing ticks and mosquitoes has expanded.
What Will It Do
The Strategy will represent a coordinated federal implementation plan needed to reverse the current increasing vector-borne diseases threat. This plan will help identify gaps, prioritize research and development across the federal government, and guide the placement of federal investments for the future.
What’s Happening
Thanks to support provided by the American Rescue Plan, CDC is investing $1.7 billion to expand activities and strengthen the workforce for genomic sequencing, analytics, and disease surveillance of viruses (such as SARS-CoV-2) and other organisms. This funding established contracts with commercial laboratories to sequence samples from across the country. Additionally, CDC has and will continue to distribute critical funds to state and local jurisdictions to support national surveillance efforts.
Why We Need It
The COVID-19 pandemic and the emergence of SARS-CoV-2 variants have underscored the importance of genomic technologies in addressing infectious disease public health threats. The technology is reshaping infectious disease surveillance, allowing for earlier detection and more precise investigation of outbreaks across a spectrum of infectious diseases. The genomic data are used in developing molecular diagnostic tests, vaccines, and medical treatments.
What Will It Do
Support from the American Rescue Plan will help CDC and US jurisdictions enhance their capacity to closely watch for SARS-CoV-2 mutations by conducting, expanding, and improving genomic sequencing activities. In 2022, CDC will establish Centers of Excellence in Genomic Epidemiology to help states and universities develop new tools and techniques while training the public health workforce of tomorrow. These centers will operate in tandem with state health departments and academic institutions, allowing all parties to share cutting-edge research. The funding will also develop a cloud-based national bioinformatics infrastructure for data sharing of SARS-CoV-2 and other current and future infectious disease threats.
NCEZID also issued research awards as part of the SARS-CoV-2 Sequencing for Public Health Emergency Response, Epidemiology, and Surveillance (SPHERES) Initiative. The awards are collaborative projects intended to expand the agency’s innovative responses to the COVID-19 pandemic and accelerate the application of SARS-CoV-2 sequencing for genomic epidemiology and pandemic response. Examples include the University of California, San Francisco’s (UCSF) quest to create a realtime network by using rapid viral sequencing to monitor the evolution and spread of SARS-CoV-2 in California and communicate data back to public health agencies to inform public health responses. UCSF’s genomic sequencing efforts detected the first confirmed case of COVID-19 caused by the Omicron variant detected in the US, with support from CDC and California’s Department of Public Health.
What’s Happening
NCEZID’s food safety program is paving the way for quicker and better outbreak detection, which involves developing and piloting new methods in states.
Why We Need It
Newer foodborne disease diagnostics, called culture-independent diagnostic tests (CIDTs), are good for patients and clinicians because they are faster and less expensive than older, culture-based tests. However, CIDTs do not produce a bacterial isolate that our current public health surveillance systems, like PulseNet, need. PulseNet collects genomic fingerprints from bacteria isolated from stool samples by using a culture-based approach, and the loss of isolates is increasingly weakening our foodborne outbreak surveillance by reducing sampling. We need a new process for genomic fingerprinting that lets public health laboratories skip the bacteria isolation step but still get the genomic data needed to detect outbreaks and to track strains of particular concern.
What Will It Do
NCEZID’s foodborne disease experts developed a new metagenomic approach using highly multiplexed amplicon sequencing (HMAS) to help identify bacteria and take PulseNet to the next level. It enables public health laboratories to more easily process and upload samples (including subtyping them) into the surveillance systems and bypass the bacterial culture step entirely. This new approach gives more detailed profiles of the pathogen culprits, expediting public health response during outbreaks. Currently, there is a pilot program with the Colorado and Minnesota state laboratories that will test the HMAS method.
What’s Happening
CDC will continue investing more than $2.1 billion from the American Rescue Plan to expand efforts that protect Americans from COVID-19 infections and other emerging infectious diseases across healthcare settings.
Why We Need It
The COVID-19 pandemic placed tremendous stress on the healthcare sector— from hospitals to nursing homes—and exposed gaps and disparities in infection prevention and control. By preventing or stopping the spread of infections in healthcare settings, we save lives and protect patients and healthcare workers. The pandemic also showed us the importance of the connection and coordination between clinical and public health labs for the detection of emerging threats and public health and healthcare responses.
What Will It Do
The funding helps CDC strengthen and equip state, local, and territorial public health departments and other partner organizations with the resources needed to better detect and fight infections in US healthcare facilities, including COVID-19 and other health threats such as antibiotic resistance. These funds will also support a critical public health workforce in health departments that investigate and respond to outbreaks of COVID-19 in nursing homes, hospitals, and other healthcare facilities throughout the pandemic.
What’s Happening
NCEZID launched the Global Antimicrobial Resistance (AR) Laboratory and Response Network in late 2021 to combat AR worldwide. CDC recently awarded $22 million to nearly 30 organizations in more than 50 countries that are leading these efforts.
Why We Need It
Each year in the US, 2.8 million people get an antibiotic-resistant infection, and 35,000 of them don’t survive it. The Global AR Lab and Response Network builds off the success of CDC’s domestic AR Lab Network by filling critical detection and response gaps globally that were identified in CDC’s 2019 AR Threats Report [PDF – 150 pages]. The collaborative network will also inform global prevention strategies to ensure AR threats are stopped when and where they emerge.
What Will It Do
Every country is an importer and exporter of resistance. The Global AR Lab and Response Network helps public health experts more rapidly identify new types of resistance (resistance genes or pathogens), while also responding to antibiotic-resistant threats and invasive bacterial and respiratory pathogens in communities. This work includes CDC’s newly launched Global Action in Healthcare Network—a global network of countries, institutions, and partners working to detect and respond to healthcare-associated pathogens.
What’s Happening
In 2022, we expect to break ground for a new high-containment laboratory building, where we can continue to safely work with some of the world’s deadliest pathogens.
Why We Need It
CDC’s existing high-containment laboratories have begun to show their age. The new laboratory will replace and enhance CDC’s high containment laboratory capacity, with six biosafety level (BSL)-4 and two BSL-3 laboratories. BSL-4 is the highest level of biological safety and these labs allow CDC to work with especially dangerous pathogens that have few vaccines or treatments. Pathogens such as Ebola virus and smallpox virus remain a threat and emerging diseases continue to be discovered as well.
What Will It Do
This updated laboratory space will allow CDC to continue safely handling the world’s most dangerous pathogens and expand the agency’s ability to conduct research and participate in the development and evaluation of life-saving vaccines, treatments, and diagnostic tests. This would enable CDC to contribute to the full pipeline of medical countermeasures development to ensure we are fully prepared to detect and respond effectively to outbreaks and ultimately prevent them from occurring.
What’s Happening
NCEZID places zoonotic and infectious disease experts in different areas around the world (like the South-East Asia region and targeted high-risk countries) to combat emerging infectious disease threats.
Why We Need It
Strategically placed staff give us eyes and ears on the ground that we need to keep one step ahead of infectious disease outbreaks. This helps us better coordinate outbreak response and address needs like monitoring disease threats to the US, bolstering public health and laboratory workforce capacity, and improving regional and national public health surveillance systems.
What Will It Do
Specialized expertise in pandemics and emerging and zoonotic disease threats sets CDC apart. Infectious disease prevention and control experts in the South-East Asia Region, will
- Provide high-level technical support to detect, prevent, and respond to emerging infectious disease threats, including healthcare-associated infections and zoonotic infections.
- Facilitate technical collaboration between NCEZID programs and country ministries of health, public health institutions, academia, WHO, and non-governmental organizations.
What’s Happening
NCEZID is strengthening our ability to produce timely data and lab results during a quickly moving pandemic and provide data that can be used for clinical management of cases.
Why We Need It
The sudden onset of COVID-19 highlighted the need for a triage laboratory at CDC that can be quickly set up during an emergency to provide real-time data. We also need to expand our genomic sequencing capacity to help produce data that clinicians can use to diagnose and treat patients.
What Will It Do
A new triage laboratory provides CDC with the infrastructure to quickly process large volumes of diagnostic samples for testing during outbreaks. This additional capacity will deliver the flexibility that CDC and state and local health departments will need to make rapid, informed decisions when the next outbreak hits.
Also expanding our Genomic Sequencing Lab (GSL) means improving our ability to perform genetic sequencing for outbreaks, public health research, and clinical applications (eg, characterizing antibiotic resistance genes). The enhanced GSL will be able to test patient samples so the data can assist state public health labs with tracking emerging strains and clinical management of patients. These necessary improvements to the GSL are timely because genomics have emerged to become a cornerstone of public health response.
