State officials in the Midwest are using an outbreak of mumps to test emergency health plans. The real-life exercise is critical for health officials, who have struggled to ready their systems for a possible flu pandemic in the near future.
So far, more than 1,000 cases of mumps have been reported in eight Midwest states, with 815 in Iowa alone. Midwest health officials said the mumps epidemic has pushed them to rehearse outbreak scenarios, monitor airline flights and streamline communications.
"It's nice that it's the mumps. It's a dirty little disease, but it's very rarely fatal. You would like to learn on something that doesn't kill people," said David Lawton, who oversees disease surveillance for Nebraska's health agency.
Outside Iowa and Nebraska, mumps has been reported in Minnesota, Kansas, Illinois, Wisconsin, Missouri, and Oklahoma, according to the Centers for Disease Control. Symptoms of the mumps include flu-like pains, such as a fever or headache, and the swelling of the salivary glands. There have been no reported deaths.
Lawton said the Nebraska outbreak has allowed the state to test two communications systems. The first sends emergency advisories to health officials and every physician in the state; the second tracks outbreak cases in almost real-time for health investigators. "No other state has this level of connectivity," Lawton said.
But more state training needs to be done, health experts said. "There is no state at the moment that is fully prepared for a pandemic. Everyone is behind the curve," said Laura Segal, who co-authored a scorecard on state health plans for the Trust for America's Health. The trust is a non-partisan advocacy group that promotes disease prevention.
The scorecard, which was released last December, tracked 10 areas of emergency health, such as whether a state had enough scientists to test for anthrax or enough ventilators for disease outbreaks. It found more than half the states were unprepared in at least five of these 10 areas.
The worst shortcoming found was the inability to staff up hospitals during large-scale health emergencies. Only two states, Rhode Island and South Dakota, had measures to ensure health-care personnel reported to work during a pandemic or terrorist attack, according to the report.
Other findings were nearly as serious. Only 10 states had adequate resources to deal with a chemical terrorist attack. Just over half could track outbreaks over the Internet. And only seven states were sufficiently prepared to provide patients with vaccines and antidotes from the national stockpile.
Segal said the lack of preparedness is tied the America's ignorance of health emergencies prior to the Sept. 11, 2001, terrorist attacks. Now state and federal lawmakers are playing catch-up — a difficult task because safeguarding against pandemics and terrorist attacks is time-consuming and expensive, she said.
To offset the cost, the U.S. Health and Human Services Department in January gave $100 million to state and local governments to prepare for pandemics. Each state received at least $500,000 and is expected to develop state pandemic plans by the summer. A federal strategy to deal with flu pandemics is expected soon.
Much of the national concern is centered on avian flu , a deadly virus found in animals, mostly birds, that has begun infecting a small number of humans. Once largely limited to Southeast Asia, human cases of the disease have spread to the Middle East and Africa. The World Health Organization is reporting 194 human cases of avian flu in nine countries; 109 patients have died as of April 12.
In response to avian flu worries, states last year redoubled efforts to improve emergency health and acquire vaccines and anti-viral medication. The movement builds on strides states have taken since 2001.
"A lot of public health departments had rotary phones and didn't have fax machines before Sept. 11," Segal said. Now all are connected through the Health Alert Network , an online system that sends emergency information to healthcare providers nationwide.
Leading the effort are states such as Delaware, South Carolina and Virginia. All three were proficient in eight of the 10 emergency areas identified by the Trust for America's Health. They outpaced states such as Alabama, Alaska, Iowa and New Hampshire, which were at the bottom of state preparedness rankings.
Emily Falone, chief of public health preparedness in Delaware, said her state has been able to prepare for health emergencies by basing their responses on U.S. Army tactics that emphasize "large and rapid deployment," she said.
In addition, the Delaware legislature has funded avian flu research at the University of Delaware and paved the way to license out-of-state health-care personnel in an emergency. Now health officials are pushing Delaware to protect volunteer health-care workers from lawsuits when these providers — often doctors or nurses who have retired or switched careers — are called to serve in an emergency.