Cost Analysis of Prevention Research Centers: Instrument Development.

The 2014-2019 Prevention Research Centers (PRC) Program Funding Opportunity Announcement stated that "all applicants will be expected to collaborate with CDC to collect data to be able to perform cost analysis." For the first time in the 30-year history of the PRC Program, a cost indicator was included in the PRC Program Evaluation and a cost analysis (CA) instrument developed. The PRC-CA instrument systematically collects data on the cost of the PRC core research project to eventually answer the CDC PRC Program Evaluation question: "To what extent do investments in PRCs support the scalability, sustainability, and effectiveness of the outcomes resulting from community-engaged efforts to improve public health?" The objective of this article is to briefly describe the development of the PRC-CA instrument.

Secondary Infections with Ebola Virus in Rural Communities, Liberia and Guinea, 2014-2015.

Persons who died of Ebola virus disease at home in rural communities in Liberia and Guinea resulted in more secondary infections than persons admitted to Ebola treatment units. Intensified monitoring of contacts of persons who died of this disease in the community is an evidence-based approach to reduce virus transmission in rural communities.

Decreased Ebola Transmission after Rapid Response to Outbreaks in Remote Areas, Liberia, 2014.

We measured the reproduction number before and after interventions were implemented to reduce Ebola transmission in 9 outbreaks in Liberia during 2014. We evaluated risk factors for secondary cases and the association between patient admission to an Ebola treatment unit (ETU) and survival. The reproduction number declined 94% from 1.

Developing the Evidence Base to Inform Best Practice: A Scoping Study of Breast and Cervical Cancer Reviews in Low- and Middle-Income Countries.

Background: Breast and cervical cancers have emerged as major global health challenges and disproportionately lead to excess morbidity and mortality in low- and middle-income countries (LMICs) when compared to high-income countries. The objective of this paper was to highlight key findings, recommendations, and gaps in research and practice identified through a scoping study of recent reviews in breast and cervical cancer in LMICs.

Methods: We conducted a scoping study based on the six-stage framework of Arskey and O'Malley.

A Cost Analysis of the 1-2-3 Pap Intervention.

Background: Cervical cancer places a substantial economic burden on our healthcare system. The three-dose human papillomavirus (HPV) vaccine series is a cost-effective intervention to prevent HPV infection and resultant cervical cancer. Despite its efficacy, completion rates are low in young women aged 18 through 26 years.

Economic Evaluation Enhances Public Health Decision Making.

Contemporary public health professionals must address the health needs of a diverse population with constrained budgets and shrinking funds. Economic evaluation contributes to evidence-based decision making by helping the public health community identify, measure, and compare activities with the necessary impact, scalability, and sustainability to optimize population health. Asking "how do investments in public health strategies influence or offset the need for downstream spending on medical care and/or social services?" is important when making decisions about resource allocation and scaling of interventions.

Rapid response to Ebola outbreaks in remote areas - Liberia, July-November 2014.

West Africa is experiencing its first epidemic of Ebola virus disease (Ebola). As of February 9, Liberia has reported 8,864 Ebola cases, of which 3,147 were laboratory-confirmed. Beginning in August 2014, the Liberia Ministry of Health and Social Welfare (MOHSW), supported by CDC, the World Health Organization (WHO), and others, began systematically investigating and responding to Ebola outbreaks in remote areas.

Elective medical and veterinary student rotations in applied epidemiology at the Centers for Disease Control and Prevention, 1975-2012.

Context: Health professionals who can bridge the gap between public health and clinical medicine are needed. The Centers for Disease Control and Prevention Epidemiology Elective Program (EEP) offers a rotation in public health for medical and veterinary students that provides an introduction to public health, preventive medicine, and the principles of applied epidemiology through real-world, hands-on experiential learning.

Objective: To describe EEP, including its role in the integration of medicine and public health, and career paths for those who subsequently have enrolled in the Epidemic Intelligence Service (EIS).

Characterization of the federal workforce at the Centers for Disease Control and Prevention.

Context: Studies characterizing the public health workforce are needed for providing the evidence on which to base planning and policy decision making both for workforce staffing and for addressing uncertainties regarding organizing, financing, and delivering effective public health strategies. The Centers for Disease Control and Prevention (CDC) is leading the enumeration of the US public health workforce with an initial focus on CDC as the leading federal public health agency.

Objective: To characterize CDC's workforce, assess retirement eligibility and potential staff losses, and contribute these data as the federal component of national enumeration efforts.

Non-pharmaceutical interventions during an outbreak of 2009 pandemic influenza A (H1N1) virus infection at a large public university, April-May 2009.

Nonpharmaceutical interventions (NPIs), such as home isolation, social distancing, and infection control measures, are recommended by public health agencies as strategies to mitigate transmission during influenza pandemics. However, NPI implementation has rarely been studied in large populations. During an outbreak of 2009 Pandemic Influenza A (H1N1) virus infection at a large public university in April 2009, an online survey was conducted among students, faculty, and staff to assess knowledge of and adherence to university-recommended NPI.

Transmission of 2009 pandemic influenza A (H1N1) at a Public University--Delaware, April-May 2009.

We investigated the first documented university outbreak of the 2009 pandemic influenza A(H1N1) to identify factors associated with disease transmission. An online student survey was administered to assess risk factors for influenza-like illness (ILI), defined as fever with cough or sore throat. Of 6049 survey respondents, 567 (9%) experienced ILI during 27 March to 9 May 2009.

Notes from the field: outbreak of 2009 pandemic influenza A (H1N1) virus at a large public university in Delaware, April-May 2009.

Background: In late April 2009, the first documented 2009 pandemic influenza A (pH1N1) virus infection outbreak in a university setting occurred in Delaware, with large numbers of students presenting with respiratory illness. At the time of this investigation, little was known about the severity of illness, effectiveness of the vaccine, or transmission factors of pH1N1 virus infection. We characterized illness, determined the impact of this outbreak, and examined factors associated with transmission.

How should immunization rates be measured in the office setting? A study from PROS and NMA PedsNet.

The aim of the study was to compare the validity and reliability of 2 sampling methods for measuring immunization rates to a reference standard in a national sample of pediatric office practices. The consecutive method involved patients seen consecutively in the office for any reason; the random record was a random selection of medical records; and the reference standard active method, data of a randomly selected subgroup of children in the random record survey were supplemented with information from a telephone interview. The consecutive method of assessing immunization rates results in rates that are, on average, higher and closer to the reference standard, but also more variable.

Knowledge and awareness of congenital cytomegalovirus among women.

Background: Congenital cytomegalovirus (CMV) infection is a leading cause of disabilities in children, yet the general public appears to have little awareness of CMV.

Methods: Women were surveyed about newborn infections at 7 different geographic locations.

Results: Of the 643 women surveyed, 142 (22%) had heard of congenital CMV.

Severe acute respiratory syndrome in children.

Background: Severe acute respiratory syndrome (SARS) is a febrile, respiratory tract illness caused by infection with the newly identified SARS-associated coronavirus. A notable feature of the 2003 global SARS outbreak was the relative paucity of cases reported among children. We reviewed the epidemiologic and clinical features of SARS in children and discuss implications of these findings for diagnosis, treatment and prevention of SARS.

Churning in Medicaid managed care and its effect on accountability.

There is concern that churning in Medicaid excludes children from the accountability system for managed care because they may not meet the one-year continuous enrollment requirement. This study explores the effect of churning in measuring childhood immunization coverage rates under the current accountability system. Data were collected from administrative databases at the Centers for Medicaid and Medicare Services and 12 states with high Medicaid managed care penetration.

Vaccine coverage levels after implementation of a middle school vaccination requirement, Florida, 1997-2000.

Objective: Little information is available about the effectiveness of school entry vaccination requirements at the middle school level. This study examined coverage levels among students entering seventh grade in Florida following implementation of a school entry vaccination requirement in 1997.

Methods: The authors analyzed county-specific vaccination coverage levels (three doses of hepatitis B vaccine, a second dose of measles, mumps, and rubella [MMR] vaccine, and a booster dose of tetanus and diphtheria toxoids [Td]) among students entering public and private schools in Florida from 1997 through 2000.

An economic analysis of the current universal 2-dose measles-mumps-rubella vaccination program in the United States.

To evaluate the economic impact of the current 2-dose measles-mumps-rubella (MMR) vaccination program in the United States, a decision tree-based analysis was conducted with population-based vaccination coverage and disease incidence data. All costs were estimated for a hypothetical US birth cohort of 3803295 infants born in 2001. The 2-dose MMR vaccination program was cost-saving from both the direct cost and societal perspectives compared with the absence of MMR vaccination, with net savings (net present value) from the direct cost and societal perspectives of US dollars 3.