US shutdown threatens response to disease outbreaks

Viruses don’t take time off when a government shuts down.

That simple fact has scientists worried this week after the Centers for Disease Control and Prevention (CDC) sent home 68 per cent of its workers, just as the 2013-2014 flu season approaches and dangerous infectious diseases are looming in several countries around the world.

The shutdown and resultant freezing of government funding comes as a result of a budgetary stand-off between political factions in Congress about whether to approve funding for a new national healthcare system.

“They protected you yesterday, can’t tomorrow,” CDC Director Thomas Frieden tweeted on Tuesday of the 8,754 staff the agency was forced to send home.

Health officials at the state and local levels aren’t affected by the shutdown. They will continue to record flu cases as usual, but that information won’t be evaluated at the national level until the CDC receives a new infusion of funding.

Missed mutations

This will hinder researchers’ ability to track the uptick in illness that signals the start of the flu season. And without access to CDC labs to identify which strains of the virus are circulating, new mutations could be missed.

“This affects our capacity to see if the virus is mutating or whether we have unanticipated strains out there,” says William Schaffner at Vanderbilt University in Nashville, Tennessee, a former president of the National Foundation for Infectious Diseases.

And that could affect the deployment of vaccines later this season, which have to be well matched to circulating strains, as well as national response time to new viruses.

“What if H7N9 sharply rears its head and enters the country?” Schaffner says, referring to the deadly strain of avian flu discovered in China earlier this year.

For now the virus has shown only limited transmission among humans – but that could change.

Freeing disease

“We’re removed some federal government functions and the only freedom we have gained is the freedom to have more disease,” Schaffner says. “Right now we’re feeling our way in the dark.”

If the shutdown drags on for long, it could also threaten communication with the international health community, says Marc Lipsitch, an epidemiologist at the Harvard School of Public Health.

“In terms of international public health threats including H7N9 and MERS, there just aren’t people at the CDC who can communicate with their colleagues in other countries right now because they aren’t allowed to come to work,” he says.

World Health Organization officials declined comment on the government shutdown, because the institute does not provide statements on “US political issues”.

But the chairman of Public Health England David Heymann, a former head of the WHO’s Health Security and Environment division, says that if the shutdown were long term, it could jeapardise US funding to the WHO’s polio eradication efforts and the Global Disease Detection programme.