Outbreaks and emerging infectious diseases pose a serious threat to our health care system.

Known infectious diseases can quickly rise to an outbreak level, and new threats can arise suddenly. Lapses in preparedness can leave communities unnecessarily vulnerable. Below are resources to help hospitals, health care coalitions and other organizations prepare for and respond to the diseases that are currently a threat to our world.

The CDC maintains a list of current outbreaks in which they are monitoring and reporting in the U.S. and internationally. 

Mpox

There currently is a global outbreak of mpox affecting multiple countries in which the disease is not endemic, including the U.S. Mpox is a rare disease that is caused by infection with the mpox virus, which belongs to the Orthopoxvirus genus in the family Poxviridae. The Orthopoxvirus genus also includes variola virus (which causes smallpox), vaccinia virus (used in the smallpox vaccine) and cowpox virus.

Mpox is considered an immediately reportable disease in the State of Missouri. To report a suspected case, hospitals and clinics should contact their local public health agency or the Missouri Department of Health and Senior Services’ Bureau of Communicable Disease Control and Prevention at 573-751-6113 or 800-392-0272 (24/7).

The Missouri State Public Health Laboratory will perform an orthopox test, and if it is confirmed positive, specimens will be submitted to the CDC for testing. Instructions for submitting specimens for testing are available.

Situational Awareness

• •  U.S. Mpox Outbreak 2022: Situation Summary
  • Map of Global Outbreak with Case Counts
  • Travel Notice – Level 2-Practice Enhanced Precautions
  • WHO Mpox Outbreak Information

Ebola

Based on current guidance for evaluating persons with Ebola, if an individual is found to be at risk, then the specified infection control measures must immediately be instituted, and hospital leadership, along with state and local public health officials, must immediately be notified. It is very important that these steps be consistently followed in all emergency departments. To report a suspected Ebola patient call the Missouri Department of Health and Senior Services at 573-751-6113 or 800-392-0272 (24 hours a day/seven days a week), and call your local public health agency. Please follow the steps below for patients who present with symptoms and have recently traveled from Uganda.

• Patients should be placed in an airborne isolation room, if available, and appropriate PPE should be worn during the evaluation process.
• Hospitals and clinics that identify possible EVD patients should first call either their Local Public Health Department or the DHSS Emergency Resources Center at 573-751-5152 or 800-392-0272.
• Prior consultation with CDC is required before shipping a specimen to CDC for Sudan virus testing. All specimens collected from patients with suspected EVD must be shipped Category A as a nonselect agent.
• There is no FDA-licensed vaccine or treatment for Sudan virus, but MBP134, an experimental antibody cocktail therapy, has demonstrated efficacy in nonhuman primates. Supportive treatment can improve chances of survival when provided early.

Highly Pathogenic Avian Influenza

Highly Pathogenic Avian Influenza (HPAI, Avian Flu, H5N1) remains a concern that is closely being monitored at the state, regional and national levels. With continued mutation, this virus could become transmissible from human to human, causing a large outbreak. A vaccine has already been developed but is not currently available.

Presently, this virus is rapidly spreading throughout both domestic and wild animal populations, including a variety of mammals. The greatest impacts can be seen in dairy cattle and poultry flocks. This disease is fatal to poultry flocks and requires the culling of infected and exposed animals to prevent the spread. While multiple outbreaks among dairy cows have been noted, and at least one worker infected, confidence remains in the pasteurization process of dairy products. The gastric environment may protect against this virus. The FDA and CDC warn against the use of raw milk.

This virus is difficult to detect in humans as it mimics other viral illnesses, and to date, the symptoms have not been severe. The course of action recommended at this time is the familiar Identify – Isolate – Inform strategy.

• Identify – Does the patient show signs of viral illness and spend significant time around commercial animal endeavors or has backyard poultry flocks that are also not well?
• Isolate – Use appropriate PPE, as with all potential patients with viral illness, and obtain appropriate lab tests.
• Inform – If the patient comes back negative for common RVI or viral illness panels, notify local public health or DHSS 24/7 about the possible need for additional testing.

Additional HPAI information, including ongoing situational awareness and clinical information on testing and treatment, is available from the CDC.