Key Objectives:
- Introduce CDC’s Unexplained Respiratory Diseases Outbreak (URDO) working group and available resources
- Discuss existing barriers and needs of local and state health departments conducting investigations of respiratory disease outbreaks due to unexplained etiologies
- Identify potential gaps and explore how CDC’s URDO working group and website could be a better resource to local and state health departments conducting respiratory outbreak investigations
Brief Summary:
Although critical to effective disease control, identifying the etiology of respiratory disease outbreaks is often challenging. Reasons include: diversity in the potential causes, including viruses, bacteria, fungi and noninfectious agents; non-specific presenting signs and symptoms; challenges in obtaining appropriate specimens for diagnostics; and limitations in local diagnostic capacities. The Centers for Disease Control and Prevention’s (CDC) Unexplained Respiratory Disease Outbreak (URDO) working group is a multidisciplinary team composed of epidemiologists and microbiologists with expertise in infectious and noninfectious respiratory diseases, environmental health, and infection control. The URDO working group seeks to be efficient and effective when assisting local, state, and international public health officials in investigating unexplained respiratory disease outbreaks. CDC’s URDO website also provides tools for local use in respiratory outbreak investigations. From 2007–2016, the working group assisted with approximately 100 URDO investigations (70% in the United States). In addition to providing telephone or email consultation, other support included conference calls with the working group (70%), laboratory testing (80%), and assistance with on-site epidemiologic investigations (14%). Of the 54 URDO investigations with available laboratory diagnostic information, a laboratory-confirmed etiology was determined in 83%, the most common being Mycoplasma pneumoniae (18%), influenza viruses (18%), and non-influenza respiratory viruses (31%). Although CDC’s URDO working group and website were established more than 10 years ago and have helped successfully identify an etiology in many outbreaks, these resources are likely underutilized; the number of requests for assistance has declined in recent years and few public health personnel may be familiar with this resource. In addition, CDC is often consulted late in local outbreak investigations, hindering efforts to identify the cause and implement appropriate interventions. In this roundtable discussion, we intend to explore ways to improve awareness of CDC’s URDO working group, increase our understanding of the needs of the state and local partners conducting respiratory outbreak investigations of unknown etiology, identify potential gaps in available resources, and develop a plan to improve the usefulness of the working group and tools available through the URDO website.