Do you think the CDC/Government did a good job on tracing the meningitis outbreak?

I know someone who has been officially informed that her shots from that lab, and is waiting to hear if the lot numbers are from the bad batch. I think they should have been able to narrow it down by now, so there wouldn’t be this interim period of stress in not knowing—but I don’t know if that’s the lab, the CDC or the clinic that is responsible for the delay.

Sure sounds like it to me. They seem to be pretty good at finding obscure connections between people who have the same illness.

Be on the receiving end of a recent steroid shot and tell me what you think.

Yes, I do. I just hope that there is the will in Congress to follow up on regulating compounding pharmacies.

I am trying to think of anything the government does well, unless lusting for power, priviledges and perks is regarded as a skill.

Yes, I believe so. Generally I find doctors (not CDC doctors, I mean your personal doctor) to not be vigilent enough sometimes in these sort of things, but the CDC and FDA usually investigate and get the word out fairly well. This story did not get the media attention of say something like H1N1 so I think some people feel not enough has been done. H1N1 was actually blown way out of proportion by the media.

Before this thread turns into an anti-government rant, can someone outline the criteria that they are using to determine the answer to the original question? What kind of data are they using to measure how outbreaks are monitored? How much experience do we (people of fluther) have evaluating this type of thing?

My mother worked for the FDA for many years. Things like the flu for instance they track as it moves across the world. Maps of the outbreaks and how the numbers climb. Lots of it comes across on Alaskan cruises LOL. But, now those cruises take more precautions. Anyway, when there is an outbreaks of some sort, generally the CDC and FDA care about and do track these things. It doesn’t mean they don’t screw up or miss sometimes, but they are pretty vigilent about contagious disease. Other types of illness I would not say our government or medical system is always so great about. I would think it would take a little time to narrow down that someone became ill from a steroid shot.

@tom_g Yes – I was wondering too how in hell we could have an informed opinion.

There used to be a TV show about people who worked for a medical investigative service. It showed them tracking illnesses and such. I loved that show. I would like to see a documentary on how this latest one was tracked.

My training is as an epidemiologist (same as the folks at the CDC who do this kind of detective work). My observations and comments are thus:

Meningitis incubation periods can range from 2 days to 2 weeks depending on the causative organism. So, first the “cases” must be diagnosed. Each state has its own list of what are termed “reportable diseases.” On each state’s list are requirements for how quickly each of these diseases must be reported to the local health department (for meningitis, I did a quick look at a couple of states and it is usually by the end of the next business day after receiving lab results that confirm or suggest meningitis (again, there are some variations depending on the type of causative organism). Then the local health department needs to report the case(s) to the state health department.

So far we have to account for the time it takes to 1) incubate the disease, 2) diagnose a case, 3) get lab results, 4) get lab results to the local health department, and 5) get information from the local health department to the state health department.

This all has to happen for anyone reports anything to the CDC. The CDC’s list of reportable diseases is updated regularly and can be found here The lab results will trickle in from the states to the CDC. There are set thresholds for the anticipated number of cases for any disease and when this threshold is exceeded, then epidemiologists at the CDC will start their detective process. These thresholds range from immediate action for a single case of something like yersinia pestis (plague) or smallpox to the requirement of more cases for diseases with greater expected likelihood of happening. Keep in mind that state-level epidemiologists are often already starting their own investigation if they are seeing an unusual number of cases in their region.

This is what gets the process started. Then the detective work can take days to begin to tie together the loose threads to begin to see the pattern. The epidemiologists have questionnaires that they use to ensure that they are capturing the same information about each case so that these data can be compared. Once it has been determined that “all these people ate the potato salad at the picnic” or “all of these people received compounded steroid products through injections into the spine,” then, in the case of a tainted drug, the FDA would be called in to start looking at lot numbers and sources for the drug.

I think the CDC and the FDA did a terrific job in this latest situation. There are so many variables that have to be considered and, often, a great deal of time elapses before the CDC is even notified of the potential problem. They have teams that are ready to get on a plane at a moment’s notice to go track down potential disease causing agents and have established mechanisms for communicating potential problems to local healthcare practitioners to help ensure that every case is identified to the extent possible.

I was wondering how to respond to the knuckle-dragging oafishness of some of the answers (‘ook, ook, gubmint no good, skreek!’), when along comes this better than great answer by Kayak8: informed, literate, and sharing. There might just be hope yet.

Again, a salutary and most commendable answer.