One Year into Ebola: A Look Back at the First Case Diagnosed in the U.S. and the Subsequent Public Health Response

EbolaOne year ago, on September 30, 2014, the CDC announced the first case of Ebola diagnosed in the United States in a person who traveled to Dallas from Liberia. In the following months, local health departments, in coordination with many other federal, state, and local organizations, developed preparedness plans to respond to the emerging threat of Ebola on U.S. soil.

Since then, local health departments in Dallas and New York City responded to cases of Ebola in their communities, while countless other local health departments worked with partners to identify Ebola treatment centers and assessment hospitals, supported hospitals with Ebola isolation units, and monitored potentially exposed incoming travelers and returning healthcare workers. Stakeholders at the federal, state, and local levels have provided leadership, funding, information, and expertise to monitor and minimize the domestic impact of Ebola. Even today, the threat of Ebola in the United States lingers as healthcare workers in West Africa continue to treat patients and work to get the number of Ebola infections to zero.

The ongoing Ebola outbreak in West Africa is the largest in history, primarily impacting the countries of Guinea, Liberia, and Sierra Leone. According to CDC, “over the span of a year, the Ebola epidemic has caused more than 10 times as many cases of Ebola than the combined total of all those reported in previous Ebola outbreaks.” The response, in turn, has been and continues to be unprecedented. The global nature of this outbreak called for a worldwide response, and here in the United States, organizations are still working tirelessly to ensure the health and safety of American communities.

Emerging infectious diseases such as Ebola pose continual threats domestically and internationally – the recent outbreaks of Legionnaires’ disease in New York and the Middle East Respiratory Syndrome outbreak in South Korea are two other examples. Assessing the domestic response to Ebola is critical to understanding how the public health system performed, identifying opportunities for improvement, and taking actions to better prepare for future outbreaks. The CDC, recognizing this, provided support for a two-day meeting hosted by NACCHO and the Association of State and Territorial Health Officials (ASTHO) in early August 2015 near Washington, D.C. to gather representatives from over 50 organizations involved in the domestic response to Ebola.

Participants spanned from epidemiologists on the ground providing real-time monitoring of the disease to health officials who served as the “face” of the response in their respective jurisdictions. Many representatives came from state and local health departments and were often their communities’ frontline responders, facilitating communication and coordination between the various levels and types of operations. Other governmental and non-profit organizations were in attendance and represented an array of sectors engaged in the Ebola response, including public health laboratories, hospitals and health systems, and public safety partners.

Four main topics were discussed over the two-day meeting, which included the following:

  • Administrative preparedness explored the fiscal, legal, and administrative aspects of the response to better understand how efforts can be streamlined, as well as modified to increase accountability.
  • Public health preparedness systems addressed the infrastructure required for an effective response, such as healthcare, public health, and community partnerships; transportation; and decontamination.
  • Epidemiology, infection control, and laboratory systems focused on the more clinical aspects of the response, such as screening and monitoring, managing persons under investigation, and testing specimens; and
  • Communications concentrated on messaging for the public, information for providers, and coordination between entities.

By gathering feedback and ideas on these four main topics, NACCHO and ASTHO will identify actionable recommendations for federal, state, and local organizations, as well as other partners, to improve future preparedness efforts and responses to infectious disease outbreaks. A summary of the meeting will be shared by NACCHO and ASTHO before the year’s end detailing major themes and next steps.

Were you involved in the domestic response to Ebola? Share your story with us by e-mailing or let us know in the comments section below. Click here to learn more about the importance of local health departments in the Ebola response and read stories from local health departments about their response to Ebola.

About Sara Chang

Sara Chang is a senior program analyst for NACCHO’s Infectious Disease team. She works with local health departments on such topics as emerging infectious diseases, infectious disease prevention and control, and healthcare-associated infections. Twitter: @changsara

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