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Public Health Resilience Checklist for High-Consequence Infectious Diseases—Informed by the Domestic Ebola Response in the United States

Sell, Tara Kirk, PhD; Shearer, Matthew P., MPH; Meyer, Diane, MPH; Chandler, Hannah, BS; Schoch-Spana, Monica, PhD; Thomas, Erin, PhD; Rose, Dale A., PhD; Carbone, Eric G., PhD; Toner, Eric, MD

Journal of Public Health Management and Practice: November/December 2018 - Volume 24 - Issue 6 - p 510–518
doi: 10.1097/PHH.0000000000000787
Research Reports: Research Full Report

Context: The experiences of communities that responded to confirmed cases of Ebola virus disease in the United States provide a rare opportunity for collective learning to improve resilience to future high-consequence infectious disease events.

Design: Key informant interviews (n = 73) were conducted between February and November 2016 with individuals who participated in Ebola virus disease planning or response in Atlanta, Georgia; Dallas, Texas; New York, New York; or Omaha, Nebraska; or had direct knowledge of response activities. Participants represented health care; local, state, and federal public health; law; local and state emergency management; academia; local and national media; individuals affected by the response; and local and state governments. Two focus groups were then conducted in New York and Dallas, and study results were vetted with an expert advisory group.

Results: Participants focused on a number of important areas to improve public health resilience to high-consequence infectious disease events, including governance and leadership, communication and public trust, quarantine and the law, monitoring programs, environmental decontamination, and waste management.

Conclusions: Findings provided the basis for an evidence-informed checklist outlining specific actions for public health authorities to take to strengthen public health resilience to future high-consequence infectious disease events.

Johns Hopkins Center for Health Security, Baltimore, Maryland (Drs Sell, Schoch-Spana, and Toner, Mr Shearer, and Mss Meyer and Chandler); Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (Drs Sell, Schoch-Spana, and Toner, Mr Shearer, and Ms Meyer); and Office of Public Health Preparedness and Response, US Centers for Disease Control and Prevention, Atlanta, Georgia (Drs Thomas, Rose, and Carbone).

Correspondence: Tara Kirk Sell, PhD, Johns Hopkins Center for Health Security, 621 E. Pratt St, Ste 210, Baltimore, MD 21202 (

This work was supported by the Centers for Disease Control and Prevention (CDC) through research contract 200-2015-M-87759. The content is solely the responsibility of the authors and does not necessarily represent the official views of the Centers for Disease Control and Prevention.

The authors acknowledge Ryan Fagan, MD, and J. Todd Weber, MD, of CDC's National Center for Emerging & Zoonotic Infectious Disease (NCEZID) for their expert review and helpful input on this article.

The authors declare no conflicts of interest.

Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.