By Chris Adams

In an age of sustained medical advances, it might be surprising that prosperous countries such as the United States are still grappling with diseases long thought extinguished.

Yet that’s the reality faced by the Centers for Disease Control and Prevention, the nation’s premier public health agency. The Atlanta-based CDC is the go-to agency for efforts to monitor – and help prevent – outbreaks of diseases such as measles, which has made an unfortunate return to the United States.

In a session with National Press Foundation fellows, Dr. Jay Butler, the CDC’s deputy director for infectious diseases, described the CDC’s surveillance efforts, which help the agency spot disease outbreaks before they spread even more. Butler, who previously led public health efforts at the state level in Alaska, also gave a brief history of vaccinations in the U.S. – from smallpox in colonial times to measles, mumps, chickenpox and a range of diseases today. He also detailed two dozen vaccine-preventable diseases that are subject to either routine or specific-exposure vaccinations.

Butler’s understanding of public health at the state level helps guide his federal actions. The CDC is not the national public health authority; that power rests at the state and county level.

“It is an enterprise where we all work together,” he said.

Consider efforts on influenza. During the 2018-19 flu season in the U.S., there were about 40 million flu illnesses, nearly 20 million flu medical visits, more than 500,000 hospitalizations and between 36,000 and 61,000 deaths.

Butler described the worldwide network that detects new strains of flu and how U.S. and World Health Organization officials determine the vaccine for the following season’s flu.

“It’s important to remember that if you’ve seen one flu season you’ve seen one flu season,” he said. “Every flu season is different.”

He also detailed vaccine coverage for flu and other diseases; flu coverage has been gradually rising in the past two decades, but it’s far from complete: Those 65 and older have the highest vaccination rate of any other age or risk group, but it’s still just 70 percent.