This article summarizes what is currently known about the 2019 novel coronavirus and offers interim guidance.

The ability to predict how different individuals will respond to vaccination and to understand what best protects individuals from infection greatly facilitates developing next-generation vaccines. It facilitates both the rapid design and evaluation of new and emerging vaccines and identifies individuals unlikely to be protected by vaccine. We describe a general-purpose machine-learning framework, DAMIP, for discovering gene signatures that can predict vaccine immunity and efficacy. DAMIP is a multiple-group, concurrent classifier that offers unique features not present in other models: a nonlinear data transformation to manage the curse of dimensionality and noise; a reserved-judgment region that handles fuzzy entities; and constraints on the allowed percentage of misclassifications. Using DAMIP, implemented results for yellow fever demonstrated that, for the first time, a vaccine's ability to immunize a patient could be successfully predicted (with accuracy of greater than 90 percent) within one week after vaccination. A gene identified by DAMIP, EIF2AK4, decrypted a seven-decade-old mystery of vaccination. Results for flu vaccine demonstrated DAMIP's applicability to both live-attenuated and inactivated vaccines. Results in a malaria study enabled targeted delivery to individual patients. Our project's methods and findings permit highlighting and probabilistically prioritizing hypothesis design to enhance biological discovery. Moreover, they guide the rapid development of better vaccines to fight emerging infections, and improve monitoring for poor responses in the elderly, infants, or others with weakened immune systems. In addition, the project's work should help with universal flu-vaccine design. © 2016 INFORMS.

In response to the 2014-2016 Ebola virus disease (Ebola) epidemic in West Africa, CDC prepared for the potential introduction of Ebola into the United States. The immediate goals were to rapidly identify and isolate any cases of Ebola, prevent transmission, and promote timely treatment of affected patients. CDC's technical expertise and the collaboration of multiple partners in state, local, and municipal public health departments; health care facilities; emergency medical services; and U.S. government agencies were essential to the domestic preparedness and response to the Ebola epidemic and relied on longstanding partnerships. CDC established a comprehensive response that included two new strategies: 1) active monitoring of travelers arriving from countries affected by Ebola and other persons at risk for Ebola and 2) a tiered system of hospital facility preparedness that enabled prioritization of training. CDC rapidly deployed a diagnostic assay for Ebola virus (EBOV) to public health laboratories. Guidance was developed to assist in evaluation of patients possibly infected with EBOV, for appropriate infection control, to support emergency responders, and for handling of infectious waste. CDC rapid response teams were formed to provide assistance within 24 hours to a health care facility managing a patient with Ebola. As a result of the collaborations to rapidly identify, isolate, and manage Ebola patients and the extensive preparations to prevent spread of EBOV, the United States is now better prepared to address the next global infectious disease threat.The activities summarized in this report would not have been possible without collaboration with many U.S. and international partners (http://www.cdc.gov/vhf/ebola/outbreaks/2014-west-africa/partners.html).

Public health experts agree that the best strategy to contain a pandemic, where vaccination is the prophylactic treatment but vaccine supply is limited, is to give higher priority to higher-risk populations. We derive a mathematical decision framework to track the effectiveness of prioritized vaccination through the course of a pandemic. Our approach couples a disease-propagation model with a vaccine queueing model and an optimization engine to determine optimal prioritized coverage in a mixed-vaccination strategy. This demonstrably minimizes infection and mortality. Given estimated outbreak characteristics, vaccine inventory levels, and individual risk factors, the study reveals an optimal coverage for the high-risk group that results in the lowest overall attack and mortality rates. This knowledge is critical to public health policy makers for determining the best strategies for population protection. This becomes particularly important in determining when to switch from a prioritized strategy emphasizing high-risk groups to a nonprioritized strategy in which the vaccine becomes available publicly. Our analysis highlights the importance of uninterrupted vaccine supply. Although the 2009 H1N1 supply, received in interrupted batches, eventually covered over 30 percent of the population, the resulting attack and mortality rates are significantly inferior to those in a scenario where only 20 percent of the population is covered with an uninterrupted supply. We also learned that early vaccination is important. Contrasting the 2009 H1N1 supply to a 10 percent uninterrupted supply, a three-week delay in vaccination reduces the 9.9 percent infection reduction of the former to a mere 0.9 percent. The optimal trigger for switching from prioritized to nonprioritized vaccination is sensitive to infectivity and vulnerability of the high-risk groups. Our study further underscores the importance of throughput efficiency in dispensing and its effects on the overall attack and mortality rates. The more transmissible the virus is, the lower the threshold for switching to nonprioritized vaccination. Our model, which can be generalized, allows the incorporation of seasonality and virus mutation of the biological agents. The system empowers policy makers to make the right decisions at the appropriate time to save more lives, better utilize limited resources, and reduce the health-service burden during a pandemic event.

The U.S. Department of Health and Human Services (HHS), CDC, other U.S. government agencies, the World Health Organization (WHO), and international partners are taking multiple steps to respond to the current Ebola virus disease (Ebola) outbreak in West Africa to reduce its toll there and to reduce the chances of international spread. At the same time, CDC and HHS are working to ensure that persons who have a risk factor for exposure to Ebola and who develop symptoms while in the United States are rapidly identified and isolated, and safely receive treatment. HHS and CDC have actively worked with state and local public health authorities and other partners to accelerate health care preparedness to care for persons under investigation (PUI) for Ebola or with confirmed Ebola. This report describes some of these efforts and their impact.

The commentary describes the role of the Centers for Disease Control and Prevention's National Public Health Improvement Initiative in advancing health department accreditation readiness activities. | For more than 2 decades, the Institute of Medicine has drawn national attention to the need for strengthening the public health infrastructure and related capabilities to protect and ensure the public's health.1,2 A strong and sustainable public health infrastructure is critical for public health departments to operate efficiently and effectively in delivering the 10 essential public health services necessary to meet the health needs of communities. | In its 2003 report, The Future of the Public's Health in the 21st Century, the Institute of Medicine called for strengthening public health performance and exploring health department accreditation as a way to ensure that public health services and programs are efficient and effective in addressing the public health challenges of today and tomorrow.3 Four years later and with support from the Centers for Disease Control and Prevention (CDC) and the Robert Wood Johnson Foundation, the Public Health Accreditation Board (PHAB) was established and work began to develop a national program to improve the quality of practice and performance within public health departments. Based on the 10 essential public health services, PHAB accreditation provides a means for a health department to identify performance improvement opportunities, enhance management, develop leadership, and strengthen community relationships; leading organizations to improved accountability, credibility, and better health outcomes. The program was successfully launched in fall 2011, and the first 11 PHAB-accredited public health departments were announced in March 2013, with many more health department applications in process.4