By Margaret A. Hamburg, M.D.
When there is a multi-state outbreak of illnesses, what federal agencies are doing in response is often the focus of attention. All too often, the dedicated efforts of countless other public servants at the state, county, and local levels aren't acknowledged as much.
As we all strive to resolve the tragic outbreak of fungal meningitis tied to contaminated steroid injections, I want to recognize the invaluable role of our colleagues across the country. These frontline public health officials at all levels of government work alongside the Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC) every day, and even more closely in times of crises.
State, county, and local health officials are often the first to hear about a problem and begin investigating. In this deadly outbreak of fungal meningitis, the alarm was first sounded by the Tennessee Department of Health. Tennessee has been one of the hardest hit in this outbreak. The Tennessee health department was told by a clinician on Sept. 18, 2012, about a patient with culture-confirmed Aspergillus meningitis