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Nebraska scored a 7 out of 10 in a new report that grades states on their preparedness for handling disease outbreak.

The report from the Trust for America’s Health and the Robert Wood Johnson Foundation scored states on 10 criteria related to preventing, detecting, diagnosing and responding to outbreaks.

Nebraska was one of 11 states to score 7 or above. Delaware, Kentucky, Maine, New York and Virginia tied for the highest score of 8.

In last place were Idaho, Kansas, Michigan, Ohio, Oklahoma, Oregon and Utah, which all scored 4.

The three areas in which Nebraska fell short include having a syringe exchange program to battle Hepatitis C infections, which are on the rise with injection drug users; having a state climate change adaption plan for infectious disease; and failing to show an annual decrease in the rate at which people are hospitalized for contracting health-care-associated infections.

The report features a laundry list of recommendations to help America deal with illness-causing pathogens including increasing resources to help states maintain basic modern disease control and laboratory capabilities; development of disease surveillance and tracking systems; decreasing antibiotic overuse; and increasing vaccination rates.

The best offense for fighting disease is a strong defense, the study said. The United States needs a consistent baseline of medical capabilities to meet ongoing health issues and the next merging threat.

It takes constant vigilance, the report says. Public health and medical experts need the support of lawmakers and government agencies to deal with ongoing outbreaks such as HIV and AIDS, antibiotic-resistant superbugs, the flu and food-borne illnesses, as well as detect new and emerging outbreaks.

American investment in fighting infectious disease has been inconsistent. The dollars tend to flow when new threats catch politicians’ attention but then ebbs as the problem seems contained.

When the Ebola outbreak dominated the news, emergency funding helped backfill gaps in health-care providers’ ability to respond. But lags in getting the dollars out meant some support came too late to address the immediate needs of states and Africa, the report says.

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On a public policy level, those funding infectious disease programs – overwhelmingly, the federal government -- must get beyond a narrow fear of Hollywood-worthy outbreaks and get down to the business of preventing and controlling ongoing disruptive diseases like HIV, Hepatitis C and antimicrobial resistant infections, said Jeffrey Levi, executive director for Trust for America’s Health, in a conference call with reporters.

“If we do that we’ll not only reduce the rate of persistent problems we’ll also be able to better respond when a new threat emerges,” Levi said.

University of Nebraska Medical Center Professor and Chief of Infectious Diseases Mark Rupp said Nebraska has come a long way in medical professionals’ ability to detect, analyze and report infectious diseases, but there remains work to be done.

But rather than staying awake at night worrying about a doomsday outbreak of a new disease or a zombie apocalypse, Nebraskans should be focused on garden-variety things that cause illness and death on a daily basis, Rupp said.

“One of big concerns we continue to have throughout our infection control program are antimicrobial resistant pathogens," he said. "More can be done to prevent their emergence through wise use of antibiotics.”

He also said funding to help hospitals handle large-scale emergencies should be a public health priority because that redundancy of services is something hospitals don’t have the resources to build on their own.

Reach the writer at 402-473-7304 or nbergin@journalstar.com. Follow him on Twitter at @ljsbergin.

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