State and local public health departments are on the front lines for detecting, responding and organizing recovery from the consequences of pandemic flu, terrorism, natural disasters, infectious disease outbreaks and other health emergencies.  State and local agencies operate detection systems that identify unusual patterns of disease and injury.  Epidemiologists at these agencies have expertise and resources to quickly respond to reports of unusual or unexplained illnesses. 

Multidrug-resistant tuberculosis (MDR TB) and extensively drug resistant tuberculosis (XDR TB) are growing threats to the health of residents in the United States. MDR TB is resistant to two of the most commonly used drugs to treat the disease. XDR TB is resistant to almost all of the drugs used to treat TB, which means it can be virtually untreatable and fatal.

Cases of XDR TB have been found in every region of the world, including the U.S. Because airplanes make it easier to travel to places where the disease is more prevalent, such as Africa, both forms of tuberculosis pose a potential threat in this country. State legislators may need to evaluate quarantine laws and emergency preparedness measures to see if their state is ready for a potential outbreak of MDR or XDR TB.

Here are some helpful resources from the CDC to help legislators understand more about tuberculosis:

• Basic information about XDR TB and its history
• Fact sheets on MDR TB
• TB Elimination: Now is the Time!  – Information about what TB is, who it affects and what is needed to fight TB in the U.S.
• Guidelines for Preventing the Transmission of Mycobacterium tuberculosis in Health Care Settings, 2005

Flu.gov is a one-stop Web site for federal information on seasonal and pandemic flu activities. The broad national response to H1N1 flu includes encouraging people to follow good hygiene to avoid infection and to be vaccinated. For more information, see: Q&A and PowerPoint about the H1N1flu and how to protect yourself and your family, federal government preparations and the role of vaccines in preventing spread of the flu. Flu.gov includes checklists for state and local governments, communities, individuals, businesses, work places and schools. School closing decision tools for local school districts to use during the 2009-2010 school year, depending on the severity of flu conditions in each community.  New guidelines for businesses to prepare for the possible impact of the flu on their employees this fall. Diagnostic tests for H1N1 flu are being developed and vaccines to prevent H1N1 infection are being distributed.  The groups that should receive the vaccine first have been identified by expert advisors to the Centers for Disease Control and Prevention. These include including pregnant women, children 6 months through 4 years of age, children 5 through 18 years of age who have chronic medical conditions, and those who live with or care for children younger than 6 months of age or are medical services workers with direct patient contact. The elderly over age 65 should receive the seasonal flu vaccine as early as possible this year. Each state’s program preparations for seasonal and H1N1 flu, including the share of the $350 million grants to states and hospitals for pandemic flu planning and preparation released by the CDC in July. All states have antiviral drugs and supplies from the strategic national stockpile. Flu maps indicate the geographic spread of influenza in the U.S.   The Association of State and Territorial Health Officials’ resources include links to each state's department of public health. The World Health Organization, which coordinates the global response, and the Pan American Health Organization provide updates on the spread of the H1N1 flu internationally.