particular sprouting firm was identified, recall recommendations would be issued for products, including other products made at that facility.

Quitugua noted the difficulty in some episodes of tracking the many kinds of information that are relevant. Agencies may craft exactly what they want to say, but as that information gets aggregated and summarized, the underlying messages can change.

Ackelsberg noted that a very similar process would be occurring at the state and local level as at the federal level. Jurisdictions would establish incident command centers so that they would be able to gather information and respond to questions as best as they can. Formal communications would be going up and down command structures, with informal communications across agencies. Public messaging would be a major focus with a disease like this that is contagious and can cause secondary infections. State and local public health departments would be working with their partners to find the source of the outbreak and stem its spread as quickly as possible.

Ackelsberg reiterated that a biosurveillance system already exists—at the local, state, and national levels—and it is being used every day. “This isn’t the time to start reducing the capacities of these systems that have been built up over the last 10 years with great investment. We are doing good work. That often goes unseen because it is just what we do every day.”



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