Two weeks into the government shutdown, flu season is about to ramp up. And without full-scale infectious-disease surveillance by the Centers for Disease Control and Prevention, experts said, health consequences for the nation could range from unsettling to disastrous.

Normally, the CDC monitors influenza outbreaks across state lines. The agency continually analyzes circulating strains to detect the potential for brewing pandemics. And if there is any sign that a mutant virus is particularly virulent or has developed resistance to antiviral drugs, the CDC spreads targeted public health messages, develops new vaccines or takes other actions.

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Now, little of that real-time vigilance is happening. The website that usually reports state-by-state cases, hospitalizations and deaths from the flu has not been updated since the shutdown began.

“Without CDC activity, which analyzes all of the information and feeds it back to everyone who needs to know, we’re flying blind,” said William Schaffner, an infectious disease specialist at Vanderbilt University’s School of Medicine in Nashville. “The government may be closed. But the virus is not.”

Every year, the fight against the flu begins many months before the virus begins its annual march through the population, starting as early as October. By closely watching which strains are circulating around the world from month to month, the CDC leads the way in developing a seasonal vaccine that aims to protect people from what is predicted to be spreading through schools and workplaces all winter long.

So far, this year’s vaccine appears to be a good match to the virus that is just beginning to infect people around the United States. And there's plenty of vaccine to go around.

But it’s still extremely early in the season, and influenza is a volatile family of viruses that change constantly. Without notice, a new strain can become especially infectious and spread rapidly -- a risk that increases as the season wears on.


“If there’s one thing I’ve learned in 30 years of working with this, it’s that it’s a fickle, fickle virus,” said Greg Poland, director of the Mayo Clinic's Vaccine Research Group in Rochester, Minn. “It’s the unpredictability of this illness that requires worldwide monitoring.”

When the CDC is up and running, Schaffner said, it's like the conductor of a finely coordinated influenza orchestra. Monitoring of the number and severity of illnesses begins at the local and state level, but all of that data gets sent to the CDC, which looks for alarming patterns or signs of emerging pandemics.

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That happened in 2009, when an outbreak of H1N1 swine flu prompted the CDC to develop and promote an additional vaccine. Last year, the agency noticed severe pockets of influenza in specific parts of the country, which helped it target public health messages and resources.

“Anything can happen,” Schaffner said. “That’s why you need that constant surveillance.”

And it’s not just the flu that has the potential to cause major problems during the current shutdown. The CDC plays an essential role in monitoring infectious diseases like measles and polio, as well as foodborne pathogens, like an ongoing salmonella outbreak that has sickened hundreds of people around the country. Careful surveillance is the only way to link cases in different states or countries as the same emerging problem.

The federal government is also responsible for conducting routine inspections of high-security labs that investigate extremely dangerous pathogens like ebola viruses.

Without a full staff at work, the potential for health crises to develop will only escalate.

The CDC has “furloughed two-thirds of their employees and only have 4,000 people working -- that’s a skeleton crew,” Poland said. “It does put the nation at some risk.”