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CDC Firings, Including In Kansas City, Raise Fears About Disease Outbreak Response

The widespread upheaval at federal health agencies in the first month of the Trump administration comes at a time when the U.S. Faces infectious disease threats on multiple fronts: The ongoing spread of bird flu around the country; the risk of emerging insect-borne viruses; and a ballooning measles outbreak in the Southwest.

Abroad, there are new strains of mpox and deadly outbreaks of Ebola and polio just a plane ride away.

Recent mass firings, primarily aimed at new and temporary workers, have thinned the ranks of the workforce that would aid in the response to outbreaks at the Centers for Disease Control and Prevention, according to interviews with more than half a dozen current staff. They requested anonymity because they were not authorized to speak publicly.

The situation has infectious disease experts worried.

"This seems like the worst time to be taking steps to degrade our nation's preparedness," says Dr. David Fleming, a former CDC official who now chairs the agency's Advisory Committee to the Director. "They are greatly diminishing CDC and the country's ability to respond to emerging infectious threats."

Those who work at CDC tell NPR they're deeply concerned about the prospect of future job cuts, and the weakening of policies around vaccination. They also caution that restrictions around communication could hamper the agency's response to unfolding outbreaks.

"The big thing that's impacting us now is the demoralizing work environment, intentional chaos, uncertainty over our jobs," says one CDC staffer. "Outbreak responses are very stressful when you have all the available resources. To be on outbreak response now in this climate is a whole new level of complexity and stress."

Dr. Deblina Datta, an infectious disease physician who retired from the CDC in 2023 says "this is just a very dangerous period of time for our country because we are addressing threats on multiple fronts. In my 24 years at the CDC, I have never seen the morale hit that is going on right now."

In response to NPR, a spokesperson for the CDC listed seven emergency responses that are currently active — such as measles in Texas, influenza A/H5N1 and mpox — but did not answer other questions about the extent of the layoffs and their impact on the agency's operations.

Fleming and other members of the committee sent a letter to acting CDC director Dr. Susan Monarez and HHS secretary Robert F. Kennedy Jr. On February 17, urging them to "take immediate action to forestall the impending crisis to our Nation's health and safety" precipitated by the firings. They haven't responded.

Key staff for detecting potential threats fired 

The full extent of the cuts remains unclear, although NPR has reported that about 750 people were let go from CDC in the first wave of firings earlier this month.

And more cuts could be on the way.

"If we have another round of layoffs, then we really will start to feel the pain in a very tangible way," the CDC staffer said.

Among those who already lost their jobs: a cadre of scientists who assist local health authorities in detecting diseases, staff who are charged with preventing the introduction of dangerous pathogens from abroad, and some involved in modeling disease outbreaks to get ahead of them, CDC sources said.

One of the programs decimated by the cuts — the Laboratory Leadership Service fellowship — had previously enlisted Ph.D.-trained researchers to pitch in on disease responses for dengue in American Samoa and Puerto Rico, Marburg virus in New York and a new rabies variant in Nebraska, according to three current CDC employees. In some cases, the fellows are needed to develop lab tests in fast-moving situations.

"They are the first responders," said another CDC staffer, "Without them on the front lines, who will develop these tests? Who will do these tests?"

In fact, one CDC fellow who received a termination letter had just spent weeks helping the state of Florida develop a plan for a potential wave of Oropouche this coming summer.

Oropouche, a viral disease spread by mosquitoes and midges — and also through sexual contact — caused large outbreaks in South America and the Caribbean last year, leading to birth defects and fetal deaths similar to those caused by the Zika virus. Florida health officials had discerned from testing past samples that cases in their state had gone undetected, the fellow told NPR: "They were terrified there might be thousands of samples come summer, and they had to be ready."

The pause on communications when Trump took office, however, prevented the fellow from sharing the response plans with the state — and now the plans could languish, since the fellow has been let go.

The firings also swept up two CDC workers, both part of a public health training program, who'd been deployed to work on a tuberculosis outbreak in Kansas City, CDC sources told NPR.

Another arm of the CDC feeling the pinch of layoffs is the already overstretched team that oversees port health stations, screening travelers for dangerous pathogens at airports and land border crossings.

Three out of the 20 port health stations now have no CDC staff and half have no officer in charge, according to a current CDC employee, who's not authorized to speak publicly.

These stations are a first line of defense. Staff there assess humans and animals for disease threats and, if a case of illness is found, work with local authorities on contact tracing if other passengers were potentially exposed.

With countries dealing with outbreaks of Ebola and other diseases, it's critical to have these trained workers in place who can recognize someone with signs or symptoms and coordinate the response, says Dr. Kimberly Dodd, dean of the College of Veterinary Medicine at Michigan State University and a former USDA official.

Stations are increasingly covering for each other, and sometimes "choosing not to do certain things because there aren't enough resources," a CDC employee with direct knowledge of the situation told NPR. "It's like a web and when you rip out part of that, you can't expect it to work the same as before," the individual says.

Fears about readiness for emerging risks

It will take time to see the consequences of the cracks introduced by these mass firings – and the broader attempt to downsize federal health agencies.

"The ripple effects, and how that impacts our infectious disease and pandemic preparedness is going to be larger and more widespread than we're able to put our arms around right now," says Dodd.

Some worry the ongoing turbulence could distract from some of the most pressing public health threats on our doorstep, including bird flu and measles.

Aside from firings, other agency functions have been interrupted. For instance, the CDC's forthcoming meeting of its vaccine advisors was postponed, playing into concerns that vaccine policy could be disrupted by the new administration.

And the CDC pulled a successful advertising campaign for the flu vaccine, amid the worst flu season in years.

The clampdown on external communication that took hold when President Trump came into office impeded some lines of communication and frayed longstanding relationships between local health officials, their partners and the federal government.

While routine meetings and updates about bird flu and other urgent threats have resumed to some extent, "communication is still not where it needs to be," says Lori Freeman, executive director of the National Association of City and County Health Officials.

The targeting of the CDC was top of mind when Freeman met with Texas health officials last week amid ongoing fears about the state's measles outbreak.

"It feels like there's a lot of areas that are threatening our ability to do work on the ground," she says. She adds that she fears the CDC may pull back funds that local public health agencies rely on.

Since mid-January, 124 cases of measles have been reported in the South Plains region of Texas, and 9 cases in neighboring New Mexico.

Both states tell NPR they are in regular contact with their counterparts at the CDC. So far though, the agency doesn't have a major presence on the ground.

"We would only request assistance if the state did not have the resources to respond to the outbreak," according to Lara Anton, a spokesperson for the Texas Department of State Health Services, who confirmed that one CDC epidemiologist is in the region.

But in the City of Lubbock, where hospitals are caring for patients with measles, some local health officials are calling for more help, whether that's from state or federal authorities.

"We need some more boots on the ground to be combating this," Katherine Wells, director of public health for the City of Lubbock, told NPR.

Robert Nott, a spokesperson for the New Mexico Department of Health, said that "on the measles front, our relationship with the CDC remains productive."

Overall, notes Datta, the former CDC official, disease outbreak response is fundamentally a human-based enterprise. While it depends on data, important information needs to be relayed between epidemiologists, health care providers on the ground and public health authorities.

"Those are not automated systems, not by a long shot," says Datta, the former CDC official.

"It takes a practiced eye to say, 'what are the next set of questions that we need to be asking? How can we confirm or negate our worst fears?" says Datta.

For instance, if a few polio cases are reported from different countries over a few months, it would take a birds-eye view to understand how they're related. Knowing where the cases are coming from is key to effectively fighting an outbreak, she says.

Have information you want to share about the ongoing changes across the federal government? Reach out to these authors via encrypted communications: Will Stone @wstonereports.95, Pien Huang @pienhuang.88.

Copyright 2025 NPR

The Kansas City TB Outbreak Shows The Value Of U.S. Government Health Funding

By Erin McConnell, Kendall Martinez-Wright, and Lizzy Lovinger

Feb. 19, 2025

McConnell, Martinez-Wright, and Lovinger work for Treatment Action Group.

An ongoing tuberculosis outbreak in the Kansas City metropolitan area straddling Kansas and Missouri has made headlines across the country, a rare feat for an infectious disease too often ignored in the United States. While previous reports describing the outbreak as "the largest in U.S. History" were quickly debunked, it is one of the bigger TB outbreaks within a one-year period over the past several decades: Since January 2024 in Wyandotte and Johnson counties, there have been 67 cases of active TB (symptomatic disease that can spread by air and can be fatal if left untreated,) and 79 cases of TB infection (asymptomatic and non-infectious, but which can eventually turn into active disease.) Two deaths have been linked to the outbreak.

As longtime TB researchers and activists, we seldom see this much attention paid to TB in the United States, let alone in the Midwest, where all three of us grew up. While TB makes more than 10 million people sick each year, fewer than 10,000 of them are in the United States. But the outbreak in greater Kansas City offers a stark reminder of the importance of public funding for TB research and programming — and the potentially deadly stakes of the Trump administration's assault on global and public health infrastructure.

Even though TB is curable and preventable, it remains the world's deadliest infectious disease, killing about 1.25 million people every year. TB mortality is largely due to lack of access to prevention, diagnosis, and treatment. Public investment makes the care and tools that fight TB available to everyone who needs them and saves lives. This includes funding the work of domestic local health departments: More than half the people living with active TB disease linked to the Kansas City-area outbreak have already been cured; the rest are still taking their course of curative treatment. The vast majority of people with TB infection in Kansas and Missouri have also taken TB preventive treatment (TPT), which will protect them from developing active disease. Local health departments traced close contacts of people diagnosed with TB and administered treatment and prevention free of charge. That not only benefits patients themselves, but also their neighbors. The Centers for Disease Control and Prevention TB Elimination Division enhances health departments' capacity to stop domestic TB outbreaks in their tracks. 

Just as everyone living in the greater Kansas City area and beyond benefits from TB programming through local health departments, we're also all better off when public health officials have the best possible scientific tools to find, cure, and prevent TB. Since the Treatment Action Group added TB to its mission back in 2002, we've seen global TB advocacy help win major advancements in TB research and development. Just over 20 years ago, we were still using technologies from the 1800s to diagnose TB, and treating it with imperfect drugs discovered back in the 1950s and 1960s. It could take many weeks and several facility visits to even diagnose a case to begin with, people had to stick with arduous medication regimens for extended periods of time and deal with severe side effects, and barely anyone with TB infection underwent TPT because the preventive regimen was as long as treatment for active disease. In other words, the TB interventions we were stuck with were a bit like cutting steak with a butter knife — but with life-and-death consequences.

Today, regimens for TB prevention and treatment are shorter and less toxic than ever before. These strides are largely thanks to public investment in TB research and trials. For example, one clinical trial sponsored by the National Institutes of Health and the CDC showed that TB infection can be successfully treated with 12 weeks of a once-weekly treatment called 3HP — findings that allowed this shorter, gentler regimen to replace the previous nine-month regimen of 270 daily doses. A related CDC trial showed that this 3HP regimen is safe for young children, making TB prevention more accessible for kids. Yet another NIH and CDC trial demonstrated that treatment time for drug-susceptible TB can be cut from six months to four months. For drug-resistant TB, a TAG analysis found U.S. Government investments in R&D for the drug bedaquiline exceeded spending by product developer Johnson & Johnson by several times, ultimately enabling DR-TB treatment to be shortened from 18 months or more to as little as six months. 

I saw firsthand in Nigeria that drugs alone can't win the war against tuberculosis

These discoveries would probably never have happened, and countless lives would have been unnecessarily cut short, without U.S. Government spending. 

The fact that health departments in Kansas and Missouri had access to these scientific breakthroughs makes TB outbreaks more manageable — stopping the outbreak well short of becoming U.S. History's largest! — and makes getting sick with TB less traumatic and disruptive for people living with the disease, their families, and communities. Ensuring that everyone on Earth has access to the best available tools reduces the TB burden everywhere, ending chains of transmission as quickly as possible.

Make no mistake — we still need even better tools, including a broadly effective vaccine, to end TB for good. The new presidential administration's relentless attack on federal spending related to TB research and science seriously threatens this progress, betraying people affected by TB across the world, and in the heartland alike.         

Erin McConnell, born and raised in Kansas City, is a senior TB Project associate at Treatment Action Group (TAG) focused on community engagement in research. Kendall Martinez-Wright, raised in Palmyra, Missouri, is the government relations and policy associate at TAG, focusing on federal legislation and budget for HIV, TB, and hepatitis C programs nationally and globally. Elizabeth (Lizzy) Lovinger, born and raised in metropolitan Detroit, is the U.S. And global health policy director at TAG, where she advocates for the policies necessary to end the HIV, TB, and hepatitis C pandemics.

Groundbreaking Study Shows Potential Of New MRNA Vaccine To Help Fight Tuberculosis

A new vaccine that boosts immunity against tuberculosis (TB) has been shown to be effective in pioneering pre-clinical trials, as part of a successful collaboration between three leading Australian research institutions.

A study into the vaccine's effectiveness, published in eBioMedicine, was led by experts from the Sydney Infectious Diseases Institute at University of Sydney, the Centenary Institute and the Monash Institute of Pharmaceutical Science (MIPS) at Monash University.

Currently the only approved vaccine for TB is the century-old Bacillus Calmette-Guerin (BCG) vaccine, which is widely used despite its effectiveness in adults being inconsistent.

The study found that the new mRNA vaccine was successful in triggering an immune defence response that helped to reduce TB numbers in infected mice. In addition, the researchers discovered that for mice that had received the BCG vaccine, a booster dose of the new mRNA vaccine significantly improved their long-term protection.

The vaccine used mRNA technology, which is where genetic instructions are used to trigger an immune response in the body, as opposed to using a weakened or deadened version of a virus.

Senior author Professor Jamie Triccas, Deputy Director of the Sydney Infectious Diseases Institute, said: "Our findings demonstrate that an mRNA vaccine can induce potent, pathogen-specific immune responses that target TB, a disease that has long evaded effective vaccine development. This represents a major advance in TB vaccine research and provides a strong rationale for further clinical development."

TB is the leading cause of infectious mortality worldwide, responsible for approximately 1.3 million deaths annually, with a particular prevalence in countries such as India, Indonesia, Vietnam and Pakistan.

The researchers hope that the mRNA vaccine will ultimately be more effective and consistent than the BCG when used in humans. This is because, unlike protein-based or live-attenuated vaccines (those that contain a weakened version of a pathogen), mRNA vaccines allow for rapid adaptation, making them an attractive option for global TB control efforts.

Dr Claudio Counoupas, co-lead author from the Centenary Institute's Centre for Infection & Immunity, highlighted the vaccine's potential impact: "mRNA vaccines offer a scalable, cost-effective, and adaptable platform that can be rapidly deployed against infectious diseases. This study is an important step in demonstrating that mRNA technology is not just for COVID-19 but could be a game-changer for bacterial diseases like TB."

Professor Colin Pouton from Monash University, a key contributor to the study, explained: "The success of mRNA vaccines in the COVID-19 pandemic underscored their ability to generate strong immune responses. Our study provides the evidence that this platform can be harnessed for TB, potentially improving protection and durability of immunity in a way that traditional vaccines cannot."

Following the study's promising results, the research team is now looking to advance the vaccine to clinical trials.

"Our next goal is to refine the formulation and assess its efficacy in larger models before moving to human studies," said Professor Triccas. "Given the global burden of TB and the limitations of current vaccines, we believe this platform could provide a new pathway toward eradicating this disease."

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