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by Nancy Maddox , MPH , writer and Gynene Sullivan , MA , CAPM , senior specialist , Communications

“ Sometimes you run into such really difficult situations ,” said Mike Pentella , PhD , recalling his work during the 2009 influenza A ( H1N1 ) pandemic that killed roughly 12,000 US residents and sickened about 60 million more . At the time , Pentella was overseeing disease control activities at the State Hygienic Laboratory at the University of Iowa .

The cost for a courier to transport the infectious disease sample to Atlanta ? $ 5,000 .

Ultimately , the influenza isolate did make its way to CDC in timely fashion , but only because the agency sent its own courier to collect it . “ And it did turn out to be the outbreak strain ,” said Pentella . “ If they hadn ’ t helped out in that situation — myself not having those kinds of dollars [ in my budget ]— we would have been delayed in knowing we had H1N1 in Iowa . ... I really appreciated CDC that day .”

This concern , among others , has driven bipartisan efforts to establish a permanent , federal fund for public health emergencies : immediately accessible money that can be tapped to bridge the gap between the onset of a public health crisis and appropriation of supplemental federal funding .

What happens in the early days of a crisis , said Scott Becker , MS , executive director of APHL , will influence how it unfolds : “ If you can control [ the problem ] while it ’ s an ember , you can prevent the wildfire .”

Just last year , for example , a different microbe was threatening the United States : Zika , a mosquito-borne virus capable of causing devastating neurological birth defects in babies born to infected women . By August 2016 , well over 150,000 cases had been reported in the southern Americas — including over 5,000 in Puerto Rico — and the very first cases of local transmission in the continental US were documented in Florida .