Public health response to urgent case reports.

We evaluated the ability of local public health agencies (LPHAs) to meet a preparedness standard set by the U.S. Centers for Disease Control and Prevention (CDC): to receive and respond to urgent case reports of communicable diseases twenty-four hours a day, seven days a week. We found substantial variability in performance and in the systems in place to respond to such reports. Development and implementation of measures of public health agencies' performance are crucial to improving public health preparedness and, ultimately, to assuring the agencies.