The Epidemic Intelligence Service (EIS) is a program of the U.S.
Centers for Disease Control and Prevention
The Centers for Disease Control and Prevention (CDC) is the national public health agency of the United States. It is a United States federal agency, under the Department of Health and Human Services, and is headquartered in Atlanta, Georgi ...
(CDC).
The modern EIS is a two-year, hands-on
post-doctoral
A postdoctoral fellow, postdoctoral researcher, or simply postdoc, is a person professionally conducting research after the completion of their doctoral studies (typically a Doctor of Philosophy, PhD). The ultimate goal of a postdoctoral rese ...
training program in
epidemiology
Epidemiology is the study and analysis of the distribution (who, when, and where), patterns and determinants of health and disease conditions in a defined population.
It is a cornerstone of public health, and shapes policy decisions and evidenc ...
, with a focus on
field work
Field research, field studies, or fieldwork is the collection of raw data outside a laboratory, library, or workplace setting. The approaches and methods used in field research vary across disciplines. For example, biologists who conduct f ...
.
History
Creation of the Epidemic Intelligence Service was proposed by Dr.
Alexander Langmuir
Alexander Duncan Langmuir (12 September 1910 – 22 November 1993) was an American epidemiologist. He is renowned for creating the Epidemic Intelligence Service.
Biography
Alexander D. Langmuir was born in Santa Monica, California. He received h ...
, chief of epidemiologic services, communicable disease center at the
U.S. Public Health Service
The United States Public Health Service (USPHS or PHS) is a collection of agencies of the Department of Health and Human Services concerned with public health, containing nine out of the department's twelve operating divisions. The Assistant ...
on March 30, 1951.
[Popham, John (March 31, 1951).]
Langmuir Warns of Germ Warfare
. ''New York Times News Service''. Chattanooga Daily Times (Chattanooga, Tennessee). p. 2. Dr. Langmuir said that it was of utmost importance to planning of appropriate defense measures against biological warfare germs, development of new detection devices, and train laboratory workers for rapid recognition of biological warfare germs.
[ It arose from ]biological warfare
Biological warfare, also known as germ warfare, is the use of biological toxins or infectious agents such as bacteria, viruses, insects, and fungi with the intent to kill, harm or incapacitate humans, animals or plants as an act of war. Bio ...
concerns relating to the Korean War
, date = {{Ubl, 25 June 1950 – 27 July 1953 (''de facto'')({{Age in years, months, weeks and days, month1=6, day1=25, year1=1950, month2=7, day2=27, year2=1953), 25 June 1950 – present (''de jure'')({{Age in years, months, weeks a ...
.
The Epidemic Intelligence Service was organized on September 26, 1951, with the purpose of investigating disease outbreaks that are beyond the control of state and local health departments, enforcement of interstate quarantine regulations, and providing epidemic aid at the request of state health agencies. The Epidemic Intelligence Service's first staff members consisted of 21 medical officers from the U.S. Public Health Service.[Epidemic Intelligence Service Is Organized]
. ''Associated Press''. The News (Frederick, Maryland). p. 13.
Background
The EIS is operated by the CDC's Center for Surveillance, Epidemiology, and Laboratory Services (CSELS), in the Office of Public Health Scientific Services (OPHSS).
Persons participating in the program, known colloquially as "disease detectives", are formally called "EIS officers" (or EIS fellows) by the CDC and have been dispatched to investigate hundreds of possible epidemics created by natural and artificial causes. Since 1951, more than 3,000 EIS officers have been involved in domestic and international response efforts, including the anthrax
Anthrax is an infection caused by the bacterium ''Bacillus anthracis''. It can occur in four forms: skin, lungs, intestinal, and injection. Symptom onset occurs between one day and more than two months after the infection is contracted. The sk ...
, hantavirus
''Orthohantavirus'' is a genus of single-stranded, enveloped, negative-sense RNA viruses in the family ''Hantaviridae'' within the order ''Bunyavirales''. Members of this genus may be called orthohantaviruses or simply hantaviruses.
Orthohantav ...
, West Nile virus
West Nile virus (WNV) is a single-stranded RNA virus that causes West Nile fever. It is a member of the family ''Flaviviridae'', from the genus ''Flavivirus'', which also contains the Zika virus, dengue virus, and yellow fever virus. The virus ...
in the United States, and the 2014–16 Ebola epidemic in West Africa.
EIS officers begin their fellowship with a one-month training program at CDC headquarters in Atlanta, Georgia; however, 95% of their two-year term consists of experiential rather than classroom training. For the remainder of their service, EIS officers are assigned to operational branches within the CDC or at state and local health departments around the country. Placement is determined via a highly competitive matching process. The CDC pairs EIS officers with a Public Health Advisor The Public Health Advisor, or "PHA" is a type of public health worker which was established in 1948 by the United States Public Health Service in the Venereal Disease Control Division. Today they are hired primarily by the U.S. Centers for Disease ...
or "PHA", forming a scientist (EIS officer) and operations (PHA) team.[ ] EIS is a common recruiting pathway into the Public Health Service Commissioned Corps
The United States Public Health Service Commissioned Corps (PHSCC), also referred to as the Commissioned Corps of the United States Public Health Service, is the federal uniformed service of the U.S. Public Health Service (PHS) and one of the e ...
.
The EIS is the prototype for Field Epidemiology Training Programs (FETP), which operate in numerous countries with technical assistance provided by the CDC.
History of responses
Since the inception of the EIS, officers have been involved with treatment, eradication, and disease-control efforts for a variety of medically related crises. Below is an abridged timeline of their work.
* 1950s: The EIS worked on polio
Poliomyelitis, commonly shortened to polio, is an infectious disease caused by the poliovirus. Approximately 70% of cases are asymptomatic; mild symptoms which can occur include sore throat and fever; in a proportion of cases more severe s ...
, lead poisoning
Lead poisoning, also known as plumbism and saturnism, is a type of metal poisoning caused by lead in the body. The brain is the most sensitive. Symptoms may include abdominal pain, constipation, headaches, irritability, memory problems, inferti ...
, and Asian influenza
* 1960s: Cancer cluster
A cancer cluster is a disease cluster in which a high number of cancer cases occurs in a group of people in a particular geographic area over a limited period of time.[smallpox
Smallpox was an infectious disease caused by variola virus (often called smallpox virus) which belongs to the genus Orthopoxvirus. The last naturally occurring case was diagnosed in October 1977, and the World Health Organization (WHO) c ...](_ ...<br></span></div>s, and <div class=)
* 1970s: Legionnaires' disease
Legionnaires' disease is a form of atypical pneumonia caused by any species of ''Legionella'' bacteria, quite often '' Legionella pneumophila''. Signs and symptoms include cough, shortness of breath, high fever, muscle pains, and headaches. Naus ...
, Ebola
Ebola, also known as Ebola virus disease (EVD) and Ebola hemorrhagic fever (EHF), is a viral hemorrhagic fever in humans and other primates, caused by ebolaviruses. Symptoms typically start anywhere between two days and three weeks after becom ...
, and Reye syndrome
Reye syndrome is a rapidly worsening brain disease. Symptoms of Reye syndrome may include vomiting, personality changes, confusion, seizures, and loss of consciousness. While liver toxicity typically occurs in the syndrome, jaundice usually do ...
* 1980s: Toxic shock syndrome
Toxic shock syndrome (TSS) is a condition caused by bacterial toxins. Symptoms may include fever, rash, skin peeling, and low blood pressure. There may also be symptoms related to the specific underlying infection such as mastitis, osteomyeliti ...
, birth defects
A birth defect, also known as a congenital disorder, is an abnormal condition that is present at birth regardless of its cause. Birth defects may result in disabilities that may be physical, intellectual, or developmental. The disabilities can ...
, and HIV/AIDS
Human immunodeficiency virus infection and acquired immunodeficiency syndrome (HIV/AIDS) is a spectrum of conditions caused by infection with the human immunodeficiency virus (HIV), a retrovirus. Following initial infection an individual ...
* 1990s: Tobacco
Tobacco is the common name of several plants in the genus '' Nicotiana'' of the family Solanaceae, and the general term for any product prepared from the cured leaves of these plants. More than 70 species of tobacco are known, but the ...
, West Nile virus
West Nile virus (WNV) is a single-stranded RNA virus that causes West Nile fever. It is a member of the family ''Flaviviridae'', from the genus ''Flavivirus'', which also contains the Zika virus, dengue virus, and yellow fever virus. The virus ...
, and contaminated water
Water pollution (or aquatic pollution) is the contamination of water bodies, usually as a result of human activities, so that it negatively affects its uses. Water bodies include lakes, rivers, oceans, aquifers, reservoirs and groundwater. Water ...
* 2000s: Post 9/11 anthrax attacks, ''E. coli'' O157:H7, SARS
Severe acute respiratory syndrome (SARS) is a viral respiratory disease of zoonotic origin caused by the severe acute respiratory syndrome coronavirus (SARS-CoV or SARS-CoV-1), the first identified strain of the SARS coronavirus species, ''sever ...
, H1N1
In virology, influenza A virus subtype H1N1 (A/H1N1) is a subtype of influenza A virus. Major outbreaks of H1N1 strains in humans include the Spanish flu, the 1977 Russian flu pandemic and the 2009 swine flu pandemic. It is an orthomyxovirus ...
, and the aftermath of Hurricane Katrina
Hurricane Katrina was a destructive List of Category 5 Atlantic hurricanes, Category 5 Atlantic hurricane that caused over 1,800 fatalities and $125 billion in damage in late August 2005, especially in the city of New Orleans and the surrou ...
* 2010s: The aftermath of the Haiti earthquake, obesity
Obesity is a medical condition, sometimes considered a disease, in which excess body fat has accumulated to such an extent that it may negatively affect health. People are classified as obese when their body mass index (BMI)—a person's we ...
, fungal meningitis
Fungal meningitis refers to meningitis caused by a fungal infection.
Signs and symptoms
Symptoms of fungal meningitis are generally similar to those of other types of meningitis, and include: a fever, stiff neck, severe headache, photophobia ...
, and Ebola
Ebola, also known as Ebola virus disease (EVD) and Ebola hemorrhagic fever (EHF), is a viral hemorrhagic fever in humans and other primates, caused by ebolaviruses. Symptoms typically start anywhere between two days and three weeks after becom ...
* 2020s: Zika virus
''Zika virus'' (ZIKV; pronounced or ) is a member of the virus family ''Flaviviridae''. It is spread by daytime-active ''Aedes'' mosquitoes, such as '' A. aegypti'' and '' A. albopictus''. Its name comes from the Ziika Forest of Uganda, whe ...
, COVID-19 pandemic
The COVID-19 pandemic, also known as the coronavirus pandemic, is an ongoing global pandemic of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The novel virus was first identif ...
EIS conference
EIS officers attend an annual conference in Atlanta, Georgia, to present components of their work from the preceding year.
During the conference, the Alexander D. Langmuir Prize is awarded "to a current officer or first-year alumnus of the EIS for the best scientific publication. The award consists of a $100 cash prize, an engraved paperweight, a case of ale or beer redolent of the John Snow Pub in London, and an inscription on the permanent plaque at CDC."
A complete list of Langmuir Prize winners is included below:
In popular culture
In the 2011
File:2011 Events Collage.png, From top left, clockwise: a protester partaking in Occupy Wall Street heralds the beginning of the Occupy movement; protests against Libyan dictator Muammar Gaddafi, who was killed that October; a young man celebrate ...
film '' Contagion'', the character Doctor Erin Mears (portrayed by Kate Winslet
Kate Elizabeth Winslet (; born 5 October 1975) is an English actress. Known for her work in independent films, particularly period dramas, and for her portrayals of headstrong and complicated women, she has received numerous accolades, incl ...
) is a physician and investigator with the Epidemic Intelligence Service who was tasked by the CDC to discover the origin of a highly contagious and deadly virus known as MEV-1 which was rapidly spreading throughout the world following initial outbreaks in Kowloon
Kowloon () is an urban area in Hong Kong comprising the Kowloon Peninsula and New Kowloon. With a population of 2,019,533 and a population density of in 2006, it is the most populous area in Hong Kong, compared with Hong Kong Island and t ...
, Hong Kong
Hong Kong ( (US) or (UK); , ), officially the Hong Kong Special Administrative Region of the People's Republic of China ( abbr. Hong Kong SAR or HKSAR), is a city and special administrative region of China on the eastern Pearl River Delt ...
and Minneapolis
Minneapolis () is the largest city in Minnesota, United States, and the county seat of Hennepin County. The city is abundant in water, with thirteen lakes, wetlands, the Mississippi River, creeks and waterfalls. Minneapolis has its origins ...
, Minnesota
Minnesota () is a state in the upper midwestern region of the United States. It is the 12th largest U.S. state in area and the 22nd most populous, with over 5.75 million residents. Minnesota is home to western prairies, now given over to ...
.
References
Further reading
*
*
*
*
*
*
*
*
* Gerard Gallagher (2017)
"CDC's EIS program molds clinicians into public health professionals
" (Healio.com)
External links
*
{{Authority control
Epidemiology
Centers for Disease Control and Prevention
Epidemiology organizations
Organizations associated with the COVID-19 pandemic