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The
United States The United States of America (USA), commonly known as the United States (U.S. or US), or America, is a country primarily located in North America. It consists of 50 states, a federal district, five major self-governing territories, 326 India ...
Centers for Disease Control and Prevention (CDC or U.S. 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 The United States Department of Health and Human Services (HHS), also known as the Health Department, is a cabinet-level executive branch department of the U.S. federal government with the goal of protecting the health of all Americans and provi ...
, and is headquartered in
Atlanta Atlanta () is the capital and most populous city of the U.S. state of Georgia. With an estimated 2019 population of 506,811, it is also the 37th most populous city in the United States. The city serves as the cultural and economic center of ...
,
Georgia Georgia usually refers to: * Georgia (country), a country in the Caucasus region of Eurasia * Georgia (U.S. state), one of the states of the United States of America Georgia may also refer to: Historical states and entities * Kingdom of Georgia ...
. Its main goal is to protect
public health Public health has been defined as "the science and art of preventing disease”, prolonging life and improving quality of life through organized efforts and informed choices of society, organizations (public and private), communities and individ ...
and safety through the control and prevention of disease, injury, and
disability A disability is a societal imposition on people who have impairments, making it more difficult for people to do certain activities or interact with the world around them. Due to cognitive, developmental, intellectual, mental, physical, and/or ...
in the US and internationally. The CDC focuses national attention on developing and applying disease control and prevention. It especially focuses its attention on
infectious disease An infection is the invasion of an organism's body tissues by disease-causing agents, their multiplication, and the reaction of host tissues to the infectious agents and the toxins they produce. An infectious disease, also known as a transmissib ...
, food borne pathogens,
environmental health ''Environmental Health'' is a peer-reviewed medical journal established in 2002 and published by BioMed Central. It covers research in all areas of environmental and occupational medicine. The editors-in-chief are Philippe Grandjean (University of S ...
,
occupational safety and health Occupational safety and health (OSH), also commonly referred to as occupational health and safety (OHS), occupational health, or occupational safety, is a multidisciplinary field concerned with the safety, health, and welfare of people at occupat ...
,
health promotion Health promotion is, as stated in the 1986 World Health Organization (WHO) Ottawa Charter for Health Promotion, "the process of enabling people to increase control over, and to improve, their health. Scope The WHO's 2005 Bangkok Charter for Hea ...
,
injury prevention Injury prevention is an effort to prevent or reduce the severity of bodily injuries caused by external mechanisms, such as accidents, before they occur. Injury prevention is a component of safety and public health, and its goal is to improve the h ...
and educational activities designed to improve the health of
United States citizens Citizenship of the United States is a legal status that entails Americans with specific rights, duties, and benefits in the United States. It serves as a foundation of fundamental rights derived from and protected by the Constitution and laws ...
. The CDC also conducts research and provides information on
non-infectious diseases A non-communicable disease (NCD) is a disease that is not transmissible directly from one person to another. NCDs include Parkinson's disease, autoimmune diseases, strokes, most heart diseases, most cancers, diabetes, chronic kidney disease, osteoa ...
, such as
obesity Obesity is a medical condition in which excess body fat has accumulated to an extent that it may have a negative effect on health. People are generally considered obese when their body mass index (BMI), a measurement obtained by dividing a pe ...
and
diabetes Diabetes mellitus (DM), commonly known as diabetes, is a group of metabolic disorders characterized by a high blood sugar level over a prolonged period of time. Symptoms often include frequent urination, increased thirst and increased appetite. I ...
, and is a founding member of the
International Association of National Public Health InstitutesThe International Association of National Public Health Institutes (IANPHI) is a member organization of national public health institutes (NPHIs), public health government agencies working to improve national disease prevention and response. IANPHI i ...
.CDC Home Page
cdc.gov; retrieved November 19, 2008.


History


Establishment

The Communicable Disease Center was founded July 1, 1946, as the successor to the
World War II World War II or the Second World War, often abbreviated as WWII or WW2, was a global war that lasted from 1939 to 1945. It involved the vast majority of the world's countries—including all the great powers—forming two opposing milit ...
Malaria Control in War Areas program of the Office of National Defense Malaria Control Activities. Preceding its founding, organizations with global influence in
malaria Malaria is a mosquito-borne infectious disease that affects humans and other animals. Malaria causes symptoms that typically include fever, tiredness, vomiting, and headaches. In severe cases, it can cause yellow skin, seizures, coma, or death. ...

malaria
control were the Malaria Commission of the
League of Nations The League of Nations, abbreviated as LON (french: Société des Nations , abbreviated as SDN or SdN), was the first worldwide intergovernmental organisation whose principal mission was to maintain world peace. Founded on 10 January 1920 follo ...
and the
Rockefeller Foundation '' The Rockefeller Foundation is an American private foundation based at 420 Fifth Avenue, New York City. It was established by the Rockefeller family in New York State on May 14, 1913, when its charter was formally accepted by the New York State L ...
. The Rockefeller Foundation greatly supported malaria control, sought to have the governments take over some of its efforts, and collaborated with the agency. The new agency was a branch of the U.S. Public Health Service and Atlanta was chosen as the location because
malaria Malaria is a mosquito-borne infectious disease that affects humans and other animals. Malaria causes symptoms that typically include fever, tiredness, vomiting, and headaches. In severe cases, it can cause yellow skin, seizures, coma, or death. ...

malaria
was endemic in the Southern United States. The agency changed names (see infobox on top) before adopting the name ''Communicable Disease Center'' in 1946. Offices were located on the sixth floor of the Volunteer Building on Peachtree Street. With a budget at the time of about $1million, 59 percent of its personnel were engaged in
mosquito A mosquito is any member of a group of about 3,500 species of small insects belonging to the order Diptera (flies). Within Diptera, mosquitoes constitute the family Culicidae (from the Latin ''culex'' meaning "gnat"). The word "mosquito" (formed ...
abatement and habitat control with the objective of control and eradication of malaria in the United States (see
National Malaria Eradication Program In the United States, the National Malaria Eradication Program (NMEP) was launched in July 1947. This federal program—with state and local participation—succeeded in eradicating malaria in the United States by 1951. History Prior to the estab ...
). Among its 369 employees, the main jobs at CDC were originally
entomology upright=1.2, A Phyllium sp., mimicking a leaf Entomology () is the scientific study of insects, a branch of zoology. In the past the term "insect" was less specific, and historically the definition of entomology would also include the study of anima ...
and engineering. In CDC's initial years, more than six and a half million homes were sprayed, mostly with
DDT Dichlorodiphenyltrichloroethane, commonly known as DDT, is a colorless, tasteless, and almost odorless crystalline chemical compound, an organochlorine. Originally developed as an insecticide, it became infamous for its environmental impacts. D ...

DDT
. In 1946, there were only seven medical officers on duty and an early organization chart was drawn, somewhat fancifully, in the shape of a mosquito. Under Joseph Walter Mountin, the CDC continued to advocate for public health issues and pushed to extend its responsibilities to many other
communicable diseases An infection is the invasion of an organism's body tissues by disease-causing agents, their multiplication, and the reaction of host tissues to the infectious agents and the toxins they produce. An infectious disease, also known as a transmissib ...
. In 1947, the CDC made a token payment of $10 to
Emory University Emory University is a private research university in Atlanta, Georgia. Founded in 1836 as "Emory College" by the Methodist Episcopal Church and named in honor of Methodist bishop John Emory, Emory is the second-oldest private institution of highe ...
for of land on Clifton Road in DeKalb County, still the home of CDC headquarters as of 2019. CDC employees collected the money to make the purchase. The benefactor behind the "gift" was Robert W. Woodruff,
chairman of the board The chairperson (also chair, chairman, or chairwoman) is the presiding officer of an organized group such as a board, committee, or deliberative assembly. The person holding the office, who is typically elected or appointed by members of the grou ...
of
The Coca-Cola Company The Coca-Cola Company is an American multinational beverage corporation incorporated under Delaware's General Corporation Law and headquartered in Atlanta, Georgia. The Coca-Cola Company has interests in the manufacturing, retailing, and market ...
. Woodruff had a long-time interest in
malaria Malaria is a mosquito-borne infectious disease that affects humans and other animals. Malaria causes symptoms that typically include fever, tiredness, vomiting, and headaches. In severe cases, it can cause yellow skin, seizures, coma, or death. ...

malaria
control, which had been a problem in areas where he went hunting. The same year, the PHS transferred its San Francisco based plague laboratory into the CDC as the Epidemiology Division, and a new Veterinary Diseases Division was established.


Growth

An
Epidemic Intelligence Service The Epidemic Intelligence Service (EIS) is a program of the U.S. Centers for Disease Control and Prevention (CDC). The modern EIS is a two-year, hands-on post-doctoral training program in epidemiology, with a focus on field work. History Creation ...
(EIS) was established in 1951, originally due to biological warfare concerns arising from the Korean War; it evolved into two-year postgraduate training program in epidemiology, and a prototype for Field Epidemiology Training Programs (FETP), now found in numerous countries, reflecting CDC's influence in promoting this model internationally. The mission of the CDC expanded beyond its original focus on malaria to include
sexually transmitted disease Sexually transmitted infections (STIs), also referred to as sexually transmitted diseases (STDs), are infections that are commonly spread by sexual activity, especially vaginal intercourse, anal sex and oral sex. STIs often do not initially ca ...
s when the Venereal Disease Division of the U.S. Public Health Service (PHS) was transferred to the CDC in 1957. Shortly thereafter, Tuberculosis Control was transferred (in 1960) to the CDC from PHS, and then in 1963 the Immunization program was established. It became the National Communicable Disease Center (NCDC) effective July 1, 1967, and the Center for Disease Control (CDC) on June 24, 1970. At the end of the Public Health Service reorganizations of 1966–1973, it was promoted to being a principal operating agency of PHS. It was renamed the Centers for Disease Control effective October 14, 1980. In 1987, the
National Center for Health Statistics The National Center for Health Statistics (NCHS) is a principal agency of the U.S. Federal Statistical System, which provides statistical information to guide actions and policies to improve the public health of the American people. NCHS is a part ...
became part of CDC. An act of the
United States Congress The United States Congress or U.S. Congress is the bicameral legislature of the federal government of the United States and consists of the House of Representatives and the Senate. The Congress meets in the United States Capitol in Washingto ...
appended the words "and Prevention" to the name effective October 27, 1992. However, Congress directed that the initialism CDC be retained because of its name recognition. Since the 1990s, the CDC focus has broadened to include
chronic diseases A chronic condition is a human health condition or disease that is persistent or otherwise long-lasting in its effects or a disease that comes with time. The term ''chronic'' is often applied when the course of the disease lasts for more than three ...
,
disabilities A disability is a societal imposition on people who have impairments, making it more difficult for people to do certain activities or interact with the world around them. Due to cognitive, developmental, intellectual, mental, physical, and/or ...
, injury control,
workplace hazards An occupational hazard is a hazard experienced in the workplace. Occupational hazards can encompass many types of hazards, including chemical hazards, biological hazards (biohazards), psychosocial hazards, and physical hazards. In the United Sta ...
,
environmental health ''Environmental Health'' is a peer-reviewed medical journal established in 2002 and published by BioMed Central. It covers research in all areas of environmental and occupational medicine. The editors-in-chief are Philippe Grandjean (University of S ...
threats, and terrorism preparedness. CDC combats emerging diseases and other health risks, including
birth defects A birth defect, also known as a congenital disorder, is a condition present at birth regardless of its cause. Birth defects may result in disabilities that may be physical, intellectual, or developmental. The disabilities can range from mild to s ...
,
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'', specifically from the genus ''Flavivirus'', which also contains the Zika virus, dengue virus, an ...
,
obesity Obesity is a medical condition in which excess body fat has accumulated to an extent that it may have a negative effect on health. People are generally considered obese when their body mass index (BMI), a measurement obtained by dividing a pe ...
,
avian Avian may refer to: *Bird, as an adjective *Avian (band), an American metal band *Avian, Iran, a village in Razavi Khorasan Province, Iran *Avian Island, an island in Antarctica *Avro Avian, a series of British light aircraft designed and built by ...
, swine, and pandemic flu, , and
bioterrorism Bioterrorism is terrorism involving the intentional release or dissemination of biological agents. These agents are bacteria, viruses, insects, fungi or toxins, and may be in a naturally occurring or a human-modified form, in much the same way as ...
, to name a few. The organization would also prove to be an important factor in preventing the abuse of
penicillin Penicillins (P, PCN or PEN) are a group of antibiotics originally obtained from ''Penicillium'' moulds, principally ''P. chrysogenum'' and ''P. rubens''. Most penicillins in clinical use are chemically synthesised from naturally-produced pen ...

penicillin
. In May 1994 the CDC admitted having sent samples of communicable diseases to the Iraqi government from 1984 through 1989 which were subsequently repurposed for biological warfare, including
Botulinum toxin Botulinum toxin (Botox) is a neurotoxic protein produced by the bacterium ''Clostridium botulinum'' and related species. It prevents the release of the neurotransmitter acetylcholine from axon endings at the neuromuscular junction, thus causing ...
,
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'', specifically from the genus ''Flavivirus'', which also contains the Zika virus, dengue virus, an ...
,
Yersinia pestis ''Yersinia pestis'' (formerly ''Pasteurella pestis'') is a gram-negative, non-motile, rod-shaped, coccobacillus bacterium, without spores. It is a facultative anaerobic organism that can infect humans via the Oriental rat flea (''Xenopsylla cheopi ...

Yersinia pestis
and
Dengue fever Dengue fever is a mosquito-borne tropical disease caused by the dengue virus. Symptoms typically begin three to fourteen days after infection. These may include a high fever, headache, vomiting, muscle and joint pains, and a characteristic skin ...
virus.


Recent history

On April 21, 2005, then–CDC Director formally announced the reorganization of CDC to "confront the challenges of 21st-century health threats". The four Coordinating Centers—established under the G.W. Bush administration and Gerberding—"diminished the influence of national centers under
heir Inheritance is the practice of passing on private property, titles, debts, entitlements, privileges, rights, and obligations upon the death of an individual. The rules of inheritance differ among societies and have changed over time. Terminolog ...
umbrella", and were ordered cut under the
Obama Administration The presidency of Barack Obama began at noon EST (17:00 UTC) on January 20, 2009, when Barack Obama was inaugurated as the 44th president of the United States, and ended on January 20, 2017. Obama, a Democrat from Illinois, took office followin ...
in 2009. As of 2013, the CDC's
Biosafety Level 4 A biosafety level (BSL), or pathogen/protection level, is a set of biocontainment precautions required to isolate dangerous biological agents in an enclosed laboratory facility. The levels of containment range from the lowest biosafety level 1 (B ...
laboratories are among the few that exist in the world, and serve as one of only two official repositories of
smallpox Smallpox was an infectious disease caused by one of two virus variants, ''Variola major'' and ''Variola minor''. The agent of variola virus (VARV) belongs to the genus Orthopoxvirus. The last naturally occurring case was diagnosed in October ...

smallpox
in the world. The second smallpox store resides at the
State Research Center of Virology and Biotechnology VECTOR The State Research Center of Virology and Biotechnology VECTOR, also known as the Vector Institute (russian: Государственный научный центр вирусологии и биотехнологии „Вектор“, Gosudar ...
in the Russian Federation. In 2014, the CDC revealed they discovered several misplaced smallpox samples while their lab workers were 'potentially infected' with anthrax. The city of Atlanta annexed the CDC headquarters effective January 1, 2018, a part of the city's largest annexation within a period of 65 years; the
Atlanta City Council The Atlanta City Council is the main municipal legislative body for the city of Atlanta, Georgia. It consists of 16 members primarily elected from 12 districts within the city. The Atlanta City Government is divided into three bodies: the legislativ ...
voted to do so the prior December. The CDC requested the Atlanta city government annex the area. Previously, the headquarters were in an
unincorporated area Sign at Heinola, an unincorporated community in Otter Tail County, Minnesota ">Minnesota.html" style="text-decoration: none;"class="mw-redirect" title="Otter Tail County, Minnesota">Otter Tail County, Minnesota An unincorporated area is a r ...
, statistically in the
Druid Hills Druid Hills is a community which includes both a census-designated place (CDP) in unincorporated DeKalb County, Georgia, United States, as well as a neighborhood of the city of Atlanta. The CDP's population was 14,568 at the 2010 census. The CDP ...
census-designated place A census-designated place (CDP) is a concentration of population defined by the United States Census Bureau for statistical purposes only. CDPs have been used in each decennial census since 1980 as the counterparts of incorporated places, such as s ...
.


Organization

The CDC is organized into "Centers, Institutes, and Offices" (CIOs), with each organizational unit implementing the agency's activities in a particular area of expertise while also providing intra-agency support and resource-sharing for cross-cutting issues and specific health threats. Generally, CDC "Offices" are subdivided into Centers, which in turn are composed of Divisions and Branches. However, the Center for Global Health and the
National Institute for Occupational Safety and Health The National Institute for Occupational Safety and Health (NIOSH, ) is the United States federal agency responsible for conducting research and making recommendations for the prevention of work-related injury and illness. NIOSH is part of the Cen ...
are freestanding organizational units and do not belong to a parent Office. As of August 2019, the CIOs are: * Director ** Principal Deputy Director *** Deputy Director – Public Health Service and Implementation Science **** Office of Minority Health and Health Equity **** Center for Global Health **** Center for Preparedness and Response **** Center for State, Tribal, Local, and Territory Support *** Deputy Director – Public Health Science and Surveillance **** Office of Science **** Office of Laboratory Science and Safety **** Center for Surveillance, Epidemiology, and Laboratory Services ****
National Center for Health Statistics The National Center for Health Statistics (NCHS) is a principal agency of the U.S. Federal Statistical System, which provides statistical information to guide actions and policies to improve the public health of the American people. NCHS is a part ...
*** Deputy Director – Non-Infectious Diseases **** National Center on Birth Defects and Developmental Disabilities **** National Center for Chronic Disease Prevention and Health Promotion **** National Center for Environmental Health and
Agency for Toxic Substances and Disease Registry The Agency for Toxic Substances and Disease Registry (ATSDR) is a federal public health agency within the United States Department of Health and Human Services. The agency focuses on minimizing human health risks associated with exposure to hazar ...
****
National Center for Injury Prevention and ControlThe U.S. Centers for Disease Control and Prevention's National Center for Injury Prevention and Control's mission is to provide leadership in preventing and controlling injuries, i.e., reducing the incidence, severity, and adverse outcomes of injury, ...
*** Deputy Director – Infectious Diseases ****
National Center for Immunization and Respiratory Diseases The National Center for Immunization and Respiratory Diseases (NCIRD), formerly known as the National Immunization Program until April 2006, is charged with responsibility for the planning, coordination, and conduct of immunization activities in t ...
**** National Center for Emerging and Zoonotic Infectious Diseases (includes the
Division of Global Migration and Quarantine The Division of Global Migration and Quarantine (DGMQ) is the part of the U.S. government responsible for U.S. Quarantine Stations and issuing quarantine orders. It is part of the National Center for Emerging and Zoonotic Infectious Diseases within ...
, which issues
quarantine A quarantine is a restriction on the movement of people, animals and goods which is intended to prevent the spread of disease or pests. It is often used in connection to disease and illness, preventing the movement of those who may have been e ...
orders) **** National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention ***
National Institute for Occupational Safety and Health The National Institute for Occupational Safety and Health (NIOSH, ) is the United States federal agency responsible for conducting research and making recommendations for the prevention of work-related injury and illness. NIOSH is part of the Cen ...
** Office of the Director *** Chief of Staff *** Chief Operating Officer **** Human Resources Office **** Office of Financial Resources **** Office of Safety, Security, and Asset Management **** Office of the Chief Information Officer *** Chief Medical Officer *** CDC Washington Office *** Office of Equal Employment Opportunity *** Associate Director – Communication *** Associate Director – Laboratory Science and Safety *** Associate Director – Policy and Strategy The Office of Public Health Preparedness was created during the 2001 anthrax attacks shortly after the terrorist attacks of September 11, 2001. Its purpose was to coordinate among the government the response to a range of biological terrorism threats.


Locations

Most CDC centers are located in
Atlanta Atlanta () is the capital and most populous city of the U.S. state of Georgia. With an estimated 2019 population of 506,811, it is also the 37th most populous city in the United States. The city serves as the cultural and economic center of ...
. A few of the centers are based in or operate other domestic locations: * The National Center for Emerging and Zoonotic Infectious Diseases' Division of Vector-Borne Diseases is based in
Fort Collins A fortification is a military construction or building designed for the defense of territories in warfare, and is also used to establish rule in a region during peacetime. The term is derived from Latin ''fortis'' ("strong") and ''facere'' ( ...
with a branch in
San JuanSan Juan , Spanish for Saint John, may refer to: Places Argentina * San Juan Province, Argentina * San Juan, Argentina, the capital of that province * San Juan (Iruya), a small village in the Iruya Department of the Salta Province * San Juan (Bue ...
, and its Arctic Investigations Program is based in
Anchorage Anchorage (officially called the Municipality of Anchorage; Dena'ina: ) is a unified municipal consolidated city-borough in the U.S. state of Alaska, on the West Coast of the United States. With an estimated 288,000 residents in 2019, it is Alas ...
. * The
National Center for Health Statistics The National Center for Health Statistics (NCHS) is a principal agency of the U.S. Federal Statistical System, which provides statistical information to guide actions and policies to improve the public health of the American people. NCHS is a part ...
is primarily located in
Hyattsville, Maryland Hyattsville is a city in Prince George's County, Maryland, United States, and also a close, urban suburb of Washington, D.C. The population was 17,557 at the 2010 United States Census. History Before Europeans reached the area, the upper Anaco ...
, with a branch in
Research Triangle Park Research Triangle Park (RTP) is the largest research park in the United States. It is named for its location relative to the three surrounding cities of Raleigh, Durham, and Chapel Hill, or more properly, for the three major research universitie ...
* The
National Institute for Occupational Safety and Health The National Institute for Occupational Safety and Health (NIOSH, ) is the United States federal agency responsible for conducting research and making recommendations for the prevention of work-related injury and illness. NIOSH is part of the Cen ...
's primary locations are
Cincinnati Cincinnati ( ) is a major city in the U.S. state of Ohio and the government seat of Hamilton County. Settled in 1788, the city is located at the northern side of the confluence of the Licking and Ohio rivers, the latter of which marks the state ...
, Morgantown,
Pittsburgh Pittsburgh ( ) is a city in the state of Pennsylvania in the United States and the county seat of Allegheny County. An estimated population of about 300,286 residents live within the city limits as of 2019, making it the 66th-largest city in th ...

Pittsburgh
,
Spokane Spokane ( ) is the largest city and county seat of Spokane County, Washington, United States. It is in eastern Washington along the Spokane River adjacent to the Selkirk Mountains and west of the Rocky Mountain foothills, south of the Canada–U ...
, and
Washington, D.C. ) , image_skyline = , image_caption = Clockwise from top left: the Washington Monument and Lincoln Memorial on the National Mall, United States Capitol, Washington Metro, Air and Space Museum, White House, ...
, with branches in
Denver Denver (), officially the City and County of Denver, is the capital and most populous city of the U.S. State of Colorado. Denver is located in the South Platte River Valley on the western edge of the High Plains just east of the Front Range ...
, Anchorage, and Atlanta. * The CDC Washington Office is based in Washington, D.C. * Building 18, which opened in 2005 at the Roybal campus, contains the premier BSL4 laboratory in America. In addition, CDC operates quarantine facilities in 20 cities in the U.S.


Budget

CDC's budget for fiscal year 2018 is $11.9billion. The CDC offers
grants Grant are funds given by an entity – frequently, a public body, charitable foundation, or a specialised grant-making institution – to an individual or another entity (usually, a non-profit organisation, sometimes a business or a local governm ...
that help many organizations each year advance health, safety and awareness at the community level throughout the United States. The CDC awards over 85 percent of its annual budget through these grants.


Workforce

, CDC staff numbered approximately 15,000 personnel (including 6,000 contractors and 840
United States 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 is one of the ...
officers) in 170 occupations. Eighty percent held bachelor's degrees or higher; almost half had advanced degrees (a master's degree or a doctorate such as a PhD, D.O., or
M.D. Doctor of Medicine (abbreviated M.D., from the Latin ''Medicinae Doctor'') is a medical degree, the meaning of which varies between different jurisdictions. In the United States, and some other countries, the M.D. denotes a professional graduate d ...
). Common CDC job titles include engineer,
entomologist upright=1.2, A Phyllium sp., mimicking a leaf Entomology () is the scientific study of insects, a branch of zoology. In the past the term "insect" was less specific, and historically the definition of entomology would also include the study of anima ...
,
epidemiologist Epidemiology is the study and analysis of the distribution (who, when, and where), patterns and determinants of health and disease conditions in defined populations. It is a cornerstone of public health, and shapes policy decisions and evidence-b ...
, biologist, physician,
veterinarian A veterinarian (vet), also known as a veterinary surgeon or veterinary physician, is a professional who practices veterinary medicine by treating diseases, disorders, and injuries in non-human animals. Description In many countries, the local ...
,
behavioral scientist Behavioral sciences explore the cognitive processes within organisms and the behavioral interactions between organisms in the natural world. It involves the systematic analysis and investigation of human and animal behavior through naturalistic ob ...
,
nurse Nursing is a profession within the health care sector focused on the care of individuals, families, and communities so they may attain, maintain, or recover optimal health and quality of life. Nurses may be differentiated from other health car ...

nurse
,
medical technologist A medical laboratory scientist (MLS) or clinical laboratory scientist (CLS) or medical technologist (MT) performs diagnostic testing of blood and body fluids in clinical laboratories. The scope of a medical laboratory scientist's work begins with ...
, economist, public health advisor, health communicator,
toxicologist Toxicology is a scientific discipline, overlapping with biology, chemistry, pharmacology, and medicine, that involves the study of the adverse effects of chemical substances on living organisms and the practice of diagnosing and treating exposur ...
, chemist,
computer scientist A computer scientist is a person who has acquired the knowledge of computer science, the study of the theoretical foundations of information and computation and their application. Computer scientists typically work on the theoretical side of co ...
, and statistician. The CDC also operates a number of notable training and fellowship programs, including those indicated below.


Epidemic Intelligence Service (EIS)

The
Epidemic Intelligence Service The Epidemic Intelligence Service (EIS) is a program of the U.S. Centers for Disease Control and Prevention (CDC). The modern EIS is a two-year, hands-on post-doctoral training program in epidemiology, with a focus on field work. History Creation ...
(EIS) is composed of "boots-on-the-ground disease detectives" who investigate public health problems domestically and globally. When called upon by a governmental body, EIS officers may embark on short-term epidemiological assistance assignments, or "Epi-Aids", to provide technical expertise in containing and investigating disease outbreaks. The EIS program is a model for the international Field Epidemiology Training Program.


Public Health Associates Program

The CDC also operates the Public Health Associate Program (PHAP), a two-year paid fellowship for recent college graduates to work in public health agencies all over the United States. PHAP was founded in 2007 and currently has 159 associates in 34 states.


Leadership

The Director of CDC is a
Senior Executive Service The Senior Executive Service (SES) is a position classification in the civil service of the United States federal government, equivalent to general officer or flag officer ranks in the U.S. Armed Forces. It was created in 1979 when the Civil Service ...
position that may be filled either by a career employee, or as a political appointment that does not require Senate confirmation, with the latter method typically being used. The director serves at the pleasure of the President and may be fired at any time.Wilgoren, Debbi and Shear, Michael D.
"Obama Chooses NYC Health Chief to Head CDC"
''The Washington Post'', May 16, 2009.
The CDC director concurrently serves as the Administrator of the
Agency for Toxic Substances and Disease Registry The Agency for Toxic Substances and Disease Registry (ATSDR) is a federal public health agency within the United States Department of Health and Human Services. The agency focuses on minimizing human health risks associated with exposure to hazar ...
. Twenty directors have served the CDC or its predecessor agencies, including three who have served during the Trump administration (including Anne Schuchat who twice served as acting director). * Louis L. Williams Jr., MD (1942–1943) * Mark D. Hollis, ScD (1944–1946) * Raymond A. Vonderlehr, MD (1947–1951) * Justin M. Andrews, ScD (1952–1953) * Theodore J. Bauer, MD (1953–1956) * Robert J. Anderson, MD, MPH (1956–1960) * Clarence A. Smith, MD, MPH (1960–1962) * , MD, MPH (1962–1966) * David J. Sencer, MD, MPH (1966–1977) *
William H. Foege William Herbert Foege (; born March 12, 1936) is an American physician and epidemiologist who is credited with "devising the global strategy that led to the eradication of smallpox in the late 1970s". From May 1977 to 1983, Foege served as the Dir ...
, MD, MPH (1977–1983) * , MD, MPH, Ph.D (1983–1989) * William L. Roper, MD, MPH (1990–1993) * David Satcher, MD, PhD (1993–1998) * Jeffrey Koplan, Jeffrey P. Koplan, MD, MPH (1998–2002) * , MD, MPH (2002–2008) * Tom Frieden, Thomas R. Frieden, MD, MPH (2009 – Jan 2017) * Anne Schuchat, MD, rear admiral, RADM United States Public Health Service, USPHS (acting, Jan–July 2017) * Brenda Fitzgerald, MD (July 2017 – Jan 2018) * Anne Schuchat, MD (acting, Jan–Mar 2018) * Robert R. Redfield, MD (March 2018–Jan 2021) * Rochelle Walensky, MD, MPH (Jan 2021–present)


Datasets and survey systems

* CDC Scientific Data, Surveillance, Health Statistics, and Laboratory Information. * Behavioral Risk Factor Surveillance System (BRFSS), the world's largest, ongoing telephone health-survey system. * Mortality Medical Data System. * Abortion statistics in the United States * CDC WONDER (Wide-ranging ONline Data for Epidemiologic Researc

* Data systems of the National Center for Health Statistics]


Areas of focus


Communicable diseases

The CDC's programs address more than 400 diseases, health threats, and conditions that are major causes of death, disease, and disability. The CDC's website has information on various infectious (and noninfectious) diseases, including
smallpox Smallpox was an infectious disease caused by one of two virus variants, ''Variola major'' and ''Variola minor''. The agent of variola virus (VARV) belongs to the genus Orthopoxvirus. The last naturally occurring case was diagnosed in October ...

smallpox
, measles, and others.


Influenza

The CDC targets the transmission of influenza, including the H1N1 swine flu, and launched websites to educate people about hygiene.


Division of Select Agents and Toxins

Within the division are two programs: the Federal Select Agent Program (FSAP) and the Import Permit Program. The FSAP is run jointly with an office within the U.S. Department of Agriculture, regulating agents that can cause disease in humans, animals, and plants. The Import Permit Program regulates the importation of "infectious biological materials." The CDC runs a program that protects the public from rare and dangerous substances such as anthrax and the Ebola virus. The program, called the Federal Select agent, Select Agent Program, calls for inspections of labs in the U.S. that work with dangerous pathogens. During the Ebola virus epidemic in West Africa, 2014 Ebola outbreak in West Africa, the CDC helped coordinate the return of two infected American aid workers for treatment at Emory University Hospital, the home of a special unit to handle highly infectious diseases. As a response to the 2014 Ebola outbreak, Congress passed a Continuing Appropriations Resolution allocating $30,000,000 towards CDC's efforts to fight the virus.


Non-communicable diseases

The CDC also works on non-communicable diseases, including chronic diseases caused by
obesity Obesity is a medical condition in which excess body fat has accumulated to an extent that it may have a negative effect on health. People are generally considered obese when their body mass index (BMI), a measurement obtained by dividing a pe ...
, physical inactivity and tobacco-use.


Antibiotic resistance

The CDC implemented their ''National Action Plan for Combating Antibiotic Resistant Bacteria'' as a measure against the spread of antibiotic resistance in the United States. This initiative has a budget of $161million and includes the development of the Antibiotic Resistance Lab Network.


Global health

Globally, the CDC works with other organizations to address global health challenges and contain disease threats at their source. They work with many international organizations such as the World Health Organization (WHO) as well as ministries of health and other groups on the front lines of outbreaks. The agency maintains staff in more than 60 countries, including some from the U.S. but more from the countries in which they operate. The agency's global divisions include the Division of Global HIV and TB (DGHT), the Division of Parasitic Diseases and Malaria (DPDM), the Division of Global Health Protection (DGHP), and the Global Immunization Division (GID). The CDC is integral in working with the WHO to implement the International Health Regulations, ''International Health Regulations'' (IHR), an agreement between 196 countries to prevent, control, and report on the international spread of disease, through initiatives including the Global Disease Detection Program (GDD). The CDC is also a lead implementer of key U.S. global health initiatives such as the President's Emergency Plan for AIDS Relief, President's Emergency Plan for AIDS Relief (PEPFAR) and the President's Malaria Initiative.


Travelers' health

The CDC collects and publishes health information for travelers in a comprehensive book, ''CDC Health Information for International Travel'', which is commonly known as the "yellow book." The book is available online and in print as a new edition every other year and includes current travel health guidelines, vaccine recommendations, and information on specific Tourist attraction, travel destinations. The CDC also issues travel health notices on its website, consisting of three levels: "Watch": Level 1 (practice usual precautions) "Alert": Level 2 (practice enhanced precautions) "Warning": Level 3 (avoid nonessential travel)


Vaccine safety

The CDC monitors the safety of vaccines in the U.S. via the Vaccine Adverse Event Reporting System (VAERS), a national vaccine safety surveillance program run by CDC and the FDA. "VAERS detects possible safety issues with U.S. vaccines by collecting information about adverse events (possible side effects or health problems) after vaccination." The CDC's Safety Information by Vaccine page provides a list of the latest safety information, side effects, and answers to common questions about CDC recommended vaccines.


Foundation

The CDC Foundation operates independently from CDC as a private, nonprofit 501(c)(3) organization incorporated in the State of Georgia. The creation of the Foundation was authorized by section 399F of the Public Health Service Act to support the mission of CDC in partnership with the private sector, including organizations, foundations, businesses, educational groups, and individuals.


Popular culture and controversies


Tuskegee study of untreated syphilis in Black men

For 15 years, the CDC had direct oversight over the Tuskegee syphilis experiment. In the study, which lasted from 1932 to 1972, a group of Black men (nearly 400 of whom had syphilis) were studied to learn more about the disease. The disease was left untreated in the men, who had not given their informed consent to serve as research subjects. The Tuskegee Study was Tuskegee syphilis experiment, initiated in 1932 by the Public Health Service, with the CDC taking over the Tuskegee Health Benefit Program in 1995.


AIDS crisis

The CDC's response to the HIV/AIDS, AIDS crisis in the 1980s has been criticized for promoting some public health policies that harmed HIV, HIV+ people and for providing ineffective public education.


2001 anthrax attacks

The agency's response to the 2001 anthrax attacks was also criticized for ineffective communication with other public health agencies and with the public.


Zombie Apocalypse campaign

On May 16, 2011, the Centers for Disease Control and Prevention's blog Preparedness 101: Zombie Apocalypse, published an article instructing the public on what to do to prepare for a Zombie (fictional), zombie invasion. While the article did not claim that such a scenario was possible, it did use the popular culture appeal as a means of urging citizens to prepare for all potential hazards, such as earthquakes, tornadoes, and floods. According to David Daigle, the Associate Director for Communications, Public Health Preparedness and Response, the idea arose when his team was discussing their upcoming hurricane-information campaign and Daigle mused that "we say pretty much the same things every year, in the same way, and I just wonder how many people are paying attention." A social-media employee mentioned that the subject of zombies had come up a lot on Twitter when she had been tweeting about the Fukushima Daiichi nuclear disaster and radiation. The team realized that a campaign like this would most likely reach a different audience from the one that normally pays attention to hurricane-preparedness warnings and went to work on the zombie campaign, launching it right before hurricane season began. "The whole idea was, if you're prepared for a zombie apocalypse, you're prepared for pretty much anything," said Daigle. Once the blog article was posted, the CDC announced an open contest for YouTube submissions of the most creative and effective videos covering preparedness for a zombie apocalypse (or apocalypse of any kind), to be judged by the "CDC Zombie Task Force". Submissions were open until October 11, 2011. They also released a zombie-themed graphic novella available on their website. Zombie-themed educational materials for teachers are available on the site.


Violence

An area of partisan dispute related to CDC funding is studying firearms effectiveness. The 1996 Dickey Amendment states "none of the funds available for injury prevention and control at the Centers for Disease Control and Prevention may be used to advocate or promote gun control". Advocates for gun control oppose the amendment and have tried to overturn it. In 1992, Mark L. Rosenberg and five CDC colleagues founded the CDC's National Center for Injury Prevention and Control, with an annual budget of approximately $260,000. They focused on "identifying causes of firearm deaths, and methods to prevent them". Their first Zombie Apocalypse report in the ''New England Journal of Medicine'' in 1993, entitled "Guns are a Risk Factor for Homicide in the Home" reported "mere presence of a gun in a home increased the risk of a firearm-related death by 2.7 percent, and suicide fivefold—a "huge" increase." In response, the NRA launched a "campaign to shut down the Injury Center." Doctors for Responsible Gun Ownership and Doctors for Integrity and Policy Research joined the pro-gun effort, and, by 1995, politicians also supported the pro-gun initiative. In 1996, Jay Dickey (R) Arkansas introduced the Dickey Amendment statement "stating "none of the funds available for injury prevention and control at the Centers for Disease Control and Prevention may be used to advocate or promote gun control" as a rider in the 1996 Appropriations bill (United States), appropriations bill." In 1997, "Congress re-directed all of the money for gun research to the study of traumatic brain injury." David Satcher, CDC head 1993-98 before he was fired advocated for firearms research. Over a dozen "public health insiders, including current and former CDC senior leaders" told ''The Trace (website), The Trace'' interviewers CDC senior leaders took a cautious stance in their interpretation of the Dickey amendment. They could do more! Rosenberg told ''The Trace'' in 2016, "Right now, there is nothing stopping them from addressing this life-and-death national problem!" In 2013, the American Medical Association, the American Psychological Association, and the American Academy of Pediatrics sent a letter to the leaders of the Senate Appropriations Committee asking them "to support at least $10million within the Centers for Disease Control and Prevention (CDC) in FY 2014 along with sufficient new taxes at the National Institutes of Health to support research into the causes and prevention of violence. Furthermore, we urge Members to oppose any efforts to reduce, eliminate, or condition CDC funding related to violence prevention research." Congress maintained the ban in subsequent budgets.


Language guidelines

In December 2017, ''The Washington Post'' reported that the Presidency of Donald Trump, Trump administration had issued a list of seven words that were forbidden in official CDC documentation. Yuval Levin, after contacting HHS officials, wrote in the ''National Review'' that the ''Post'' story was exaggerated and argued that these were not prohibited words but guidelines on words to watch when writing budget-requests to avoid setting off congressional Republicans.


COVID-19

The first confirmed case of COVID-19 pandemic in the United States, COVID-19 was discovered in the U.S. on January 20, 2020. But widespread COVID-19 testing in the United States was effectively stalled until February 28, when federal officials revised a faulty CDC test, and days afterward, when the Food and Drug Administration began loosening rules that had restricted other labs from developing tests. In February 2020, as the CDC's early COVID-19 pandemic in the United States, coronavirus test malfunctioned nationwide, CDC Director Robert R. Redfield reassured fellow officials on the White House Coronavirus Task Force that the problem would be quickly solved, according to White House officials. It took about three weeks to sort out the failed test kits, which may have been contaminated during their processing in a CDC lab. Later investigations by the FDA and the
Department of Health and Human Services The United States Department of Health and Human Services (HHS), also known as the Health Department, is a cabinet-level executive branch department of the U.S. federal government with the goal of protecting the health of all Americans and provi ...
found that the CDC had violated its own protocols in developing its tests. In November 2020, ''NPR'' reported that an internal review document they obtained revealed that the CDC was aware that the first batch of tests which were issued in early January had a chance of being wrong 33 percent of the time, but they released them anyway. In May 2020, ''The Atlantic'' reported that the CDC was conflating the results of two different types of coronavirus tests — tests that diagnose current coronavirus infections, and tests that measure whether someone has ever had the virus. The magazine said this distorted several important metrics, provided the country with an inaccurate picture of the state of the pandemic, and overstated the country's testing ability. In July 2020, the Trump administration ordered hospitals to bypass the CDC and instead send all COVID-19 patient information to a database at the
Department of Health and Human Services The United States Department of Health and Human Services (HHS), also known as the Health Department, is a cabinet-level executive branch department of the U.S. federal government with the goal of protecting the health of all Americans and provi ...
. Some health experts opposed the order and warned that the data might become politicized or withheld from the public. On July 15, the CDC alarmed health care groups by temporarily removing COVID-19 dashboards from its website. It restored the data a day later. White House advisers have repeatedly altered the writings of CDC scientists about COVID-19, including recommendations on church choirs, social distancing in bars and restaurants, and summaries of public-health reports. In August 2020, the CDC recommended that people showing no COVID-19 symptoms do not need testing. The new guidelines alarmed many public health experts. The guidelines were crafted by the White House Coronavirus Task Force without the sign-off of Anthony Fauci of the NIH. Objections by other experts at the CDC went unheard. Officials said that a CDC document in July arguing for "the importance of reopening schools" was also crafted outside the CDC. On August 16, the chief of staff, Kyle McGowan, and his deputy, Amanda Campbell, resigned from the agency.Weiland, Noah,
‘Like a Hand Grasping’: Trump Appointees Describe the Crushing of the C.D.C.
', The New York Times, December 16, 2020
The testing guidelines were reversed on September 18, 2020, after public controversy. Emails obtained by ''Politico'' showed that then-public affairs official Paul Alexander of the HHS requested multiple alterations in a Morbidity and Mortality Weekly Report, a publication normally protected from political interference. The published alterations included a title being changed from "Children, Adolescents, and Young Adults" to "Persons." One current and two former CDC officials who reviewed the email exchanges said they were troubled by the "intervention to alter scientific reports viewed as untouchable prior to the Trump administration" that "appeared to minimize the risks of the coronavirus to children by making the report’s focus on children less clear." In September 2020, the CDC drafted an order requiring masks on all public transportation in the United States, but the White House Coronavirus Task Force blocked the order, refusing to discuss it, according to two federal health officials. In the lead up to 2020 Thanksgiving, the CDC told Americans not to travel for the holiday given the escalating COVID-19 cases in the country. In November, the CDC also warned that no one should travel on cruise ships.


Eroding trust in the CDC as a result of COVID-19 controversies

In a poll conducted by the COVID-19 Consortium for Understanding the Public’s Policy Preferences Across States, it was indicated that “nearly 8 in 10 Americans trust the CDC," which has decreased from 87 percent in April 2020. The COVID-19 Consortium consists of researchers from universities across the country, such as Northeastern University, Northeastern, Harvard University, Harvard, and Northwestern University, Northwestern Universities. As the trustworthiness has eroded, so too has the information it disseminates. According to a Kaiser Family Foundation study, trust in the CDC’s ability to offer reliable and truthful information regarding COVID-19 has decreased 16 percentage points since April, now standing at 67 percent. The diminishing level of trust in the CDC and the information releases also has incited "vaccine hesitancy" which, according to the same Consortium poll, "just 53 percent of Americans said they would be somewhat or extremely likely to get a vaccine." Amid these recent accusations and the faltering image of the CDC, the agency's leadership has been called into question. Former Acting Director at the CDC, Richard E. Besser, Richard Besser, said of Dr. Redfield that “I find it concerning that the CDC director has not been outspoken when there have been instances of clear political interference in the interpretation of science.” In addition, Mark L. Rosenberg, Mark Rosenberg, the first director of CDC’s
National Center for Injury Prevention and ControlThe U.S. Centers for Disease Control and Prevention's National Center for Injury Prevention and Control's mission is to provide leadership in preventing and controlling injuries, i.e., reducing the incidence, severity, and adverse outcomes of injury, ...
, also questioned Redfield's leadership and his lack of defense of the science. Former CDC officials have come to the defense of the Morbidity and Mortality Weekly Report, Morbidity and Mortality Weekly Report (MMWR), like Dr. Sarita Shah saying that, "It’s really important to maintain the independence and the integrity of the MMWR". Others, like Dr. Sonja Rasmussen and her colleagues, took to the JAMA (journal), Journal of the American Medical Association to pen an Op/ed defending the MMWR in the face of recent allegations. The CDC has also received criticism for its mixed messaging surrounding COVID-19 vaccine, COVID-19 vaccines and the state of the pandemic.


Publications

* CDC publications * State of CDC report * CDC Programs in Brief * ''Morbidity and Mortality Weekly Report'' * ''Emerging Infectious Diseases'' (monthly journal) * ''Preventing Chronic Disease'' * Vital statistics (government records), Vital statistics


See also

* Consumer Product Safety Commission, U.S. Consumer Product Safety Commission * Gun violence in the United States * Haddon Matrix * Home Safety Council * List of national public health agencies * National Highway Traffic Safety Administration *
National Institute for Occupational Safety and Health The National Institute for Occupational Safety and Health (NIOSH, ) is the United States federal agency responsible for conducting research and making recommendations for the prevention of work-related injury and illness. NIOSH is part of the Cen ...


Further reading

*


References


Citations


Sources

*


External links

*
CDC
in the ''Federal Register''
CDC Online Newsroom

CDC Public Health Image Library

CDC Global Communications Center

CDC Emerging Infectious Diseases LaboratoryAtlanta, Georgia

CDC WONDER online databases

Vaccine Safety Monitoring Systems and Methods (CDC) a slide deck presented at October 2019 Advisory Committee on Immunization Practices (ACIP) meeting
{{DEFAULTSORT:Centers For Disease Control And Prevention Centers for Disease Control and Prevention, 1946 establishments in Georgia (U.S. state) Biosafety level 4 laboratories Government agencies established in 1946 Medical and health organizations based in Georgia (U.S. state) Medical research institutes in the United States Buildings and structures in DeKalb County, Georgia Buildings and structures in Atlanta Organizations based in Atlanta Organizations based in DeKalb County, Georgia United States Department of Health and Human Services agencies United States Public Health Service Government health agencies