Centers for Disease Control and Prevention
By Bob Kelley and Judy Gantt
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Reviews for Centers for Disease Control and Prevention
2 ratings1 review
- Rating: 5 out of 5 stars5/5This is a well written history of the Centers for Disease Control in Atlanta, and well worth one’s time to understand the united States Infrastructure to respond to contagious disease. Its a short read abd very informative.
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Centers for Disease Control and Prevention - Bob Kelley
year.
INTRODUCTION
For nearly 70 years, the Centers for Disease Control and Prevention (CDC) has been at the forefront of protecting the United States—and the world—from threats to public health such as infectious and chronic diseases, injuries, workplace hazards, disabilities, and environmental health issues. Not only has it been a leader in assisting with public health challenges, its elite scientists, epidemiologists, researchers, surveillance teams, doctors, and public health advisors have taught local staff members in communities, states, territories, and countries worldwide to carry on its work long after CDC’s public health professionals have packed their equipment and returned home.
Organized on July 1, 1946, CDC evolved from a World War II agency, the Office of Malaria Control in War Areas (MCWA), a program within the US Public Health Service (PHS). Established in 1942, MCWA’s primary job was malaria control and prevention in areas around military bases and industrial sites tasked with production related to World War II. These war areas
were primarily located in 15 southeastern states, Puerto Rico, the Virgin Islands, and Caribbean areas related to the United States. Once World War II was over, the federal government converted MCWA operations from war-related efforts to addressing more general communicable disease problems that affect the nation as a whole, and MCWA became the Communicable Disease Center (CDC), with headquarters in Atlanta, Georgia. It is fitting that CDC emerged from a wartime effort, because from its inception, it has been waging war against the world’s gravest health threats and medical mysteries.
A brief glimpse at the nation’s public health landscape prior to the creation of CDC may offer added appreciation for the agency’s stunning accomplishments over the years.
When the country’s founders formed the United States, the 13 original colonies were primarily seaports on the Atlantic Coast with outlying small towns inland. The colonies had local sanitation laws and were keenly aware of diseases being carried on ships sailing to the New World. Even after the formal creation of the United States, public health was not addressed by the government; the US Constitution makes no mention of it. However, following a yellow fever epidemic in 1798, Pres. John Adams signed the first federal public health law, which created the Marine Hospital Service (MHS) for merchant seamen—a forerunner of the modern PHS. This law imposed a monthly hospital tax of 20¢ that was deducted from the pay of merchant seamen for the care of sick seamen and the building of independently operated Marine hospitals. An amending act to the legislation of 1798 extended MHS benefits to officers and enlisted men of the US Navy. MHS was also responsible for the medical inspection of immigrants, the supervision of national quarantine, and prevention and control of the interstate spread of diseases such as yellow fever, cholera, and smallpox.
Throughout the 18th and 19th centuries, diseases ran rampant due to poor sanitation and the limited availability of doctors. Most family illnesses were treated at home using homemade herbal remedies. Often, if no cause for an epidemic was known, people simply waited until it had run its course. Although doctors
were officially recognized in 1769, they were only educated to take care of broken bones and to prescribe herbs and hard liquor that would vanquish evil spirits. Few doctors had any formal training; most learned from other physicians in an informal setting.
In 1902, Congress enacted a bill to increase the efficiency and change the name of the Marine Hospital Service to the Public Health and Marine Hospital Service. The law authorized the establishment of specified administrative divisions and, for the first time, designated a bureau of the federal government as an agency in which public health matters could be coordinated. In 1912, it simply became the US Public Health Service, broadening the PHS research program to include disease of man
and contributing factors such as pollution of navigable streams and information dissemination. By the early 20th century, some progress had been made in treating communicable diseases, but epidemics—such as the plague that hit San Francisco in the early 1900s and the global Spanish influenza epidemic in 1918 and 1919—showed that despite PHS efforts, there was still much to be done to address health emergencies.
When CDC was created in 1946, the fledgling program had an ambitious agenda, but with a core staff of only 430 and a budget of $1.6 million, it faced formidable challenges. Dr. Joseph Mountin, a visionary leader in the PHS, hoped to expand CDC’s interests to include all communicable diseases and to provide guidance and practical help to all entities associated with the United States. World-class scientists soon began filling CDC’s laboratories, and many states and foreign countries sent staff members to Atlanta for training. Although the new agency was making headway in the prevention and control of malaria, typhus, and yellow fever, Dr. Mountin was not satisfied with this progress and impatiently pushed the staff to do more. He reminded them that CDC was responsible for any communicable disease. To survive, it had to become a center for epidemiology.
In 1949, Dr. Alexander Langmuir came to CDC to head the epidemiology division. He quickly organized a disease surveillance system that would ultimately become the cornerstone of CDC. The threat of biological warfare that loomed after the outbreak of the Korean War in 1950 led to the organization of CDC’s Epidemic Intelligence Service (EIS). EIS officers were charged with guarding against ordinary threats to public health while simultaneously watching for new and emerging infectious diseases.
The first class of EIS officers began work in 1951, pledging to go wherever they were needed over the following two years. They quickly became known as disease detectives.
Using shoe-leather epidemiology,
they traveled door-to-door in areas suffering from a disease outbreak to gather surveillance data, literally making house calls around the world. There were 23 recruits in the first EIS class: 22 physicians and one sanitary engineer. Today, classes of around 80 EIS officers are given two-year assignments domestically and internationally. Classes are composed of medical doctors, veterinarians, nurses, researchers, dentists, and scientists. In addition to working with CDC public health advisors in global disease hot spots,
the majority of EIS graduates work with state and local health departments to address a broad spectrum of health challenges including chronic disease, injury prevention, violence, environmental health, occupational safety and health, and maternal and child health, as well as infectious diseases.
Two major health crises in the 1950s helped to establish CDC’s credibility and reputation. A surge of poliomyelitis cases in the 1950s created a nationwide panic as state and local health departments were tasked with administering a national project to vaccinate thousands of children and adults across the country. When polio appeared in children following inoculation with the Salk vaccine, EIS officers helped identify the problem as stemming from a distributor of the vaccine. In 1957, when the United States was faced with the huge Asian flu pandemic, EIS teams gathered data and developed national guidelines for an influenza vaccine. In this era, CDC contributions to coordinating immunization campaigns and involvement in other public health–related projects began to give the nation and the world a glimpse of its real potential.
In the late 1950s and 1960s, CDC grew even larger with the addition of the venereal disease program (1957), the tuberculosis program (1960), and the Foreign Quarantine Service (1967)—one of the oldest and most prestigious units of the PHS. In 1961, the National Office of Vital