By Patricia Sullivan
Washington Post Staff Writer
Wednesday, July 23, 2008
Michael B. Gregg, 78, the epidemiologist who as editor of an internationally known government report alerted the world to the AIDS crisis, toxic shock syndrome, Legionnaire's disease and Reye's syndrome, died of congestive heart failure July 9 at Brattleboro Memorial Hospital in Vermont.
Under his editorship from 1967 to 1988, the Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report not only was a scientifically reliable compendium of disease outbreaks and death statistics, but it also put the sometimes-dense data into perspective with the addition of a then-innovative editorial note.
Its June 5, 1981, editorial note on the first five cases in Los Angeles of an extremely rare infection called the occurrence "unusual," adding, "The fact that these patients were all homosexuals suggests an association between some aspect of a homosexual lifestyle or disease acquired through sexual contact and Pneumocystis pneumonia in this population."
The publication of that report -- the first widely available official account of the worldwide AIDS crisis -- came only after a vigorous debate within the CDC about whether the cases constituted a significant cluster and were harbinger of an epidemic, or a statistical quirk, said Dr. Richard A. Goodman, who succeeded Dr. Gregg as MMWR editor.
As it turned out, AIDS-related diseases have resulted in more than a million cases in the United States alone. Between 1981 and 1996, the MMWR published more than 350 additional reports on the epidemic.
"Distributing objective scientific information, albeit often preliminary, to the public at large, MMWR has filled that critical time gap between the immediacy of the news media's interpretation and the long wait for publication in the scientific journals," said a 1996 CDC report, Highlights in Public Health, looking back over the report's previous 35 years. "In fact, CDC has published extra issues when health events of national importance required immediate, scientific, and objective reporting."
Dr. Gregg published an "extra" in 1976 when an effort to vaccinate the U.S. population against swine flu went awry. Some vaccinated patients developed the nervous-system disorder Guillain-Barré syndrome, and after the MMWR issue came out, the vaccination campaign was stopped immediately, preventing an epidemic.
As an editor, Dr. Gregg set the standard "as an impartial ensurer of the quality and integrity of the science," Goodman said. "We were to make sure the report rests on scientifically sound data, and make sure the information is translated in some kind of message of practical utility for the reading audience, especially for state and local health officials."
In addition to his weekly editorial duties, Dr. Gregg simultaneously did other jobs. He edited a standard and widely used textbook, "Field Epidemiology" (1996), helped train hundreds of epidemiologists and medical providers around the world and led the CDC's epidemic intelligence service, which tracks down mysterious medical problems.
"This is a national resource. We are ready to respond on literally a moment's notice," he told The Washington Post in 1986.
A native of Paris, Dr. Gregg graduated from Stanford University and received his medical degree from what was then called Western Reserve University in Cleveland in the 1950s.
He entered the U.S. Public Health Service in 1959, working first at the National Institutes of Health Rocky Mountain Laboratory, then had further training in infectious diseases in Lahore, Pakistan. He joined the CDC in 1966.
He helped train state and local epidemiologists in how to conduct field investigations at the CDC and through an international program based in France. A believer in the value of good statistics, he noted that the federal government had no direct ability to order states to report serious diseases.
"The public health community has not been very imaginative in promoting good reporting," he told the New York Times in 1990. "Reporting cases ought to be as much of a reflex as carrying a stethoscope, and the names of serious offenders should be made public."
A gentlemanly colleague, he was known informally as the CDC's poet laureate, penning personalized doggerel for retirements and celebrations in the Atlanta offices until he retired in 1989. He was also a jazz drummer.
Survivors include his wife of 50 years, Mary Lila White Gregg of Guilford, Vt.; three daughters, Jennifer Geise of Mystic, Conn., Marianne Lawrence of Guilford and Pamela McFadden of Dummerston, Vt.; a sister; two brothers; and seven grandchildren.