During the government shutdown in 2013, Sen. Barbara Mikulski (D-Md.) told her colleagues it was time to give funding back to the Centers for Disease Control and Prevention. She was especially concerned about getting the disease detectives back to work.
"Did you also know that there are disease detectives?" she told the Senate. "Many people don't know that there are disease detectives." She went on. "Sometimes there is an outbreak and people get sick. People even die. They wonder what it is. They dial 911, and there is a group of people who are like a disease identification SWAT team. They work with the best and brightest at that state level, use the best technology in science from our country, and even around the world, to identify what that is."
In 2003, Hillary Clinton talked up the disease detectives while introducing a budget amendment in the Senate. She was concerned about bioterrorism, and wanted to beef up the United States' ability to respond to potential outbreaks.
The official name for these epidemiological spies -- SPIN Magazine once called them the "CIA of health care" -- is the Epidemic Intelligence Service, which you've surely seen sprinkled through dozens of articles about the government's response to the Ebola outbreak.
That's not the only reason they might sound familiar. Kate Winslet played an EIS officer in Contagion. In 2004, there was an NBC show called "Medical Investigation," which the Washington Post described as "Part ER, part CSI."
They get out a lot; the EIS calls its members "shoe leather epidemiologists" for a reason. The service brags that it can send out agents, anywhere in the world, in hours.
The EIS program is a postdoctoral fellowship that lasts two years -- any more contact with infectious diseases seems to be tempting fate -- and is usually a launching pad to big gigs in public health and medical thought. The CDC's current director, Tom Frieden, began his career with EIS. Lawrence Altman, who writes about medicine for the New York Times, described his former gig as an EIS officer on the program's 50th anniversary.
As epidemiologists, we acted as part scientists, historians, sleuths, statisticians and journalists, relying on people's willingness and memories to tell what happened to them, their relatives and friends.
They've been on the edge of our discussion of public health and mass illness-induced hysteria for a long time. For the past 63 years, in fact. In 1951, the United States Public Health Service, the CDC's former title, set up a staff of 21 medical officers in 21 states, assigned to play defense if the Cold War downgraded from detente to biological warfare. Military leaders were worried that biological weapons would be used against American soldiers in the Korean War.
In the next 20 years, EIS officer investigated a case of a child contracting polio after getting a polio vaccination, and the mysterious cause of an entire building sick with an unknown illness -- which then infected the government officials sent to solve the problem. It took a decade before the EIS figured out the illness was Legionnaire's disease.
In 1969, a team of disease detectives was dispatched to Houston, assigned to identify every single illness that NASA employees might come down with for a period of three weeks. The first astronauts has just returned from the moon. Government officials were worried they might have brought back moon germs too.
The astronauts were quarantined, as were lunar rocks. An errant cough was enough to send a worker to the makeshift EIS clinic. The New York Times reported:
Conceivably, the building might be contaminated by dangerous moon germs, if such unlikely things exist and if some of them elude the elaborate quarantine precautions already in effect. It is far more likely that some worker in the building will fall ill from a natural earthly cause.
Luckily, a moon germ pandemic did not extinguish humanity, and the EIS continued to identify those more pernicious natural earthly causes. They warned Americans about the dangers of eating bear meat and helped the government figure out the proper reaction to the post-9/11 anthrax scare. They helped diagnose the first five men to get AIDS in the United States, researched the spread of Hepatitis A at jam band concerts and track annual flu outbreaks. When a man "playfully " threw a dead squirrel at his wife in 1981, the EIS determined that a flea on the rodent was probably what gave him the bubonic plague. They helped fill the pages of the CDC's magazine of sorts, the Morbidity and Mortality Weekly Report.
The disease detectives even star in a new iPad game, Solve the Outbreak.
The game's description on the CDC Web site reads, "As soon as a new outbreak is suspected, you race to the scene to figure out what's happening, why, how it started, and how it's spread. Act fast and you can save a whole town, state, or even a country. Come up with the wrong answers and, well…you can always try again!"
The same isn't true of Ebola, the outbreak the EIS is currently trying to stop. For now, Americans are confident the CDC will be able to do so, as the Fix reported earlier this week. The EIS has covered this ground before too; they investigated the Ebola outbreak of 1976. And given the current debate about CDC funding during the 2014 midterms, you can be sure disease detectives will soon take their place in political debates as well as medical ones.
Want to read more about the Epidemic Intelligence Service? Lucky for you, a lot has been written (as you might have noticed, they're kind of fascinating). Here's a few places to start.
- "Inside the work of Ebola 'Disease Detectives,'" Dan Gorenstein, Marketplace
- "Beating Back the Devil," Maryn McKenna: A former CDC reporter follows around the first EIS class after 9/11
- "Inside the Outbreaks: The Elite Medical Detectives of the Epidemic Intelligence Service," Mark Pendergast
- "A Correspondent Recalls His Days as a Medical Sleuth," Lawrence Altman," The New York Times