Epidemic Intelligence Service

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The Epidemic Intelligence Service (EIS) is a program of the U.S. Centers for Disease Control and Prevention (CDC). Established in 1951 by Alexander Langmuir, it arose from biological warfare concerns relating to the Korean War.[1] The modern EIS is a two-year, hands-on post-doctoral training program in epidemiology, with a focus on field work.

The EIS is operted by the CDC's Center for Surveillance, Epidemiology, and Laboratory Services (CSELS), in the Office of Public Health Scientific Services (OPHSS).[2] 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, hantavirus, West Nile virus in the United States, and the 2014–16 Ebola epidemic in West Africa.[3][4]

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.[5] 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.[6] The CDC pairs EIS officers with a Public Health Advisor or "PHA," forming a scientist (EIS officer) and operations (PHA) team.[7] EIS is a common recruiting pathway into the Public Health Service Commissioned Corps.[8]

The EIS is the prototype for Field Epidemiology Training Programs (FETP), which operate in numerous countries with technical assistance provided by the CDC.[9]

History of responses[edit]

Since the inception of the EIS, officers have been involved with treatment, eradication, and disease-control efforts for a variety of medically related crises.[10] Below is an abridged timeline of their work.

EIS Conference[edit]

EIS officers attend an annual conference in Atlanta, Georgia, to present components of their work from the preceding year.[11]

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."[12]

A complete list of Langmuir Prize winners is included below:[13]

Year Article Title Publication Author(s)
1966 Complications of Smallpox Vaccination: I. National Survey in the United States, 1963. N Engl J Med 1967;276:125–32. J.M. Neff, J.M. Lane, J.H. Pert, R. Moore, J.D. Millar, D.A. Henderson
1967 An Outbreak of Neuromyasthenia in a Kentucky Factory—The Possible Role of a Brief Exposure to Organic Mercury. Am J Epidemiol 1967;86:756–64. G. Miller, R. Chamberlin, W.M. McCormack
1968 Salmonellosis from Chicken Prepared in Commercial Rotisseries: Report of an Outbreak. Am J Epidemiol 1969;90:429–37. S.B. Werner, J. Allard, E.A. Ager
1969 Outbreak of Tick-Borne Relapsing Fever in Spokane County, Washington. JAMA 1969;210:1045–50. R.S. Thompson, W. Burgdorfer, R. Russell, B.J. Francis
1970 Tularemia Epidemic: Vermont, 1968—Forty-Seven Cases Linked to Contact with Muskrats. N Engl J Med 1969;280:1253–60. L.S. Young, D.S. Bicknell, B.G. Archer, et al.
1971 Tomato Juice-Associated Gastroenteritis, Washington and Oregon, 1969. Am J Epidemiol 1972;96:219–26. W.H. Barker Jr., V. Runte
1972 Salmonella Septicemia from Platelet Transfusions: Study of an Outbreak Traced to a Hematogenous Carrier of Salmonella cholerae-suis. Ann Intern Med 1973;78: 633–41. F.S. Rhame, R.K. Root, J.D. MacLowry, T.A. Dadisman, J.V. Bennett
1973 Outbreak of Typhoid Fever in Trinidad in 1971 Traced to a Commercial Ice Cream Product. Am J Epidemiol 1974;100:150–7. A. Taylor Jr., A. Santiago, A.Gonzales-Cortes, E.J. Gangarosa
1974 Oyster-Associated Hepatitis: Failure of Shellfish Certification Programs To Prevent Outbreaks. JAMA 1975;233:1065–8. B.L. Portnoy, P.A. Mackowiak, C.T. Caraway, J.A. Walker, T.W. McKinley, C.A. Klein Jr.
1975 Staphylococcal Food Poisoning Aboard a Commercial Aircraft. Lancet 1975;2:595–9. M.S. Eisenberg, K. Gaarslev, W. Brown, M. Horwitz, D. Hill
1976 Nursery Outbreak of Peritonitis with Pneumoperitoneum Probably Caused by Thermometer-Induced Rectal Perforation. Am J Epidemiol 1976;104:632–44. M.A. Horwitz, J.V. Bennett
1977 Epidemic Yersinia entercolitica Infection due to Contaminated Chocolate Milk. N Engl J Med 1978;298:76–9. R.E. Black, R.J. Jackson, T. Tsai, et al.
1978 Measles Vaccine Efficacy in Children Previously Vaccinated at 12 Months of Age. Pediatrics 1978;62: 955–60. J.S. Marks, T.J. Halpin, W.A. Orenstein
1979 An Outbreak of Legionnaires’ Disease Associated with a Contaminated Air-Conditioning Cooling Tower. N Engl J Med 1980;302:365–70. T.J. Dondero Jr., R.C. Rendtorff, G.F. Mallison, et al.
1979 Risk of Vascular Disease in Women: Smoking, Oral Contraceptives, Noncontraceptive Estrogens, and Other Factors. JAMA 1979;242:1150–4. D.B. Petitti, J.Wingerd, J. Pellegrin, et al.
1980 Injuries from the Wichita Falls Tornado: Implications for Prevention. Science 1980;207:734–8. R.I. Glass, R.B. Craven, D.J. Bregman, et al.
1981 Respiratory Irritation due to Carpet Shampoo: Two Outbreaks. Environ Int 1982;8:337–41. K. Kreiss, M.G. Gonzalez, K.L. Conright, A.R. Scheere
1981 Toxic-Shock Syndrome in Menstruating Women: Association with Tampon Use and Staphylococcus aureus and Clinical Features in 52 Cases. N Engl J Med 1980;303:1436–42. K.N. Shands, G.P. Schmid, B.B. Dan, et al.
1982 Risk Factors for Heatstroke: A Case-Control Study. JAMA 1982;247:3332–6. E.M. Kilbourne, K. Choi, T.S. Jones, S.B. Thacker
1983 Epidemic Listeriosis C—Evidence for Transmission by Food. N Engl J Med 1983;308:203–6. W.F. Schlech III, P.M. Lavigne, R.A. Bortolussi, et al.
1984 Unexplained Deaths in a Children’s Hospital: An Epidemiologic Assessment. N Engl J Med 1985;313: 211–6. J.W. Buehler, L.F. Smith, E.M. Wallace, C.W. Heath, R. Kusiak, J.L. Herndon.
1984 Medication Errors with Inhalant Epinephrine Mimicking an Epidemic of Neonatal Sepsis. N Engl J Med 1984;310:166–70. S.L. Solomon, E.M. Wallace, E.L. Ford-Jones, et al.
1985 The Use and Efficacy of Child-Restraint Devices: The Tennessee Experience, 1982 and 1983. JAMA 1984;252:2571–5. M.D. Decker, M.J. Dewey, R.H. Hutcheson Jr., W.S. Schaffner
1986 The Role of Parvovirus B19 in Aplastic Crisis and Erythema Infectiosum (Fifth Disease). J Infect Dis 1986;154:383–93. T.L. Chorba, P. Coccia, R.C. Holman, et al.
1987 Oral Contraceptives and Cervical Cancer Risk in Costa Rica: Detection Bias or Causal Association? JAMA 1988;259:59–64. K.L. Irwin, L. Rosero-Bixby, M.W. Oberle, et al.
1988 A Day-Care–Based Case-Control Efficacy Study of Haemophilus influenzae B Polysaccharide Vaccine. JAMA 1988;260:1413–8. L.H. Harrison, C. Broome, A.W. Hightower, et al.
1989 Group A Meningococcal Carriage in Travelers Returning from Saudi Arabia. JAMA 1988;260:2686–9. P.S. Moore, L.H. Harrison, E.E. Telzak, G.W. Ajello, C.V. Broome
1989 Transmission of Plasmodium vivax Malaria in San Diego County, California, 1986. Am J Trop Med Hyg 1990;42:3–9. Y.A. Maldonado, B.L. Nahlen, R.R. Roberta, et al.
1990 An Outbreak of Surgical Wound Infections due to Group A Streptococcus Carried on the Scalp. N Engl J Med 1990;323:968–72. T.D. Mastro, T.A. Farley, J.A. Elliott, et al.
1991 An Investigation of the Cause of the EosinophiliaMyalgia Syndrome Associated with Tryptophan Use. N Engl J Med 1990;323:357–65. E.A. Belongia, C.W. Hedberg, G.J. Gleich, et al.
1992 An Outbreak of Multidrug-Resistant Tuberculosis Among Hospitalized Patients with the Acquired Immunodeficiency Syndrome. N Engl J Med 1992;326:1514–21. B.R. Edlin, J.I. Tokars, M.H. Grieco, et al.
1993 Comparison of Pr evention Strategies for Neonatal Group B Streptococcal Infection: A Population-Based Economic Analysis. JAMA 1993;270:1442–8. J.C. Mohle-Boetani, A. Schuchat, B.D. Plikaytis, J.D. Smith, C.V. Broome
1993 Retrospective Study of the Impact of Lead-Based Hazard Remediation on Children’s Blood Lead Levels in St. Louis, Missouri. Am J Epidemiol 1994;139:1016–26. C. Staes, T. Matte, C.B. Copley, D. Flanders, S. Binder
1994 A Massive Outbreak in Milwaukee of Cryptosporidium Infection Transmitted Through the Public Water Supply. N Engl J Med 1994;331:161–7. W.R. Mac Kenzie, N.J. Hoxie, M.E. Proctor, et al.
1995 A Multistate Outbreak of Escherichia coli 0157:H7-Associated Bloody Diarrhea and Hemolytic Uremic Syndrome from Hamburgers: The Washington Experience. JAMA 1994;272:1349–53. B.P. Bell, M. Goldoft, P.M. Griffin, et al.
1996 A Multistate Outbreak of Salmonella Enteritidis Infections Associated with Consumption of Schwan’s Ice Cream. N Engl J Med 1996;334:1281–6 T.W. Hennessy, C.W. Hedberg, L. Slutsker, et al.
1996 Passenger to Passenger Transmission of Mycobacterium tuberculosis Aboard Commercial Aircraft During Transoceanic Travel. N Engl J Med 1996;334:993–8. T.A. Kenyon, S.E. Valway, W.W. Ihle, I.M. Onorato
1997 Epidemic Meningococcal Disease and Tobacco Smoke: A Risk Factor Study in the Pacific Northwest. Pediatr Infect Dis J 1997;16:979–83. M.A. Fisher, K. Hedberg, P. Cardosi, et al.
1998 Suicide After Natural Disasters. N Engl J Med 1998;338:373–8. E.G. Krug, M. Kresnow, J.P. Peddicord, et al.
1999 Legalized Physician-Assisted Suicide in Oregon—The First Year’s Experience. N Engl J Med 1999;340:577–83. A.E. Chin, K. Hedberg, G.K. Higginson, D.W. Fleming
2000 Infantile Hypertrophic Pyloric Stenosis After Pertussis Prophylaxis with Erythromycin: A Case Review and Cohort Study. Lancet 1999;354:2101–5. M.A. Honein, L.J. Paulozzi, I.M. Himelright, et al.
2001 Salmonella Typhimurium Infections Transmitted by Chlorine-Pretreated Clover Sprout Seeds. Am J Epidemiol 2001;154:1020–8. J.T. Brooks, S. Rowe, P. Shillam, et al.
2002 Serratia liquefaciens Bloodstream Infections from Contamination of Epoetin Alfa at a Hemodialysis Center. N Engl J Med 2001;344:1491–7. L.A. Grohskopf, V.R. Roth, D.R. Feikin, et al.
2003 Transmission of West Nile Virus from an Organ Donor to Four Transplant Recipients. N Engl J Med 2003;348:2196–203. M. Iwamoto, D.B. Jernigan, A. Guasch, et al., the West Nile Virus in Transplant Recipients Investigation Team
2004 Risk of Ba cterial Meningitis in Children with Cochlear Implants. N Engl J Med 2003;349:435–45. J. Reefhuis, M.A. Honein, C.G. Whitney, et al.
2005 Changes in Invasive Pneumococcal Disease Among HIV-Infected Adults Living in the Era of Childhood Pneumococcal Immunization. Ann Intern Med 2006;144:1–9. B.L. Flannery, R.T. Heffernan, L.H. Harrison, et al.
2006 Case-Control Study of an Acute Aflatoxicosis Outbreak, Kenya, 2004. Environ Health Perspect 005;113:1779–83. E. Azziz-Baumgartner, K.Y. Lindblade, K. Gieseker, et al., and the Aflatoxin Investigative Group
2007 Methamphetamine Use Is Independently Associated with Risky Sexual Behaviors and Adolescent Pregnancy. J Sch Health 2008;78:641–8. L.B. Zapata, S.D Hillis, P.M. Marchbanks, K.M. Curtis, R. Lowry
2008 Characteristics of Perpetrators in Homicide-Followedby-Suicide Incidents: National Violent Death Reporting System—17 US States, 2003–2005. Am J Epidemiol 2008;168:1056–64. J. Logan, H.A. Hill, A.E. Crosby, D.L. Karch, J.D. Barnes, K.M. Lubell
2009 Epidemiologic Investigation of Immune-Mediated Polyradiculoneuropathy Among Abattoir Workers Exposed to Porcine Brain. PLoS ONE. 2009;5:e9782. S.M. Holzbauer, A.S. DeVries, J.J. Sejvar, et al.
2010 Increasing Compliance with Mass Drug Administration Programs for Lymphatic Filariasis in Orissa, India, 2009: Impact of an Education and a Lymphedema Management Program. PLoS Negl Trop Dis. 2010;201;4:e728. P.T. Cantey, J. Rout, G. Rao, J. Williamson, L.M. Fox
2011 Effect of Rota virus Vaccine on Healthcare Utilization for Diarrhea in US Children. N Engl J Med 2011;365;12:1108–17. J. Cortes, A. Curns, J. Tate, M. Cortese, M. Patel, F. Zhou, U. Parashar
2012 Multistate Outbreak of Escherichia coli O157:H7 Infections Associated with In-Store Sampling of a Raw-Milk Gouda Cheese, 2010. J. McCollum, N. Williams, S. W. Beam, et al.
2013 Necrotizing Cutaneous Mucormycosis After a Tornado in Joplin, Missouri, in 2011. N Engl J Med 2012;367;2214–25. R. Fanfair, K. Benedict, J. Bos, et al.
2014 Raccoon Rabies Virus Variant Transmission Through Solid Organ Transplantation. JAMA 2013;310:398–407. N.M. Vora, S.V. Basavaraju, KA Feldman, et al.
2015 New Delhi metallo-beta-lactamase-producing carbapenem-resistant E. coli associated with exposure to duodenoscopes. JAMA. 2014;312(14):1447-1455 L. Epstein, J. Hunter, M.A. Arwaddy, et al.
2016 Exposure to Advertisements and Electronic Cigarette: Use Among U.S. Middle and High School Students. T. Singh, I.T. Agaku, R.A. Arrazola, K.L. Marynak, L.J. Neff, I.T. Rolle, B.A. King
2017 Geospatial analysis of household spread of Ebola virus in a quarantined village – Sierra Leone, 2014 Epi and Inf 2017;145(14):2921-2929. B. L. Gleason, S. Foster, G. E. Wilt, et al.

In Popular Culture[edit]

In the 2011 film Contagion, the character Doctor Erin Mears (portrayed by Kate Winslet) 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, Hong Kong and Minneapolis, Minnesota.

References[edit]

  1. ^ "EIS History" (PDF). cdc.gov. Retrieved 2018-01-20. 
  2. ^ "Who We Are". cdc.gov. Retrieved 2018-01-20. 
  3. ^ "A History of Success". cdc.gov. Retrieved 2018-01-20. 
  4. ^ "2014-2016 Ebola epidemic in West Africa". cdc.gov. Retrieved 2018-01-20. 
  5. ^ "Frequently Asked Questions About EIS|Epidemic Intelligence Service|CDC". Cdc.gov. 2015-03-05. Retrieved 2016-12-31. 
  6. ^ "Frequently Asked Questions About EIS|Epidemic Intelligence Service|CDC". Cdc.gov. 2015-03-05. Retrieved 2016-12-31. 
  7. ^ Thacker SB, Goodman RA, Dicker RC (1990). "Training and Service in Public Health Practice, 1951-90: CDC's Epidemic Intelligence Service" (PDF). cdc.gov. 105 (6): 599–604. PMC 1580174Freely accessible. PMID 2175439. Retrieved 2018-01-20. 
  8. ^ "U.S. Public Health Service Commissioned Corps Opportunities" (PDF). USPHS. Retrieved 2018-01-20. 
  9. ^ "Field Epidemiology Training Program". cdc.gov. Retrieved 2018-01-20. 
  10. ^ "Recruitment Resources | Epidemic Intelligence Service | CDC". Cdc.gov. Retrieved 2016-12-31. 
  11. ^ "EIS Conference". cdc.gov. Retrieved 2018-01-20. 
  12. ^ "James Buffington Jr. And Lois Chapman Buffington Endowment For The Alexander D. Langmuir Prize". CDC Foundation. Retrieved 2018-01-20. 
  13. ^ "2017 EIS Conference" (PDF). cdc.gov. Retrieved 2018-01-20. 

Further reading[edit]

External links[edit]