'Disease detectives' track epidemics worldwide

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http://www.usatoday.com/news/healthscience/health/2001-07-25-detect-usat.htm

07/24/2001 - Updated 10:31 PM ET

'Disease detectives' track epidemics worldwide

By Anita Manning, USA TODAY

For half a century, an army of scientists and physicians has quietly (and

often in obscurity) faced down some of the world's most vicious killers.

It helped destroy one of them - smallpox - and continues to do battle with

others. The Epidemic Intelligence Service (EIS) annually recruits about 70

physicians and scientists for two-year stints, sending them across the

country and around the world to solve the mysteries of disease outbreaks.

Popularly known as the " disease detectives, " some of them will be on Capitol

Hill today to brief Congress on their mission. They have tracked everything

from E. coli to Ebola in service to public health.

The Atlanta-based EIS, a part of the Centers for Disease Control and

Prevention, is " one of the absolute jewels " among agencies serving the

American people, says CDC director Koplan, who started out as an EIS

officer in 1972 when he worked in Bangladesh to help eradicate smallpox.

While both " exciting and rewarding, " Koplan says, the job can be difficult

and dangerous.

" Sometimes those who do it are prey to the disease they are investigating,

and sometimes you're sent to places that present a personal test of

endurance and persistence, " he says.

Founded in 1951 - just after the start of the Korean War - to detect

biological warfare attacks, EIS evolved into an agency that investigates

outbreaks of infectious diseases in the USA and around the world.

Koplan says he has contracted a couple of the diseases he was sent to

detect, including a form of E. coli and histoplasmosis, a lung infection

caused by a soil fungus.

While in Bangladesh, he encountered everything from severe leg abscesses to

having guns pointed at him.

These experiences pale next to the work of EIS officers who last year spent

weeks in Uganda investigating the largest outbreak ever of the deadly Ebola

virus, Koplan says.

" Here were these folks, literally 24 hours a day exposing themselves to a

disease that has no treatment, no cure and a highly lethal component, " he

says.

Throughout its history, the EIS has been on the front lines of battles

against once-unknown diseases such as AIDS, Lyme disease and hantavirus.

Now, the focus has broadened to include such public health threats as

obesity, injury and chronic disease.

About 2,500 people have gone through the program.

" We came to CDC for a two-year program, then thought we would go back to

whatever we had been doing, " Koplan says. " But for many of us, it was a

career-transforming experience. It changed our outlook on what we were doing

and altered our profession for the rest of our lives. "

Former EIS officers can be found in state and local health departments, as

heads of major medical centers and medical schools, and in key public health

positions overseas. International EIS officers have spread the U.S. approach

to public health around the world, and the program is being emulated in 20

other countries.

" It's a communicable training program, " he says. " That's the best outcome

you could hope for. "