Battling Disease Outbreaks in the Big Apple

Posted on by Scott Harper

Over one-third of New York City (NYC) residents are from outside the United States, so in addition to preparing for and responding to numerous indigenous infectious diseases, we also encounter many imported cases, some of which end up causing outbreaks.

From Atlanta to New York City


new york dept of health After spending five years in the CDC Influenza Division in Atlanta, I became a Career Epidemiology Field Officer (CEFO) in 2005 and moved to NYC, where I am stationed at the New York City Department of Health & Mental Hygiene. I currently lead surveillance and response activities for influenza, zoonotic, and vectorborne diseases. My background before coming to CDC was mainly in tropical and travel medicine, so this role has been a good fit.


The Case of H1N1

One of our most recent disease importations came in the form of pandemic H1N1 Influenza in 2009-10. After hearing from a colleague in California about the first two cases of swine influenza occurring in San Diego, I started participating in nightly conference calls with CDC, California, and later Texas when cases emerged there. We knew something big might be happening and mobilized an effort to actively seek influenza A viruses in laboratories across the city to determine whether it might already be here.
CDC’s Emergency Operations Center was fully activated during the 2009–2010 H1N1 pandemic
CDC’s Emergency Operations Center was fully activated during the 2009–2010 H1N1 pandemic

Our first cases occurred when high school students brought it back with them after spending spring break in Mexico; we were able to acquire clinical samples and have them tested both in our public health lab and at CDC very soon after hearing about the high school outbreak. In short order, enhanced surveillance and epidemiology in NYC provided important early data during the pandemic, providing clinical information for colleagues worldwide, and helping to target high-risk groups for receipt of antivirals, and later vaccine.

My primary role early in the pandemic was to serve as a subject matter expert for CDC Director Dr. Tom Frieden, who was the NYC health commissioner at the time, and occasionally for the mayor and other city leaders. I also spent a fair bit of time working with the media.

Earlier in my CDC career, I had been involved in outbreaks both at the international and national levels (Ebola in Uganda and anthrax in Washington, DC). Years spent working with the great people in the Influenza Division were foundational in helping me to contribute to the pandemic response in NYC, and CDC did an exceptional job preparing me for the press interactions, scrutiny, and politics that would occur here at the local level.

NYC DEPT of Health LogoAn Ideal Place to Serve
New York City runs at 5,000 RPM, and so does its health department. It’s a great place for a CEFO to be stationed, and I count myself lucky to serve the people of NYC as a CDC medical officer.

I’d like to hear your thoughts or answer any questions you may have about this post.

Learn more about the New York City Department of Health & Mental Hygiene.

Posted on by Scott Harper

17 comments on “Battling Disease Outbreaks in the Big Apple”

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    it is always refreshing to read words from people who enjoy their jobs! hope you will continue to do so for many years to come!

    I hope to keep connected with the Infectious Disease world as I am a retired Infection Prevention Practitioner in a mental health and substance abuse hospital. It was a real challenge to try to maintain prevention of anything infectious within this arena with un cooperative clients at times and clients from outlying areas where incidence was different from local areas. Keeping staff educated and vaccinated was also a very important task. All this for one person in a shrinking budget for health care in any hospital is a huge undertaking. I appreciate all in CDC and the many practitioners I had experience with in efforts to keep people healthy and disease free. I will keep your Blog on my radar. Thanks.

    Epidemiologically, as a preventative response ,have you considered Airport-Airplane sceening using recently developed technical devises avilable from key manufactures -perhaps funded by HHS BARDA and /or the military.I believe most of NYC foregin (infected or incabating ILIs )population arrives by airplane as you well know. Also as you noted NYC’s initial outbreak was traced to school children returning from Mexico(obviously by Plane) I too was staioned in NYC by CDC through thier outstanding Health Department as a Public Health Advisor. I am now a Senior VolunteerPubliv Health Adviser to The Harrisburg Pa Infragard- a partnership organization with the FBI- to protect the (CI.KR) critical Infratructures and key resoures(19) from natural occurances and terror attacks.-Public Health is one of the 19.A natural event currently seen as a major threat to the US including NYC is a Solar Flare Electromagnetic Pulse. which will wipe out of our electric grid. Thus,Hospitals and Public health infrastructures need to take precautions similar to our Military to keep our sector protected

    Great information. I did have a question for you concerning the level of danger associated with the H1N1. I have seen research indicating that the H1N1 strain is actually considerably less virulent then initially estimated. What is your feeling now that we are allowed the luxury of hindsight? Thanks.

    when i’ll be bigger I want to be just like you… All the best in your new job.
    i’m also in the field of tropical and travel medicine and i’ve been doing some hummanitarian aid, so I was very touch by your article.

    Hi John,

    I think people would agree that there were fewer deaths associated with this pandemic than were seen in a pandemic like the one that occurred in 1918. That being said, it is estimated that over 12,000 people died in the U.S. during the 2009-10 pandemic, and many more worldwide, so it was a significant public health event. CDC and other public health and clinical partners are continuing to monitor influenza viruses from around the world to detect potential changes in these viruses that might lead to an increase in virulence.


    As a graduate student who aspires to work in the public health field, I would love to work at the NYC Department of Health & Mental Hygiene.

    Are there no adults to supervise the CDC? It is sad to see that adolescents have spread throughout our government, wasting taxpayers’ money on such tripe.

    Very interesting information. I am a nursing student and we just had a seminar on international health. Communicable diseases once thought to “not affect” the Western world or the US are very relevant now. Everything is only a plane ride away. I did not realize 1/3 of NYC’s population are from outside the US. Therefore, health care professionals need to be even more vigilant for infectious disease outbreaks, especially in New York. An ER nurse could be the first line of defense for the city against a communicable disease. Nurses must be well informed in regards to signs and symptoms. At the first inkling of a infectious disease, proper precautions should be implemented until the disease is ruled out in order to prevent spread to other staff or patients. Thanks for the article!

    If you are a uninsured or underinsured woman in NYC over 40 years old who has never gotten a mammogram before, please call 1-877-628-9090 to schedule a no-cost mammogram on the mobile clinic. Its a great health service for the women of NYC, so please spread the word. It’s breast cancer awareness month starting next week…so…

    This is very interesting information. I love the big city but I am relatively paranoid about catching something when I’m up there. 3 years ago I caught strep throat, not the worst thing but its still a pain. gives a lot of good information on how to avoid getting strep throat; the advice also applies to many other infectious diseases.

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Page last reviewed: April 5, 2012
Page last updated: April 5, 2012