Epidemic Intelligence Service: Disease Detectives at Work

The news is out. A potentially lethal disease is spreading rapidly. Doctors report the illness to public health departments, but no one knows whether it is contagious or has an environmental link. Health professionals turn to the CDC for help.

Does this sound like the plot for a movie? Actually, it is—the 2010 movie Contagion is based on the real work of epidemiologists at the Centers for Disease Control and Prevention (CDC).

Epidemiologists are the “disease detectives” who investigate how and why a disease occurs in a specific population. Local and state health departments, federal agencies, or international organizations and ministries of health can formally request CDC’s help in conducting epidemic assistance investigations or “Epi-Aids.” The 160 officers of CDC’s Epidemic Intelligence Service (EIS) support more than 100 Epi-Aids every year.

EIS is a two-year post-graduate training program of service and on-the-job learning for health professionals interested in applied epidemiology. The EIS program is modeled after a medical residency with both classroom instruction and hands-on assignments.

Each year, CDC selects 70 to 80 of the nation′s top health professionals to become part of the EIS program. Most of them hold PhDs or doctoral degrees in medicine, veterinary science, or dentistry. About 75% of EIS graduates remain in public health at CDC or in state or local health departments. Many become leaders in public health throughout the world. In fact, the CDC director, Dr. Thomas Frieden, began his CDC career as an EIS officer.

Candidates for the EIS must submit applications to CDC between May 1 and September 1 of each year. After acceptance into the program, new officers attend the annual EIS conference in Atlanta, Georgia, to interview for placement in a CDC program. Most CDC program areas have EIS officers, including infectious disease, chronic disease, injury prevention and control, and environmental health.

EIS accepted current officer Dr. Matt Lozier in 2012, and he attended the conference for the first time that April. Of the interview experience he says, “Supervisors are not necessarily searching for experts in a specific field. Instead, they are looking for officers with applied expertise in the analytical skills used in epidemiology.”

Because there are more positions than officers available to fill them, CDC programs compete for the new officers. The program directors and new epidemiologists rank their preferences, and they are matched as closely as possible. Matt was matched with the National Center for Environmental Health’s Division of Environmental Hazards and Health Effects (EHHE), which is responsible for programs including asthma, air pollution, climate and health, and safe water.

During their service, officers work on projects both inside and outside their programs. In fact, Matt says, “Division EIS supervisors encourage officers to seek out projects that interest them across CDC/ATSDR.” These projects give EIS officers opportunities to learn more about other subject areas and investigation techniques.

Supervisors ensure that EIS officers get a well-rounded experience consisting of 12 required activities. These include conducting field investigations, evaluating surveillance systems, presenting original work, and writing and submitting public health updates and scientific manuscripts. The EIS also protects officers’ time so that they can help respond to public health emergencies such as disasters or disease outbreaks.

Since 2012, Matt has participated in a number of investigations and studies as an EIS officer. As part of an EHHE asthma surveillance system evaluation, he learned more about using data to help public health departments decide the best ways to improve the health of people with asthma. He also collaborated in an Epi-Aid in Rhode Island where he investigated a cluster of deaths from drug overdoses. “This investigation was the first to identify a novel, potent, illicit drug that has killed at least 20 persons in three states,” he explains.

Since 1951, over 3,000 EIS officers have responded to requests for epidemiologic assistance. Many have been part of ground-breaking investigations into disease outbreaks, including

• E. coli and Salmonella
• Mercury poisoning in Peru
• West Nile virus epidemic
• Liver disease in Ethiopia
• Cholera epidemic in Haiti

EIS officers are a vital force on the frontlines of public health and have made a significant contribution to public health in the United States and around the world.

Learn more about the EIS program and investigations.

Learn about NCEH/ATSDR environmental EIS investigations.