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The Epidemic Intelligence Service (EIS) is a program of the United States'
Centers for Disease Control and Prevention The Centers for Disease Control and Prevention (CDC) is the National public health institutes, national public health agency of the United States. It is a Federal agencies of the United States, United States federal agency under the United S ...
(CDC). The modern EIS is a two-year, hands-on post-doctoral training program in
epidemiology Epidemiology is the study and analysis of the distribution (who, when, and where), patterns and Risk factor (epidemiology), determinants of health and disease conditions in a defined population, and application of this knowledge to prevent dise ...
, with a focus on
field work Field research, field studies, or fieldwork is the empirical research, collection of raw data outside a laboratory, library, or workplace setting. The approaches and methods used in field research vary across branches of science, disciplines. ...
.


History

Alexander Langmuir, Chief of the U.S. Public Health Service, proposed the creation of the Epidemic Intelligence Service on March 30, 1951.Popham, John (March 31, 1951).
Langmuir Warns of Germ Warfare
. ''New York Times News Service''. Chattanooga Daily Times (Chattanooga, Tennessee). p. 2.
Langmuir argued that the agency could identify appropriate defense measures against
biological warfare Biological warfare, also known as germ warfare, is the use of biological toxins or Pathogen, infectious agents such as bacteria, viruses, insects, and Fungus, fungi with the intent to kill, harm or incapacitate humans, animals or plants as an ...
germs, develop new detection methods, and train laboratory workers to rapidly recognize biological warfare germs. This justification arose from
biological warfare Biological warfare, also known as germ warfare, is the use of biological toxins or Pathogen, infectious agents such as bacteria, viruses, insects, and Fungus, fungi with the intent to kill, harm or incapacitate humans, animals or plants as an ...
concerns during the
Korean War The Korean War (25 June 1950 – 27 July 1953) was an armed conflict on the Korean Peninsula fought between North Korea (Democratic People's Republic of Korea; DPRK) and South Korea (Republic of Korea; ROK) and their allies. North Korea was s ...
. The Epidemic Intelligence Service was organized on September 26, 1951, with the purpose of investigating disease outbreaks that are beyond the control of state and local health departments, enforcing interstate quarantine regulations, and providing epidemic aid at the request of state health agencies. The Epidemic Intelligence Service's first staff members were 21 medical officers of the Public Health Service.Epidemic Intelligence Service Is Organized
. ''Associated Press''. The News (Frederick, Maryland). p. 13.


Background

The EIS is operated by the CDC's Center for Surveillance, Epidemiology, and Laboratory Services (CSELS), in the Office of Public Health Scientific Services (OPHSS). Program participants, 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 Anthrax is an infection caused by the bacterium '' Bacillus anthracis'' or ''Bacillus cereus'' biovar ''anthracis''. Infection typically occurs by contact with the skin, inhalation, or intestinal absorption. Symptom onset occurs between one ...
,
hantavirus ''Orthohantavirus'' is a genus of viruses that includes all hantaviruses (family ''Hantaviridae'') that cause disease in humans. Orthohantaviruses, hereafter referred to as hantaviruses, are naturally found primarily in rodents. In general, each ...
,
West Nile virus West Nile virus (WNV) is a single-stranded RNA virus that causes West Nile fever. It is a member of the family ''Flaviviridae'', from the genus ''Flavivirus'', which also contains the Zika virus, dengue virus, and yellow fever virus. The virus ...
in the United States, and the 2013–2016 Ebola outbreak in
West Africa West Africa, also known as Western Africa, is the westernmost region of Africa. The United Nations geoscheme for Africa#Western Africa, United Nations defines Western Africa as the 16 countries of Benin, Burkina Faso, Cape Verde, The Gambia, Gha ...
. EIS officers begin their fellowship with a one-month training program at CDC headquarters in
Atlanta Atlanta ( ) is the List of capitals in the United States, capital and List of municipalities in Georgia (U.S. state), most populous city in the U.S. state of Georgia (U.S. state), Georgia. It is the county seat, seat of Fulton County, Georg ...
,
Georgia Georgia most commonly refers to: * Georgia (country), a country in the South Caucasus * Georgia (U.S. state), a state in the southeastern United States Georgia may also refer to: People and fictional characters * Georgia (name), a list of pe ...
; however, 95% of their two-year term consists of experiential rather than classroom training. 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. The CDC pairs EIS officers with a Public Health Advisor, forming a scientist (EIS officer) and operations (PHA) team. The EIS is a common recruiting pathway into the
Public Health Service Commissioned Corps The United States Public Health Service Commissioned Corps (USPHSCC; also referred to as the Commissioned Corps of the United States Public Health Service) is the Uniformed services, uniformed service branch of the United States Public Health S ...
. The EIS is the prototype for Field Epidemiology Training Programs (FETP), which operate in numerous countries with technical assistance provided by the CDC. However, attempts to establish FETPs in
Indonesia Indonesia, officially the Republic of Indonesia, is a country in Southeast Asia and Oceania, between the Indian Ocean, Indian and Pacific Ocean, Pacific oceans. Comprising over List of islands of Indonesia, 17,000 islands, including Sumatra, ...
,
Hungary Hungary is a landlocked country in Central Europe. Spanning much of the Pannonian Basin, Carpathian Basin, it is bordered by Slovakia to the north, Ukraine to the northeast, Romania to the east and southeast, Serbia to the south, Croatia and ...
,
Ivory Coast Ivory Coast, also known as Côte d'Ivoire and officially the Republic of Côte d'Ivoire, is a country on the southern coast of West Africa. Its capital city of Yamoussoukro is located in the centre of the country, while its largest List of ci ...
, and within the
World Health Organization The World Health Organization (WHO) is a list of specialized agencies of the United Nations, specialized agency of the United Nations which coordinates responses to international public health issues and emergencies. It is headquartered in Gen ...
have failed due to insufficient long-term support.


History of responses

Since the inception of the EIS, officers have been involved with treatment, eradication, and disease-control efforts for a variety of medically related crises. Below is an abridged timeline of their work. * 1950s: The EIS worked on
polio Poliomyelitis ( ), commonly shortened to polio, is an infectious disease caused by the poliovirus. Approximately 75% of cases are asymptomatic; mild symptoms which can occur include sore throat and fever; in a proportion of cases more severe ...
,
lead poisoning Lead poisoning, also known as plumbism and saturnism, is a type of metal poisoning caused by lead in the body. Symptoms may include abdominal pain, constipation, headaches, irritability, memory problems, infertility, numbness and paresthesia, t ...
, and Asian influenza * 1960s: Cancer clusters, and
smallpox Smallpox was an infectious disease caused by Variola virus (often called Smallpox virus), which belongs to the genus '' Orthopoxvirus''. The last naturally occurring case was diagnosed in October 1977, and the World Health Organization (W ...
* 1970s:
Legionnaires' disease Legionnaires' disease is a form of atypical pneumonia caused by any species of ''Legionella'' bacteria, quite often ''Legionella pneumophila''. Signs and symptoms include cough, shortness of breath, high fever, myalgia, muscle pains, and headach ...
,
Ebola Ebola, also known as Ebola virus disease (EVD) and Ebola hemorrhagic fever (EHF), is a viral hemorrhagic fever in humans and other primates, caused by ebolaviruses. Symptoms typically start anywhere between two days and three weeks after in ...
, and
Reye syndrome Reye syndrome is a rapidly worsening brain disease. Symptoms of Reye syndrome may include vomiting, personality changes, confusion, seizures, and loss of consciousness. While liver toxicity typically occurs in the syndrome, jaundice usually ...
* 1980s:
Toxic shock syndrome Toxic shock syndrome (TSS) is a condition caused by Exotoxin, bacterial toxins. Symptoms may include fever, rash, skin peeling, and low blood pressure. There may also be symptoms related to the specific underlying infection such as mastitis, ...
,
birth defects A birth defect is an abnormal condition that is present at birth, regardless of its cause. Birth defects may result in disabilities that may be physical, intellectual, or developmental. The disabilities can range from mild to severe. Birth de ...
, and
HIV/AIDS The HIV, human immunodeficiency virus (HIV) is a retrovirus that attacks the immune system. Without treatment, it can lead to a spectrum of conditions including acquired immunodeficiency syndrome (AIDS). It is a Preventive healthcare, pr ...
* 1990s:
Tobacco Tobacco is the common name of several plants in the genus '' Nicotiana'' of the family Solanaceae, and the general term for any product prepared from the cured leaves of these plants. More than 70 species of tobacco are known, but the ...
,
West Nile virus West Nile virus (WNV) is a single-stranded RNA virus that causes West Nile fever. It is a member of the family ''Flaviviridae'', from the genus ''Flavivirus'', which also contains the Zika virus, dengue virus, and yellow fever virus. The virus ...
, and contaminated water * 2000s: Post 9/11 anthrax attacks, ''E. coli'' O157:H7,
SARS Severe acute respiratory syndrome (SARS) is a viral respiratory disease of zoonotic origin caused by the virus SARS-CoV-1, the first identified strain of the SARS-related coronavirus. The first known cases occurred in November 2002, and the ...
,
H1N1 Influenza A virus subtype H1N1 (A/H1N1) is a subtype of influenza A virus (IAV). Some human-adapted strains of H1N1 are endemic in humans and are one cause of seasonal influenza (flu). Other strains of H1N1 are endemic in pigs ( swine influen ...
, and the aftermath of Hurricane Katrina * 2010s: The aftermath of the Haiti earthquake,
obesity Obesity is a medical condition, considered by multiple organizations to be a disease, in which excess Adipose tissue, body fat has accumulated to such an extent that it can potentially have negative effects on health. People are classifi ...
,
fungal meningitis Fungal meningitis refers to meningitis caused by a fungal infection. Signs and symptoms Symptoms of fungal meningitis are generally similar to those of other types of meningitis, and include: a fever, stiff neck, severe headache, photophobia ...
, and
Ebola Ebola, also known as Ebola virus disease (EVD) and Ebola hemorrhagic fever (EHF), is a viral hemorrhagic fever in humans and other primates, caused by ebolaviruses. Symptoms typically start anywhere between two days and three weeks after in ...
* 2020s:
Zika virus Zika virus (ZIKV; pronounced or ) is a member of the virus family ''Flaviviridae''. It is spread by daytime-active ''Aedes'' mosquitoes, such as '' A. aegypti'' and '' A. albopictus''. Its name comes from the Ziika Forest of Uganda, where ...
,
COVID-19 pandemic The COVID-19 pandemic (also known as the coronavirus pandemic and COVID pandemic), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), began with an disease outbreak, outbreak of COVID-19 in Wuhan, China, in December ...


EIS conference

EIS officers attend an annual conference in Atlanta, Georgia, to present components of their work from the preceding year. 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 London is the Capital city, capital and List of urban areas in the United Kingdom, largest city of both England and the United Kingdom, with a population of in . London metropolitan area, Its wider metropolitan area is the largest in Wester ...
, and an inscription on the permanent plaque at CDC." A complete list of Langmuir Prize winners is included below:


In popular culture

In the
2011 The year marked the start of a Arab Spring, series of protests and revolutions throughout the Arab world advocating for democracy, reform, and economic recovery, later leading to the depositions of world leaders in Tunisia, Egypt, and Yemen ...
film '' Contagion'', the character Doctor Erin Mears (portrayed by
Kate Winslet Kate Elizabeth Winslet (; born 5 October 1975) is an English actress. Primarily known for her roles as headstrong and complicated women in independent films, particularly period dramas, she has received numerous accolades, including an Ac ...
) 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 Kowloon () is one of the areas of Hong Kong, three areas of Hong Kong, along with Hong Kong Island and the New Territories. It is an urban area comprising the Kowloon Peninsula and New Kowloon. It has a population of 2,019,533 and a populat ...
,
Hong Kong Hong Kong)., Legally Hong Kong, China in international treaties and organizations. is a special administrative region of China. With 7.5 million residents in a territory, Hong Kong is the fourth most densely populated region in the wor ...
and
Minneapolis Minneapolis is a city in Hennepin County, Minnesota, United States, and its county seat. With a population of 429,954 as of the 2020 United States census, 2020 census, it is the state's List of cities in Minnesota, most populous city. Locat ...
,
Minnesota Minnesota ( ) is a U.S. state, state in the Upper Midwestern region of the United States. It is bordered by the Canadian provinces of Manitoba and Ontario to the north and east and by the U.S. states of Wisconsin to the east, Iowa to the so ...
.


References


Further reading

* * * * * * * * * * Gerard Gallagher (2017)
"CDC's EIS program molds clinicians into public health professionals
" (Healio.com)


External links

* {{Authority control Epidemiology Centers for Disease Control and Prevention Epidemiology organizations Organizations associated with the COVID-19 pandemic