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Last Updated

04 Jan 2003

Source: Atlanta-Journal Constitution, March 7, 2002.


CDC enlists 146 disease detectives

Unit works in epidemic intelligence

M.A.J. McKenna, Staff

One missed her brother's wedding. Another almost missed her own.

Every summer, the Centers for Disease Control and Prevention takes about 65 new doctors, pharmacists, Ph.D.s and veterinarians and makes them its Special Forces in the war on disease. Members of the Epidemic Intelligence Service expect to spend two years working extreme hours on modest salaries for the chance to tackle problems they would face in no other job.

Recent months have exceeded all their expectations.

The EIS has a total of 146 members this year. Since September, 136 have been sent out from Atlanta on assignments related to terrorism. The mobilization is by far the biggest since the group was created in 1951 to respond to fears that returning Korean War troops might have been infected with biological weapons.

"Before this, the largest single deployment in EIS history was 46 people," said Dr. Douglas Hamilton, who runs the disease-detective corps from a souvenir-crammed office where Friday is Hawaiian-shirt day. "When I put out a call for volunteers on Sept. 11, I had 50 responses the next morning."

EIS officers must be able to leave at any hour to respond to any kind of public health emergency. They investigated the first cases of Legionnaires' disease, hantavirus and AIDS. Over the past six months, they were the front-line troops countering the first fatal bioterrorist attack on U.S. soil.

"Some have deployed four times. They come home, do their laundry and ask to go out again," Hamilton said. "I offer them time off, but people won't take it."

Jennita Reefhuis, a 30-year-old epidemiologist, is a specialist in analyzing birth defects. She expected to spend her two-year appointment at a computer examining data. The EIS realized her skills had another application.

Bioterror threat rises

The CDC began worrying about bioterrorism immediately after the Sept. 11 attacks. If disease organisms were used as weapons, the results would soon show up in doctors' offices and emergency rooms. But unless those cases were immediately distinguished from everyday problems, bioterrorism could go unnoticed and might spread.

To detect anything unusual, the agency needed statistical programs that Reefhuis could write. She left for Washington in late September, sacrificing a trip to her brother's wedding in the Netherlands. She came back Oct. 2. Two days later, she was sent to Florida.

"I wasn't allowed to tell anyone where I was going, and I couldn't tell anybody why I was going," she said. "I couldn't even tell my fiance."

Reefhuis did four tours all told, constructing databases and teaching local health departments how to use them. Assignments for other EIS officers varied.

McKenzie Andre, a 31-year-old physician from Brooklyn, arrived at ground zero two days after the attacks. Health authorities were worried about conditions for emergency workers. Andre made sure recovery workers had respirators that fit.

"There were about six construction workers working in the basement in a nearby building, and they didn't want to come out," he said. "So I went in and I tested them. They were working 48 and 72 hours straight. They wouldn't stop."

On Sept. 11, Dr. Kelly Moore was in Cairo on her first EIS assignment, investigating fatal bloodstream infections among babies in intensive care. She didn't return to Atlanta until Sept. 20.

Moore, who grew up on a farm within sight of the Huntsville Space Center, was in New York a week later. She expected to stay two weeks. Then the city's first anthrax case was announced. The following day, she went to NBC News, explaining the disease to anxious employees who were far enough from the letters not to need antibiotics.

"One guy told me, 'My wife wouldn't let me sleep in the bed with her. She said I might give her anthrax,' " Moore said. "And I had to say, 'Well, sir, she's going to have to come up with a new excuse.' "

Loved ones left behind

The EIS credential carries long-term benefits: Prominent researchers and policy-makers are among the alumni. But this year especially, the experience has come at a sacrifice. When officers deploy, they often leave partners and young children behind.

Dejana Selenic, who worked eight years for Doctors without Borders before joining the EIS, had planned to marry her fiance Sept. 23. On Sept. 20, she got one of Hamilton's phone calls, putting her on a plane to Washington in several hours.

She called her fiance to tell him. Several minutes later, he called back. "Let's be married now," he said.

Her supervisor found a judge who would stay late at the DeKalb County Courthouse, and an hour later, they were married. She made the deployment with minutes to spare.

"The EIS is one of the great innovations in public health, and not only because it draws good people to the CDC," said Dr. William Foege, a dean of public health in America and a former CDC director. "People talk about what the experience does for individuals. But something that's not understood is how much it has improved the agency itself. The CDC has had to become worthy of the people it sends out there."