CDC (United States Centers for Disease Control and Prevention)
█ BRIAN HOYLE
CDC is an acronym for Centers for Disease Control and Prevention. The center, which is headquartered in Atlanta, Georgia, is one of the predominant public health institutions in the United States and in the world. The CDC serves United States national security by monitoring the incidence of infectious disease in the U.S. (and around the world), and through the development and implementation of disease control procedures. As part of this mandate, the CDC is one of the few facilities in North America that houses a biological laboratory capable of handling very infectious and lethally-dangerous microorganisms such as the Ebola virus and Bacillus anthracis , the bacterium that causes anthrax.
The CDC is the pre-eminent institution in the United States dedicated to the prevention of disease, and is a global leader in public health. In addition to the Atlanta headquarters, the CDC has facilities in San Juan, Puerto Rico, and in eight other locations in the continental United States. The U.S. locations are Anchorage (Alaska), Cincinnati (Ohio), Fort Collins (Colorado), Morgantown (West Virginia), Pittsburgh (Pennsylvania), Research Triangle Park (North Carolina), Spokane (Washington), and Washington D.C.
Approximately 8,500 people work at the CDC in 170 occupations pertaining to public health research, administration, monitoring, and education. CDC personnel are also seconded to other international health agencies such as the World Health Organization and to state and local health agencies in response to disease outbreaks.
The CDC is organized into 11 national centers that are concerned with health care and disease prevention. The national centers study:
- Birth Defects and Developmental Disabilities,
- Chronic Disease Prevention and Health Promotion,
- Environmental Health (that includes the Office of Genomics and Disease Prevention),
- Health Statistics
- HIV (Human Immunodeficiency Virus), STD (Sexually Transmitted Disease), and TB (Tuberculosis) Prevention,
- Infectious Diseases,
- Injury Prevention and Control,
- Immunization Program,
- Occupational Safety and Health,
- Epidemiology Program, and,
- Public Health Practice Program.
At the beginning of 2003, the CDC enters its 57th year of existence. The institution was established on July 1, 1946 in Atlanta. At that time the acronym CDC stood for Communicable Disease Center. The CDC replaced another center known as the Malaria Control in War Areas. The former institution had been established as part of the Public Health Service to rid the southern United States of malaria during the years of World War II. As well, the center had assumed the responsibility for keeping the region free of murine typus fever. The establishment of the Communicable Disease Center continued these functions while expanding to include all diseases that could be transmitted from person to person.
The institute's founding director was Dr. Joseph M. Mountin. In its early days, the center was small and research and surveillance programs were still geared towards insect-transmitted diseases such as malaria. After an aggressive campaign of expansion by Mountin, however, which was intended to entrench CDC's position and value to the country, the center became the national agency for epidemiology (the study of the origin and spread of diseases).
The Korean War in the 1950s solidified the center's value as an epidemiological resource. The Epidemiological Intelligence Service (EIS) was created during that time, with the mandate to protect U.S. citizens from diseases that originated in other regions of the world. The EIS remains an important part of today's CDC, especially because of the recognition, in the 1950s, that biological warfare was an emerging threat to national security.
Two other events in the 1950s besides the Korean conflict increased the national importance of the CDC, and served to ensure that the funding of the center continued. First, a national campaign to inoculate children with the recently approved Salk polio vaccine led to a spate of poliomyelitis cases. A Polio Surveillance Unit was established at CDC. The unit quickly determined that a contaminated batch of the vaccine has been the problem. Their findings allowed the contaminated units of vaccine to be withdrawn from use, and the inoculation program continued with confidence. In retrospect, the continuation of the vaccination campaign has been invaluable, since it was pivotal in the eradication of polio, and since it instilled the confidence in vaccines in general that helped ensure the
success of other vaccination campaigns. These outcomes also solidified the CDC's reputation as a disease-monitoring center of excellence. The other event was a large influenza outbreak in the U.S. Once again, a surveillance campaign on the type of virus that was involved and its pattern of spread helped future efforts to develop effective vaccines and inoculation programs.
During the 1950s and 1960s, the CDC grew through the assumption of responsibility for programs that had been previously handled by other government departments and agencies. Examples include the centers of venereal disease, tuberculosis, and immunization.
Beginning in the 1960s, CDC assumed an increasingly important role in the public awareness of infectious diseases. One important example occurred in 1961 when the institution took over the publication of the Mortality and Morbidity Weekly Report (MMWR). The MMWR publishes information on the number of deaths and cases of infectious disease from every state in the country each week. The availability of such detailed information has allowed the progression of some emerging diseases such as AIDS to be charted.
By the late 1960s, the CDC had become much more than a center for the study and action against communicable diseases. These activities had moved CDC far beyond its original mandate as a communicable disease center. In recognition of the center's changed role, its name was changed in 1970 to the Center for Disease Control. Further expansion led to a slight name change in 1981, to the Centers for Disease Control. Finally, as further expansion took the CDC into disease prevention, in 1992 the organization became the Centers for Disease Control and Prevention. Even so, for the sake of continuity the acronym CDC has been retained.
These and other efforts have contributed to national security through the preservation of public health. In more recent times, accomplishments of significance have included participation in the development of a smallpox vaccine and inoculation program, and the identification of the agents of several diseases including Legionnaire's disease, toxic shock syndrome, hantavirus pulmonary syndrome, and Acquired Immunodeficiency Syndrome.
In 1978, biosafety level 4 containment laboratory was opened in the CDC Atlanta headquarters. Then as now, this is one of only a handful of level 4 labs in North America. Other similar facilities are present in San Antonio, Texas, at the U.S. Army Medical Research Institute of Infectious Disease (USAMRIID) in Fort Detrick, Maryland, and in Winnipeg, Manitoba, Canada. It is only at these facilities that highly infectious and lethal viruses and bacteria can be safely studied and treatments devised. At CDC, for example, the Special Pathogens Branch studies the Ebola, Marburg, and Hantaviruses.
In the present day, CDC provides a great deal of information concerning naturally occurring infectious diseases and, particularly since in the aftermath of the September 11, 2001 terrorist attacks on the U.S., information on bioterrorist threats such as anthrax. The research and disease surveillance expertise at CDC is being harnessed, along with other national laboratories and intelligence gathering organizations, to strengthen the United States from bioterrorist attacks.
█ FURTHER READING:
Epidemiology Program Office, CDC. "CDC's 50th Anniversary: History of CDC." Morbidity and Mortality Weekly Report no. 45 (1996): 525–30.
Centers for Disease Control and Prevention. "About CDC." November 2, 2002. < http://www.cdc.gov/aboutcdc.htm > (28 December 2002).
Centers for Disease Control and Prevention. "CDC Timeline." < http://www.cdc.gov/od/oc/media/timeprnt.htm > (28 December 2002).