The ScienceBlogs Book Club has come back to life, and is now featuring Mark Pendergrast's Inside the Outbreaks: The Elite Medical Detectives of the Epidemic Intelligence Service. Mark Pendergrast's introductory post is well worth a read. He describes Alexander Langmuir, the "visionary leader" who founded the Epidemic Intelligence Service within the CDC in 1951; gives examples of some of the many different kinds of outbreaks EIS officers deal with; and identifies some of the ways the EIS has evolved over the past several decades.
I'll be putting up a couple of posts about Inside the Outbreaks in the coming weeks at the ScienceBlogs Book Club blog (full disclosure: I got a free copy for participating). The book is a great read for anyone interested in public health, and I encourage anyone who's read it to check out the book club blog and join in the discussion. Actually, I'm guessing that many of our readers know enough about the diseases and issues in question to comment after having read just a few excerpts. In today's post, for instance, I highlight some of what Pendergrast has written about Reye's Syndrome. Here's an excerpt from my first post:
Mark Pendergrast's Inside the Outbreaks: The Elite Medical Detectives of the Epidemic Intelligence Service is a fast-paced tour through nearly six decades of epidemiology achievements by this relatively small program of the Centers for Disease Control and Prevention. It's a fast and fascinating read, and its episodic structure makes it an easy book to carry around and dip into whenever you've a got a few minutes of free time.
The public-health professionals who join the EIS - usually for two-year stints, though some stay longer - are often young and willing to take risks, from giving smallpox vaccinations in a war zone to taking controversial positions on issues like gun control. It's easy to envision them dashing from one outbreak to the next, using their time in transit to read up on anthrax, smallpox, or whatever other agent is suspected of sickening people in the places they're heading. Reading Inside the Outbreaks is kind of like watching a season of a superhero TV show - there's always a new villain threatening an innocent community (salmonella in cake mix one week, tapeworm from sheep the next), plus an old nemesis or two that can be weakened but not killed off (malaria, influenza). Not every episode ends in victory, but after reading the book I'm in awe of all the EIS has achieved.
As exciting as that is, though, it's clear that there's a lot of grunt work involved. Pendergrast uses the phrase "shoe-leather epidemiology" often - it's a concept EIS founder Alexander Langmuir drummed into EIS officers' heads. When EIS investigators arrive on the scene of an outbreak, they often start by taking lots of samples - of blood, stool, air, soil, and any other substances that might give them a clue. They survey people about what they've eaten, what activities they've been engaged in, and which parts of a building they walk through. Then they crunch the data - and if that doesn't yield an answer, they have to go back and ask more questions. Here's one description of an approach Langmuir taught to EIS recruits ...
Read the whole thing here.
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This sounds like the basis for the show Medical Investigation, which is just the kind of superhero style TV show about the CDC that you imagine. I thought when I watched the show that it was far-fetched - a kind of House for epidemiologists with as much connection to the real world of outbreak investigation as House does to internal medicine - but perhaps I judged it too soon.
I am keen to read the book now. Thanks for bringing it to my attention
I'll have to check out Medical Investigation! I did actually think of House when I was writing that sentence, and wondered if it's possible for a show to create a popular prime-time drama without stretching the medical truth.