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CDC’s 62nd Annual Epidemic Intelligence Services (EIS) Conference Begins Today: Showcases “Disease Detectives” and their Life-Saving Work

Publishing Date: April 22, 2013

The U.S. Centers for Disease Control and Prevention (CDC) this week kicked off its 62nd Annual Epidemic Intelligence Service (EIS) Conference in Atlanta, beginning a week-long conference dedicated to showcasing the life-saving work of its current EIS officers, or “disease detectives,” and welcoming the incoming class of officers to the two-year postgraduate EIS program.

The week began with opening remarks from CDC Director Tom Frieden, MD, MPH, (audio file: mp3[25:07 23MB] | transcript) who discussed, among other things, the future of the field of disease detection. Today through Friday, disease detectives will present their research findings from U.S. and international-based investigations conducted over the past year. Below are several EIS officers and their work that will be featured during the conference.

Conference Spokesperson

Tom Frieden, MD, MPH

Tom Frieden, MD, MPH

Director, Centers for Disease Control and Prevention

"For more than 60 years, CDC’s Epidemic Intelligence Service (EIS) program has attracted and mentored some of the most innovative minds in health. This is an exciting time to be an EIS officer. The future of disease detection is advancing – it’s not only spreadsheets and shoe leather anymore, rather its spreadsheets and shoe leather combined with molecular sequencing and bioinformatics. CDC needs next generation thinkers and technologies to find and stop lethal threats before they spread in order to continue to save lives, protect people, and support America’s economic progress."

Biography

Advanced Molecular Detection (AMD) and Response to Infectious Disease Outbreaks

Carbapenem-Resistant Klebsiella pneumoniae Producing New Delhi Metallo-Beta-Lactamase at an Acute-Care Hospital — Denver, Colorado, 2012

The four month outbreak of a type of Carbapenem-resistant Enterobacteriaceae (CRE) known as New Delhi Metallo-Beta-Lactamase occurred at one hospital and highlights the risk for potential organism spread of this type of CRE. Investigators conducted whole genome sequencing in addition to other laboratory tests that identify resistance to antibiotics. Using conventional testing methods alone, all isolates appeared to match (90-95% similar). By adding whole genome sequencing, investigators were able to divide these closely related strains into three distinct clusters, which when correlated with patient movements and locations, revealed that transmission primarily occurred in four specific places in the hospital. This study shows that whole genome sequencing can help pinpoint the cause of outbreaks and help public health experts stop them in the future.

Abstract

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Klebsiella pneumoniae

Klebsiella pneumoniae

Lab samples showing the presence of CRE

CDC staff show two plates growing bacteria in the presence of discs containing various antibiotics. The isolate on the left plate is susceptible to the antibiotics on the discs and is therefore unable to grow around the discs. The one on the right has a CRE that is resistant to all of the antibiotics tested and is able to grow near the disks.

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Our research shows how next-generation tools like whole genome sequencing can help disease detectives rapidly and accurately find and control dangerous microbes that cause healthcare-associated infections. Combining traditional epidemiology with new technologies can help prevent further spread and protect more people from these highly transmissible and often deadly infections.

Erin E. Epson, MD - EIS Officer

Back to Top

Outbreak of Listeriosis Associated with Imported and Cross-Contaminated Cheeses — Multiple States, March–October 2012

In 2012, an imported soft cheese called ricotta salata was implicated in a multistate outbreak of 22 Listeria infections. Two people died, a pregnant woman had a miscarriage, and other people were seriously ill. Not all of the ill persons ate ricotta salata, and the outbreak strain of Listeria was also detected in four other soft cheeses. CDC investigators strongly suspect that imported ricotta salata was the original source, and that it cross-contaminated other cheeses during distribution or at cheese stores.

Abstract

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Description

Listeria monocytogenes bacteria

Description

CDC Epidemic Intelligence Service (EIS) officer Michael Gronostaj, MD, PharmD, MPH (LCDR, USPHS) transporting a cooler of cheese samples to the laboratory for microbiological testing

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Cheese retailers need to understand that Listeria and other pathogens can sometimes contaminate soft cheeses, and that they should take measures to prevent cross-contamination from one cheese to another via cutting boards and knives. Pregnant women, the elderly, and immune-compromised persons should be aware that soft cheese can be a source of serious Listeria illness.

Michael Gronostaj, MD, PharmD, MPH - EIS Officer

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Environmental Tobacco Smoke (ETS) Exposure and All-Cause Mortality: A Prospective Cohort Analysis of the Third National Health and Nutrition Examination Survey (NHANES III)

This study examined the association between secondhand smoke and deaths from all causes and from heart disease. Although the risk of death from secondhand smoke is already known, previous studies have relied on self-reported information about people’s exposure to secondhand smoke.  What makes this study unique is that it is nationally-representative of the U.S. population and we looked at markers in people’s blood to determine their level of exposure to secondhand smoke. 

Abstract

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Description

Secondhand smoke causes an estimated 46,000 premature deaths from heart disease and 3,400 deaths from lung cancer among U.S. nonsmokers each year.

Description

Secondhand smoke contains more than 7000 chemicals. Hundreds are toxic and about 70 can cause cancer.

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Heart disease is the leading cause of death for both men and women in the United States. Our study confirmed that exposure to secondhand smoke was associated with an increased risk of death from heart disease in a nationally representative sample of adult non-smokers.

Tala H.I. Fakhouri, PhD, MPH - EIS Officer

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Increasing Number and Disproportionate Morbidity and Mortality Associated with Multistate Foodborne Disease Outbreaks — United States, 1973–2010

Over the past 40 years, the number of multistate foodborne disease outbreaks has increased four-fold. These outbreaks represented only 1 percent of foodborne disease outbreaks over the last decade; however, they accounted for 5 percent of outbreak-related illnesses, 21 percent of hospitalizations, and 26 percent of deaths.

Abstract

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Description

Dr. Nguyen interviewing a California patient as part of multistate foodborne outbreak investigation

Description

Many different foods, including some of these, have been implicated in multistate foodborne outbreaks

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Our ability to detect multistate outbreaks has improved in several ways: first, there is increased collaboration between local, state, and federal public health authorities; and second, we have improved surveillance using systems like PulseNet, the national network of public health laboratories created in 1996, that subtypes germs isolated from ill people. Preventing outbreaks requires implementation of more effective measures from farm to table, and the participation of producers, government, and consumers.

Von D. Nguyen, MD, MPH - EIS Officer

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Progress in Reducing National Burden of Invasive Methicillin-Resistant Staphylococcus aureus Infections — United States, 2005–2010*

Methicillin-resistant Staphylococcus aureus (MRSA) is the most common cause of skin and soft tissue infections in the United States and often causes serious invasive infections, including bloodstream infections and death. Recent efforts to reduce MRSA in healthcare have resulted in a 54 percent decline in serious MRSA infections in hospitals between 2005 and 2011. This study showed that there were 30,800 fewer serious MRSA infections and over 9,000 fewer deaths among individuals hospitalized with MRSA in 2011 verses 2005. Serious MRSA infections are now more common in community individuals with no recent health exposures than hospitalized individuals. Future efforts need to focus on preventing serious MRSA infections outside of hospitals.

Abstract

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Description

CDC Epidemiology Intelligence Service Office, Dr. Raymund Dantes, samples a blood pressure cuff for microorganisms during an healthcare-associated infection outbreak.

Description

CDC microbiologist, Valerie Albrecht, holds up two plates of methicillin-resistant Staphylococcus aureus (MRSA).

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Once we know where infections occur, we can work to better prevent them. Although serious hospital MRSA infections have been cut in half in recent years, more work needs to be done to protect patients from these serious infections both inside and outside the hospital.

Raymund B. Dantes, MD, MPH - EIS Officer

*Data being presented is updated from the original abstract to include 2011 numbers.

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Tri-National Outbreak of Salmonella enterica Serotype Braenderup — The California Experience, July–September 2012

In August 2012 an outbreak caused by the bacteria, Salmonella, was detected in multiple states in the United States and Canada. The majority of infections occurred in California where more than 100 people fell ill and 30 were hospitalized. An investigation conducted by the California Department of Public Health identified mangoes imported from a supplier in Mexico as the source of illness. Mangos produced by the supplier tested positive for Salmonella. To prevent further illness an import alert was place on the mango supplier by the U. S. Food and Drug Administration and certain lots of mangos were voluntarily recalled by distributers in the United States and Canada.

Abstract

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Description

State and federal experts identified mangos imported from a supplier in Mexico as the source of illness among multiple states in the U.S. and Canada.

Description

EIS Officer Racheal Joseph, VMD, MPH, interviews a patient infected with the outbreak strain of Salmonella.

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An increasingly globalized food market has led to greater potential for multinational outbreaks of Salmonella. This investigation highlights the importance of collaborating with our public health partners across international borders to identify sources of illness and prevent future foodborne outbreaks.

Rachael H. Joseph, VMD, MPH - EIS Officer

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