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Stories From the Field

These stories illustrate the work CDC and its partners do to advance public health across the United States and around the globe.

CDC experts work with states, countries, and other partners to detect and respond to outbreaks, train professionals and strengthen health systems, and create programs that increase the safety of people's food, water, and environment.

Read about some of the specific ways we do this below, and explore our general work with food, water, and fungus.

In the United States

Food

Bill Keene A Public Health Star Goes Out

Some people we meet through our work affect us well beyond professional exchange.  It is with deep regret that we share with you that Dr. William E. Keene, one of the nation’s top food safety epidemiologists, died Sunday December 1, 2013 at age 56, from complications of acute pancreatitis.

Baby laying on pillow Stopping a Salmonella Outbreak among Infants in a Nursery

In a quaint town along the South Carolina coast, an otherwise healthy 5 month old girl began to show signs of getting sick. After a few days of diarrhea, her condition worsened, and she started having blood in her stools. Her parents immediately took her to their pediatrician, where a stool sample revealed a Salmonella infection.

Foodcore group photoSpotlight on the 2013 Vision Meeting

Nearly 50 people attended the 2013 FoodCORE Vision Meeting in Atlanta on May 15-16, 2013. There were productive discussions about a variety of topics. The FoodCORE centers were able to develop group consensus about ongoing and upcoming projects, including model practices, metrics reporting and collaborating with partners.

Graphic: FoodNet mapFoodCORE and FoodNet: Complementary Collaborations in Connecticut

In 2012, CDC scientists monitored between 16 and 57 potential food poisoning clusters each week and investigated more than 200 multistate clusters nationwide. Two of CDC's food safety programs partner with 15 jurisdictions to get ahead of stubborn foodborne outbreaks: FoodCORE and FoodNet.

Graphic: University of FoodCORE logo"U" niversity partnerships-at the core of FoodCORE

It's hard to imagine that simply having students talk with patients about chicken livers, raw milk, and sprouts could help protect our food supply and save lives, but it's true. These students have become integral in identifying the culprits in outbreaks of foodborne illness across the country.

Photo: Computer keyboard keysOhio Uses Social Media to Help Protect People from Norovirus

Foodborne Diseases Centers for Outbreak Response Enhancement (FoodCORE) played a key role in solving a 2012 multistate outbreak of Salmonella Bareilly and Nchanga infections.

Photo: Raw Scraped Ground TunaHelping Solve Salmonella Outbreak Mysteries

Foodborne Diseases Centers for Outbreak Response Enhancement (FoodCORE) played a key role in solving a 2012 multistate outbreak of Salmonella Bareilly and Nchanga infections.

Photo: Group picture of New York City's 'Team Salmonella'New York City's "Team Salmonella" Successful in Solving an Outbreak

In August 2011, public health officials began an investigation into a Salmonella outbreak in which many cases resided in New York. An in-depth investigation was conducted by the New York City Department of Mental Health and Hygiene (NYCDOHMH), who is a partner in the FoodCORE project.

Photo: Blocks of Queso Fresco cheeseUtah Solves a Two-year Outbreak Mystery

For over 2 years, public health officials in Utah struggled with a Salmonella outbreak linked to queso fresco.

Image of a CantaloupeInvestment in public health saves lives

The September 2011 Listeria outbreak, which was linked to a single cantaloupe farm in Colorado, is a textbook example of how investments in coordinated public health response can save lives.

Image of Hazelnut PlantPulseNet at Work: Detecting Hazardous Hazelnuts

They're usually in bowls of mixed nuts that are a holiday staple. But for 8 people who lived in Michigan, Wisconsin, and Minnesota, the 2010 holidays weren't so merry. Beginning in late December, they all came down with a rare and serious illness caused by Escherichia coli O157:H7 that was lurking in, of all places, hazelnuts.

Image of Lady Working In Lab.PulseNet & Foodborne Disease Outbreak Detection

Pulse Net was developed after the 1993 E. coli O157 outbreak from hamburgers made 726 people sick and killed 4 children. After the outbreak, more clinical labs began testing ill people for E. coli and found many more infections—revealing the problem was more serious than originally thought.

Image of dead mouseWisconsin's Salmonella mystery and the surprising culprit

Salmonella – we've all heard the news and have avoided the recalled foods. Did you ever think you could get Salmonella without eating these tainted foods? The Association of Public Health Laboratories reports how one Wisconsin infant's illness sparked an international investigation that led to a surprising source and the role that CDC’s PulseNet played in the investigation.

Surveillance Chart.Surveillance finds the culprit

What do ground beef, leafy greens, unpasteurized apple juice, and raw cookie dough have in common? They all have been associated with one of the most lethal, and now one of the best known, foodborne pathogens—E. coli, which captured media attention in the U.S. after outbreaks caused widespread sickness and even death.

Image of Salami on BreadA food sleuth + a shopper card + a salami = Successful investigation

"A disease detective" is how CDC's Casey Barton Behravesh described her role in tracking down the source of a Salmonella outbreak in 2010 that sickened more than 270 persons in more than 40 states. And what unlocked the mystery? Something most of us have in our wallets or on our key rings.

Image of Mary McGonigle-MartinReal Stories of the Dangers of Raw Milk

Mary McGonigle-Martin, from California, is the kind of mom who does her homework. Searching for a healthier way to provide dairy for her 7-year-old son, she considered raw milk.

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Water

Girl in lake floating on tubeWisconsin's Public Health Sleuths Take to the Lake

In the summer of 2012, a Wisconsin lake was the site of an outbreak of gastrointestinal illnesses. Local public health officials at the Jackson County Health Department were quickly notified of these illnesses and started to investigate the situation. Early on, officials found that many of the sick people had been at the same outdoor recreation area the day before they got ill. They felt an urgency to rapidly identify a cause so they could keep more people from getting sick.

Image of Frozen PipesFrozen pipes could be hazardous to your health

We've all probably experienced water pressure drops, or even interruptions in water service. It's usually no more than mildly inconvenient. But when you're without water for 12 days, like people in two rural counties in Alabama were in January 2010, it could be dangerous to your health.

Image of Campylobacter on PetriA camp(y) fire tale

Around the 4th of July 2010, near West Yellowstone, Montana, people were reporting to clinics and emergency departments with symptoms of acute gastroenteritis. Almost 100 people had come down with illness caused by a very common gastrointestinal germ, Campylobacter jejuni.

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Fungus

Image of Iowa's Governor's MansionIllness tracked at the Iowa governor's mansion

In January 2008, 9 cases of lung disease were identified in office workers in Des Moines. They had symptoms similar to those of influenza: fever, chills, muscle aches, and cough. CDC assisted the county and state health departments in conducting environmental sampling to find the source.

Image of quote - 'C.Gatti is still rare so we don't want people to panic or to misunderstand the risk of   infection, but it is serious,' Dr. Julie Harris, CDC's National Center  for Emerging and Zoonotic  Infectious DiseasesAlert Montana disease detective identifies the suspect: Cryptococcus gattii

In response to increasing numbers of cases of Cryptococcus gattii in the US Pacific Northwest, the northwest states (OR, WA, MT, ID, and AK) formed a Working Group in 2008 to address this public health nemesis that causes a variety of serious infections.

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Parasite

CowTennessee Detectives Investigate an Outbreak of Cryptosporidium

In the summer of 2012, public health officials in Tennessee were notified that a group of volunteers were sick with gastroenteritis. The volunteers were from multiple states and had traveled to Tennessee to work on a farm. Tennessee officials collaborated with several other states to figure out what caused the illness. They used an online survey to collect information, but after a couple days only a few volunteers had responded.

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Around the Globe

Food

Image of Dr. Raufu Ibrahim, highly trained Nigerian Salmonella researcherGlobal Foodborne Infections Network strengthens foodborne disease outbreak detection and response

Frustrated by a lack of adequate laboratory supplies and dated laboratory facilities, Dr. Raufu Ibrahim, a highly trained Salmonella researcher in Nigeria, was unable to confirm his suspicion about a new strain of Salmonella. Undeterred, Dr. Ibrahim contacted international reference laboratories for assistance and received a response from the Global Foodborne Infections Network.

Map of the PulseNet International Network: 83 member countries from 7 nationalPulseNet International: Tracking foodborne disease outbreaks throughout the world

In February 2007, millions of Americans heard news reports about a large multistate outbreak of Salmonella traced to peanut butter produced in Atlanta, Georgia. But foodborne disease outbreaks do not respect borders—so CDC's PulseNet program was working to ensure global detection of the outbreak.

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Water

Two members of the safe water club at Sino SDA Primary School in Nyanza Province in rural Kenya treating the school drinking water with WaterGuard. Typhoid Fever Targets Children from Kenyan Urban Slums

About 200,000 people live in Kibera, a slum on the outskirts of Nairobi, Kenya, and the largest informal settlement in East Africa. With an estimated one-pit latrine for every 200 people, residents use plastic bags for relief and then dispose of them anywhere. This practice, known as ‘flying toilets’, is more common at night among women and children concerned about the area’s lack of security. Without sanitation facilities to contain and dispose of human feces, those living nearby are at risk for enteric diseases (those that cause diarrhea, nausea, or vomiting), such as typhoid fever.

GEMS TeamDefeating Diarrhea: CDC and Partners Tackle Causes and Consequences in Kenya and Beyond

"What if we lost 50 city buses full of children today?" asks Michael Beach, the associate director for healthy water in CDC's National Center for Emerging and Zoonotic Infectious Diseases. "That's 2,195 children—the number who die daily of diarrhea around the world. That's more than die from AIDS, malaria, and measles combined."

Photo: Two buckets stacked on a lawn.Christian Health Association of Kenya Collaborates with CDC in Safe Water

Limited access to safe water in Nyanza and Western Provinces, Kenya is a major problem. Diarrhea rates in these regions are among the highest in Kenya. An inexpensive safe water system can reduce the risk of diarrhea from 25–85%.

Photo: Haitian children in front of a CDC vehicleInternational Outbreak Investigations

International outbreak investigations involve providing assistance to foreign Ministries of Health to identify the causes, understand the associated risk factors, control transmission, and prevent further spread of water, sanitation, and hygiene (WASH)-related disease—like a typhoid fever outbreak in Zimbabwe or Cholera outbreak in Haiti.

Photo: Young girl drinking beside clay potDelivering Health by the Drop

In the world today, close to 1 billion people still drink water collected directly from streams, lakes and shallow hand-dug wells, while hundreds of millions more drink contaminated water from unsafe municipal systems or borehole wells.

Graphic: Country Map of Where the CDC WorksLife–saving collaborations: USAID and CDC

In global health work, it is important to find legacies that stand the test of timeand scrutiny. CDC and USAID's collaboration to address critical global health issues is one that provides both agencies the opportunity to build such a legacy.

Image of An Ivorian child washes her hands on the first Global Handwashing Day, which took place in 2008Lack of soap means illness, death for millions of children

It still makes Fatoma Dia's eyes widen whenever the Hilton hotel cleaning worker sees a bar of barely used soap on a bathroom counter. "This," she says, picking it up with a gloved hand and dropping it in a brown bucket, "is valuable where I come from." The 35-year-old grew up in a mountainous region of southern Sudan where soap can cost more than a day's wages. CNN Heroes reports on the CDC-WHO collaboration that has led to facilitating better sanitation in needy regions and teaching people the importance of basic hand washing.

Image of Two Kenyan School ChildrenSafe water school interventions in Kenya save lives

Over 1.1 billion people worldwide do not have access to safe drinking water. Nearly two million children die each year due to diarrhea and other infectious diseases resulting from unsafe drinking water, inadequate sanitation, and poor hygiene. To prevent these deaths, CDC and its partners developed the Safe Water System.

Image of Kenyan WomanSafe water and HIV: Evidence-based integration

Jemima is a woman living with HIV in rural western Kenya, where rates of HIV are among the highest in the world. She founded a group that provides emotional support and small loans to HIV-affected families in her home area. However, Jemima's own HIV disease continued to progress.

Image of Haitian Woman and a water bucketBasic public health actions rapidly mobilized to lessen impact of cholera in earthquake-devastated Haiti

When the January 2010 earthquake struck Haiti, the first priorities of Haitian public health officials and their partners, including CDC and USAID, were improving access to clean water and sanitation and promoting basic hygiene to protect Haitians from threats they faced living in crowded, temporary camps.

Image of Haitian Health Workers in RoomTraining teaches Haitian health care workers: "No one need die from diarrheal disease"

When a cholera outbreak occurs in resource-limited countries like Haiti, where sanitary conditions are poor and safe water systems do not exist, public health officials must act quickly. A first request of CDC and partners was to help educate health care workers to manage cholera and teach Haitians how to prevent it.

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Fungus

Image of a GlobeFighting a deadly fungus: A new strategy to prevent deaths due to Cryptococcus

In people with weakened immune systems, the fungus Cryptococcus causes life-threatening meningeal infections in nearly a million people every year. Cryptococcus is the most common cause of meningitis in sub-Saharan Africa, and is a leading cause of death among people with HIV.

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