Epidemiologic Assistance (Epi-Aids) and Field Investigations
An Epi-Aid is an investigation of an urgent public health problem, such as infectious or non-communicable disease outbreaks, unexplained illnesses, or natural or manmade disasters. When a public health authority requests assistance from the U.S. Centers for Disease Control and Prevention, an Epi-Aid allows rapid, short-term (1–3 weeks), generally onsite, technical assistance by EIS Officers and other CDC subject matter experts. The focus on an Epi-Aid investigation is to assist partners in making rapid, practical decisions for actions to prevent and control the public health problem.
These are examples of Epi-Aids and field investigations conducted by EIS Officers at NCEH/ATSDR.
- Undetermined causes of severe bleeding among emergency room patients reporting use of synthetic cannabinoids — Illinois, 2018
- Legionellosis cluster associated with working at a racetrack — West Virginia, 2018
- A large-scale outbreak of acute gastroenteritis on a cruise ship, 2018

Amy Lavery (EIS ’17) and Jared Rispens (EIS ’18), pictured with Keisha Houston, Amy Freeland, and Aimee Treffiletti, responding to a large-scale outbreak of acute gastroenteritis on a cruise ship. 3-D maps of the ship helped the team understand where and how cases occurred over time throughout the ship.
- Undetermined risk factors for invasive mold infections among immunocompromised residents in flood-affected areas — Houston Metropolitan Area, Texas, 2017
- Community Assessment for Public Health Emergency Response (CASPER) addressing the ongoing response to Zika virus – U.S. Virgin Islands, 2017
- Community Assessment for Public Health Emergency Response (CASPER) addressing Oregon drought conditions – Crook County, Oregon, 2017
- Community Assessment for Public Health Emergency Response (CASPER) addressing population health needs after hurricanes Irma and Maria, 2017

Audrey Pennington (EIS ’17) collecting environmental samples following Hurricane Harvey
- Epidemiology support for Spokane Tribe assessment of private well water — Wellpinit, WA, 2016
- Zika surveillance for the U.S. Zika Pregnancy Registry — American Samoa, 2016
- Investigation of high levels of lead in drinking water — Flint, Michigan, 2016
- Improvement of water, sanitation, and hygiene during a cholera outbreak — Tanzania, 2016
- Undetermined risk factors for asthma-related healthcare utilization — Puerto Rico, 2016

Nanda Issa (EIS ’16) arrives in the U.S. Virgin Islands to perform a Community Assessment for Public Health Emergency Response (CASPER)
- Investigation of severe illness and death associated with homemade alcoholic beverage among funeral attendees — Mozambique, 2015
- Investigation of adverse events associated with synthetic cannabinoid — Mississippi, 2015

Lillianne Lewis (EIS’15) and Emilio Dirlikov (EIS’15) in Puerto Rico

Alice Wang (EIS ’15) in Tanzania
- Investigation of Ebola Virus Disease — Ohio, 2014
- Investigation of Ebola Virus Disease Importation — Texas, 2014
- Undetermined risk for childhood lead poisoning in the area surrounding a former lead paint production facility — Pennsylvania, 2014
- Undetermined burden of disease and risk factors for chikungunya virus infections — Puerto Rico, 2014
- Investigation of asthma-related ER visits — Utah, 2014
- Undetermined risk factors and mode of transmission in a healthcare-associated Legionnaires’ disease outbreak — Alabama, 2014
- Undetermined source for a Legionnaires’ disease outbreak associated with a resort — Georgia, 2014

Amy Kasper (EIS ’14) interviews cases in Mozambique
- Medical chart review and hospital survey after the Elk River chemical spill — West Virginia, 2013
- Impact of Drought Conditions on Private Well Owners — Multistate, 2013
- Community Assessment for Public Health Emergency Response (CASPER) for Rapid Identification of Disaster Response and Recovery Needs of Communities Affected by the Elk River Chemical Spill – West Virginia, 2013
- Investigation of fatal opiate-related overdoses — Rhode Island, 2013
- Investigation of NICU deaths in Hospital A — Panama, 2013
- An epidemiologic and environmental investigation of a Legionnaires’ disease outbreak associated with a family reunion — Georgia, 2013
- Steroid contamination of nutritional supplements — New York, 2013
- Investigation of a fatal, unknown, psychoactive substance-related intoxication — Colorado, 2013
- Acute Hepatitis and Liver Failure Following Use of a Dietary Supplement — Multistate, 2013
- Investigation of new cases of liver disease to characterize the outbreak, identify risk factors for illness, and assess exposure to PAs from food grains — Ethiopia, 2013

Ethan Fechter-Leggett (EIS ’13) and Sherry Burrer (EIS ’08) collecting surveys from volunteers during a Community Assessment for Public Health Emergency Response (CASPER) following the Elk River chemical spill in West Virginia
- Polio surveillance rapid field assessment — Kenya, 2012
- Acceptance and understanding of National Weather Service NWS winter weather warnings — North Dakota, 2012
- Evaluation of the impact of adult mosquito control during a West Nile virus outbreak — Texas, 2012
- Community preparedness for emergencies — Michigan, 2012
- Community health effects of mercaptan exposure — Alabama, 2012
- Clinical Characterization of Case-Patients Identified as Part of an Outbreak of Fungal Infections Associated with Medications — Indiana, Virginia, 2012
- Shelter Surveillance post Hurricane Sandy — New Jersey, 2012
- Community experiences and perceptions of geothermal venting and emergency preparedness — California, 2012
- Investigation after vinyl chloride release from a train derailment — New Jersey, 2012

Bryan Christensen (EIS ’10) and Matthew Lozier (EIS’12) sample for hydrogen sulfide and methane in a community where geothermal venting releases these gases into the air.
- The body burden of environmental contaminants in a vulnerable population — Ethiopia, 2011
- Evaluation of dogs as sentinels for human risk for Rocky Mountain spotted fever in an emergent area — Arizona, 2011
- Elevated radiation exposure in patients following Rubidium-82 cardiac imaging scans — Alabama, Florida, Nevada, New York, 2011
- Risk assessment for rabies PEP following exposure to a bat on an airplane — Wisconsin, 2011
- Chlorine Gas Exposure at a Poultry Processing Plant — Arkansas, 2011
- Heat-related illness among migrant farmworker populations — Southern Georgia, 2011
- Investigation of a liver disease of unknown etiology — Tigray, Ethiopia, 2011

Danielle Buttke (EIS ’10) analyzing samples in Ethiopia

Ekta Choudhary (EIS ’09) in American Samoa for a Community Assessment for Public Health Emergency Response (CASPER)