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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.

In the United States

SoyNut Butter
Protecting Children: Early Clues Help Quickly Solve Outbreak of E. coli Infections
Prompt action by CDC and its public health partners in early 2017 helped stop a fast-moving foodborne outbreak of Shiga toxin-producing Escherichia coli O157:H7 (STEC O157:H7) infections.

PulseNet 20 year anniversary
States use PulseNet to identify and solve outbreaks
States use PulseNet to identify and solve outbreaks of E. coli, Salmonella, Listeria, and Campylobacter, and other foodborne infections. In many cases, investigations lead to product recalls. As PulseNet celebrates its 20th anniversary, learn more about how this national laboratory network managed by CDC has helped protect the public’s health.

Transforming public health microbiology with whole genome sequencing for foodborne diseases
CDC is upgrading to a single, fast, and efficient whole genome sequencing process. This project will provide more reliable information about the germs that cause most illnesses associated with food, helping increase food safety in the United States and globally.

How much faster are CIDT's?
FoodCORE Centers and Real-World Use of GI CIDTs: Adapting to Changes in Clinical Diagnostics
The use of rapid tests to diagnose foodborne illness pose challenges to monitoring illnesses and progress toward preventing foodborne diseases. FoodCORE centers are making changes so they can continue to identify and investigate foodborne disease outbreaks efficiently.

Cow and milk
Innovative Product Testing Method Solves Outbreak Linked to Raw Milk
It is difficult to detect Campylobacter in raw milk, so Utah health agencies collaborated with partners to use a new sampling method to test raw milk for the outbreak strain. Their determination to confirm the source of the outbreak and success of this sampling methods stopped the outbreak and prevented additional illnesses.

potato salad
Quick Response to Botulism Outbreak Saves Lives
Botulism paralyzes or kills quickly. Just one case is a public health emergency, because it can signal an outbreak. That’s why CDC’s botulism clinical consultation service is on call 24/7.

photo of long road
Tennessee and Colorado Successfully Collaborate Despite being Miles Apart
Strong collaboration was key for the Colorado and Tennessee FoodCORE centers when investigating a Salmonella outbreak at a summer camp in Colorado. Teamwork is an important piece of the FoodCORE program. FoodCORE centers collaborate internally between laboratorians, epidemiologists, and environmental health specialists as well as externally with other centers and health departments.

Caramel Apples
Whole Genome Sequencing Pinpoints Source of Listeriosis Outbreak
Seven people died and 34 were hospitalized during a multistate listeriosis outbreak in fall 2014.  Investigators needed to know which cases of listeriosis were related to find the source of the outbreak. Whole genome sequencing, a laboratory technology that allows for detailed comparison of germs, helped investigators find the source of the outbreak sooner than if they only used traditional lab technologies.

woman using cellphone eating
Using Online Restaurant Reviews to Find Local Foodborne Outbreaks
Local health departments detect many foodborne outbreaks through illness complaint systems. The public, however, may not use these systems or may not be aware of them. Staff at the New York City Department of Health and Mental Hygiene worked with Columbia University and Yelp, an online review site, to pilot a project to identify foodborne outbreaks that may go undetected through traditional complaint systems.

chia seed and powder.
Asking the Right Questions Quickly from the Beginning
During an already busy summer in 2014, several FoodCORE centers proved once again to be instrumental during the investigation of a multistate outbreak of Salmonella infections involving multiple Salmonella serotypes. PulseNet initially detected several ill people with a rare DNA fingerprint of Salmonella Newport and multiple health departments, including six FoodCORE centers, immediately began working with their federal partners on the investigation.

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.

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.

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

Sea Otter swimming on his back in water
Poisoned Sea Otters in California

California scientists and veterinarians found themselves in the middle of a mystery. Over the span of a year, 11 dead or dying sea otters had been found around Monterey Bay, California. The sea otters’ gums had turned yellow and they had swollen livers, but when scientists and veterinarians tested for common diseases that can affect the liver, they didn’t find anything. They started exploring other possibilities and finally found a clue—a positive lab test revealed that the sea otters had died of something called microcystin. Microcystin is a toxin given off by a type of phytoplankton called cyanobacteria, also commonly known as “blue-green algae.”

Girl in lake floating on tube
Wisconsin’s Public Health Sleuths Take to the Lake

In the summer of 2012, an outbreak of gastrointestinal illnesses occurred at a Wisconsin lake. The Jackson County Health Department received quick notice of these illnesses and officials started to investigate. Officials found that many of the sick people had been at the same outdoor recreation area the day before they got ill. Investigators wanted to find the cause fast so they could keep more people from getting sick.

Candida auris
C. auris: CDC’s Response to a Global Emerging Threat
Candida auris (C. auris) is a multidrug-resistant fungus that can cause serious infections and even death. CDC alerted U.S. healthcare facilities to the risk that C.auris could spread between patients in hospitals, and continues to work with partners to better contain and prevent its spread.

cocci map
Improving Antibiotic Prescribing with Rapid Diagnostics and Education
People who get Valley fever are often misdiagnosed with bacterial pneumonia and given antibiotics. However, Valley fever is caused by a fungus, so antibiotics will not work. CDC is working to help healthcare providers better diagnose Valley fever, in part by supporting development of rapid diagnostic tests that can quickly provide clinicians with the information they need to appropriately treat patients.

fungus Coccidioides
Investigating the Expanding Geographic Range of Coccidioides into the State of Washington
In the past, scientists believed that Coccidioides, the fungus that causes valley fever, only lived in the Southwestern United States and parts of Latin America. However, cases of valley fever have recently been found in people in the south-central region of Washington State. CDC has been developing new tools that make it faster and easier to detect Coccidioides in the environment.

Photomicrograph of Exserohilum rostratum
Tracking the Long-term Progress of Patients Affected in the Multistate Fungal Meningitis Outbreak
After an unprecedented outbreak of fungal meningitis associated with contaminated steroid injections from a compounding pharmacy, CDC and partners are studying long-term outcomes for those patients.

Photomicrograph of Rhizopus oryzae
Fatal Gastrointestinal Fungal Infection Following Use of a Contaminated Dietary Supplement
CDC, FDA, and state health departments investigated a fatal case of gastrointestinal mucormycosis caused by Rhizopus oryzae in a premature infant.

MiSeq whole genome sequencer machine with CDC scientist working in the foreground
CDC Works to Improve Cryptosporidium Tracking in the United States
In the United States, the parasite Cryptosporidium sickens almost 750,000 people each year with watery diarrhea that can last for weeks. In 2010, CDC launched CryptoNet to collect Cryptosporidium DNA fingerprinting results. CryptoNet is the first tracking and DNA fingerprinting system for a disease caused by a parasite. It has provided valuable information on the different Cryptosporidium species infecting people in the United States.
Tennessee 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 worked with several states to figure out what caused the illness.

Around the Globe

solar concentrator

Using Solar Energy to Treat Waste in Kenya

Refugee camps are often crowded, making it essential—but difficult—to provide adequate infrastructure for safe drinking water and sanitation. Solar sanitation is an inexpensive, innovative, and effective form of waste treatment that uses concentrated solar energy to treat waste so it can be safely discarded or potentially used for fertilizer or fuel. This is a critical component of a holistic waste management system that will ensure latrines are emptied, maintained clean, and reused—conserving space in the camp and reducing open defecation.

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.


Defeating 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: Young girl drinking beside clay pot

Delivering 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 Works

Life–Saving Collaborations: USAID and CDC

In global health work, it is important to find legacies that stand the test of time and 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 a Globe
Fighting a Deadly Fungus: Preventing deaths from Cryptococcus

The fungus Cryptococcus causes life-threatening meningitis in hundreds of thousands of people every year. Most of these infections occur in sub-Saharan Africa. In countries with large populations of people living with HIV/AIDS, CDC is helping implement targeted cryptococcal screening programs and build laboratory capacity to detect cryptococcal infections early.

Dominican Republic Histoplasmosis Tunnel
Disease Detectives Investigate a Histoplasmosis Outbreak in the Dominican Republic

Outbreaks of histoplasmosis have been described in North, Central, and South America after activities that stir up soil or large amounts of bird or bat droppings. However, there had never been a known histoplasmosis outbreak in the Dominican Republic. In September 2015, a number of previously healthy young men were hospitalized with fever, headache, and cough, and the Dominican Republic Ministry of Health suspected the cause was histoplasmosis.