Centers for Disease Control and Prevention

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Centers for Disease Control and Prevention
US CDC logo.svg
Agency overview
Formed July 1, 1946; 69 years ago (1946-07-01)
Preceding agencies
  • Office of National Defense Malaria Control Activities (1942)
  • Office of Malaria Control in War Areas (1942–1946)
  • Communicable Disease Center (1946–1967)
  • National Communicable Disease Center (1967–1970)
  • Center for Disease Control (1970–1980)
  • Centers for Disease Control (1980–1992)
Jurisdiction Federal government of the United States
Headquarters DeKalb County, Georgia, U.S.
Employees 15,000
Annual budget US $7.010 billion (2016 FY)
Agency executive
Parent agency United States Department of Health and Human Services
Website "CDC website" (PDF). Retrieved November 9, 2015. 

The Centers for Disease Control and Prevention (CDC) is the leading national public health institute of the United States. The CDC is a federal agency under the Department of Health and Human Services and is headquartered in unincorporated DeKalb County, Georgia, a few miles northeast of the Atlanta city limits.[2][3][4]

Its main goal is to protect public health and safety through the control and prevention of disease, injury, and disability. The CDC focuses national attention on developing and applying disease control and prevention. It especially focuses its attention on infectious disease, food borne pathogens, environmental health, occupational safety and health, health promotion, injury prevention and educational activities designed to improve the health of United States citizens. In addition, the CDC researches and provides information on non-infectious diseases such as obesity and diabetes and is a founding member of the International Association of National Public Health Institutes.[5]

History[edit]

See also: Centers for Disease Control and Prevention timeline
CDC headquarters in Druid Hills, Georgia, as seen from Emory University
CDC′s Roybal campus in Atlanta, Georgia
Arlen Specter Headquarters and Emergency Operations Center
Tom Harkin Global Communications Center
CDC and MSF staff preparing to enter an Ebola treatment unit in Liberia, August 2014

The Communicable Disease Center was founded July 1, 1946, as the successor to the World War II Malaria Control in War Areas program[6] of the Office of National Defense Malaria Control Activities.[7] Preceding its founding, organizations with global influence in malaria control were the Malaria Commission of the League of Nations and the Rockefeller Foundation.[8] The Rockefeller Foundation greatly supported malaria control,[8] sought to have the governments take over some of its efforts, and collaborated with the agency.[9]

The new agency was a branch of the U.S. Public Health Service and Atlanta was chosen as the location because malaria was endemic in the Southern United States.[10] The agency changed names (see infobox on top) before adopting the name Communicable Disease Center in 1946. Offices were located on the sixth floor of the Volunteer Building on Peachtree Street. With a budget at the time of about $1 million, 59 percent of its personnel were engaged in mosquito abatement and habitat control with the objective of control and eradication of malaria in the United States[11] (see National Malaria Eradication Program).

Among its 369 employees, the main jobs at CDC were originally entomology and engineering. In CDC's initial years, more than six and a half million homes were sprayed, mostly with DDT. In 1946, there were only seven medical officers on duty and an early organization chart was drawn, somewhat fancifully, in the shape of a mosquito. Under Joseph Walter Mountin, the CDC continued to advocate for public health issues and pushed to extend its responsibilities to many other communicable diseases.[12] In 1947, the CDC made a token payment of $10 to Emory University for 15 acres (61,000 m2) of land on Clifton Road in DeKalb County, still the home of CDC headquarters today. CDC employees collected the money to make the purchase. The benefactor behind the “gift” was Robert W. Woodruff, chairman of the board of The Coca-Cola Company. Woodruff had a long-time interest in malaria control, which had been a problem in areas where he went hunting. The same year, the PHS transferred its San Francisco based plague laboratory into the CDC as the Epidemiology Division, and a new Veterinary Diseases Division was established.[6] An Epidemic Intelligence Service (EIS) was established in 1951, originally due to biological warfare concerns arising from the Korean War; it evolved into two-year postgraduate training program in epidemiology, and a prototype for Field Epidemiology Training Programs (FETP), now found in numerous countries, reflecting CDC's influence in promoting this model internationally.[13]

The mission of CDC expanded beyond its original focus on malaria to include sexually transmitted diseases when the Venereal Disease Division of the U.S. Public Health Service (PHS) was transferred to the CDC in 1957. Shortly thereafter, Tuberculosis Control was transferred (in 1960) to the CDC from PHS, and then in 1963 the Immunization program was established.[14]

It became the National Communicable Disease Center (NCDC) effective July 1, 1967.[7] The organization was renamed the Center for Disease Control (CDC) on June 24, 1970, and Centers for Disease Control effective October 14, 1980.[7] An act of the United States Congress appended the words "and Prevention" to the name effective October 27, 1992. However, Congress directed that the initialism CDC be retained because of its name recognition.[15]

Currently the CDC focus has broadened to include chronic diseases, disabilities, injury control, workplace hazards, environmental health threats, and terrorism preparedness. CDC combats emerging diseases and other health risks, including birth defects, West Nile virus, obesity, avian, swine, and pandemic flu, E. coli, and bioterrorism, to name a few. The organization would also prove to be an important factor in preventing the abuse of penicillin.

In May 1994 the CDC admitted having sent several biological warfare agents to the Iraqi government from 1984 through 1989, including Botulinum toxin, West Nile virus, Yersinia pestis and Dengue fever virus.[16]

On April 21, 2005, then-CDC Director Julie Gerberding, formally announced the reorganization of CDC to "confront the challenges of 21st-century health threats".[17] The four Coordinating Centers — established under the G. W. Bush Administration and Gerberding — "diminished the influence of national centers under [their] umbrella", [clarification needed] and were ordered cut under the Obama Administration in 2009.[18]

The CDC's Biosafety Level 4 laboratories are among the few that exist in the world,[19] as well as one of only two official repositories of smallpox in the world. The second smallpox store resides at the State Research Center of Virology and Biotechnology VECTOR in the Russian Federation. The CDC revealed in 2014 that it had discovered several misplaced smallpox samples and also that lab workers had potentially been infected with anthrax.[20]

Organization[edit]

The CDC is organized into "Centers, Institutes, and Offices" (CIOs) which allow it to be responsive and effective in its interface with public health concerns. Each organizational unit implements the agency's response in a particular area of expertise. Within "Offices" are Centers, Divisions, and Branches.

CIOs are

  • CDC Washington Office
  • Center for Global Health
  • National Institute for Occupational Safety and Health
  • Office for State, Tribal, Local and Territorial Support
  • Office of Equal Employment Opportunity
  • Office of Infectious Diseases
    • National Center for Emerging and Zoonotic Infectious Diseases
      • Division of High-Consequence Pathogens and Pathology (DHCPP)
        • Viral Special Pathogens Branch (VSPB)
    • National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
    • National Center for Immunization and Respiratory Diseases
  • Office of Minority Health and Health Equity
  • Office of Noncommunicable Diseases, Injury and Environmental Health
    • National Center for Chronic Disease Prevention and Health Promotion
    • National Center for Environmental Health/Agency for Toxic Substances and Disease Registry
    • National Center for Injury Prevention and Control
    • National Center on Birth Defects and Developmental Disabilities
  • Office of Public Health Preparedness and Response
    • Division of Emergency Operations
      • Emergency Operations Center (EOC)
  • Office of Public Health Science Services
    • Center for Surveillance, Epidemiology and Laboratory Services
    • National Center for Health Statistics
  • Office of the Associate Director for Communication
  • Office of the Associate Director for Policy
  • Office of the Associate Director for Science
  • Office of the Chief of Staff
  • Office of the Chief Operating Officer

Budget and workforce[edit]

CDC’s Fiscal Year 2014 budget was $6.9 billion.[21][22][needs update]

As of 2008, staff numbered approximately 15,000 (including 6,000 contractors and 840 Commissioned Corps officers) in 170 occupations. Eighty percent have earned bachelor's degrees or higher; almost half have advanced degrees (a master's degree or a doctorate such as a PhD, D.O., or M.D.).[23] CDC job titles include engineer, entomologist, epidemiologist, biologist, physician, veterinarian, behaviorial scientist, nurse, medical technologist, economist, public health advisor, health communicator, toxicologist, chemist, computer scientist, and statistician.[24]

In addition to its Atlanta headquarters, the CDC has other locations in the United States and Puerto Rico. Those locations include Anchorage; Cleveland; Cincinnati; Fort Collins; Hyattsville; Morgantown; Pittsburgh; Research Triangle Park; San Juan, Puerto Rico; Spokane, Washington; Detroit; and Washington, D.C. The CDC also conducts the Behavioral Risk Factor Surveillance System, the world’s largest, on-going telephone health survey system.[25]

The CDC offers grants that help many organizations each year bring health, safety and awareness to surrounding communities throughout the entire United States. As a government-run department, the Centers for Disease Control and Prevention awards over 85 percent of its annual budget through these grants to accomplish its ultimate goal of disease control and quality health for all.[26]

The CDC operates the Public Health Associate Program (PHAP), a two-year paid fellowship for recent college graduates to work in public health agencies all over the United States. PHAP was founded in 2007 and currently has 159 associates in 34 states.[27]

Directors[edit]

David Sencer points to a depiction of Triatomine sp., which transmits Chagas disease.

The President of the United States appoints the director of the CDC and the appointment does not require Senate confirmation. The director serves at the pleasure of the President and may be fired at any time.[28][29] Sixteen directors have served the CDC or its predecessor agencies.[30][31]

  • Louis L. Williams, Jr., MD (1942–1943)
  • Mark D. Hollis, ScD (1944–1946)
  • Raymond A. Vonderlehr, MD (1947–1951)
  • Justin M. Andrews, ScD (1952–1953)
  • Theodore J. Bauer, MD (1953–1956)
  • Robert J. Anderson, MD, MPH (1956–1960)
  • Clarence A. Smith, MD, MPH (1960–1962)
  • James L. Goddard, MD, MPH (1962–1966)
  • David J. Sencer, MD, MPH (1966–1977)
  • William H. Foege, MD, MPH (1977–1983)
  • James O. Mason, MD, MPH (1983–1989)
  • William L. Roper, MD, MPH (1990–1993)
  • David Satcher, MD, PhD (1993–1998)
  • Jeffrey P. Koplan, MD, MPH (1998–2002)[32]
  • Julie Gerberding, MD, MPH (2002–2008)
  • Thomas R. Frieden, MD, MPH (2009–present)[28]

Foundation[edit]

The CDC Foundation[33] operates independently from CDC as a private, nonprofit 501(c)(3) organization incorporated in the State of Georgia. The creation of the Foundation was authorized by section 399F of the Public Health Service Act to support the mission of CDC in partnership with the private sector, including organizations, foundations, businesses, educational groups, and individuals.

Data and survey systems[edit]

Publications[edit]

Diseases[edit]

Donald Henderson as part of the CDC's smallpox eradication team in 1966.

Influenza[edit]

The CDC has launched campaigns targeting the transmission of influenza, including the H1N1 swine flu. The CDC has launched websites including [flu.gov] to educate people in proper hygiene.[44]

Other infectious diseases[edit]

The CDC's website (see below) has information on other infectious diseases, including smallpox, measles, and others. The CDC runs a program that protects the public from rare and dangerous substances such as anthrax and the Ebola virus. The program, called the Select Agents Program, calls for inspections of labs in the U.S. that work with dangerous pathogens.[45]

During the 2014 Ebola outbreak in West Africa, the CDC helped coordinate the return of two infected American aid workers for treatment at Emory University Hospital, the home of a special unit to handle highly infectious diseases.[46]

As a response to the 2014 Ebola outbreak, the U.S. House of Representatives proposed and passed a Continuing Appropriations Resolution to allocate up to $30,000,000 towards CDCP's efforts to fight the virus.[47]

Non-infectious diseases[edit]

The CDC also works on non-infectious diseases, including obesity.[48]

Popular culture and controversies[edit]

Historically, the CDC has been relatively free of political manipulation.[49]

Tuskegee Study of Untreated Syphilis in the Negro Male[edit]

For 15 years, the CDC had direct oversight over the "Tuskegee Study of Untreated Syphilis in the Negro Male". In the study, which lasted from 1932 to 1972, a group of African American men (nearly 400 of whom had syphilis) were studied to learn more about the disease. Notably, the disease was left untreated in the research subjects and they never gave their informed consent to serve as research subjects. The Tuskegee Study was initiated in 1932 by the Public Health Service. The CDC took over the study in 1957.[50]

The CDC's response to the AIDS crisis in the 1980s has been criticized for promoting some public health policies that harmed HIV+ people and for providing ineffective public education.[49]

The agency's response to the 2001 anthrax attacks was criticized for ineffective communication with other public health agencies and with the public.[49]

CDC zombie apocalypse outreach campaign[edit]

On May 16, 2011, the Centers for Disease Control and Prevention's blog published an article instructing the public on what to do to prepare for a zombie invasion. While the article did not claim that such a scenario was possible, it did use the popular culture appeal as a means of urging citizens to prepare for all potential hazards, such as earthquakes, tornadoes, and floods.[51]

According to David Daigle, the Associate Director for Communications, Public Health Preparedness and Response, the idea arose when his team was discussing their upcoming hurricane information campaign and Daigle mused that "we say pretty much the same things every year, in the same way, and I just wonder how many people are paying attention." A social media employee mentioned that the subject of zombies had come up a lot on Twitter when she had been tweeting about the Fukushima Daiichi nuclear disaster and radiation. The team realized that a campaign like this would most likely reach a different audience from the one that normally pays attention to hurricane preparedness warnings and went to work on the zombie campaign, launching it right before hurricane season began. "The whole idea was, if you're prepared for a zombie apocalypse, you're prepared for pretty much anything," said Daigle.[52]

Once the blog article became popular, the CDC announced an open contest for YouTube submissions of the most creative and effective videos covering preparedness for a zombie apocalypse (or apocalypse of any kind), to be judged by the "CDC Zombie Task Force". Submissions were open until October 11, 2011.[53] They also released a zombie themed graphic novella available on their website.[54] Zombie-themed educational materials for teachers are available on the site.[55]

Gun violence[edit]

One area of current partisan dispute related to CDC funding is studying gun violence. In the immediate aftermath of Charleston, South Carolina massacre in 2015, the US House of Representatives Appropriations Committee rejected an amendment, supported by Democrats but opposed by most Republicans, which would have allowed the Centers for Disease Control and Prevention to study the underlying causes of gun violence.[56][57][58][59]

See also[edit]

Wikimedia Commons has media related to Centers for Disease Control and Prevention.
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For similar agencies elsewhere, see the list of national public health agencies.

References[edit]

  1. ^ Thomas R. Frieden, MD, MPH profile, cdc.gov; accessed November 9, 2015.
  2. ^ CDC Home Page, cdc.gov; retrieved November 19, 2008.
  3. ^ "Groundbreaking held for new CDC virus research labs", Atlanta Journal-Constitution, December 3, 1985, p. A21; retrieved February 5, 2011. "The new facility will sit behind and be connected to CDC's red-brick complex of buildings on Clifton Road in DeKalb County[...]"
  4. ^ "Druid Hills CDP, GA", United States Census Bureau; retrieved May 5, 2009.
  5. ^ cdc.gov
  6. ^ a b Parascandola J (November–December 1996). "From MCWA to CDC—origins of the Centers for Disease Control and Prevention". Public Health Reports 111 (6): 549–51. PMC 1381908. PMID 8955706. 
  7. ^ a b c "Records of the Centers for Disease Control and Prevention (Record Group 442) 1921–2004". Guide to Federal Records. United States: National Archives and Records Administration. November 9, 2010. Archived from the original on November 18, 2010. Retrieved 2009-10-04. 
  8. ^ a b Nájera JA (June 2001). "Malaria control: achievements, problems and strategies". Parassitologia 43 (1–2): 1–89. PMID 11921521. 
  9. ^ Stapleton DH (2004). "Lessons of history? Anti-malaria strategies of the International Health Board and the Rockefeller Foundation from the 1920s to the era of DDT". Public Health Rep 119 (2): 206–15. PMC 1497608. PMID 15192908. 
  10. ^ Sledge, Daniel (2012). "War, Tropical Disease, and the Emergence of National Public Health Capacity in the United States". Studies in American Political Development. 
  11. ^ Division of Parasitic Diseases (February 8, 2010). "Malaria Control in War Areas (1942–1945)". The History of Malaria, an Ancient Disease (2004). Atlanta, Georgia: Centers for Disease Control and Prevention. Retrieved 2011-03-21. 
  12. ^ Scheele LA (1952). "Dr. Joseph W. Mountin, pioneer in public health, 1891-1952". Public Health Rep 67: 425. PMC 2030772. PMID 14930166. 
  13. ^ White, Mark; McDonnell, Sharon M.; Werker, Denise H.; Cardenas, Victor M.; Thacker, Stephen B. (2001). "Partnerships in International Applied Epidemiology Training and Service". American Journal of Epidemiology 154 (11): 993–999. doi:10.1093/aje/154.11.993. 
  14. ^ Beth E. Meyerson; Fred A. Martich; Gerald P. Naehr (2008). Ready to Go: The History and Contributions of U.S. Public Health Advisors. Research Triangle Park: American Social Health Association. 
  15. ^ CDC (1992). "CDC: the nation's prevention agency". MMWR Morb Mortal Wkly Rep 41 (44): 833. PMID 1331740. Archived from the original on November 18, 2010. 
  16. ^ "The eleventh plague: the politics of biological and chemical warfare" (pp. 84-86) by Leonard A. Cole (1993)
  17. ^ "CDC Office of Director, The Futures Initiative". CDC—National Center for Disease Control and Prevention. Retrieved 2008-12-28. 
  18. ^ Koenig, Robert. "New Chief Orders CDC to Cut Management Layers". Blogs.sciencemag.org. Retrieved 2012-04-16. 
  19. ^ "Viral Special Pathogens Branch (VSPB)". Retrieved 2016-05-18. 
  20. ^ "CDC Smallpox and Anthrax Mishaps Signal Other Potential Dangers". Retrieved October 17, 2014. 
  21. ^ "CDC wins in budget deal". Atlanta Business Chronicle. 
  22. ^ "Budget Request Summary—Fiscal Year 2015" (PDF). Centers for Disease Control and Prevention. 
  23. ^ Office of the Associate Director for Communication (May 19, 2010). "State of CDC: Budget and Workforce" (XHTML). CDC Impact Story Topics. Centers for Disease Control and Prevention. Retrieved 2011-03-21.  For more data on 2008, click on the "2008" link.
  24. ^ "Top Jobs at the CDC". Employment Information Homepage. CDC. April 1, 2008. Retrieved 2011-03-21. 
  25. ^ "Behavioral Risk Factor Surveillance System". CDC: National Center for Chronic Disease Prevention and Health Promotion. Retrieved 2006-08-05. 
  26. ^ "CDC Grants at LoveToKnow Charity". Retrieved 2010-01-11. 
  27. ^ Public Health Associate Program website, Cdc.gov; retrieved 2014-04-12.
  28. ^ a b Wilgoren, Debbi and Shear, Michael D. "Obama Chooses NYC Health Chief to Head CDC." Washington Post. May 16, 2009.
  29. ^ Etheridge, Elizabeth W. Sentinel for Health: A History of the Centers for Disease Control. Berkeley, Calif.: University of California Press, 1992; ISBN 978-0-520-07107-0; Patel, Kant; Rushefsky, Mark E.; and McFarlane, Deborah R. The Politics of Public Health in the United States. M.E. Sharpe, 2005; ISBN 978-0-7656-1135-2.
  30. ^ "Past CDC Directors/Administrators". Office of Enterprise Communication. Centers for Disease Control and Prevention (U.S. Department of Health and Human Services). February 19, 2009. Retrieved 2009-05-19. 
  31. ^ Records of the Centers for Disease Control and Prevention Administrative History; retrieved 2009-10-04.
  32. ^ "National Public Health Institute, NPHI Advocacy". IANPHI. Retrieved 2012-04-16. 
  33. ^ "CDCfoundation.org". CDCfoundation.org. Retrieved 2012-04-16. 
  34. ^ "CDC Data and Statistics". CDC – National Center for Chronic Disease Prevention and Health Promotion. Retrieved 2006-08-10. 
  35. ^ "Behavioral Risk Factor Surveillance System". CDC – National Center for Chronic Disease Prevention and Health Promotion. Retrieved 2006-08-10. 
  36. ^ "NCHS – Mortality Data – About the Mortality Medical Data System". CDC – National Center for Health Statistics. Retrieved 2007-01-09. 
  37. ^ "CDC – Data and Statistics – Reproductive Health". Cdc.gov. April 4, 2012. Retrieved 2012-04-16. 
  38. ^ "CDC – Publications". CDC – National Center for Disease Control and Prevention. Retrieved 2012-10-10. 
  39. ^ "State of CDC Report". CDC – National Center for Disease Control and Prevention. Retrieved 2012-10-10. 
  40. ^ "Programs in Brief: Home Page". CDC – National Center for Disease Control and Prevention. Archived from the original on July 18, 2006. Retrieved 2006-08-10. 
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  42. ^ "Emerging Infectious Diseases". CDC – National Center for Disease Control and Prevention. Retrieved 2012-10-10. 
  43. ^ "CDC/National Center for Health Statistics". Retrieved October 14, 2014. 
  44. ^ CDC Health Topics A to Z, cdc.gov; accessed April 26, 2015.
  45. ^ Cohen, Bryan. "CDC’s Select Agents Program protects against bioterror threats". BioPrepWatch, February 10, 2014; accessed October 17, 2014.
  46. ^ Achenbach, Joel; Dennis, Brady; Hogan, Caelainn. "American doctor infected with Ebola returns to U.S.". www.washingtonpost.com. The Washington Post. Retrieved August 2, 2014. 
  47. ^ "Continuing Appropriations Resolution, 2015" (PDF). congress.gov. Retrieved September 17, 2014. 
  48. ^ "Overweight & Obesity". Centers for Disease Control and Prevention. Retrieved August 4, 2015. 
  49. ^ a b c Patel, Kant; Rushefsky, Mark E. (2015-05-20). The Politics of Public Health in the United States. Routledge. pp. 94–95. ISBN 9781317455264. 
  50. ^ "CDC Ran the Tuskegee Experiment for 15 Years: Any Connection To Operation Paperclip?". exopolitics.blogs.com. August 27, 2014. Retrieved August 4, 2015. 
  51. ^ Khan, Ali S. (2011-05-16). "CDC Zombie Warning". "Preparedness 101: Zombie Apocalypse". Retrieved 2014-03-08. 
  52. ^ "Skepticality Podcast". Centers for Zombie Control and Prevention. 2011-10-25. Retrieved 2014-03-08. 
  53. ^ "Are You Prepared? Video Contest". Prepare.challenge.gov. Retrieved 2012-04-16. 
  54. ^ "Preparedness 101: Zombie Pandemic". 2012-07-16. Retrieved 2014-03-08. 
  55. ^ "Zombie Preparedness". Retrieved 2014-03-08. 
  56. ^ "Obama calls for CDC to study whether video games are linked to violence: 'We don't benefit from ignorance", Obama said at the White House event. "We don't benefit from not knowing the science of this epidemic of violence'", thehill.com; accessed November 28, 2015.
  57. ^ "Quietly, Congress extends a ban on CDC research on gun violence". Pri.org. Retrieved 2015-11-29. 
  58. ^ "Democrats push to restart CDC funding for gun violence research". Philly.com. Retrieved 2015-11-29. 
  59. ^ "Democrats want $60 million to study guns". Washington Times. Retrieved 2015-11-29. 

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Coordinates: 33°47′56″N 84°19′32″W / 33.798817°N 84.325598°W / 33.798817; -84.325598 This article incorporates public domain material from websites or documents of the Centers for Disease Control and Prevention.

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