1. The Road to Applied Epidemiology
John R. MacArthur, MD, MPH
Director
Thailand MOPH – US CDC Collaboration

2. Family and Community Medicine
COPC
Faculty influence
Epidemic Intelligence Service

3. Family and Community Medicine
Carrillo Community Clinic – Santa Barbara, California, USA
Primary health care for low income patients
Social determinants of health
Georgetown University School of Medicine, Washington, DC, USA
Catholic University – Jesuits
Refugee health care
University of California at San Francisco
Primary health care for low income migrants
Refugee & migrant health

4. Community Oriented Primary Care
Community-oriented primary care (COPC) is a systematic approach to health care based upon principles derived from epidemiology, primary care, preventive medicine, and health promotion (Longlett et al. 2001)

5. Faculty Influences
Internal medicine, surgery, pediatrics, obstetrics & gynecology, family practice, radiology, dermatology…
Teaching but also mentoring, orientation, guidance…
 What about going beyond the traditional models of patient – physician care?
Community as your patient
Magnitude of impact
Opening new horizons

6. Hey, have you ever thought about EIS?

7. What is the Epidemic Intelligence Service (EIS)?
Training through service
on the front lines of Public Health
CDC’s 2-year training program in the practice of applied epidemiology

8. EIS Officers
Are physicians, veterinarians, scientists, and other health professionals
Complete a 2-year, on-the-job training, and service fellowship
Serve our country while learning to apply epidemiology
Gain practical skills to become future leaders

9. Historical Background
July 1946 — CDC established with mandate to help state control communicable diseases
October 1947 — CDC assigned responsibility for epidemic aid to states
July 1951 — Epidemic Intelligence Service (EIS) established with 23 recruits

10. 60+ Years of Training, Service, and Response
Polio Vaccines
Lead Paint
H2N2 Pandemic
1960s:
Smallpox eradication
Cancer clusters
War in Nigeria
H3N2 Pandemic
1970s:
Lead in fuel
Lassa Fever
Ebola Virus Disease
Legionella
Reye’s Syndrome
1980s:
Toxic Shock Syndrome
HIV Pandemic
Salmonella in Oregon
1990s:
Cryptosporidium
E-Coli
West Nile Virus
2000s:
9-11
Anthrax attacks
SARS
Hurricane Katrina
H1N1 Pandemic
2010s:
Haiti Earthquake
Mediterranean Coronavirus
Ebola Virus Disease
Zika Virus
????

11. EIS Officer Assignments
State or Local Health Department (Field)
Broad, front-line public health experience
Surveillance, investigation, and intervention
Headquarters
Specialized, disease- or problem-specific experience (e.g., vaccine preventable disease, STD, injury, ectopic pregnancy)
Surveillance, investigation, and policy development

12. EIS Mission: Training
The 158 officers in the 2015 and 2016 EIS classes are assigned to CDC headquarters and field positions

13. Field Investigations topics -- 2014 and 2015 EIS classes

14. Field Investigations Botswana Cambodia China Colombia Cote de Ivoire
DRC
Dominican Republic
Ethiopia
Gambia
Georgia
Ghana
Guinea
Haiti
India
Indonesia
Kenya
Liberia
Malawi
Mali
Mongolia
Mozambique
Nigeria
Saudi Arabia
Sierra Leone
South Africa
Tanzania
Uganda
Ukraine

15. 79 EIS Officers (Class of 2016) Were Selected from 564 Applicants

16. Setting of First Job After EIS (n = 618), 2004-2013 EIS Classes
EIS Officers Gain Skills and Experience Needed to Strengthen the Public Health Workforce
Setting of First Job After EIS (n = 618), EIS Classes

17. EIS Mission: Training What is an EIS Graduate?
An applied epidemiologist who can:
Respond to public health emergencies
Complete an epidemiologic study from design to results
Evaluate and improve surveillance systems
Publish short reports and peer-reviewed journal articles
Present findings coherently to lay and scientific audiences
Collaborate with domestic and international partners
A future subject matter expert or public health leader!
Photo descriptor: Training is an integral part of the EIS mission. This EIS officer assigned to the NYC Department of Health and Mental Hygiene took part in a NYC health department vaccination program against rabies — participating in the activity to trap, vaccinate, tag, and release raccoons in remote parts of Central Park, helping to keep human rabies a rare occurrence. As a part of their training, EIS officers learn to apply the science of epidemiology to solve public health problems. About 95% of learning is experiential, on-the-job service, gaining epidemiologic skills. Skill development, as a part of EIS training, includes…….