Hunting for the Hidden Killers: AIDS

Disease detectives face a never ending quest

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Those medical-mystery solvers include general practitioners and specialists who become involved in a particular case because it affects their patients. Others can be found among the nation's state and local public health officers. Researchers at the NIH supply scientific support. Coordinating this network, and indeed serving as the FBI of disease detection and the Interpol for medical sleuths around the globe, are the 4,030 workers at the CDC. The vanguard of this organization is the center's Epidemic Intelligence Service (EIS), which sends out its corps of 120 young, bright and determined investigators around the U.S. and the world. "We see the CDC people as our sort of big brother," says Nevada Health Official Dr. Otto Ravenholt.

The CDC complex near Atlanta belies its importance. Its headquarters are located in a squat suburban brick building, graced in front by a bust of Hygeia, the Greek goddess of health. Some sections are housed in wooden barracks around a former Army hospital. The agency, then known as Malaria Control in War Areas (MCWA), was created in 1942 to find ways to protect U.S. soldiers against malaria. The organization has since taken part in the successful campaign against polio (by pioneering the use of the Salk vaccine), and lessened the threat of rabies (by showing it could be carried by bats). The CDC also conducted nationwide childhood immunization programs for measles, mumps and rubella. Says Director Foege: "Today 5,000 children are running around who would be in their graves if it weren't for these programs."

For all its successes, the CDC has had to fight for funds—including money to set up EIS in 1951—by stressing the national security benefits of the center. In 1981, the White House considered cutting the CDC budget by 23%; Richard Schweiker, who was then HHS Secretary, successfully fought to protect its funds. With the current concern about AIDS, the CDC seems secure for the present; its 1983 budget is $261 million, less than 1% of the amount spent for Medicare and Medicaid.

Each year the CDC accepts 60 or so people involved in health care for a two-year tour of duty with the EIS. "We look for the bright, somewhat aggressive independent thinker," says Dr. Lyle Conrad, head of the division's field service officers. About half are based in Atlanta; the rest are assigned to public health departments around the country, with which the CDC works closely. All are on call 24 hours a day, ready to go wherever a disease breaks out, be it food poisoning or a case of primary pneumonic plague that appeared in 1980 in California (all 185 people who were exposed to the victim were inoculated six hours after the disease was confirmed). After completing their two years, EIS graduates are given a prized emblem of their craft: a key chain with a tiny metal keg of Watney's Red Barrel Beer, served at the John Snow Pub on the site of the infamous water pump in London.

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