Veterinarians at CDC

Jennifer Gordon Wright, DVM, MPH, DACVPM Auburn University, 1998 [email protected]

Presentation Today

Why veterinarians and public health?

How I came to be where I am Opportunities for employment Veterinarians at CDC How can you start a career in the federal or state government?

Public Health

“ is what we, as a society, do collectively to assure the conditions in which people can be healthy.”

Institute of Medicine, The Future of Public Health, 1988

Serving the Nation in All Components of the Veterinary Oath

Being admitted to the profession of veterinary medicine, I solemnly swear to use my scientific knowledge and skills for the benefit of society through the protection of animal health, the relief of animal suffering, the conservation of animal resources, the promotion of public health , and the advancement of medical knowledge.

Links Between Human and Animal Health Foodborne Disease Antibiotic Resistance Injuries Emerging Diseases Bio- Agro Terrorism Mental Health Occupational Health Environmental Health

Emerging and Re-emerging Zoonoses, 1996 –2005 Cryptosporidiosis West Nile Virus Hantavirus pulmonary syndrome Lyme Borreliosis Leptospirosis Venezuelan Equine Encephalitis Reston virus Lassa fever

Recent outbreaks

Influenza / Madagascar CCHF / Afghanistan, Iran Tularemia / USA, Kosovo Yellow fever / Ivory Coast Brucellosis / Mongolia E. coli 0157 / Canada Hantavirus / US BSE-vCJD/ UK Nipah virus / Malaysia West Nile / USA, Canada Ebola / Gabon, Congo BSE /Canada Monkeypox Monkeypox / DRC/ US SARS / Global Avian Influenza H5N1 Brucellosis Equine morbillivirus Hendra virus E.coli O157 NV-CJD Influenza A(H5N1) Reston Virus Nipah Virus Ross River virus

Veterinarians Preventing Zoonoses in Clinical Practice Rabies Ascarids and Hookworms Toxoplasmosis Cat Scratch Fever Salmonellosis Scabies, ringworm Brucellosis; Undulant fever Psittacosis Tick-borne diseases Other

The long and winding road… Bachelor of Science in Microbiology, Auburn University

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Interest in working at CDC, but in what capacity?

DVM from Auburn University, 1998

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Planned a career in small animal practice

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Turning point – a lecture in sophomore PH lecture about a human case of plague Went into practice for a few years

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Found the EIS program while searching the web for jobs Began MPH work in 2000, worked at CDC Entered EIS in July 2002

History of CDC 1946 - Communicable Disease Center founded in Atlanta by Dr Joseph W Mountin 400 employees, mostly engineers and entomologists working on malaria prevention

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Original focus on vectorborne and zoonoses Growing awareness that expansion to all communicable diseases was necessary

CDC in 1944

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History of CDC

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1950 – Korean War –threat of biological warfare loomed

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Dr Alexander Langmuir – emphasis on epidemiology and surveillance to guard against threats to public health

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Created CDC ’s Epidemic Intelligence Service (EIS)

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“Disease Detectives”

Key CDC Successes 1955: Surveillance data used to trace polio and influenza epidemics, leading to national guidelines for use of vaccines 1962 – 1977: Global smallpox eradication Mid 1970s – 1980s: Identified the cause of Legionnaires Disease and toxic-shock syndrome 1981: Acquired Immunodeficiency Syndrome first mentioned in MMWR

CDC today One of 13 components of DHHS >8000 employees

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Headquarters – Atlanta, Morgantown, Ft. Collins, Cincinnati, Hyattsville

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State health departments International reputation Applies research and findings to improve daily lives Respond to health emergencies Not just infectious diseases

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Chronic diseases, injuries, workplace hazards, disabilities, environmental health threats

CDC in 2006 “ The function of developing and protecting health must rank even above that of restoring it when it is impaired. “ Hippocrates

How CDC operates Jurisdiction over:

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Cruise ships docking in US ports

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Importation of people/animals with communicable disease Otherwise, need invitation of the state or reservation to assist

Veterinarians at CDC As of December 2005 State Health Departments (14) Reproductive Health (1) Bioterrorism (2) Injury Prevention (1) AIDS/STD (8) Bacterial Diseases (10) Immunizations (2) Environmental Health (12) Quarantine (2) Office of the Director (6) USDA liaisons (2) Viral Diseases (13) Parasitic Diseases (5) Vectorborne Diseases (4) Laboratory Animal Issues (7) NIOSH (4)

Veterinarians at CDC Epidemiologists Laboratory animal veterinarians Laboratory research Health Educators

Epidemiologists EIS program Outbreak investigations Research and surveillance Policy recommendations

What is the EIS Program?

Epidemic Intelligence Service (aka “Disease Detectives”) Established in 1951 Mission: To prevent & control communicable diseases A 2 year training program in applied epidemiology Domestic and International Service

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Respond to Requests for Epidemiologic Assistance

EIS

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55-75 officers, 6-9% are veterinarians Applications are due in October for the following year’s class Additional training or experience in public health encouraged prior to application http://www.cdc.gov/eis/about/about.htm

Where do EIS Officers Train?

Forest Fires Legionnaires' Disease/Norwalk virus West Nile Virus/Anthrax Bombing Hurricane Hugo Hurricanes Norwalk Virus

Polio Eradication: Ghana and Nepal

Cost of effectiveness of Brucella vaccine, Egypt

Tularemia outbreak, Martha’s Vineyard

Oral Rabies Vaccine Effectiveness

Q fever outbreak, Bosnia-Herzegovina

Collecting bats in the Philippines, 1998

Sept 11, 2001 – New York City

Anthrax letters, 2001

FMD Surveillance, UK May 2001

Serosurvey of sheep to lift quarantine in infected areas

Rocky Mountain Spotted Fever, Arizona, 2004

Norwalk virus outbreaks on cruise ships, 2002

Monkeypox Outbreak, 2003

E. coli

Outbreaks in Petting Zoos

Response to Hurricanes Katrina and Rita, 2005

Collecting swamp water for Leptospirosis testing, Florida, 2005

Laboratory Animal Veterinarians Care for CDC research animals

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Horses, non-human primates, rabbits, ferrets, etc Instrumental during Monkeypox outbreak for arranging transport of potentially infected animals from the Midwest for testing purposes Laboratory animal medicine residency/board certification desirable, but not 100% necessary to work in the office

Laboratory research Influenza, Salmonella, E. coli, parasitic diseases, as a few examples Additional schooling – MS or PhD necessary to assist in most laboratories Emerging Infectious Diseases Fellowship

Health Educators Healthy Pets, Healthy People website Consultations to TV shows

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Publicize important health messages “House MD” – message on 3/7 episode regarding risks of eating unpastuerized cheese Prudent use of antimicrobials in veterinary curriculum Develop educational activities around outbreak investigation/research findings

Student/Recent Graduate Opportunities State and local health departments Opportunities with USDA, FDA Public Health Service co-step program* CDC - Summer student employment CDC – Epidemiology elective Emerging Infectious Diseases fellowship http://www.cdc.gov/phtrain/ * currently limited opportunities due to budget

Epidemiology Elective http://www.cdc.gov/eis/applyeis/elective.htm

September through June 6-8 weeks Defined project, often a chance to assist with outbreak investigations Deadline: May 30 th of your Junior year No financial support for living expenses, etc; support for investigation related travel

Emerging Infectious Diseases Fellowship 1 year program Field of degree must in some way be applicable to research program US Citizens only Application deadline is mid-February each year Must be graduating before start fellowship

Personnel Systems Civil Service Commissioned Corps of US Public Health Service Military Services (Air Force, Army) Fellows Contractors

USPHS Com Corps Veterinarians Who are we and what do we do?

How do you get a job with the Com Corps of the Public Health Service?

What are our roles?

Emergency Response Force for the Nation

Appointment Process Step 1: PHS Application Step 2: Identify vacancy

Step 3: Accept offer Step 4: Call to active duty

Summary Exciting career opportunities at CDC exist for veterinarians About 35-40% of CDC veterinarians are PHS officers Training programs are important entry points

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EIS class is a great entry point Epidemiology elective – invaluable experience

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Additional education (MS, MPH, PhD) a plus

[email protected]

Acknowledgments Nina Marano, CDC Marguerite Pappaniou, U Minn Jennifer McQuiston, CDC Diane Gross, CDC Marta Guerra, CDC Steve McLaughlin, CDC Kristy Murray, U Texas - Houston Paul Arguin, CDC Joel Montgomery, CDC Kathy Perdue, NIH Linda Demma, CDC