A Review of Inside the Outbreaks: The Elite Medical Detectives of the Epidemic Intelligence Service

doi:10.1128/jmbe.v11i2.218

Tara C. Smith , PhD
Department of Epidemiology, University of Iowa, Iowa City, IA, E-mail:
tara-smith@uiowa.edu .

Inside the Outbreaks: The Elite Medical Detectives of the Epidemic Intelligence Serivce ; Mark Pendergrast; (2010). Hough-ton Mifflin Harcourt. Boston. 432 pages.

The Epidemic Intelligence Service (EIS) of the Centers for Disease Control and Prevention (CDC) has represented the epitome of shoe-leather epidemiology for almost 60 years, with EIS epidemiologists investigating outbreaks and battling disease in the U.S. and overseas during their long and storied history. Mark Pendergrast thoroughly explores this history in his book, Inside the Outbreaks.

Beginning with the inception of the EIS by Alexander Langmuir in 1951, Pendergrast journeys through the annals of this ambitious program. Though the focus of the book is on the EIS officers and their investigations, Pendergrast also weaves in narrative throughout the book which sews together the fieldwork with the evolution and politics of the EIS program, from its beginnings during the Korean War as an all-male “doctor draft” focusing on infectious diseases, to its present-day mission which encompasses a broader expanse, and includes chronic disease and injury epidemiology (amongst others). EIS now employs not only physicians but also veterinarians, nurses and PhD scientists in a wide range of expertise areas.

Unlike a recent book on the EIS (2) , Pendergrast organizes Inside the Outbreaks not by illness but by time, and presents the material in short vignettes (most segments range in length from a few paragraphs to a few pages). This has its advantages and drawbacks for students. It allows for quick reads and it puts outbreaks into their historical context. However, it also breaks up multiple studies on the same organism; for example, the 1976 outbreak of Legionnaire’s disease, the subsequent identification of the causative organism, and the link to the 1968 outbreak of Pontiac fever. Pendergrast does refer back to these via footnotes, but this mechanism interrupts the flow of the reading.

One future advantage to this book is the potential for associated on-line content. Pendergrast has deposited his reference and interview materials on-line via Emory University (http://marbl.library.emory.edu), and will upload his uncut manuscript, complete with endnotes, after the book has been published one year (April 2011). This would be much more valuable than the book in its current state, which does not include references noting publications resulting from the outbreak investigations described.

Professors who already cover infectious disease epidemiology in their microbiology courses may be familiar with Outbreak Investigations Around the World (1) , which covers somewhat similar territory. While Dworkin’s text covers 19 outbreak investigations in great detail, Pendergrast’s gives a more cursory overview of an extensive number of such field studies. As such, Inside the Outbreaks: Infectious Disease Case Studies for Microbiologists may be an appealing alternative for teachers who would like to incorporate an examination of field epidemiology in their courses but do not have the available class time to spend exploiting Dworkin’s text to its fullest extent.

REFERENCES

1 . Dworkin, M. 2010. Outbreak investigations around the world. Jones and Bartlett Publishers, Sudbury, MA.

2 . McKenna, M. 2004. Beating back the devil: on the front lines with the disease detectives of the epidemic intelligence service. Free Press, New York, NY.

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JMBE
ISSN: 1935-7885

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Journal of Microbiology & Biology Education

A Review of Inside the Outbreaks: The Elite Medical Detectives of the Epidemic Intelligence Service

REFERENCES