Centers for Disease Control and Prevention
Etheridge, Elizabeth W., Journal of Environmental Health
Fifty Years of History
Editor's note: Throughout the last 50 years, the Centers for Disease Control and Prevention has made invaluable contributions to the field of environmental health. In bringing you a portion of its 50th Anniversary story, as published in the June 28, 1996 issue of Morbidity and Mortality Weekly Report, we hope you share our appreciation for the history of this organization and the impact it has made upon our dedicated profession.
CDC, an institution synonymous around the world with public health, [turned] 50 years old on July 1. The Communicable Disease Center was organized in Atlanta, Georgia, on July 1, 1946; its founder, Dr. Joseph W. Mountin, was a visionary public health leader who had high hopes for this small and comparatively insignificant branch of the Public Health Service (PHS). It occupied only one floor of the Volunteer Building on Peachtree Street and had fewer than 400 employees, most of whom were engineers and entomologists. Until the previous day, they had worked for Malaria Control in War Areas, the predecessor of CDC...which had successfully kept the southeastern states malaria-free during World War II and, for approximately one year, from murine typhus fever. The new institution would expand its interests to include all communicable diseases and would be the servant of the states, providing practical help whenever called.
Distinguished scientists soon filled CDC's laboratories, and many states and foreign countries sent their public health staffs to Atlanta for training. Any tropical disease with an insect vector and all those of zoological origin came within its purview. Dr. Mountin was not satisfied with this progress, and he impatiently pushed the staff to do more. He reminded them that except for tuberculosis and venereal disease, which had separate units in Washington, D.C., CDC was responsible for any communicable disease. To survive, it had to become a center for epidemiology.
Medical epidemiologists were scarce, and it was not until 1949 that Dr. Alexander Langmuir arrived to head the epidemiology branch. He saw CDC as "the promised land," full of possibilities. Within months, he launched the first-ever disease surveillance program, which confirmed his suspicion that malaria, on which CDC spent the largest portion of its budget, had long since disappeared. Subsequently, disease surveillance became the cornerstone on which CDC's mission of service to the states was built and, in time, changed the practice of public health.
The outbreak of the Korean War in 1950 was the impetus for creating CDC's Epidemic Intelligence Service (ELS). The threat of biological warfare loomed, and Dr. Langmuir, the most knowledgeable person in PHS about this arcane subject, saw an opportunity to train epidemiologists who would guard against ordinary threats to public health while watching out for alien germs. The first class of ElS officers arrived in Atlanta for training in 1951 and pledged to go wherever they were called for the next two years. These "disease detectives" quickly gained fame for "shoe-leather epidemiology" through which they ferreted out the cause of disease outbreaks.
The survival of CDC as an institution was not at all certain in the 1950s. In 1947, Emory University gave land on Clifton Road for a headquarters, but construction did not begin for more than a decade. PHS was so intent on research and the rapid growth of the National Institutes of Health that it showed little interest in what happened in Atlanta. Congress, despite the long delay in appropriating money for new buildings, was much more receptive to CDC's pleas for support than either PHS or the Bureau of the Budget.
Two major health crises in the mid-1950s established CDC's credibility and ensured its survival. In 1955, when poliomyelitis appeared in children who had received the recently approved Salk vaccine, the national inoculation program was stopped. The cases were traced to contaminated vaccine from a laboratory in California; the problem was corrected, and the inoculation program, at least for first and second graders, was resumed. …