1. Jennifer Gordon Wright, DVM, MPH, DACVPM
Veterinarians at CDC
Jennifer Gordon Wright, DVM, MPH, DACVPM
Auburn University, 1998

2. 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?

3. 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

4. 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.

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

6. Emerging and Re-emerging Zoonoses, 1996–2005
Nipah Virus
Hendra virus
Multidrug resistant Salmonella
Lyme Borreliosis
West Nile
Cryptosporidiosis
Reston virus
Venezuelan
Equine Encephalitis
E.coli O157
Lassa fever
Yellow fever
Ebola
Monkeypox
Influenza A(H5N1)
Rift valley Fever
NV-CJD
Ross River virus
Equine morbillivirus
Nv-CJD
E.coli non-O157
West Nile Virus
Reston Virus
Brucellosis
Hantavirus pulmonary
syndrome
Leptospirosis
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
Avian Influenza / Hong Kong
West Nile / USA, Canada
Ebola / Gabon, Congo
BSE /Canada
Monkeypox / DRC/ US
SARS / Global
Avian Influenza H5N1

7. 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
Veterinarians in clinical practice are practicing public health every day that they step into an exam room and educate a client on the prevention of rabies, parasites, tick borne diseases and other infectious processes.

8. The long and winding road…
Bachelor of Science in Microbiology, Auburn University
Interest in working at CDC, but in what capacity?
DVM from Auburn University, 1998
Planned a career in small animal practice
Turning point – a lecture in sophomore PH lecture about a human case of plague
Went into practice for a few years
Found the EIS program while searching the web for jobs
Began MPH work in 2000, worked at CDC
Entered EIS in July 2002
Growing up, my parents were always watching the news and I can remember being concerned about Salmonella and “food poisoning” from an early age. When I went to college I knew I wanted to be a veterinarian, but I wasn’t sure what I wanted to major in, until my interest in infectious disease re-surfaced with a microbiology course. I majored in microbiology before going on to veterinary school. Once in vet school I assumed I would graduate and open a small animal, possibly even feline only, practice. It wasn’t until my sophomore year, in our public health course, when we covered a case study that really intrigued me. The case involved a lady who presented to the ER with a fever of unknown origin. In the end, she wound up dying with a diagnosis of plague. Upon investigation, it was determined that her cat had died recently and she had nursed him while he was sick – the cat also had plague and the owner contracted it while caring for her pet. My first thought was – that I didn’t realize plague still existed, and secondly what a cool career that would be, to investigate such cases. But I still didn’t realize that was really a career option, or how to get there.
So when I graduated, I went into practice for a few years, first in a feline only practice, then one of the largest small animal practices in Atlanta. After about 6 months in my first job – I came home one night and started surfing the web looking for information on CDC – determined to find a better job and quality of life! I hit upon the EIS program, the Epidemic Intelligence Service, which we’ll talk about in just a few minutes, and quickly realized these were the people who investigated cases such as the one of the woman with plague. I knew this was what I had to do! Unfortunately, the educational requirements for veterinarians included either a public health degree, or public health experience. So I went back to school to get a master’s of public health, kept working in the clinic, and found a part-time job in the foodborne and diarrheal diseases branch at CDC.

9. The Department of Health and Human Services is the principal agency in the United States government for protecting the health and safety of all Americans and for providing essential human services.

10. History of CDC
Communicable Disease Center founded in Atlanta by Dr Joseph W Mountin
400 employees, mostly engineers and entomologists working on malaria prevention
Original focus on vectorborne and zoonoses
Growing awareness that expansion to all communicable diseases was necessary

11. CDC in 1944
Return to top.

12. History of CDC continued
1950 – Korean War –threat of biological warfare loomed
Dr Alexander Langmuir – emphasis on epidemiology and surveillance to guard against threats to public health
Created CDC’s Epidemic Intelligence Service (EIS)
“Disease Detectives”

13. 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

14. CDC today One of 13 components of DHHS >8000 employees
Headquarters – Atlanta, Morgantown, Ft. Collins, Cincinnati, Hyattsville
State health departments
International reputation
Applies research and findings to improve daily lives
Respond to health emergencies
Not just infectious diseases
Chronic diseases, injuries, workplace hazards, disabilities, environmental health threats

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

16. How CDC operates Jurisdiction over:
Cruise ships docking in US ports
Importation of people/animals with communicable disease
Otherwise, need invitation of the state or reservation to assist

17. Veterinarians at CDC As of December 2005
Just under 100 vets currently work at CDC, in multiple capacities

18. Veterinarians at CDC Epidemiologists Laboratory animal veterinarians
Laboratory research
Health Educators

19. Epidemiologists EIS program Outbreak investigations
Research and surveillance
Policy recommendations

20. 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
Respond to Requests for Epidemiologic Assistance
So I’ve mentioned EIS several times, and you are probably wondering ‘what is EIS’? Entry into the EIS program would be the next step in a career as public health veterinarian and epidemiologist for many of you, so I’m going to take a few minutes to introduce you to the program. Many of the vets present during the lunch session are EIS “graduates” and will be happy to talk about their experiences with the program.
The EIS program was established in 1951, following the start of the Korean war, as an early warning system against biological warfare and man-made epidemics. EIS officers are often referred to as ‘disease detectives”, and are ready to travel at a moment’s notice. EIS is a 2 year training program in applied epidemiology that teaches and reinforces quantitative skills, research design, epidemiologic judgment, communications skills, and surveillance skills. EIS officers respond to requests for domestic and international service. As an EIS officer you never know where you will be going next, so you should always keep your bag packed and your passport ready!

21. EIS continued
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

22. Legionnaires' Disease/Norwalk virus
Where do EIS Officers Train?
TB in immigrants
Lead screening
Legionnaires' Disease/Norwalk virus
Copper in drinking water
Cryptosporidiosis
E. coli
EIS officers train in either a state based position, or a CDC office in Cincinnati, OH; Ft. Collins, CO; Morgantown, WVA or Atlanta, GA. EIS officers have worked with hanta virus, hurricane reponses, norwalk virus outbreaks on cruise ships, the west nile outbreak which began in NYC in 1999, 9/11 and the resultant anthrax outbreaks, just to name a few.
EIS Officers played a key role in the global eradication of smallpox; are currently working towards eradicating polio and guinea worm,and discovered how the AIDS virus was transmitted.
West Nile Virus/Anthrax
Forest
Fires
Bombing
Hurricane Hugo
Cyclosporiasis
Hanta Virus
Hurricanes
Malaria
Norwalk Virus

23. Polio Eradication: Ghana and Nepal

24. Cost of effectiveness of Brucella vaccine, Egypt

25. Tularemia outbreak, Martha’s Vineyard

26. Oral Rabies Vaccine Effectiveness

27. Q fever outbreak, Bosnia-Herzegovina

28. Collecting bats in the Philippines, 1998

29. Sept 11, 2001 – New York City

30. Anthrax letters, 2001

31. FMD Surveillance, UK May 2001
Serosurvey of sheep to lift quarantine in infected areas

32. Rocky Mountain Spotted Fever, Arizona, 2004

33. Norwalk virus outbreaks on cruise ships, 2002

34. Monkeypox Outbreak, 2003

35. E. coli Outbreaks in Petting Zoos

36. Response to Hurricanes Katrina and Rita, 2005

37. Collecting swamp water for Leptospirosis testing, Florida, 2005

38. Laboratory Animal Veterinarians
Care for CDC research animals
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

39. 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

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

41. 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
So as a student, the next step for many of you would be to explore electives in public health. You can always check with you state and local health departments for opportunities, as well as the agencies we discussed earlier today. In addition, I will have some flyers out during the lunch session from the University of maryland about some employment and elective opportunities. The PHS has a co-step program for summer opportunities, as well as a paid program for senior students.
CDC has a summer student employment program and an epidemiology elective program. Announcements for the summer employment program usually appear on the CDC job openings website during the winter. The epidemiology elective is a mini-introduction to EIS, usually lasting 6-8 weeks with a defined project and a chance to assist with outbreak investigations. Deadlines are May 30th of your junior year and more information can be obtained from this website.
*currently limited opportunities due to budget

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

43. 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

44. Personnel Systems Civil Service
Commissioned Corps of US Public Health Service
Military Services (Air Force, Army)
Fellows
Contractors
I’d like to take just a few minutes to introduce you to the Public Health service, since I’m sure you have been wondering why a navy officer is talking to you about CDC, or better yet, a Delta pilot….There are many personnel systems within the federal governmen and the majority of veterinarians at CDC are either civil servants or officers in the Public Health Service.

45. 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?
The public health service is a uniformed service, not a branch of the military, although our roots are with the Navy. The public health service is rapidly deployable in the event of a national emergency, such as 9/11 or the hurricanes of recent years. Over 80% of PHS vets had the opportunity to work in Mississippi, Louisiana or Texas this fall following the hurricanes and many of us were on the road with less than 24 hours notice. The PHS also offers some opportunities for students, through a junior co-step program, and a paid program, usually with USDA, during your senior year. The Surgeon General is the top PHS officer.

46. What are our roles? Emergency Response Force for the Nation
In addition to serving as the nation’s emergency response force to public health emergencies, PHS officers work in:
Epidemiology and surveillance Laboratory animal medicine Pathology and other laboratory sciences Entomology Food safety and zoonoses control Bio/chem terrorism preparedness and security Quarantine and inspection Drug safety Environmental health and toxicology

47. Appointment Process
Step 1: PHS Application
Step 2: Identify vacancy
Step 3: Accept offer
Step 4: Call to
active duty

48. Summary Exciting career opportunities at CDC exist for veterinarians
About 35-40% of CDC veterinarians are PHS officers
Training programs are important entry points
EIS class is a great entry point
Epidemiology elective – invaluable experience
Additional education (MS, MPH, PhD) a plus
In summary, there are many varied and exciting career opportunities for you as a public health veterinarian. Many times training programs serve as important entry points for a career at a certain agency, such as the EIS program at CDC, or the Veterinary services career program at USDA. We often work in positions not exclusively designated for veterinarians.
Veterinarians currently make up approximately half a percent of the US public health workforce and 2.8% of the federal workforce. As a large number of PH veterinarians are projected to retire in the coming years, the need for vets in PH is growing.

49. I hope I’ve been able to give you a quick over view of some of the opportunities available in the federal government, and especially here at CDC. My address is on the screen and I’m always happy to answer questions about EIS, the PHS, or CDC in general.

50. 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