What Is The CDC And How Does It Work?

CDC disease detectives conducting testing out in the field during the 2014 Ebola outbreak in Liberia. (Photo credit: John Saindon/CDC)

What is the CDC?

The Centers for Disease Control and Prevention (CDC) manages public health. Headquartered in Atlanta, Georgia, the CDC monitors health threats, including viruses like the novel coronavirus, also known as COVID-19.

Founded in 1946, the CDC conducts research, works to prevent disease, evaluates and oversees the management of disease, outbreaks and health-related security threats in the US and globally. It also provides support to frontline healthcare providers. Headed by Robert R. Redfield, it is part of the Department of Health and Human Services (HHS).

What is the CDC responsible for?

The CDC serves as our foremost public health organization, conducting research, monitoring global health issues, supporting local health systems, and improving disease management and prevention. The agency’s role, from the CDC:

• Detecting and responding to new and emerging health threats
• Tackling the biggest health problems causing death and disability for Americans
• Putting science and advanced technology into action to prevent disease
• Promoting healthy and safe behaviors, communities and environment
• Developing leaders and training the public health workforce, including disease detectives
• Taking the health pulse of our nation.

The CDC’s handling of the Ebola epidemic

In 2014, amidst an unprecedented outbreak of Ebola in the crowded capitals of Guinea, Liberia, and Sierra Leone, a single traveler arrived in the US carrying the Ebola virus. The disease was confirmed on September 23, 2014. In July of 2014, the CDC activated its Emergency Operations Center to assist the response to the West African health crisis; on August 8, 2014, the World Health Organization (WHO) declared it a Public Health Emergency of International Concern (PHEIC). The PHEIC designation indicates the risk of worldwide spread and the need for a coordinated international response.

Travelers were screened leaving West African countries, and travelers arriving in the US from Guinea, Liberia Sierra Leone and Mali, underwent “enhanced entry screening,” at specific airports equipped to properly assess them. President Obama declined to enact a travel ban as it would likely actually worsen the situation.

During the outbreak, the CDC Emergency Operations Center aided:

• Surveillance
• Contact Tracing
• Data Management
• Laboratory Testing
• Health Education
• Logistics
• Staffing
• Communication
• Analytics
• Management

Seeking to improve prevention and control, the CDC also trained nearly 25,000 health care workers in West Africa, and 6,500 in the US. In the US, Ebola-infected a total of 11 people with two deaths: the initial or “index” patient; and a doctor who had been administering care to Ebola patients in West Africa.

Two US healthcare workers contracted the virus from the index patient, and both recovered. After their infection, the CDC closely examined the cases to determine how the infections occurred. Suspecting a breach in protocol, the CDC launched an Ebola response team to aid and train local hospitals to better contain the infection. The two nurses were the only Ebola cases contracted on US soil.

The CDC traced the contacts of the index patient and the infected nurses, isolating hundreds of people while monitoring them for signs of infection, and even tracking down a homeless man who had shared an ambulance with the index patient. Prior to the diagnosis, one of the nurses was given clearance by the CDC to fly on a commercial plane, despite a temperature of 99 degrees, which was deemed too low to be a fever. None of the additional people monitored showed signs of infection or contracted Ebola.

The remaining US cases were mostly medical evacuations for Americans who contracted Ebola largely while caring for the ill in Africa, though one case was a photographer covering the West African outbreak. The second and last death in the US from Ebola was a physician who was medically evacuated from Sierra Leone, but died November 17, 2014.

The US outbreak led to revisions in protocols for handling infectious diseases, as some argued the flexibility in choice of equipment by the government was not restrictive enough. Patients were kept in biocontainment units; 11 such beds exist across the US at The University of Nebraska Medical Center, the National Institutes of Health, St. Patrick Hospital and Health Sciences Center in Montana and Emory University Hospital.

Quarantines, rapid response teams and a specific Ebola coordinator appointed by Obama aided in the effort to stop the spread. Experimental treatments, including ZMapp and brincidofovir, and blood transfusions from survivors of Ebola all appeared to improve the outcomes of the people infected with Ebola.

Who is the current director of the CDC?

Robert R. Redfield, the current director of the CDC, is a virologist whose background includes both seeing patients and research, particularly in the area of HIV. He was initially hired with an unprecedented salary of $375,000; under scrutiny, he agreed to a reduction to $209,700. A controversial Trump appointee, Redfield instituted early HIV policies at Walter Reed Medical center that included investigating the sex partners of military personnel, and led to the discharge, without support, of HIV-positive soldiers. In the 1980s, He collaborated with W. Shepherd Smith, Jr.’s Christian organization, Americans for a Sound AIDS/HIV Policy, which claimed HIV was God’s punishment for homosexuality. In the ‘90s he wrote a book decrying needle exchanges and the distribution of condoms.

A delay in the authorization of needle exchanges in 2015 led to an HIV outbreak in Indiana under then-Governor Mike Pence, one experts argue could have been prevented with a faster response. Vice-President Pence was put in charge of the US Coronavirus response by President Trump on February 27, 2020.

What department of government does the CDC belong to?

The CDC belongs to the Department of Health and Human Services, which is under the Executive Branch.

History of the CDC?

Established in July of 1946, from the Office of Malaria control, an agency designed to aid soldiers in malaria-heavy regions, the-then Communicable Disease Center, was founded to support the states with a science-based approach to controlling communicable disease. With a mandate that evolved along with its name, in 1970, it became the Center for Disease Control, broadening its focus to include “occupational and environmental health, family planning and reproductive health, and chronic diseases.”

Another reorganization in 1980 added education and health promotion, zeroed in on the health risks and consequences of smoking, and the newly-discovered human immunodeficiency virus, which had become an epidemic. In 1992, via an act of Congress, the CDC got its present name, the Center for Disease Control and Prevention, to emphasize its role in prevention of disease and injury.

The David J. Sencer CDC Museum, in Association with the Smithsonian Institution, offers a rich, interactive timeline dating back to the founding of the CDC packed with information about what the agency was doing and what it was combatting throughout its history.

Current outbreaks monitored by the CDC within the US

• Coronavirus Disease 2019 (COVID-19)
  ANNOUNCED JANUARY 2020
• Hard-boiled Eggs – Listeria Infections
  ANNOUNCED JANUARY 2020
• Pet Store Puppies – Multidrug-resistant Campylobacter Infections
  ANNOUNCED DECEMBER 2019
• Lung Injury Associated with E-cigarette Use or Vaping
  ANNOUNCED AUGUST 2019
• Raw Milk – Drug-resistant Brucella (RB51)
  ANNOUNCED FEBRUARY 2019
• Measles Outbreaks 2019
  ANNOUNCED JANUARY 2019
• Outbreaks of hepatitis A in multiple states among people who are homeless and people who use drugs
  ANNOUNCED MARCH 2017

The Rantt Rundown

The CDC is the governmental office in charge of public health, through researching, educating, managing and monitoring all types of disease and injury. Founded in 1946 to combat communicable disease, its role and focus has evolved over the decades. In addition to its work in the US, it monitors global health threats, coordinating with global agencies to end world-wide outbreaks, as it did in 2014 with Ebola. Currently led by Robert R. Redfield, the CDC is on the frontline in the containment and treatment of novel coronavirus or COVID-19.