Inside the outbreaks: the elite medical detectives of the Epidemic Intelligence Service

Abstract

The book describes the history of the EIS in 3 segments, including the ‘‘Grand Adventures of Dr. Langmuir’s Boys,’’ covering the inception of the program through 1970; the ‘‘Golden Age of Epidemiology,’’ dealing with changes in the organization and presenting short histories of some of the outbreaks that EIS officers evaluated through 1982; and ‘‘Complex Challenges,’’ covering more recent events in the program’s history from 1983 to the present. Short chapters in each section focus primarily on the facts of various epidemics, the geopolitical climates that influenced the investigations, and the reporting of the investigations. The quotes included from the field officers give the stories a fictional and dramatic character and draw readers into the accounts of the outbreaks. Although I read most of the book in 2 sessions, this text could be read in segments without critical loss of flow. Each of the short chapters stands alone and provides interesting factual reading and substantial entertainment for fans of field epidemiology. Chapter 21, ‘‘Into the Twenty-first Century’’ briefly summarizes many of the public health challenges that society faces today, and that EIS officers are engaged in worldwide—in addition to comments on the political backgrounds that influence the prevention of some of these contemporary diseases. The book is a valuable addition to the ever-lengthier literature on epidemics. Most chapters offer multiple brief, but fascinating accounts of epidemiologic investigations. The vignettes are not closely tied to one another, except perhaps for the temporal associations related to the book’s organization into 3 time periods. Consequently, within any chapter, the author might give attention to an enteric pathogenassociated outbreak, followed by a chronic disease example or a behavioral health example (such as a cluster of suicides) and also supply information on the unfolding history of the EIS program at that particular time. The examples provided were all informative to read, and, from my first- (or at least second-) hand knowledge of many of the outbreaks, few errors in fact appear in the accounts of the various epidemics covered. The author deserves congratulations on the extensive sleuthing that he undertook in writing this book: he conducted hundreds of interviews with EIS officers and outbreak-related personnel, and he researched numerous textbooks, articles, archives, and government documents that are difficult to access. He lists these useful sources at the book’s end and provides a full bibliography online. He surprisingly includes his e-mail address so interested readers can contact him, presumably to correct errors or provide other feedback.