“The work of epidemiology is related to unanswered questions, but also to unquestioned answers.” – Patricia Buffler
Editor-In-Chief, Chester “Trip” Buckenmaier III, MD, COL (ret.), MC, USA
Pam and I have been hanging out in central Maine at an ancestral lake cabin that has been in Pam’s family for over 100 years. We are fortunate to have this haven to retreat to as our lightning-struck boat/home is being repaired. I like hiking for exercise in the Maine woods, which occasionally necessitates moving through dense vegetation. Following one hike, I broke out in an incredibly itchy rash on my back and chest. It felt like I had rolled around in a field of poison ivy (which I decidedly did not), and the rash seemed to spread to new areas of my body as days passed. When the erythemic, weeping papules (I apologize now to the squeamish) approached my perineum, I decided I needed help.
The nurse practitioner at the urgent care facility recognized the rash immediately. I was the victim of the browntail moth (Euproctis chrysorrhoea) caterpillar. The browntail moth is an invasive species accidentally introduced from Europe to Somerville, Massachusetts, in 1897. The moth was initially confined to the New England coastal regions, but with global warming has exploded into the interior (where I was hiking). If I did not know better, I would assume this bugger is a fictional alien from the pages of a science fiction horror. The distinctive caterpillars (hairy-brown with two red spots on the tail) shed barbed hairs filled with a toxin that can persist for up to three years. The hairs become embedded in the skin of hapless humans moving through an infested area, and the toxin causes the intensely pruritic rash. In some sensitive folks (like me), the rash can become severe and last for weeks. The nurse prescribed a short steroid course, which relieved my symptoms, but I have not recovered from my avoidance of more forested strolls.
I have been coming to our cabin in Maine for 30-plus years and have never encountered such a fiendish toxin or delivery system. Sadly, my experience with the browntail moth represents just one example of the growing health challenges global warming will bring to an environment near you. Notwithstanding the opinions of card-carrying members of The Flat Earth Society (yes, it is a thing), most researchers consider human-induced global warming settled science. We are living with the consequences of our planet warming today. We will need federal health professionals to help understand and effectively respond to emerging new health threats induced by our changing environment. For these reasons, I was encouraged to learn through my daughter, Susan, about the existence of the Epidemic Intelligence Service (EIS). Susan is presently completing a PhD in epidemiology at Emory University and was recently accepted to the highly competitive EIS 2-year fellowship program.
EIS officers work with trained professionals at the ‘spearpoint’ of public health at home and abroad. According to the EIS website (https://www.cdc.gov/eis/php/about/index.html), “When disease outbreaks or other public health threats emerge, EIS officers investigate, identify the cause, rapidly implement control measures, and collect evidence to recommend preventive actions.” The need for a proactive approach to public health has always been essential in modern society. The ravages of COVID on our country and the countless lives lost is only the latest example of why the Centers for Disease Control (CDC) is so essential for our country’s well-being. Our investment in the training and development of federal CDC experts will be key and essential as the public health realities of global warming impact the planet.
Recognizing my particular bias for my daughters, I am so pleased and proud to see Susan entering such an impactful and essential position of service in our federal government. My family has a long tradition of service to this country, and I can think of few more meaningful occupations that have such a profoundly positive impact on society. The EIS program is just another example of the countless federal medicine officers and employees who toil quietly, without fanfare, on the nation’s behalf. The professionals developed from this program (PhD, physicians, and nurses) will be sorely needed to respond to the health challenges of our changing planet. I am honored to have an opportunity to bring the EIS program to your attention.