In July 1946, the Centers for Disease Control and Prevention — then known as the Communicable Disease Center — was launched to combat the spread of malaria, according to JAMA. Seventy years later, the organization has grown mightily and is now in the throes of a historical battle with another mosquito-borne illness, Zika.
As of Oct. 12, there have been 3,936 cases of Zika reported in the United States, including 878 cases involving pregnant women. In April, the CDC confirmed the link between Zika and microcephaly, a neurologically debilitating birth defect in which babies are born with abnormally small heads. On Aug. 1, the CDC issued a travel warning advising pregnant women not to travel to the Wynwood neighborhood of Miami where local Zika transmission was detected. The advisory marked the first such travel warning the agency issued for an American neighborhood.
Recently, CDC Director Tom Frieden, MD, spoke with JAMA about current health issues and his goals for the agency's future.
Here are seven quotes from Dr. Frieden's interview in JAMA.
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1. On lessons learned from Ebola: "Countries around the world need to get better at finding, stopping and preventing health threats [by] improving laboratory systems, disease detection systems, rapid response systems, surveillance and monitoring systems. At CDC we've helped more than 40 countries develop their own systems for rapid detection and control, but we also know that the world has to be ready to surge in when a country is overwhelmed."
2. On containing Zika in the U.S.: "We don't think the environment in the U.S. makes it likely that we'll see widespread Zika transmission in the continental U.S., but we do expect that we will see occasional cases and rare clusters of Zika. In Miami, it's going to be very difficult to get rid of because the Aedes aegypti mosquito is hard to knock down. It's hard to eliminate. It breeds in the amount of water that fits in a bottle cap. The eggs can last a year. It lives indoors and out. And very low numbers of them can sustain infections in a community."
3. On the plan for Miami: "We've told pregnant women to avoid travel to [affected areas]. We've advised women who are living there who are pregnant to do everything possible to avoid mosquito bites. And we're doing very aggressive mosquito control. The state of Florida, Miami-Dade County and [the CDC] agreed on a plan for the aerial application of both an insecticide that kills adult mosquitoes and a larvicide to kill the larval forms."
4. On Zika in Puerto Rico: "Zika is going to be very difficult to control in Puerto Rico. We recommended aerial spraying, as we did in Miami. For a variety of reasons, that has not been undertaken. We don't see other vector control or mosquito control interventions being likely to turn the tide of the number of Zika infections. A vaccine is at least a year or two away. And getting rid of standing water in a tropical environment is a Herculean endeavor."
5. On America's obesity epidemic: "We have made some progress against obesity. We've seen, for example, breast-feeding increase. We've seen decreases in childhood obesity in many states. The Women, Infants, and Children (WIC) program really improved the quality of nutrition being provided to young children. But we don't know how to turn this epidemic around. We know that it's not our genes because it changed in a generation. Childhood obesity tripled. Adult obesity doubled. And we're going to change it back by changing the environment ... we have to make it easier for people to do healthy things, whether that's walking, or biking, or having healthier food, drinking water, or other zero-calorie beverages. This all has to get easier so that if you go with the flow, you don't end up overweight or obese."
6. On gun violence: "We have a surveillance system in place to monitor for all violent deaths called the National Violent Death Reporting System ... Whether legislators act on that data is not a CDC issue; that's a political issue for legislatures to decide. But there is science in gun violence. We would like to have additional dollars to do additional research to understand more fully how we could reduce gun violence. That's been a request in the President's budget for [several] years and Congress has opted not to fund the research."
7. On goals Dr. Frieden hopes to accomplish during his tenure at the CDC: "Ending polio forever, preventing a million heart attacks and strokes through the Million Hearts initiative, turning the tide on the opioid epidemic, beginning to get an even better handle on the HIV epidemic, reducing teen pregnancy and motor vehicle crashes, turning the obesity epidemic around, achieving, as we have, the lowest proportion of U.S. smokers in U.S. history. We've seen progress on many of those specific efforts, but the more general issue is ensuring that the CDC continues for the long term as a scientifically rigorous, independent technical agency that has operational excellence on the ground throughout the U.S. and throughout the world."
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