From cholera to Contagion: How preventive medicine and public health go hand-in-hand (albeit gloved hands) at a new College of Medicine program

We’ve all seen the movies: 1995’s Outbreak, even zombie flicks like 28 Days Later, and most recently, Contagion. For humans, disease on the population scale has always held a dramatic—if not slightly macabre—appeal.

And while real-life research isn’t accompanied by a musical score and every researcher doesn’t look like Rene Russo, the work being done to understand such communicable diseases is undeniably compelling.

Why? Because new diseases and new variations of diseases really can develop and spread that rapidly between humans, animals and their sources of food and water.  Understanding the complexities of these diseases is a daunting task, and the first and most important key to combating them is prevention.

That’s where a new program from the Texas A&M Health Science Center (TAMHSC) College of Medicine comes in.

In conjunction with the TAMHSC College of Medicine, the Williamson County and Cities Health District, and the TAMHSC School of Rural Public Health, the Centers for Disease Control and Prevention (CDC) assigned Ethel Taylor, DVM, MPH, DACVPM as the first CDC fellow to the College of Medicine’s Preventive Medicine Residency and Fellowship in August 2011.

With an academic pedigree that includes Animal Science and Doctor of Veterinary Medicine degrees from Texas A&M University, a Master of Public Health with a concentration in Infectious Diseases and Zoonoses from Kansas State University, and a Veterinary Homeland Security Certificate from Purdue University, Taylor is well equipped for her new role.

What’s more, she’s also a member of the CDC’s Epidemic Intelligence Service (EIS) and the U.S. Public Health Service Commissioned Corps.

During the year-long practicum with the Preventive Medicine Residency and Fellowship, she will focus not on one particular area of study, but the broader scope of applied public health and disease prevention.

I will work on a variety of projects,” Taylor said.  “Underlying themes will be to understand how we implement, manage and evaluate projects to ensure we in public health use our limited resources wisely and to maximize the number of people impacted by our programs.

Taylor will also examine policy issues to better understand the intersection of science, public opinion and politics that form health care policy and the broader issues facing public health professionals today.

Food for Thought

Prior to landing the CDC fellowship at the TAMHSC College of Medicine campus in Round Rock, Texas, Taylor worked primarily on food safety issues at the CDC in Atlanta, Georgia through the EIS.

She served as an EIS officer assigned to the Division of Foodborne, Waterborne, and Environmental Diseases where she worked primarily with foodborne pathogens like E. coli, Salmonella and Listeria on a variety of projects across the United States and even internationally in Malawi.

Taylor also examined patterns among Campylobacter outbreaks in the United States over an 11-year period including the routes of transmission, commonly infected foods, and size and seasonality of outbreaks, looking for clues and connections that would hopefully lead to an increased public awareness of food sanitation practices.

(Campylobacter is a particularly nasty bacterium that causes acute bacterial gastroenteritis, also known as diarrhea, abdominal pain and vomiting.)

“Once the data have been collected and examined, making a public health recommendation actionable is imperative,” Taylor said.  “People must be able to understand and act upon recommendation to make sure they stay healthy.” 

If all of this sounds a bit academic, consider this: there are an estimated 130,000 cases of foodborne illness reported each day in the United States.  Annually, about 1 out of 6 Americans (48 million people) gets sick, 128,000 are hospitalized, and 3,000 die from foodborne diseases.

In essence, public health officials, be they scientists, physicians or veterinarians like Taylor, are the “first responders” on a global scale when it comes to public health emergencies.

That passion is what led her to the CDC Preventive Medicine Fellowship through the College of Medicine.

Strengthening Public Health Programs

The biggest challenge is staying up-to-date on such a variety of study areas, Taylor said, because public health covers everything from infectious diseases to immunizations, maternal and child health, cancer, diabetes and environmental health.

“Especially when working at the local level, I have to be aware of programs, policies, and new evidence or recommendations for all of these, which means I’m constantly trying to absorb new information. Working across these diverse areas provides Taylor with a unique opportunity to see where they overlap and what policies or interventions could be applied to multiple problems.

Particularly in light of current budgetary constraints at all levels, Taylor’s aim will be to examine financial resources and possible partnerships between all levels of government, academia, private industry, and the public. Such partnerships, she said, will be necessary to achieve public health improvements with available resources.

Additionally, Taylor will evaluate public health programs systematically to objectively determine whether the programs are meeting their stated goals and outcomes.

“Ultimately, this fellowship will give me the opportunity to develop these skills, which I can carry throughout the remainder of my career, Taylor said.

For now, there is no such thing as a typical day.

“One of the things I most enjoy about being a CDC Preventive Medicine Fellow is the variety of activities, said Taylor. I might be working on workplace wellness one day and emergency preparedness issues the next day.

Through it all, Taylor emphasizes that public health and preventive medicine initiatives must focus on how to effectively communicate the science to the public and to decision makers. 

It doesn’t matter how appropriate our methodology is or how sound our data is, said Taylor. We must communicate our findings to the public in a way that allows them to make well educated and informed decisions. That distinction, she said, is what can save lives. 

Public health has a big job to do, with limited resources, so I think it is important that we learn how to work with the populations we serve to provide them with meaningful information that is actionable, she concluded.

By putting actionable information into the hands of citizens, this Preventive Medicine Fellow not only unites public health and preventive medicine, she confirms just how valuable that ounce of prevention really is.