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It's a Small World for Public Health
CDC Director Gerberding emphasizes need for networks to respond to global health threats
The traveler felt bad when he checked into the hotel in Hong Kong. But he didn't realize he was carrying the deadly SARS virus.
Julie Gerberding, M.D., director of the U.S. Centers for Disease Control and Prevention, accepts the President's Award for Leadership in Health from UT Health Science Center at Houston President James T. Willerson, M.D. Photo by Bruce Bennett
In less than 48 hours, the other travelers with rooms on the same floor in the hotel were infected. As they continued their trips, the travelers literally took the virus overnight to all corners of the world.
The spread of SARS is an example of the rapid global spread of disease in today's world through networks, said Julie Gerberding, M.D., director of the U.S. Centers for Disease Control and Prevention (CDC). Gerberding spoke March 24 at The University of Texas School of Public Health at Houston about how networks are reshaping the world and reshaping public health and health care.
Gerberding visited the UT Health Science Center at Houston to receive the first President's Award for Leadership in Health.
In presenting the award, UT Health Science Center President James T. Willerson, M.D., said, "It is given for your outstanding leadership in medicine, in prevention of infectious disease and your leadership of the CDC." He also presented a certificate on behalf of Texas Governor Rick Perry.
Among Gerberding's accomplishments, Willerson said, "She developed the programs that we have bene- fited from for prevention of infectious disease, particularly related to anthrax. Two years ago she was named the director of the CDC, and she's in the process of reorganizing that and bringing it up to date."
In reorganizing the CDC, Gerberding has turned to the model of small world networks, a concept, she said, that also helps in understanding today's health threats. A small world network is "characterized by very highly clustered areas, where there is a great deal of connectivity, and strong links that are shortcuts from one part of the network to another," she said.
The spread of SARS through a network of travelers illustrates "how the connectivity between parts of the world has become so extraordinary; how something in one little local corner of the world can become a global problem overnight; how an international health threat can become a problem in your backyard the next day, affecting your local health department, your local hospitals and communities, and your local schools and individual citizens," she said.
"We have learned that we have to adapt and change in order to be able to do our job in the context of this very small world," Gerberding said. Increasingly the CDC is building small world networks with clinicians, infection control professionals, veterinarians, laboratories, and the Department of Defense.
The new operation model at CDC is built on a small world network concept, Gerberding said, bringing people from the specialized centers together to form multidisciplinary teams of experts.
"Probably the single most important concept," she said, "is the recognition that this is not just all going to go away. The fact that we've been in emergency operation mode almost continuously since 9/11 has to be part of the new normal of public health, not exceptional, but something that's routine, that we take in stride, that we plan for, we staff for, and we integrate into our overall agency goals and expectations."
Gerberding complimented the health science center on its use of networks. "When I talked to the students who are involved in the student epidemic and health service, the network liaison to the local health department, the liaison to various other agencies in the state - these are all examples of strong ties that are being developed from one hub to another in the system. I think in the long run this is probably the only way that we can be successful in the world in which we're living."
School of Public Health Dean Guy Parcel, Ph.D., welcomed Gerberding as the #1 leader in public health in the country.
The health science center's vice president for biotechnology, S. Ward Casscells, M.D., was one of the organizers of her visit.
By Ina Fried, Public Affairs