Abstract
The treat of bioterrorism is in the public eye again, and major public health agencies are urging preparedness efforts and special federal funding. In a sense, we have seen this all before. The Centers for Disease Control and Prevention grew substantially during the Cold War era in large part because Alexander Langmuir, Chief Epidemiologist of the CDC, used an earlier generation's anxieties to revitalize the CDC, create an Epidemic Intelligence Service, and promote epidemiologic "surveillance" as part of the nation's defense. Retrospective investigation suggests that, while Langmuir contributed to efforts promoted by the Department of Defense and the Federal Civil Defense Administration, the United States did not have real cause to fear Communist biological warfare aggression. Given clear historical parallels, it is appropriate to ask, What was gained and what was lost by Langmuir's central role in that first instance of American biopreparedness? Among the conclusions drawn is that biopreparedness efforts fed the Cold War climate, narrowed the scope of public health activities, and failed to achieve sustained benefits for public health programs across the country.
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Selected References
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- Bernstein B. J. The birth of the U.S. biological-warfare program. Sci Am. 1987 Jun;256(6):116–121. doi: 10.1038/scientificamerican0687-116. [DOI] [PubMed] [Google Scholar]
- Bryan J. L., Fields H. F. An ounce of prevention is worth a pound of cure-shoring up the public health infrastructure to respond to bioterrorist attacks. Am J Infect Control. 1999 Dec;27(6):465–467. doi: 10.1016/s0196-6553(99)70021-0. [DOI] [PubMed] [Google Scholar]
- Christopher G. W., Cieslak T. J., Pavlin J. A., Eitzen E. M., Jr Biological warfare. A historical perspective. JAMA. 1997 Aug 6;278(5):412–417. [PubMed] [Google Scholar]
- Cohen H. W., Gould R. M., Sidel V. W. Bioterrorism initiatives: public health in reverse? Am J Public Health. 1999 Nov;89(11):1629–1631. doi: 10.2105/ajph.89.11.1629. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Derickson A. The House of Falk: the paranoid style in American health politics. Am J Public Health. 1997 Nov;87(11):1836–1843. doi: 10.2105/ajph.87.11.1836. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Foster S. O., Gangarosa E. Passing the epidemiologic torch from Farr to the world. The legacy of Alexander D. Langmuir. Am J Epidemiol. 1996 Oct 15;144(8 Suppl):S65–S73. doi: 10.1093/aje/144.supplement_8.s65. [DOI] [PubMed] [Google Scholar]
- Fraser M. R., Brown D. L. Bioterrorism preparedness and local public health agencies: building response capacity. Public Health Rep. 2000 Jul-Aug;115(4):326–330. doi: 10.1093/phr/115.4.326. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Hay A. A magic sword or a big itch: an historical look at the United States biological weapons programme. Med Confl Surviv. 1999 Jul-Sep;15(3):215–234. doi: 10.1080/13623699908409460. [DOI] [PubMed] [Google Scholar]
- Hay A. Simulants, stimulants and diseases: the evolution of the United States biological warfare programme, 1945-60. Med Confl Surviv. 1999 Jul-Sep;15(3):198–214. doi: 10.1080/13623699908409459. [DOI] [PubMed] [Google Scholar]
- Krieger N. Epidemiology and the web of causation: has anyone seen the spider? Soc Sci Med. 1994 Oct;39(7):887–903. doi: 10.1016/0277-9536(94)90202-x. [DOI] [PubMed] [Google Scholar]
- Krieger N., Fee E. Measuring social inequalities in health in the United States: a historical review, 1900-1950. Int J Health Serv. 1996;26(3):391–418. doi: 10.2190/B3AH-Q5KE-VBGF-NC74. [DOI] [PubMed] [Google Scholar]
- LANGMUIR A. D., ANDREWS J. M. Biological warfare defense. 2. The Epidemic Intelligence Service of the Communicable Disease Center. Am J Public Health Nations Health. 1952 Mar;42(3):235–238. doi: 10.2105/ajph.42.3.235. [DOI] [PMC free article] [PubMed] [Google Scholar]
- LANGMUIR A. D. The potentialities of biological warfare against man. An epidemiological appraisal. Public Health Rep. 1951 Mar 30;66(13):387–399. [PMC free article] [PubMed] [Google Scholar]
- Langmuir A. D. Evolution of the concept of surveillance in the United States. Proc R Soc Med. 1971 Jun;64(6):681–684. doi: 10.1177/003591577106400646. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Langmuir A. D. The Epidemic Intelligence Service of the Center for Disease Control. Public Health Rep. 1980 Sep-Oct;95(5):470–477. [PMC free article] [PubMed] [Google Scholar]
- Lillibridge S. R., Bell A. J., Roman R. S. Centers for disease control and prevention bioterrorism preparedness and response. Am J Infect Control. 1999 Dec;27(6):463–464. doi: 10.1016/s0196-6553(99)70020-9. [DOI] [PubMed] [Google Scholar]
- Osterholm M. T. Bioterrorism: media hype or real potential nightmare? Am J Infect Control. 1999 Dec;27(6):461–462. doi: 10.1016/s0196-6553(99)70019-2. [DOI] [PubMed] [Google Scholar]
- Schaffner W., LaForce F. M. Training field epidemiologists: Alexander D. Langmuir and the epidemic intelligence service. Am J Epidemiol. 1996 Oct 15;144(8 Suppl):S16–S22. doi: 10.1093/aje/144.supplement_8.s16. [DOI] [PubMed] [Google Scholar]
- Wetter D. C., Daniell W. E., Treser C. D. Hospital preparedness for victims of chemical or biological terrorism. Am J Public Health. 2001 May;91(5):710–716. doi: 10.2105/ajph.91.5.710. [DOI] [PMC free article] [PubMed] [Google Scholar]
