Transcript Alternative Career Pathways

Alternative Career
Pathways
John D. Tilden, DVM, MPH
Food Safety Epidemiologist
Michigan Department of Agriculture
“We must be
architects of change
and not it’s victims”
Don Gingrich, Iowa pork producer
Overview
• My Career Pathway
• The Information Explosion
• Field Epidemiology Investigations
• Lessons Learned
Graduation Day: My Plans
• Large animal herd health
• Maybe some mixed animals
• Definitely no:
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pigs
poultry
research
more schooling
Timeline
• 1983
• 1983-1985
MSU
Mixed Animal Practice,
Frederick, MD
• 1985-1986
School of Aerospace Med.,
San Antonio, TX
• 1986-1989
United States Air Force (MI)
• 1989-1990
Johns Hopkins University (MD)
Timeline (continued)
• 1990-1991
USDA, APHIS, Washington, DC
(Food Safety Policy)
• 1991-1993
USDA, APHIS, Puerto Rico
(International Development,)
• 1993-1995
Epidemic Intelligence
Service, CDC
• 1995-1996
Pseudorabies Eradication,
S.W. Michigan
• 1996-Present
Food Safety Epidemiologist
Emerging Threats and the
Information Explosion
• Data saturation
• Tendency to specialize
• Potential career springboard
– funding source for further
education
– Positions created to address
newly identified needs
Food Safety Disciplines
• Biology
• Epidemiology
• Microbiology
• Public Health
• Animal Health
Laboratory Evidence:
PFGE Analysis
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Epidemiology
• The study of the distribution
and determinants of diseases
and injuries in populations.
Dr. John Snow, September, 1854
Statistical Evidence
Disease
+
-
Total
+
9
0
9
-
0
3
3
9
3
12
Exposure
Fisher’s Exact p value = .005
The Centers for Disease
Control and Prevention
• Part of the U.S. Department of Health and
Human Services
• Initiated in the 1940’s to control malaria in
southern states
• Grew and evolved
–
–
–
–
disease outbreaks
effective treatment
education
prevention strategies
Current CDC Structure
• National Center for Infectious Diseases
• National Center for Health Statistics
• National Center for Environmental Health
• National Center for Injury Prevention and
Control
• National Institute for Occupational Safety
and Health (NIOSH)
Why Conduct Field
Investigations?
• Increase understanding of disease
– “natural experiments”
• Assist prevention efforts
• Political pressure
Checking out apparently isolated cases:
Isolated Snow Flake?
Or Tip of an Iceberg?
Number of Patients
Multistate Outbreak of Listeriosis,
United States, 1998-1999
12
11
10
9
8
7
6
5
4
3
2
1
0
Fatal
Non-fatal
Recall
Usual listerosis
incubation period
Plant
Construction
6/27
8/2
9/6
10/11
11/15
Date
12/20
1/24
2/27
4/3
Disease Investigations
• Citizens
• Private practitioners
• Local department of public
health
• State government
• CDC
• Universities
Number
of
Cases
Cryptosporidium
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•
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•
•
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1907: First described
1976: First human case
1981: First AIDS patient diagnosed
1983: Person-to-Person transmission
1984: Waterborne transmission (Well)
1987: Waterborne transmission (Surface)
1988: Waterborne transmission (Pool)
1993: March 1993 - 403,000 ill in Milwaukee
1993: August - 7 ill in Madison, WI
Non-Foodborne Routes of
Disease Transmission
E. coli 0157:H7
• 1982: First recognized as a foodborne pathogen
• 1984: Person-to-person transmission
• 1985: Association with HUS Documented
• 1990: Waterborne transmission
• 1991: Acid tolerance: apple cider
• 1992: Most common cause of bloody diarrhea
• 1993: Heat resistance
• November 1994 - 17 ill in Seattle, WA
Lessons Learned
• If its not fun, its not epidemiology
• Ride the Funding Waves
• Never Say Never
Lessons Learned
• Freedom to change is important
• Keep your options open
“Progress is the
activity of today that
ensures a tomorrow”
Ralph Waldo Emerson