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Disease Control and Prevention

Fighting the Spread of Epidemic Diseases

By 1878 the Marine Hospital Service had begun to lose its identity as a relief organization solely for sick seamen. The prevalence of major epidemic diseases such as smallpox, yellow fever, and cholera spurred Congress to enact a national law in 1878 to prevent the introduction of contagious and infectious diseases into the United States, later extending it to prevent the spread of disease among the states. The task of controlling epidemic diseases through quarantine and disinfection measures as well as immunization programs fell to the Marine Hospital Service and hastened its evolution into the Public Health Service which served the whole nation.

As a result of new laws the functions of the Service expanded greatly to include the supervision of national quarantine, the medical inspection of immigrants. the prevention of interstate spread of disease, and general investigations in the field of public health, such as that of yellow fever epidemics. To help the Service meet these increased tasks the Congress in 1889 established the Commissioned Corps along military lines, with titles and pay corresponding to Army and Navy grades. In 1930 and 1944 the Corps was expanded to include, besides physicians, engineers, dentists, research scientists, nurses, and other health care specialists.

As epidemic diseases were brought under control the Public Health Service began to shift its attention to other areas such as cancer, heart disease, health in the workplace, and the impact of environmental problems, such as toxic waste disposal, on health. But the Public Health Service is still called upon to investigate outbreaks of disease such as Legionnaire's, toxic shock syndrome, and now the deadliest epidemic of our age -- AIDS. Much of the work of the early plague fighters and sanitarians is now carried out by the scientists at the Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia.

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