U.S. Public Health Service

As part of the U.S. Department of Health and Human Services, the U.S. Public Health Service (PHS) works both to investigate the causes of disease and to combat epidemics. It traces its origins to an Act signed by President John Adams in 1798. This Act created the Marine Hospital Service, a network of hospitals intended to serve the nation's merchant marines. In 1873, a ‘Supervising Surgeon General’ was named to oversee the Service, and in 1889, the Commissioned Corps, a uniformed and mobile division of medical officers, was created.

During the late 19th century, the growth of trade, travel, and immigration networks led the Service to expand its mission to include protecting the health of all Americans. To reflect this change, the Marine Hospital Service was renamed the Public Health and Marine Hospital Service in 1902. Ten years later, in 1912, the name was shortened to the Public Health Service.

Under this new name, the PHS was given clear legislative authority ‘to investigate the diseases of man and [the] conditions influencing the propagation and spread’ of these diseases in 1912. All types of illness, regardless of their cause, now fell under the purview of the PHS.

However, even before this name change, commissioned officers had advocated the use of aggressive and innovative means to investigate and combat diseases as they emerged. As part of this initiative, the Marine Hospital Service launched the Bulletin of the Public Health (later renamed The Public Health Reports) in 1878. This weekly report tracked epidemics both within and outside the United States. Throughout the past 125 years, this publication, along with Mortality and Morbidity Weekly Report, has provided PHS officers with the latest information on disease outbreaks, enabling them to chart an epidemic as it develops.

With the advent of the 20th century, the PHS began to use increasingly sophisticated techniques to track and fight diseases. In 1906, for example, the PHS initiated and implemented an epidemiological investigation into a typhoid epidemic centered in Washington, D.C. Covering a four-state area, this was one of the most comprehensive epidemiological investigations implemented by a public health agency. The investigation—and the corresponding eradication of the epidemic—provided the nation's legislators with a dramatic and very local demonstration of the power of epidemiological investigations both to prevent and arrest epidemics. In the wake of this success, PHS officer Wade Hampton Frost developed and implemented an innovative epidemiological investigation of the 1918 to 1919 influenza pandemic.

Building on these successes, the PHS launched a program to eradicate malaria within the United States during World War II. Based in Atlanta, the Malaria Control in War Areas program (MCWA) gradually expanded to include the control of other communicable diseases such as yellow fever, typhus, and dengue. In 1946, the MCWA adopted a new name, the Communicable Disease Center (CDC) and became a permanent component of the PHS. The CDC received its current designation as the Centers for Disease Control and Prevention in 1992.

Although the CDC has not been the only PHS agency to investigate the ‘conditions influencing the propagation and spread’ of disease both within and outside the United States, it has consistently been at the forefront of this aspect of the PHS mission. In 1951, the creation of the Epidemic Intelligence Service (EIS) at the CDC provided a blueprint for training medical officers in epidemiology. EIS officers, then and now, received a brief but intensive training in epidemiology and statistics followed by an assignment with a public health unit associated with the PHS or a state or local public health department. These EIS officers are on permanent call and can be dispatched quickly to investigate a disease outbreak.

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