Medical Sleuths Hunt Down Culprit Bugs : Disease: Atlanta center is charged with solving and controlling outbreaks of illness around the world.

When 97 investment bankers in mid-town Manhattan became violently ill the same day, their bosses needed a medical Sherlock Holmes.

Dr. Jean Clare Smith fit the bill. With syringes and a portable computer, she tracked down the culprit bug, closed the restaurant that spread it and sent federal regulators to the Delaware farm that hatched the problem.

Sleuthing is elementary for Smith and her colleagues at the Centers for Disease Control and Prevention charged with solving and controlling outbreaks of illness around the world.

“When you’re investigating an outbreak, time is of the essence. There’s something that’s putting the public in jeopardy,” said Smith, a new member of CDC’s Epidemiology Intelligence Service. “You have to make the right decision.”

EIS is where doctors begin careers with the agency that sets the nation’s, and to some extent the world’s, health standards.

Some become famous in medical circles: William H. Foege, credited with eradicating smallpox; Joseph McDade and Charles Shepard, who discovered Legionnaires’ disease, and Wayne Shandera, who first reported the outbreak that became the AIDS epidemic.

But most EIS cases aren’t discoveries. Instead, 160 EIS officers struggle to thwart the spread of known diseases, investigating everything from tuberculosis in U.S. hospitals to cholera in Bangladesh or measles in Mexico.

“When there’s an acute outbreak, we worry about a common source,” said Dr. Ward Cates, the program chief. “We also monitor long-term health trends that show us blips. Small rises in diseases can also trigger an investigation.”

When Cates gets a call for help, he puts a disease detective on the next plane out of Atlanta.

In September, Smith raced to Manhattan and found salmonella among 97 bankers at two institutions.

Then she had to find the cause of the sometimes fatal food poisoning, which had left four of the bankers hospitalized.

Smith learned that the same restaurant catered to both banks. Everybody who got sick ate something containing mayonnaise.

She discovered that a restaurant cook secretly whipped up homemade mayonnaise every Thursday when he ran out of the commercial brand he was supposed to use.

Smith suspected salmonella lurked in eggs used in the mayonnaise, but couldn’t yet prove it. Something else could be to blame, such as the broken refrigerator thermometer that allowed foods to get too warm.

So she got city officials to close the restaurant so no one else would get sick.

When tests proved that the eggs carried the salmonella bacteria, Smith used serial numbers from their cartons to trace them to a Delaware farm.

Meanwhile, in a basement lab at the CDC, Dr. Frances Brenner had pinpointed which of the many types of salmonella was to blame.

“It was Type 13,” she said.

Smith went back through case files and discovered two other recent Type 13 outbreaks in New York. Both were caused by contaminated eggs from that same farm.

The U.S. Department of Agriculture is now investigating the farm.

EIS was formed in 1951 when the CDC decided to train 20 epidemiologists to deal with the possibility of biological warfare. It grew into a program where doctors spend two years fighting and tracking outbreaks of disease or violence--anything that threatens the health of a population.

After this on-the-job training, many EIS officers go on to epidemiology careers with the CDC.

“This isn’t exactly what you learn in medical school,” said Dr. Cynthia Whitman, who just returned from an outbreak of diarrhea among 46 children at a Las Vegas day care center.