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Centers for Disease Control and Prevention

Ch. 1 of 8
— CH. 1 · INTRODUCTION —

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Centers for Disease Control and Prevention

8 sections
  • In 1947, the Centers for Disease Control and Prevention, known as the CDC, bought 15 acres of land from Emory University for a token $10. Its own employees collected the money. The real benefactor was Robert W. Woodruff, chairman of the board of the Coca-Cola Company. He had a long-time interest in malaria control, because the disease troubled the areas where he went hunting. That land on Clifton Road in DeKalb County was still home to the agency's headquarters as of 2025.

    Today the CDC is the national public health agency of the United States. It is a federal agency under the Department of Health and Human Services, headquartered in Atlanta, Georgia. Its stated goal is to protect public health and safety by controlling and preventing disease, injury and disability, both at home and around the world.

    How did an agency that began with mosquito control grow into that role? Where did it make its mark, and where did it stumble in public view? And why have doctors and scientists recently warned about its independence and the trust Americans place in it?

  • On the 1st of July 1946, the Communicable Disease Center opened in Atlanta as the successor to a wartime effort called Malaria Control in War Areas. Atlanta was chosen as the location because malaria was endemic in the Southern United States. The new agency was a branch of the U.S. Public Health Service, with offices on the sixth floor of the Volunteer Building on Peachtree Street.

    The starting budget was about $1 million. Fifty-nine percent of the personnel worked on mosquito abatement and habitat control, with the aim of controlling and eradicating malaria in the United States. Among 369 employees, the main trades were entomology and engineering. Only seven medical officers were on duty in 1946. In those early years, more than six and a half million homes were sprayed, mostly with DDT.

    Two organizations with global influence in malaria control had come before the agency: the Malaria Commission of the League of Nations and the Rockefeller Foundation. The Rockefeller Foundation gave heavy support to the cause and hoped governments would take over some of its efforts. It also collaborated with the new agency.

    Under Joseph Walter Mountin, the CDC kept speaking up for public health and pushed to take responsibility for many other communicable diseases. The Public Health Service moved its San Francisco based plague laboratory into the CDC as the Epidemiology Division. A new Veterinary Diseases Division was also established.

    The CDC also inherited a darker project from its predecessor, the Tuskegee syphilis experiment. Researchers studied a group of Black men, nearly 400 of whom had syphilis, to learn more about the disease. The men were left untreated, and they had never given informed consent to serve as research subjects. The study had begun in 1932, and it did not end until 1972.

  • In 1951, Chief Epidemiologist Alexander Langmuir warned that the Korean War might bring biological warfare. His warnings spurred the creation of the Epidemic Intelligence Service, or EIS, a two-year postgraduate training program in epidemiology.

    EIS members are described as "boots-on-the-ground disease detectives" who investigate public health problems at home and abroad. When a governmental body asks for help, officers can head out on short assignments called Epi-Aids to contain and investigate outbreaks.

    The success of the EIS inspired the Field Epidemiology Training Programs, launched in 1980. They have trained more than 18,000 disease detectives in over 80 countries. Thailand was the first such site created outside North America, and in 2020 the CDC marked 40 years of supporting it. The Training Programs in Epidemiology and Public Health Interventions Network, called TEPHINET, has graduated 950 students.

    The mission widened in steps. The Venereal Disease Division of the Public Health Service moved to the CDC in 1957. Tuberculosis Control followed in 1960, and an Immunization program was established in 1963.

    The name changed along with the mission. The agency became the National Communicable Disease Center effective the 1st of July 1967, and the Center for Disease Control on the 24th of June 1970. After the Public Health Service reorganizations of 1966-1973, it was promoted to a principal operating agency of the service. The plural Centers for Disease Control arrived effective the 14th of October 1980, as the modern structure of several constituent centers took shape.

    By 1990 the agency had four centers formed in the 1980s. They covered infectious diseases, chronic disease prevention and health promotion, environmental health and injury control, and prevention services. It had also absorbed two outside bodies: the National Institute for Occupational Safety and Health in 1973 and the National Center for Health Statistics in 1987.

    An act of Congress added the words "and Prevention" effective the 27th of October 1992. Lawmakers directed that the initialism CDC be kept, because the name was already so well recognized. Since the 1990s, the agency's focus has broadened to chronic diseases, disabilities, injury control, workplace hazards, environmental health threats and terrorism preparedness. Its list of challenges grew to include birth defects, West Nile virus, obesity, several kinds of flu and E. coli. It also proved to be an important factor in preventing the abuse of penicillin.

  • In 1992, Mark L. Rosenberg and five CDC colleagues founded the agency's National Center for Injury Prevention and Control, with an annual budget of approximately $260,000. Their focus was "identifying causes of firearm deaths, and methods to prevent them".

    Their first report appeared in the New England Journal of Medicine in 1993 under the title "Guns are a Risk Factor for Homicide in the Home". It found that a gun in the home raised the risk of a firearm-related death. It also reported a fivefold increase in the risk of suicide.

    The National Rifle Association of America responded by launching a campaign to shut down the Injury Center. Two conservative pro-gun groups, Doctors for Responsible Gun Ownership and Doctors for Integrity and Policy Research, joined the effort. By 1995, politicians were supporting it too.

    In 1996, Jay Dickey, a Republican from Arkansas, introduced the Dickey Amendment as a rider in that year's appropriations bill. It said that none of the funds available for injury prevention and control at the CDC "may be used to advocate or promote gun control". Gun control advocates opposed the amendment and kept trying to overturn it. In 1997, Congress redirected all of the money for gun research to the study of traumatic brain injury.

    David Satcher, who led the CDC from 1993 to 1998, advocated for firearms research. In 2013, the American Medical Association, the American Psychological Association and the American Academy of Pediatrics wrote to Senate appropriators. They asked for at least $10 million for violence prevention research in fiscal year 2014. Congress maintained the ban in later budgets.

    In 2016, more than a dozen public health insiders, including current and former CDC senior leaders, spoke to The Trace. They said that CDC leaders read the Dickey Amendment cautiously and could do more. They were afraid of political and personal retribution.

  • On the 16th of May 2011, the CDC's blog published an article telling the public how to prepare for a zombie invasion. It did not claim such a scenario was possible. It used the pull of popular culture to urge people to get ready for earthquakes, tornadoes and floods.

    The idea began with David Daigle, the associate director for communications in public health preparedness and response. His team was planning its hurricane-information campaign, and he wondered aloud: "we say pretty much the same things every year, in the same way, and I just wonder how many people are paying attention." A social-media employee then mentioned that zombies had come up often on Twitter while she was tweeting about the Fukushima Daiichi nuclear disaster and radiation.

    The team realized a zombie campaign would likely reach a different audience from the one that follows hurricane warnings. They launched it right before hurricane season. Daigle summed up the thinking: "The whole idea was, if you're prepared for a zombie apocalypse, you're prepared for pretty much anything."

    The campaign grew quickly. The CDC opened a contest for the most creative and effective YouTube videos about zombie preparedness, to be judged by the "CDC Zombie Task Force". Entries were accepted until the 11th of October 2011. The agency also released a zombie-themed graphic novella and educational materials for teachers.

    The CDC's travel guidance speaks in a much more sober voice. Its book CDC Health Information for International Travel, commonly called the "yellow book", is published online and in a new print edition every other year. It carries current travel health guidelines, vaccine recommendations and details on specific destinations.

    On its website, the agency also issues travel health notices at three levels. Level 1 is "Watch" and asks for usual precautions. Level 2 is "Alert" and asks for enhanced precautions. Level 3 is "Warning" and tells travelers to avoid nonessential travel.

  • Most CDC centers sit in the Atlanta area, across three major campuses. The Chamblee Campus in Chamblee, Georgia, opened in 1946 on the site and buildings of Lawson General Hospital. It was meant to close once the Roybal Campus opened, but the Roybal site proved unsuitable for live animal facilities.

    The Roybal Campus is the largest, named for the late Representative Edward R. Roybal and originally called the Clifton Road Campus. It did not open until 1960. Its Building 18, which opened in 2005, holds the premier BSL4 laboratory in the United States. The Lawrenceville Campus in Lawrenceville, Georgia, was acquired as a possible home for Chamblee's animal facilities. It was first developed in the early 1960s.

    Other units are scattered across the country. The National Center for Health Statistics is based mainly in Hyattsville, Maryland. The Division of Vector-Borne Diseases is in Fort Collins, Colorado, with a branch in San Juan, Puerto Rico. The Arctic Investigations Program is in Anchorage. Quarantine facilities operate in 20 U.S. cities. The city of Atlanta annexed the Atlanta headquarters property effective the 1st of January 2018, in its largest annexation in 65 years.

    As of 2013, the CDC's Biosafety Level 4 laboratories were among the few that exist in the world. They included one of only two official smallpox repositories, the other being at the State Research Center of Virology and Biotechnology VECTOR in the Russian Federation. In 2014, the CDC revealed it had found several misplaced smallpox samples. In the same period, lab workers were "potentially infected" with anthrax.

    In May 1994, the CDC admitted that it had sent samples of communicable diseases to the Iraqi government from 1984 through 1989. They were later repurposed for biological warfare. The samples included Botulinum toxin, West Nile virus, Yersinia pestis and Dengue fever virus.

    Today the Federal Select Agent Program, run jointly with an office within the U.S. Department of Agriculture, regulates agents that can sicken humans, animals and plants. It calls for inspections of U.S. labs working with dangerous pathogens such as anthrax and Ebola. During the 2014 Ebola outbreak in West Africa, the CDC helped coordinate the return of two infected American aid workers to Emory University Hospital, which has a special unit for highly infectious diseases. Congress allocated $30,000,000 to the CDC's efforts against the virus.

    CDC staff numbered approximately 15,000, including 6,000 contractors and 840 United States Public Health Service Commissioned Corps officers, across 170 occupations. The agency also keeps staff in more than 60 countries, most of them from the countries where they work. Its budget for fiscal year 2024 is $11.581 billion.

  • On the 20th of January 2020, the first confirmed case of COVID-19 in the United States was discovered. Widespread testing stayed stalled until the 28th of February, when federal officials revised a faulty CDC test. Days afterward, the Food and Drug Administration began loosening rules that had kept other labs from developing tests. Director Robert R. Redfield had reassured the White House Coronavirus Task Force that the problem would be fixed quickly. Sorting out the failed kits took about three weeks, and they may have been contaminated during processing in a CDC lab.

    Later investigations by the FDA and the Department of Health and Human Services found that the CDC had violated its own protocols in developing the tests. In November 2020, NPR reported on an internal review document. It showed that the agency knew the first batch of tests, issued in early January, had a 33 percent chance of being wrong. They were released anyway.

    In May 2020, The Atlantic reported that the CDC was combining the results of two different kinds of tests. One kind diagnoses current infections, and the other measures whether someone has ever had the virus. The magazine said this distorted important metrics and overstated the country's testing ability.

    In July 2020, the Trump administration ordered hospitals to bypass the CDC and send all COVID-19 patient information to a database at the Department of Health and Human Services. On the 15th of July, the CDC alarmed health care groups by temporarily removing its COVID-19 dashboards. It restored the data a day later.

    In August 2020, the agency advised that people with no symptoms did not need testing. The White House Coronavirus Task Force crafted the guidelines without the sign-off of Anthony Fauci of the NIH, and objections from other CDC experts went unheard. On the 16th of August, chief of staff Kyle McGowan and his deputy Amanda Campbell resigned. The guidance was reversed on the 18th of September 2020, after public controversy.

    In September 2020, the CDC drafted an order requiring masks on all public transportation. According to two federal health officials, the task force blocked it and refused to discuss it. In October 2020, it came out that White House advisers had repeatedly altered CDC scientists' writing, including advice on church choirs and on social distancing in bars and restaurants.

    Starting in June 2020, Michael Caputo, the HHS assistant secretary for public affairs, and his chief advisor Paul Alexander tried to delay, suppress or edit releases of the Morbidity and Mortality Weekly Report. Caputo demanded to know the political leanings of scientists who reported that hydroxychloroquine had little benefit, while Trump said the opposite. In emails, Alexander accused CDC scientists of trying to "hurt the president" and writing "hit pieces on the administration". In one October 2020 report, a title was changed from "Children, Adolescents, and Young Adults" to "Persons."

    In May 2021, after criticism from scientists, the CDC updated its guidance to acknowledge airborne transmission. It had previously said most infections came through close contact. In December 2021, after a request from the CEO of Delta Air Lines, it shortened the recommended isolation period for asymptomatic infected people from 10 days to five. Until 2022, the agency also withheld critical data on vaccine boosters, hospitalizations and wastewater.

    Public trust fell. A poll in September 2020 found nearly 8 in 10 Americans trusted the CDC, down from 87 percent in April 2020. By January 2022, an NBC News poll found only 44% trusted it, compared with 69% at the start of the pandemic. Four previous directors said the agency's voice had been "muted for political reasons".

    In 2022, Rochelle Walensky acknowledged "some pretty dramatic, pretty public mistakes, from testing to data to communications". On the 17th of August 2022, she promised drastic changes and an overhaul of how the CDC analyzes and shares data. She told employees: "For 75 years, CDC and public health have been preparing for COVID-19, and in our big moment, our performance did not reliably meet expectations."

  • In January 2025, a CDC official ordered all staff to stop working with the World Health Organization. Around the 31st of January, pages and datasets on HIV and STI prevention, LGBT health and youth health became unavailable. The agency was complying with a Trump executive order to remove material on "diversity, equity, and inclusion" and "gender identity".

    That month, a communications pause at federal health agencies also halted the Morbidity and Mortality Weekly Report. It was the first time that had happened since the publication began in 1960. The president of the Infectious Diseases Society of America called the pause a "disaster." It also caused the cancellation of a meeting between the CDC and that society about the H5N1 influenza virus.

    On the 1st of February 2025, the CDC ordered its scientists to retract unpublished research containing any of a list of banned terms, such as "transgender," "LGBT" and "pregnant person." Larry Gostin, director of the World Health Organization Center on Global Health Law, said the directive amounted to censorship of private citizens as well as government employees. If a CDC lead author withdraws, the submission dies, even when private coauthors remain. Other censored topics included climate change and HIV.

    Doctors for America sued on the 4th of February. On the 11th of February, a judge ordered removed pages restored temporarily, citing doctors who said the material was "vital for real-time clinical decision-making". Some, but not all, of the pages came back. Researchers and journalists preserved databases themselves, and many removed articles were uploaded to the Internet Archive.

    On the 14th of February 2025, around 1,300 CDC employees were laid off, including all first-year officers of the Epidemic Intelligence Service. The cuts also ended 16 of the 24 Laboratory Leadership Service fellowships. In March, the administration quietly withdrew its director nominee, Dave Weldon, minutes before his Senate confirmation hearing on the 13th of March.

    April brought reports of more eliminations: the Freedom of Information Act team, the Division of Violence Prevention, laboratories testing for antibiotic resistance, and the team that decides recalls of hazardous infant products. In August 2025, over 600 more employees were laid off. Maternal and child health services, oral health programs and the Violence Against Children and Youth Surveys were dismantled. Under the announced 2025 reorganization, the agency is to be reoriented toward infectious disease programs.

    On the 8th of August 2025-30-year-old Patrick Joseph White of Kennesaw, Georgia, attacked the Roybal Campus. Security stopped him from entering the headquarters. He drove across the street to a CVS Pharmacy, barricaded himself on the second floor, and fired a rifle at the campus. Shots struck four CDC buildings more than 180 times and broke about 150 windows. Authorities recovered more than 500 shell casings and five firearms.

    David Rose, a 33-year-old DeKalb County police officer, was fatally wounded as he arrived. Officers entered the pharmacy and found White dead from a self-inflicted gunshot wound. White is believed to have been motivated by distrust of vaccines, and he believed the COVID-19 vaccine had made him depressed and suicidal. The group Fired But Fighting, made up of laid-off CDC employees, blamed anti-vaccine rhetoric from members of the administration. Secretary Robert F. Kennedy Jr. said "no one should face violence while working to protect the health of others".

    In June 2025, Kennedy fired all 17 members of the Advisory Committee on Immunization Practices. With one exception, he appointed members who are either anti-vaccine activists or lack expertise in vaccines. Susan Monarez was confirmed as CDC head on the 31st of July 2025. On the 27th of August, it was announced on X that she had been fired. She disputed the legality of the firing and, according to the account, had refused to rubber stamp expected unscientific recommendations from the committee. She had also refused to fire senior staff vaccine experts.

    At least four senior officials resigned afterward: Debra Houry, Demetre Daskalakis, Daniel Jernigan and Jennifer Layden. Dozens of CDC employees walked out of headquarters in support. Jim O'Neill was named as a replacement the next day.

    On the 19th of November 2025, the CDC's web page on autism and vaccines was radically rewritten. Kennedy reportedly said he had personally instructed the agency to abandon its longstanding position that vaccines do not cause autism. The New York Times noted that dozens of scientific studies have failed to find evidence of a link. Medical groups including the American Academy of Pediatrics and the American Medical Association protested. David S. Mandell, a psychiatry professor, told FactCheck.org: "As any scientist knows, you can't 'prove' the lack of association."

    The data systems suffered too. In October 2025-38 publicly available CDC databases that should be updated monthly were not current. By December 2025, only one of them had been updated. In February 2026, Scientific American wrote that trust in the CDC had "plummeted under" Kennedy's watch. It described a "shadow CDC" of states and medical societies forming to fill the vacuum. The agency's list of directors now ends with Jay Bhattacharya, listed from the 18th of February 2026.

Updated

Common questions

When was the Centers for Disease Control and Prevention founded?

The CDC was founded on the 1st of July 1946 as the Communicable Disease Center in Atlanta, Georgia. It succeeded the wartime Malaria Control in War Areas program.

Why is the Centers for Disease Control and Prevention headquartered in Atlanta?

Atlanta was chosen because malaria was endemic in the Southern United States, and malaria control was the agency's first mission. In 1947 the CDC bought 15 acres from Emory University for $10 on Clifton Road.

What is the Epidemic Intelligence Service at the Centers for Disease Control and Prevention?

The Epidemic Intelligence Service is a two-year postgraduate training program in epidemiology created in 1951 after Alexander Langmuir warned of biological warfare during the Korean War. Its officers act as disease detectives and can be sent on short Epi-Aid assignments to contain outbreaks.

What is the Dickey Amendment and how did it affect the Centers for Disease Control and Prevention?

The Dickey Amendment, introduced by Jay Dickey in 1996, says CDC injury prevention funds may not be used to advocate or promote gun control. In 1997 Congress redirected all of the CDC's gun research money to the study of traumatic brain injury.

What mistakes did the Centers for Disease Control and Prevention make during COVID-19?

The CDC's early coronavirus test malfunctioned, and it took about three weeks to sort out the failed kits. Rochelle Walensky later acknowledged "some pretty dramatic, pretty public mistakes, from testing to data to communications".

What happened at the Centers for Disease Control and Prevention headquarters shooting in 2025?

On the 8th of August 2025, Patrick Joseph White fired a rifle from a CVS Pharmacy across the street at the CDC's Roybal Campus in Atlanta. He struck four buildings more than 180 times and fatally wounded DeKalb County police officer David Rose.

Why did trust in the Centers for Disease Control and Prevention decline?

A September 2020 poll found nearly 8 in 10 Americans trusted the CDC, down from 87 percent in April 2020. By January 2022 an NBC News poll found only 44% trusted it, and in February 2026 Scientific American wrote that trust had "plummeted under" Robert F. Kennedy Jr.

All sources

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