Acting director of CDC thrust into public role with swine flu outbreak

Acting CDC head adopts public role with swine flu

ATLANTA — Dr. Richard Besser had a relatively low public profile at the nation’s public health agency. Then swine flu hit.

Without a health and human services secretary in place, it was Besser who became the government’s lead health spokesman as acting head of the Centers for Disease Control and Prevention in Atlanta.

The federal agency — responsible for investigating outbreaks of illness and preventing chronic illness — has been without a permanent director since Dr. Julie Gerberding left at the end of the Bush administration. And key positions at HHS are still being filled; former Kansas Gov. Kathleen Sebelius was only confirmed to head that agency last Tuesday.

So when health officials diagnosed a never-before-seen form of influenza infecting people in countries around the world — most notably in Mexico and the United States — it was Besser who stepped up, speaking in a calm but frank manner about the swine flu outbreak in televised press conferences.

He was not only reassuring but, at times, humorous, like when a reporter asked if people should abstain from kissing to stop spread of the virus.

“We’re not recommending an end of affection,” Besser said, drawing gentle laughter from reporters.

“This is a period of time when we need a little more affection. But doing it in a way that isn’t going to transmit it would be the CDC approach,” he added.

For years, Besser admitted in a telephone interview on Sunday, some of the training exercises to prepare for a potential flu pandemic had seemed a little over the top. But the last two weeks showed the value of those drills.

“This was a real return on investment and energy,” he said. “Microbes don’t read and follow the plans, but those exercises taught us what to do.”

Besser has proved himself a natural at the job during the swine flu outbreak, said a former colleague, Dr. Jim Hughes, longtime director of the CDC’s National Center for Infectious Diseases and a professor of medicine and public health at Emory University.

“He has done a terrific job. He understands the science and he is a skilled communicator,” Hughes said. “He’s been very calm, he’s been very direct, he’s been very willing to indicate what is known and similarly to indicate what is not known.”

Gerberding, too, praised his performance.

“In the context of the current flu outbreak, he has earned people’s confidence as a spokesperson and trusted resource. I am delighted and not all surprised by his success and will always give him my enthusiastic support,” she told the AP.

Besser, 49, is well-liked by many of the agency’s more than 9,000 employees and calls working for CDC “my dream job.” Before becoming acting director, he headed the agency’s office for terrorism preparedness and emergency response. He started that job in 2005, only hours before Hurricane Katrina hit and a few years after the anthrax scare. The post deeply involved him in planning for pandemics and other crises.

Born in Germany, Besser grew up in Princeton, N.J., where his father is a gynecologist. He has a bachelor’s in economics from Williams College in Williamstown, Mass., and became interested in international health while traveling around the world for a year after college.

He went to medical school at the University of Pennsylvania, and did his residency in pediatrics at Johns Hopkins University Hospital in Baltimore.

In 1991, he joined the CDC’s Epidemic Intelligence Service, the “disease detective” program. His first outbreak took him to Boston to investigate six children seriously ill with E. coli infections. Parents of the sick kids had compared notes and decided fish sticks were to blame.

Besser wasn’t so sure. Kids eat a lot of fish sticks in New England, but they eat other things too, his pediatrician training told him. A careful scientific analysis ruled out fish sticks and sliced deli cheese before it led him to apple cider from one farm stand.

It was the first time anyone had linked E. coli to cider, but Besser didn’t stop there. He collected deer droppings from the orchard and swabbed cows in the farmer’s yard to check for the germ, trying to make the link that fallen apples were being contaminated and then pressed into cider.

His work set a less-glorious precedent: The three-month investigation ran up a huge tab and led to new rules for how long staffers could spend in the field.

But there also was a major benefit to Besser — he met his wife, Jeanne, a food writer. They have two children.

“I am probably the only EIS to go out on an outbreak and come back with a spouse,” Besser has said. Besser’s investigation — and romance — was profiled on a TV show called “Vital Signs.”

After the two-year disease detective program, he directed a pediatric residency program in San Diego, where he made weekly appearances on a television show discussing medical topics.

He returned to CDC in 1998 in the Respiratory Diseases Branch, where he started “Get Smart: Know When Antibiotics Work,” CDC’s national campaign to promote appropriate antibiotic use in the community.

“It’s the one thing that I’m most proud of,” he said.

Asked if he expects to stay on as director, Besser replied: “I’m going to do the job until they ask me to turn over the keys.”

AP Medical Writer Marilynn Marchione reported from Milwaukee.