The CDC Field Epidemiology Manual

The fourth edition of the classic Epidemic Intelligence Service (EIS) training text lives up to the editors’ promotion; it is “a new and essential resource for the practice of epidemiology and public health.” But more importantly, it serves as an easy-to-use reference for any health services researcher interested in, or involved with, epidemiologic research. The manuscript is broadly divided into 2 sections, by 25 chapters. The first section, entitled “The Field Investigation,” provides a broad overview of initiating, performing, analyzing, and communicating the findings of an epidemiologic investigation. While the first 2 chapters in this section are a bit too indistinct to be of much use in a field manual, the rest of the manuscript keeps the reader quite satisfied. The meat of this first section lies in Chapters 3–8. These chapters describe the steps of initiating and completing an epidemiologic investigation. The writing is clear and concise and structured in a logical progression, such that even novice investigators can apply the steps to a wide range of situations. The authors made an effort to highlight the foundational concepts in epidemiology: the collection of good data in a manner that allows for efficient analysis, standardization of data representation, and application of appropriate analytic techniques. The authors provide numerous examples from actual Centers for Disease Control and Prevention (CDC) EIS outbreak investigations to help keep the reader engaged. Importantly, the application of modern computing tools to outbreaks is discussed and dissected. The bottom line is that these chapters are an example of the CDC at its best. Top-notch epidemiologic methods are described in plain, clear detail. Any individual, from a collegiate or university-level student to a seasoned EIS officer, would benefit from referencing, and re-referencing, these core chapters. Chapter 12 was an unexpected gem. In this chapter, the authors describe communication techniques and pearls: techniques usable for on-the-ground epidemiologists. Through numerous examples, the authors assist the reader in navigating the complex world of communicating timely and, often, controversial subjects to laypersons. The second section of the book, entitled “Special Considerations,” discusses specific challenges encountered in the logistics of running an investigation and the application of core epidemiologic concepts to commonly encountered outbreak situations. The chapter titled “Legal Considerations” is important, in that it serves as a quick reference for individuals initiating or actively pursuing an investigation. The following 2 chapters—"Coordination of Multiple States, Federal Agencies and Multinational Outbreak Investigations” and “Emergency Operations Centers and Incident Management Structures”—provide sage guidance to investigators looking to navigate the often labyrinthine political dynamics that surround public health crises. The chapter “Geographic Information System Data” felt more convoluted than other chapters, but the table on page 337 was quite useful. References to hard- and soft-copy technical geographic information system texts would have been helpful to guide those readers seeking more information. The final 8 chapters of the second section discuss recommended approaches to common epidemiologic environments. Each of these chapters will be useful for persons investigating outbreaks in specific situations, ranging from traditional enteric and health-care–associated outbreaks to less-traditional topics, such as suicide and violence. In the era of easily accessed digital media, textbooks are increasingly obsolete. Yet The CDC Field Epidemiology Manual has been revamped and restructured to provide relevant and easily accessible guidance for any researcher involved in epidemiologic research. Without reservation, this text should be a part of the armamentarium of any epidemiologist who is ready, willing, and able to put boots on the ground and explore the public health challenges we will face in the coming decades. Potential conflicts of interest. The authors: No reported conflicts of interest. Both authors has submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest.