Helen L. Regnery,

       I felt really happy coming to work at the Centers for Disease Control today. I was gratified that the most important deadline of the year had once again been met successfully. I had that feeling of personal satisfaction that comes when you know you have done your best and know you could not have done it without a great staff.
       Every year we pull together data that are used to determine which viruses should go into this year’s flu vaccine. The last week in January, we travel to Washington, where we present the data to the FDA Vaccines and Related Biological Products Advisory Committee. Because the effectiveness of the vaccine depends on our ability to understand and collect information about circulating strains, this meeting requires a lot of work and careful analysis. Every year the work is intense, and every year the staff wonders if we will make it–yet we do. This year was the tallest mountain any of us has ever climbed. Before we even started, “bird flu” put enormous obstacles in our course. How? It stretched our resources beyond the limit. Staff that would usually have been on hand to help out were instead in Hong Kong for almost two months. The crisis also stretched our laboratory resources–we needed to create a new laboratory to contain this strain. But once again, we made it.
       I also had mixed feelings today. For the past eight years I have made this trip and presented data along with our branch chief and one branch epidemiologist. In the spring, I made a decision to change my career direction and consequently resigned as the Influenza Branch Strain Surveillance section chief. Sasha Klimov, who is a member of our research staff, was interested in the position, and I have been working with him to ensure a smooth transition. This was Sasha’s first trip to Washington, and I got to stay home. It was a pleasure to do that and not have the pressure of a presentation, but I did miss seeing the people who make the difference, and seeing what happened during the discussions.
       Since it was Friday, I thought I would have the time to catch up with the many things that had been neglected during the past two weeks–e-mail and letters to write. Typically, this did not happen. First, Dr. Pinherio from the Pan American Health Organization called to discuss testing for a respiratory illness occurring in Peru. The outbreak of an unidentified agent was causing severe illness and some deaths. The problem in most situations like this is that proper reagents are needed to identify the pathogen. A commercial reagent kit to diagnose a panel of respiratory viruses seemed a reasonable solution. Information was passed along.
       A second unplanned event occurred when we received a request for information for an upcoming appropriations hearing. The information is due Monday. The first question for me was: What is CDC’s role in the influenza pandemic preparedness plan? And the second was: What has been CDC’s role in the recent occurrence of influenza A(H5N1) in Hong Kong?
       My answer to the first is long and complicated, but my answer to the second, I think, is interesting. CDC played a major role in the investigation of the first single case of avian flu and then followed up with more intensive investigation. First we confirmed that the virus strain was in actual fact due to an avian virus and that this virus did not contain any human genes. (If it had contained human genes, it would have been more readily spread.) We intensified surveillance; we investigated family clusters; we did epidemiological studies to address the question of how transmission of this flu works from birds to humans, as well as how it works from humans to humans. We issued reagent kits for laboratories throughout the world for labs to identify new strains of avian flu. We participated with the World Health Organization and others in a fact-finding mission to Southern China.
       And then–zip!--my day is gone already. It is better to be busy, but I can forget leaving early. At least I did have time to plan for next week–and a free weekend off! The first since December. And importantly, a home-cooked meal with my family.