As Americans pick the spinach out of their salads and sandwiches, and patients contact doctors to ask if there will be enough flu vaccine to go around this season, the phones at the Centers for Disease Control in Atlanta are ringing with calls from reporters. But one newspaper is calling more often than others, and probing deeper into the mechanics of one of the most venerable federal agencies.

On Sunday, the Atlanta Journal-Constitution broke the story that the CDC employees who have been receiving the bulk of cash awards and performance bonuses are not scientists, but management and administrative personnel. The paper's report, authored by Alison Young, was based on CDC awards documents obtained under the Freedom of Information Act. It prompted an immediate response from the CDC, which is now launching its own investigation of the awards system.

But the Sept. 17 article was just one of the most recent in a series of strong investigative stories on the CDC published by the AJC.

The reports began in early 2004 when Dr. Julie Gerberding, who took the helm at the CDC in 2002, began to draw heat over a reorganization plan that she dubbed the Futures Initiative. The structural changes were intended to streamline the CDC's operations in the wake of the organization's "struggle to deal with the anthrax scares of 2001 and its much-praised response to the global outbreak of SARS last year," wrote AJC reporter M.A.J. McKenna. But the plan drew instant criticism from employees at the CDC who feared bureaucratic meddling would hamper their mission to guard the public health.

Based on Internet searches, the only other newspaper to cover the mounting internal discord was the Washington Post, which picked up the story in August 2004, a few months after the first accounts appeared in the AJC. The Post continued its coverage in March 2005, by which time the CDC was "roiled by internal dissention" and had been "thrown into turmoil," by, among other things, a mass exodus of some its most esteemed scientists, wrote Rob Stein. The Post was the first to quote an employee at the CDC, having obtained an internal memo circulated by Robert A. Keegan, the deputy director of the Global Immunization Division, who spoke of a "crisis of confidence" and a "real problem with morale."

But the AJC appears to be the only newspaper that followed up the expanding crisis a year later -- understandably, to be fair, as the CDC is headquartered in the paper's backyard. In May 2006, Alison Young wrote two stories about two independent investigations of the CDC by the U.S. Senate's Finance Committee. One concerned the ongoing debate over Gerberding's Futures Initiative, the other was breaking news about a whistleblower that accused the CDC of mismanaging $3.8 billion in grants it doled out to local health providers for bioterrorism preparedness projects.

This month, the AJC's pursuit of the story continued on Sept. 10 beneath the front-page headline: "Exodus, Morale Shake CDC." The article's hook came from a "rare joint letter" of complaint that five of six of the agency's former directors sent to Gerberding. Young, who authored the story, delivered a detailed account of the CDC's woes, comparing the organization's precarious "footing" to the beleaguered Federal Emergency Management Agency (FEMA) during Hurricane Katrina. In a balanced report of nearly 4,000 words, Young cites numerous sources inside and outside the CDC, breaking through to current employees who had previously been reluctant to talk. She quotes a senior adviser in the Global Immunization Division, Dr. Stephen Cochi, saying, "The capacity of the CDC to [tackle public health problems] has seriously eroded in a very short time ... The American people need to be concerned."

If the American people need to be concerned, the AJC is the only media outlet warning them. Young cites internal personnel surveys and vitriolic comments on the CDC's employee blog that show a much greater level of discord than is revealed by other news sources. But the author is also careful to note high in the story that "The Journal-Constitution has found it difficult to quantify whether the agency's ability to respond in a crisis has been harmed."

Indeed, as Young quotes one expert from the Fels Institute for Government at the University of Pennsylvania saying, "The only proof of this is how an organization responds to a crisis." The same day that Young's story ran on the front page, the AJC ran a short staff report on the inside with the rhetorical headline, "CDC Brain Drain?" The staff report makes clear it found no indication of "significant jumps in overall employee departures," but points to the expertise of individuals that had already jumped ship or were planning to. Most of the text is devoted to a list of the most illustrious names, including a short bio for each.

Young kept the pressure on high with Sunday's article about the majority of the agency's cash bonuses and awards going to non-scientific personnel. That disclosure sparked the ire of CDC employees on the agency's blog, who complained about poor management. In rapid response to Sunday's piece, Young followed up with a Monday article that said the CDC had created an awards committee to examine its distribution scheme. The tone of the piece remains critical (skeptical might be more accurate). It is less concerned with the committee's creation and more interested in the choice of Barbara Harris, the CDC's chief financial officer, to lead the committee. The article begins:

 

Top officials at the Centers for Disease Control and Prevention have appointed one of the agency's most frequent recipients of large cash bonuses to lead an examination of whether the financial rewards program she benefited from is fair.

 

Whatever the future holds for Gerberding and the CDC, the Journal-Constitution deserves praise for its penetrating investigation. The media has done a thorough job of covering the CDC's response to the recent E. coli scare and concerns about shortages in flu vaccine. But only the AJC went the extra mile on this agency that is so central to our system of public health.