An Academic’s Guide to Applied Public Health Microbiology

Nov. 19, 2019

I’m always excited to talk about the field of Public Health Microbiology and my career as a public health official. However, after spending most of my career in academic research, moving out of that more academic path into the world of applied public health microbiology came with more than a few surprises. In honor of Public Health Thank You Day, I offer a little about my experiences for those thinking of taking the same path.
Lisa Leung running microbiological tests as part of her duties as a public health microbiologist.
Source: Photo courtesy of APHL

What is Public Health Microbiology?

Public Health Microbiology is a highly interdisciplinary field that includes anyone involved with the microorganisms and infectious diseases that impact human health. It is a vast area comprised of researchers, physicians, laboratorians, epidemiologists, environmental scientists, veterinarians, biostatisticians, and too many more specialists to name. This breadth of specialties is necessary because public health microbiology encompasses every aspect of infectious disease in humans, from diagnosis and treatment to prevention and protection. This also means that fields like Clinical Microbiology, Food Microbiology, Water Microbiology and Environmental Microbiology exist entirely or partially within the scope of Public Health Microbiology. Why define a term that you’ve read a thousand times before? Because that was lesson one when I left my university to enter the world of Public Health Microbiology: The focus is not just on you and your dissertation project anymore; you are now part of a broad and diverse group of people whose job is to serve the public.

Public Health Microbiologists Focus on the Public

I had a Ph.D. in Microbiology and over a decade of experience in academic labs when I became an Association of Public Health Laboratories (APHL) Fellow at the Maryland Public Health Laboratory. I became part of the Centers for Disease Control and Prevention (CDC)’s Antibiotic Resistance Laboratory Network (AR Lab Network), a massive initiative to improve nationwide laboratory capacity to detect antimicrobial resistance. The extended network also allows quick aggregation and dissemination of information for better local responses to prevent the spread of resistant organisms and protect the public. APHL Fellows are stationed at public health laboratories scattered across the country, including the 7 regional labs of the AR Lab Network. State labs and local health departments and health care facilities are also involved in the ARLN efforts in concert with the CDC and regional labs. 

Listen to a conversation about the 20th anniversary of the Laboratory Response Network with Julie Villanueva, Chief of the Laboratory Preparedness and Response Branch of the CDC

As you can imagine, these efforts are an enormous undertaking requiring elaborate coordination and organization on multiple levels. Suddenly I transitioned from working in small academic labs with a single weekly meeting to spending half of each day in meetings. Suddenly I shifted from discussing shared research goals with my mentor and colleagues to discussing goals with an entire network of people at all levels of government, all of whom have vastly different occupations and motivations. And suddenly the decisions made in these meetings no longer affected simply my research schedule for next week. These meeting could have far-reaching implications, from altering infection control measures in a hospital, to food recalls and closing down businesses, to affecting policy and regulation.

Public Health Microbiologists Look for  the “Whats” not the “Whys”

My graduate school was not a school of public health, but my dissertation was very much a public health dissertation: I developed and evaluated a diagnostic platform for identifying microorganisms during infection. When I wrote papers and applied for grants, I sometimes found myself having to defend the translational nature of my work. The point was not why did it work, the point was that it worked, and this was bothersome for some basic research reviewers. 

When I entered my fellowship, however, I became the one with that academic instinct. I’ve had many conversations with epidemiologists when I was more concerned with the whys of a test or an investigation, while they were concerned with what it means and what we were going to do about it. It’s important why a test isn’t working or an infection continues to spread, but it is equally important that we figure out how to stop it: both are clearly vital in the public health landscape. If a test shows people from 3 restaurant chains have salmonellosis due to the same strain, what does this mean for finding the source of the outbreak and what happens to the restaurants meanwhile? Or, the antibiogram of local hospitals shows an increase in carbapenem-resistant Enterobacteriaceae—what does this mean about empiric drug prescription recommendations for this region? It really was an eye-opening experience to communicate with people with wholly different perspectives, understand their viewpoints and find that mutually agreeable course of action that satisfied us both. That requirement for extensive cooperation exemplifies my next point: applied public health microbiology takes Networking.

Public Health Microbiologists Must Network with a capital “N”

Any scientist can tell you that advancing a career in science takes a lot of networking. And many of those same scientists simultaneously loathe the idea: standing uncomfortably at networking events or meet and greets, sometimes approaching total strangers at conferences to talk about your work. If you plan a career in applied public health microbiology, you’d better get used to those awkward feelings because that is now your life times ten. All that large-scale collaboration requires a lot of communication, especially when inevitable differences and disagreements need to be resolved. 
Lisa Leung, second from left in the front row, with just some of her team of colleagues
Source: Photo courtesy of APHL

A public health microbiologist must keep up with colleagues and other subject matter experts in their field but will also need to talk to people outside their specific field: doctors, nurses, or even politicians, courts of law and the press. Who you’re talking to profoundly alters the messaging and the language you use, and you have to be prepared for that. Advocacy, outreach and education make up a big part of this field, and providing your expert advice to all different kinds of people and groups is no longer simply encouraged; it’s your job. Your boss is the public, and you have to answer to them now!

Do You Want to Become a Public Health Microbiologist?

As someone who loves this work and the people I work with, I say go for it! It’s an exciting field with a diverse array of opportunities; you really can build the job you want.  But remember, it’s a different experience than the experiences of graduate training, and it is not without its share of challenges. Understand what you’re getting into, and you’ll do fine. I look forward to working with you.

This fellowship was supported by an appointment to the Antimicrobial Resistance Laboratory Fellowship Program administered by the Association of Public Health Laboratories (APHL) and funded by the Centers for Disease Control and Prevention (CDC). The contents of this post is solely the responsibility of the author and do not necessarily represent the official views of APHL, CDC or FDA.

Author: Lisa Leung

Lisa Leung
Dr. Lisa Leung is a Reviewer of Microbiology Diagnostic Devices at the U.S. Food and Drug Administration Center for Devices and Radiological Health. Her research interests include diagnostics development with a focus on antimicrobial-resistant organisms. You can follow her on Twitter at @LeungTweets.