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Public Health 'detectives' work to keep community safe

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Public Health is on the lookout for the next outbreak of disease that could cause a pandemic right here in our state. That work starts inside the labs where disease detectives are at work every single day to keep you safe.

The headlines are familiar. 

A hepatitis C outbreak at Good Samaritan Hospital in Puyallup; norovirus at a nursing facility in Tacoma.

But public health officials say that is just the tip of a very large iceberg.

They are on the front lines of a daunting battle, these scientists inside this public health laboratory run by the state Department of Health. 

Their mission is to find out what viruses we are spreading.

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"I mean we worry about pandemics of influenza for example," said Nigel Turner, director of Tacoma-Pierce County's Communicable Disease Division.

He says preventing those viruses from infecting an entire community is the vital, often overlooked work of public health.

"Every day in public health we're looking in the community for cases of disease," said Turner. "We have a relationship with medical providers whereas when they test for a particular disease, they're required to report that to the health department."

That is the very scenario Turner and his staff faced squarely earlier this year.

"The only common medical provider who treated the eight patients and administered intravenous injections to each positive hepatitis C patient," Turner said at a news conference last June, "is the nurse who no longer works at Good Samaritan Hospital."

A nurse at Good Sam was blamed for infecting several patients with the same strain of hepatitis C. She denies that and the case is working its way through the court system. 

But while the lab identified the presence of hepatitis C, someone had to find the link.

That detective work fell to Kim Desmarais, Tacoma-Pierce County's hepatitis C coordinator.

"Certainly with hepatitis C, there is no one test that will tell us that this is a brand new case," said Desmarais. "We have to put together the pieces of the puzzle. We have to take a variety of labs. 

We have to look at symptoms, circumstances, risk factor, and put that all together to determine if somebody is actually a new case or if perhaps they have had it for a few years."

Then they speak to those who are infected.

"And get information from them," she said, "absolutely."

Still, it is not a quick process.

"Absolutely," Desmarais said. "So we're doing as thorough a job as quickly as possible, on a daily basis."

The number of conditions health providers are required to report is daunting. 

The Tacoma-Pierce County website lists them from A to V, from animal bites, E.coli and rabies to Lyme disease, syphilis and tuberculosis. 

Investigating those cases is the quiet, unsung work Public Health does every day.

"This is disease investigation work that doesn't happen just with hepatitis," said Desmarais. "It happens throughout communicable disease. 

This is one of those core, foundational public health responsibilities that we have to protect the health of the community."

So far the number of hepatitis C cases from Good Samaritan Hospital with the same genetic link is up to 13. 

Another 59 people tested positive for a different strain of hepatitis C. 

They would likely never have been tested and might ultimately have died but for the work of public health.

 

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