Happy Birthday, Maya!

Forever Maya, you have left your hand print upon my soul. I love you.

What Is Disease Surveillance?

Take measles. If a child suddenly develops signs and symptoms of measles she goes to the Doctor. Why, because she is deathly ill. Measles is a reportable disease. A reportable disease mandates that the Dr. report its occurrence to the local health department. The local health department reports it to the state health department, who in turns reports it to the CDC. In the case of measles, one case is considered an outbreak. What is an outbreak? An outbreak occurs when by definition it happens. This means that the public health machine on the local, state and federal level swings into action. Ok, what next? This is what must be determined.

1. Who has the confirmed case of the disease and who is suspected of having it.
2. Has that person been immunized if an immunization is available?
3. Who has this person been in contact with?
4. Start with family members.
5. Are these people immunized? If not, offer immunization or prophylactic medicine IF there is one.
6. Is anyone starting to show signs and symptoms of the illness?
7. If so, whom have each of these people been in contact?
8. Follow up with each and every contact to see if they have been immunized. If not, offer immunization and prophylaxis. This continues until a point is reached that no one is showing signs or symptoms of the illness. Also, with each person it must be determined if they have traveled, where, by what mode of transportation, and whom each of these "contacts" could have possibly been in contact.

Disease surveillance and contact investigation is the only way we have to stop a communicable disease in its tracks. This is a heck of a lot of work for just a few people to do. Is it easier to just close a school and prevent additional contacts....Yes.

Any new virus which has the potential to kill, or any old contagious illness which causes death or disability is enough to get this cycle going. We know that measles kills people and can leave them permanently disabled. It is known that H1N1 kills, but we have no idea how fast or if it can cause permanent disability. Please give public health, the CDC, and the WHO a break. They are working overtime with an unknown entity. They are working to protect the entire population of the world. Do you want that job?

Remember the horror this county felt when it was discovered that Rubella, the mild 3-day German measles left the human unborn fetus with horrible birth defects? I remember and guess what? I was pregnant with my first baby and there was no preventable vaccine. Did I worry, well yea...I was in nurses training taking care of sick children.

During 1964 and 1965 a rubella epidemic in the United States caused an estimated 12.5million cases of rubella and 20,000 cases of congenital rubella syndrome (CRS) which led to more than 11,600 babies born deaf, 11,250 fetal deaths, 2,100 neonatal deaths, 3,580 babies born blind and 1,800 babies born mentally challenged.

My hope is that H1N1 will turn out to be less potent. But, in the mean time, is it better to have too much information than not enough? Is it better to be too cautious?

Yes!

Good News....

The H1N1 virus lacks an essential amino acid which is necessary to replicate rapidly. This is good news. It is the job of Public Health to prepare for any new bug that decides to show up. The only models in which we have had to follow is the 1918 Spanish Flu outbreak, the Swine Flu outbreak of 1976, and the "Bird Flu" that showed up in Asia around 2002.

What happens when a new virus shows up? Well, it frightens people on the front line in Public Health. Why? Public Health is responsible to do just that, protect the health of the public. How big is the public? In the US it is around 3 million people. Ok, what does that mean? As an example, the county in which I am employed has a population of around 200,000 people. There are exactly 10 nurses who have been trained in communicable disease surveillance. These same nurses have absolutely NO immunity to any new virus or germ that suddenly shows up. This is why getting the word out is so important. It is also very scary to think that we only have hand hygiene and cough etiquette to protect "the Public" from any new bug. Kinda primitive, but effective.

There are exactly 2 labs in North America who have the ability to dissect any new bug that suddenly appears. Dissecting takes time. Hopefully, we have been given the time to understand this new virus. But, what happens if it mutates into something new? This issue is always a possibility. And, this is always in the mind of every Public Health professional. It is mind boggling to figure out how to protect the health of the public. How much is over kill? What happens if the public becomes complacent? The scary fact is that we do know exactly what "could" happen.

Just keep in mind the importance of hand washing and the "decent" way to cough which is into the crook of your elbow. Remember, it has been less than 2 weeks since we first heard of "something weird happening in Mexico." Stay tuned, stay alert, and keep your hands away from your face. The only way to protect children from a host of terrible bugs is to keep adults well. To do this, adults must wash their hands, OFTEN. Just think, 64% of people still do not wash their hands after going to the bathroom. And, people want to know how illness is spread! For current and accurate information please go to www.cdc.gov.

Thank You Jesus for Bob.....

Do you remember April 2008? At this time last year I was in AZ visiting my Candy Hearts. Life was actually quite peachy. We were still listening to the presidential candidates. The banks were still functioning, or so we thought. The US was "just in an economic slow down." Jobs were relatively secure, or so we thought. American auto makers were still selling cars, and most of us only worried about our weight. This April we are worried about a new deadly flu virus.

Yes, it has only been a year since life in the US was relatively normal. I am a trained public health Communicable Disease nurse for the state of MD. I have been working in other programs for a few years, but my main training has been in CD. MD is currently waiting to see if 6 probable cases of H1N1 are indeed confirmed cases. Is MD ready to swing into pandemic mode? Yes, MD is ready and I am ready to change nursing hats.

I care for my 88 year old mother who has numerous chronic and severe medical problems. She requires constant monitoring and care. If I start working 12 hour shifts 6 days a week, who is going to care for her? I have a very willing daughter who is also an RN, but she lives in AZ with many responsibilities. And....?

Well, I am lucky to have Plan B. Plan B is my husband Bob. Bob owns a gas station and has been in business for 40 years. Dear Bob has been willing to train in order to care for Mama....just in case. He can check B/P, monitor an apical pulse, recognise drug interactions, adverse reactions, and perform complicated medical treatments. Bob is almost 70 and he has never said NO.......to anything. No matter what my request. He is the one who makes up the difference. Makes no difference if it is money for plane tickets, rental cars, donations, illness or time...Bob always says, "Yes."

Today, I want to give praise to Jesus for Bob. I am so grateful for my good husband. It has not been easy for Bob to learn all that he needs to know in order to take on the responsibility of Plan B. But, he has been willing to do whatever is necessary in order to guarantee Mama is cared for...at all times. Thanks Honey! You are wonderful and I love you. More than that, I sincerely appreciate everything that you have done for Mama, me, my children, and our grandchildren. You are my pal and partner. You are quiet and do not like attention. But today, I want to shout to the world, THANK YOU DEAR JESUS FOR BOB!