Think Bomb

Monday, August 07, 2006

While I'm here in Coeur d'Alene, I thought it would be fun to interview my mother, Randi Lustig, a long time Coeur d'Alene resident and epidemiologist at the local health department. Epidemiology is the study of the causes, distribution, and control of diseases in populations. The health department and epidemiologists are an essential part of any community as they seek to mitigate the spread of disease and ensure a healthy population.

In Idaho, there are over 60 reportable diseases, most of which are communicable and present a considerable public health concern. Some of those diseases include Chlamydia, a common STD, West Nile Virus, Hepatitis A and other food borne diseases, Pertussis (whooping cough), and Meningitis. The work of an epidemiologist is as variable as the people they treat and the diseases they encounter. It combines a bit of sleuth skill to find out who’s at risk, the care of a nurse when dealing with patients face to face, and sometimes a commander-like role is called for to get a handle on potential epidemics.

For example, rabies is a concern in Coeur d'Alene as it is spread by our large bat and dog populations here. Finding the sources of the disease usually involves sending out the heads of infected animals for examination.
"When heads roll, we pack 'em," says my mom of this curious aspect of her work life.

Although some diseases are dealt with only a few people (or bats or dogs for that matter) at a time, others require a more wide scale effort for control. A case if Tuberculosis (TB), one of the deadliest diseases today, caused a recent scare at one of the local high schools. The health department's nurses had to test over 1300 individuals for exposure to the bacterium. The methods behind the TB test are intreguing; a fluid tiberculin solution is injected into a small bubble under the arm of the skin (only millimeters wide, nothing too squimish!). After a few days, the body's immune response will indicate whether that person has encountered the diseases before. If they are having a secondary immune response, the body will quickly recognize the particles in the solution and begin to inflame the small bubble more than a primary immune response, which takes longer to react, would. Depending on how much the bubble has grown, nurses can identify whether the person should have further testing of is not of conern.

1300 is impressive, but far from the health department’s max load. After 9/11, the Center for Disease Control started a national stock pile system that would allow shipping of antibiotics, IV, and other important materials to outbreak sites in 12 hours. In June the Coeur d'Alene health department ran an exersise to see if they could potentially provide anti-anthrax biotics to the entire district population, and, "yes," my mom says, "it's doable."

The Drink!: My mom's always been a big fan of red wine and one of her current favorites is Sata Ema Merlot, which she is enjoying on her back porch.

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