Preventing The Next Epidemic

The threat of avian flu has the state disease investigation team on call 24/7 looking for signs of an outbreak and seeking the source to stop it in its tracks

Wednesday - October 12, 2005
By Alice Keesing
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Preventing The Next Epidemic

It could be said that disease investigators lead rather strange lives. On the front lines of the state’s fight against infectious diseases, they live in a world swarming with all the little yuksome things that make us sick.

Their suspects are the harmful organisms that are hitchhiking in our food, or fired off in a sneeze, or carried in the bite of a mosquito. For the state Department of Health disease investigation team, the job never stops; 24/7 they’re on call, sifting through reams of data looking for signs of an outbreak, tracking down the source, then acting fast to stamp it out before it spreads and claims more victims.

One day they might be flying off to Kona to protect a church congregation from an outbreak of meningococcal meningitis. The next night they might be doing the same work in a Honolulu strip bar. They might be fielding calls on a preschool uku infestation. Or planning for the dreaded arrival of the avian flu.

“Our job is so interesting,” says Augustina Manuzak, an epidemiological specialist who has been on the team for two years.

Every day the disease investigation team receives reports from the state’s doctors, hospitals, clinical labs and the public. Already this year, it has responded to 1,500 cases on Oahu alone.

And sometimes the situations are as dramatic as any of the medical-based television shows.

Like the time they traced a case of cholera to a stash of smuggled clams. A nurse looking for a second income had illegally imported 70 pounds of the contaminated clams from the Philippines in her suitcase for sale at the open markets.

Or the time they traced a simmering hotbed of measles to a group of pregnant teenage girls brought to Hawaii from the Pacific Islands to deliver their babies for adoption.

Measles. Cholera. Leptospirosis. West Nile virus. Dengue fever. They are among the 60-plus infectious diseases that are on the state’s watch list. But the biggest baddie of all these days is avian influenza. In the last two years, the bird flu virus has wiped out huge numbers of birds in Asia. It has jumped to humans and killed at least 65 people. And experts are concerned the virus will mutate into a form that spreads easily among humans creating a global flu pandemic.

“It is a constant worry because the avian flu does seem to be spreading,” says Dr. Sarah Park, deputy chief of the disease outbreak control division. “People feel that it is only a matter of time.”

Right now Hawaii has a small measure of protection because of its geographic isolation and because it is not on the migratory flight path of any of the affected bird populations. But if it reaches the point where the virus can transmit between humans, then “Hawaii is as safe as anywhere else,” Park says.

While the seasonal flu attacks the weakest - the young, elderly and ailing - a new flu strain like this would hit everyone, says Joe Elm,

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