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Keeping tabs on Vail Valley diseases

Dustin Racioppi
dracioppi@vaildaily.com
Vail Valley, CO Colorado

AIL VALLEY, Colorado ” Inside one of the three Eagle County Department of Health offices each day, while the rest of the world goes about its business, somebody is regularly monitoring the Vail Valley’s health.

That person is usually Becky Larson, an epidemiologist and health planner for the county. She checks in with hospitals and physicians. She takes phone calls and tips from locals. And probably her biggest source to keep track of any diseases or possible outbreaks in the county is a Web-based database called the Colorado Electronic Disease Reporting System ” often referred to as CEDRS ” which she checks throughout the day.

“We have a huge disease prevention program that’s kind of invisible to the public,” said Jill Hunsaker, manager of Eagle County Department of Public Health. “I don’t think they know how much we work to try and prevent diseases from getting out there.”

Preventing an outbreak

The computer database ” which is fed by the state department and local doctors and hospitals ” is a major part of the county’s prevention. Larson normally investigates one to two cases a week, and depending on the case, it could be longer.

“Even if a physician suspects a disease, they send it to us,” Larson said. “We start investigating that immediately.”

That component of her job takes up about a quarter of her time. When it’s busy, it could take up to half, along with the help of six of the county’s nurses. Mostly the department is dealing with cases such as salmonella, giardia and campobylacter ” all common and preventable diseases known in the medical world as “fecal to oral” diseases that cause unwanted quality time with the commode.

But when there are a string of those cases reported in the department’s system, though common, the department has to begin investigating to be sure it isn’t from a single source, and therefore creating the potential for an outbreak. An outbreak by the department’s standards is any case load that is above the normal level.

“If there’s one case of measles, I would consider that an outbreak,” Hunsaker said.

That’s mild compared to what the department has dealt with in the past. Contaminated water in Alamosa recently had the department on alert making sure people in the county weren’t exposed to the water. There were cases of West Nile virus a couple years ago. And at least once or twice a year, the department is investigating the Hanta Pulmonary Virus, an often-deadly respiratory virus that can be contracted when someone is exposed to dust with deermice in it, Hunsaker said.

That’s why the communication system within the state and the department is so valuable. Larson and the department’s nurses can assess whatever the case is and quickly treat it and alert surrounding counties.

“It’s been a great partnership controlling diseases,” Larson said.

Depending on technology

The chief of the state health department’s communicable disease program, Dr. Ken Gershman, said county departments and the state rely on the system, and Colorado was one of the first states to launch such a program.

“This is the state’s database. This is the interaction for communicable diseases and reporting them,” Gershman said. “It’s not a sexy thing, but we’re dependent on it. It’s very useful.”

The alternative is using the phone, fax machine or that old tradition of sending a letter to notify other departments of important cases. And even then, there wouldn’t be a central database everyone has access to. Though Gershman couldn’t quantify how successful the system’s been ” like a figure on how many outbreaks were thwarted ” he said the best measure is knowing how easy it is for people like Larson and Hunsaker to use.

“They’re the ones at the local level investigating and following up on cases, so if it works for them, then we’re doing something right,” he said.

In an ideal world, Hunsaker and Larson wouldn’t need the system so much, though.

A lot of the diseases the department investigates could be prevented with a vaccine, Hunsaker said. Even without the shot, there’s simple practices Hunsaker and Larson agreed could combat the spread of diseases ” cover your coughs and sneezes, don’t cross contaminate your food and, in the spirit of National Handwashing Awareness Week, which ended Saturday, wash your hands.

The problem is people generally don’t follow those simple rules too well. That’s why there’s somebody like Larson keeping an eye out for the next possible threat to people in the county.

dracioppi@vaildaily.com


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