A Day in the Life of a Disease Investigator

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You may be reading that title and wondering what a disease investigator is and why the topic is being discussed in a public health blog post, so let’s start there!

In the state of Washington (and all states), there are certain health conditions that are considered “notifiable,” which means that anytime they are diagnosed (or suspected) by a healthcare provider, the information is forwarded to the local health department so they can learn more about who has the condition and how they got it. This is where a disease investigator comes in!

Disease investigators usually work within the communicable disease division of health departments, and you may have even talked to one before! When a community member gets sick with something like salmonella, E. coli, or hepatitis C, we reach out to ensure the patient is aware of their test results, discuss treatment, if necessary, and work to ensure the disease doesn’t continue to spread further. A day in the life of a disease investigator can be very exciting stuff.

An example of a typical (but busy) day can look like:

  • A member of the public called to say they got sick with a stomach bug after eating at a birthday party.
  • We received a call from the Washington State Department of Health letting us know they need our assistance reaching out to a local nursing home to test residents for a possible multidrug-resistant organism exposure.
  • We received A new lab result in the state reporting system notifying us there is a new case of valley fever (coccidioidomycosis) to evaluate. It is important to call the patient to find out if they have recently traveled.
  • A local veterinarian called asking for advice about whether or not a dog they are treating should be tested for rabies since it came in contact with a live bat.
  • A fax from a hospital came in with a lab result for someone who tested positive for salmonella. Upon speaking with the patient, we discovered they ate at the same birthday party we received that call about earlier. Time to figure out if we have an outbreak on our hands!
  • A school nurse called to inform us that one of their students is being evaluated for chickenpox. Even though it isn’t notifiable, we still have guidance and a notification letter we share just in case.

The possibilities are endless! The next steps we take depend on the needs of the case we are investigating.

Next steps might look like:

  • Interviewing the patient to learn about their experience, including how they may have been exposed, their symptoms, and if they may have accidentally exposed others.
  • Conducting contact tracing to inform contacts they may have been exposed and possible guidance if they need to seek healthcare.
  • Consulting with healthcare providers to help them decide next steps for treatment.
  • Conducting a foodborne illness outbreak investigation with the help of our environmental health team.
  • Providing treatment if the person is unable to see a healthcare provider (for certain conditions, not all).
  • Packaging specimens and shipping them to the public health lab for further testing. This can include things like stool specimens, nasal swabs, and even animals.
  • Providing education on how to prevent the illness from spreading to others. Which usually always involves talking about good hand washing!

And at the end of the day, we take our on-call phone home with us in case of any urgent needs throughout the night. Though no day is the same, it usually contains a mix of these things, plus a few meetings. As disease investigators we often make interesting discoveries that make us feel like a detective. But no matter what the day brings, we’re here to help determine the cause of an outbreak, keep tabs on where and how disease spreads, connect people with the proper treatment when appropriate, and help prevent others from getting sick.

Include Preparations for Diseases in Your Emergency Planning

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Guest post by Skagit County Emergency Management

Emergencies come in all shapes and sizes, and sometimes they become stacked on top of each other — like dealing with flood or wildfire season during a pandemic. Skagit County Department of Emergency Management recommends that you take the time to revise your family emergency plans to consider how you will keep your family safe in the event of an emergency during a disease outbreak. These plans will be critical not only during COVID-19, but in the case of possible future outbreaks of other diseases.

The most important thing you can do in preparation for emergencies during a pandemic or disease outbreak is to learn about and practice effective infection control. Illnesses are usually spread through the air (when someone coughs or sneezes) or through contact (you touch something contaminated, then touch your face). The easiest and most effective way to limit disease spread is to frequently wash your hands, use good cough and sneeze hygiene, and avoid close contact with ill people.

So how can you work those preventions into your family emergency plans? (You do have a plan, don’t you?) Focus on being able to keep your hands and face clean, to clean surfaces if needed, and to maintain space.

Some examples of things you should consider:

  • Keep a supply of face masks, hand sanitizer, and tissues in your go bag for every person in your house. Wear a face mask whenever you are around other people.
  • Practice good cough and sneeze hygiene:
    • Cover your mouth and nose with a tissue when you cough or sneeze.
    • Throw away used tissues in a lined trash can.
    • Immediately wash your hands with soap and water for at least 20 seconds. If soap and water are not available, clean your hands with an alcohol-based hand sanitizer that contains at least 60% alcohol.
    • For answers from the Centers for Disease Control and Prevention (CDC) to frequently asked questions about handwashing, just click here.
  • Stock supplies to disinfect surfaces, whether in your home or at an evacuation location.
  • Consider how social distancing will work if you have to evacuate — maintain enough space from others with only a small amount of time spent close to people outside of your household. Plan on having enough supplies so you don’t have to borrow from anyone you don’t live with, and maintain enough space between you and other households to limit contact. Be aware that you may need to travel farther away from home to find shelter; in order to maintain social distancing, local evacuation centers may not be able to serve as many people as normal.
  • Be sure water sources are safe and surfaces are effectively cleaned during and after an event. Standing water and open sewage are places of contamination and disease spread.
  • Know where to get verified information, not only for evacuations and weather, but also regarding disease information. The Washington State Department of Health and Skagit County Public Health are good sources of current, local information.
  • Know the signs of any major illnesses in the area. For example, the CDC recently updated the range of COVID-19 symptoms, including:
    • Fever or chills
    • Cough
    • Shortness of breath or difficult breathing
    • Fatigue
    • Muscle or body aches
    • Headache
    • New loss of taste or smell
    • Sore throat
    • Congestion or runny nose
    • Nausea or vomiting
    • Diarrhea
  • Think through how you can keep others safe if you were to fall ill during an emergency. Plan ahead for a safe location where you can maintain appropriate distance from other people if you need to leave your home. Consider ways to limit other’s exposure to you, such as wearing a face mask and isolation.

Planning for emergencies is a never-ending process. If you don’t have a plan, talk with your household and come up with one. If you do, you can find ways to make your plan better. Adding a few things to your plan to keep you healthy during a disease outbreak — even if it’s not a pandemic — makes you and your family better prepared for anything that happens.