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November 8, 2005

Polio in Minnesota

1963 polio eradication campaign in Oklahoma City
from the CDC's Public Health Image Library (ID#: 1624)

There's an excellent N.Y. Times article on the recent polio outbreak here in Minnesota. It elucidates some key points that I hadn't realized. First, the index case is a infant with an immune system deficiency. This probably put her at risk of acquiring the virus in the first place. But it also means that her body can't easily get rid of the virus, so she most likely will continue to produce and shed the virus in her stool. Indeed, it has spread to four other children who live on neighboring farms.

Another good point is that just because the community is Amish doesn't mean the people are necessarily isolated and immobile. "The Amish commonly take buses and trains, and occasionally even planes," the article notes. Members of the infected infant's Amish community recently attended a large wedding in Ontario, Canada. In the realm of public health at least, we are all one community. Surveillance efforts should strive to extend towards all; prevention and protection should strive to support all. Interwoven among these ideas is the question of reconciling individual rights with what is necessary to protect the larger group. All of the varied scientific and ethical issues that the public health community wrestles with are present in this one case.

Lots of weighty concepts. Lots of uncertainty. But for me, I am glad of one thing: if the case had to occur somewhere, I'm glad it happened in Minnesota. Why am I happy it happened in my state? Because we have the best and brightest public health minds working for us. We have one of the most thorough and comprehensive public health infrastructures. We have integrated laboratory surveillance. We go further than other states in tracking down cases and following leads. That's why I'm here in Minnesota getting my Ph.D. at the School of Public Health. That's why so many come here to be a part of this team: the health department, department of agriculture, the board of animal health, the Pollution Control Agency, environmental health, the Veterinary Diagnostic Lab, and on, and on.

The Times article noted the difference in this polio outbreak:

As [the infant's] care became increasingly complex, she was shuttled through four hospitals. At the third, she developed diarrhea. On Aug. 27, doctors sent a stool sample to the hospital's laboratory, which determined that the girl had an intestinal virus. In many states, nothing more would have been done.

But in Minnesota, hospitals send such samples to a sophisticated state laboratory...

I'd like to close with a special thank you to Minnesota residents and public officials. Thank you for paying the taxes and choosing to fund this great work. What you sow will be reaped by so many.

Posted by rigd0003 at November 8, 2005 2:53 PM | Public Health