How The 'Disease Detectives' Of Pinal County Are Fighting The Measles Outbreak

By Stina Sieg
Published: Friday, June 24, 2016 - 8:33am
Updated: Friday, June 24, 2016 - 6:51pm
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(Photo by Stina Sieg - KJZZ)
Infectious disease investigators in various work hand-in-hand with Arizona's Department of Health Services lab.
(Photo by Stina Sieg - KJZZ)
Disease investigators are constantly with officials from other counties, as well as the state lab, especially during outbreaks.

A new case of measles was diagnosed this week in Pinal County, bringing the total number infected to 18 in an outbreak that began last month at a detention center in Eloy. For most people, the news ends there. But for health officials, this is just the latest in a daily fight against all kinds of illness.

We all think we know how our government responds to infectious disease, right? That’s if we believe the 1995 movie “Outbreak,” with Dustin Hoffman battling that Ebola-like illness ravaging a tiny, all-American town. In one famous scene, he throws pictures of infected residents across table in front of a dismayed Morgan Freeman.

“You got to isolate the sick, and I mean really isolate them, Billy!” Hoffman yells. “We got to get everybody else back in their houses. We got to keep them there!”   

But Jabette Franco knows the reality of working in public health, and that can mean being on the phone. A lot. She estimates she makes about 25 calls a day from her office at the infectious diseases and epidemiology section of Pinal County Public Health Services in Florence.

“I was calling to see how you are doing,” she said into her receiver on a recent morning. “Did you have a fever today?”

Franco’s on fever watch, meaning she’s calling people who may have been exposed in this recent measles outbreak to see if they’re exhibiting symptoms. She’s one of a handful of investigators for the department. Many of these “disease detectives” have a master’s degree in public health, while Franco has decades of experience in the field under her belt. But they all work together toward the same end.

As program administrator Graham Briggs puts it: “Trying to get ahead of an infectious disease that doesn’t know what’s good or evil or know what borders are, or doesn’t care about who it infects, it just does its thing.”

Right now that “thing” is creeping out of a federal immigration detention center in Eloy, where a measles outbreak began around Memorial Day. So far, every case has been linked directly back to the center. But Briggs cautions it would be so easy for measles to get out to the general public, because it stays in the air for hours, even after an infected person has left the area.

He describes measles as if it’s a predator, hunting for anyone who isn’t immunized or whose immune system is compromised.

“If it finds one of those people, it will jump into that person,” he said, “and then it will try to jump into more people from there.”

So far, that hasn’t happened. That might be plain luck, or because Briggs’ team is continuing to make calls, knock on doors, even visit people in the hospital. They’re trying to determine where infected people were every moment of every day they were a danger to others and letting the public know, all while keeping in contact with other county health departments and the state’s main lab.

Investigator Clancy Hill explained they use a similar protocol for more than 80 diseases, from food-borne illnesses to sexually transmitted infections.

“Every salmonella case will get a phone call from us,” she said. “Every E. coli case will get a phone call from us. Every West Nile case is going to get contacted by us.”

Whenever anyone is diagnosed with those illnesses, healthcare providers are required to contact the health department. Hill likes to think of it as a safety net for the public, that most people don’t even know exists.

“I feel like it’s almost the better we do our job, the less you should hear about us," Hill said.

So working in public health is not about public glory, or the kind simple solutions to disease you see in the movies. Remember how in "Outbreak," scientists were able to cure a whole town with blood from a monkey?

It’s a wonderfully simple idea, and Graham Briggs says it’s also totally unrealistic.

“That would make our job so much easier, if we could just find that little monkey every outbreak,” he said.

With no cure-all monkey in sight, Briggs’ team will keep making their calls, doing their visits, looking at data — and waiting — until they can officially declare Pinal County in the clear from measles. At this point, that won’t be until August, and that’s only if no new cases are found.

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