USA Today: Navajo nurses deserve praise for raising alarm on salmonella
A USA Today story today gives props to public health nurse Kimberlae Houk and her colleagues in the Navajo Nation for raising the alarm early about the ongoing salmonella outbreak in tomatoes. The article describes the magnitude of the impact, which is nationwide, gives a timeline, and credits Houk and the Shiprock Indian Health Services Unit for quick action:
...it could have been a lot worse if a red flag hadn't been raised early in the outbreak last month by a public health nurse with good instincts in one of the nation's poorest, most remote regions.
Indeed, health officials say that because the first cluster of patients surfaced on the Navajo Nation in New Mexico, where they are served by a small, close-knit medical community, federal investigators were able to quickly identify the contaminated foods and take steps to contain the outbreak the past two weeks.
After being the first to recognize the signs of an emerging outbreak, the federal Indian Health Service staff played a key role in the search for the tainted food. "It was 21st-century molecular epidemiology and old-fashioned boot leather," says John Redd, the infectious disease branch chief with the Indian Health Service in Albuquerque. "You've got to get out from behind your desk and hit the road sometimes.
...Shiprock Indian Health Services Unit provides medical care to more than 45,500 American Indians, mostly Navajo, in an area that covers 23 communities in the three states. Homes can be extremely isolated, and many are without telephones.
Houk knew something was up on Monday, May 19, when four people very sick with diarrhea, fever and abdominal cramps showed up at the Northern Navajo Medical Center in Shiprock, N.M.
"A lot of time with these kinds of diseases you get your babies and your grandmas in the hospital," she says. "But in this one we had fit 30-year-olds. And we just don't get 30-year-olds in the hospital with dehydration."
And these people weren't just dropping in at the doctor's office. "We serve a very rural population. They have to drive an hour to the clinic and an hour back. So it's a big deal to come in," Houk says.
With previous experience with outbreaks of measles, whooping cough, hantavirus and even the plague, Houk immediately went into outbreak mode. "We literally drop everything when there's a communicable disease, to protect people."
That day, "We all just ran," says Houk. "We can really get on top of things quickly because all our nurses, our doctors, our clinics, our labs, we're all under the same roof."
The tomato salmonella outbreak is nationwide, and the source is still undetermined. The article points out that the factory farming from which most of our food these days originates makes what in the past might have been localized outbreaks now a national danger:
The outbreak is a reminder that consumers pay a price for the vast agricultural production and distribution system that supplies cheap, plentiful produce year round, says Kenneth Albala, a food historian at the University of the Pacific in Stockton, Calif.
"In the past most food was produced and consumed locally, you wouldn't have much trouble figuring out where (tainted) food came from," he says.
Today, he says, having fresh, ripe, cheap tomatoes available in salads nationwide in April — inconceivable two generations ago — also means "the distribution is so broad that something (contaminated) can show up in 13 states the next day."
While the outbreak is nationwide, New Mexico is tied with Texas in most reported cases--68 so far. Be sure to check out the entire article--there's a great photo of the Shiprock Indian Health Service department of public health nursing team.
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