It's late afternoon on Jan. 30. The Durango Herald reports two big local burglary cases were solved.
Meanwhile, two nurses at San Juan Basin Health Department are investigating another new case involving a different culprit - pertussis. This investigation doesn't involve a crime, but it does involve protecting the community.
Serving as disease detectives, these public-health nurses question individuals, examine linkages and patterns, recommend preventive measures and even put out a kind of all-points-bulletin - otherwise known as Health Alert Network. This alert is sent to physicians' offices and hospitals. Alerts also are sent to potentially affected populations such as day care centers and schools.
Every confirmed and suspected case of pertussis is reported to San Juan Basin Health Department. Joe Fowler, R.N., or Patsy Ford, R.N., immediately contact the affected person, piecing together a story about how the individual got sick and who else may be at risk.
Each disease has a specific definition regarding "close exposure." For pertussis, it's being within 3 feet and facing the person while he or she is coughing or sneezing.
"We often hear from parents of kids sitting in the same classroom, but not seated right next to the coughing child," Fowler says. "This is not considered close exposure, and their child is very likely not at risk."
After identifying those individuals with close exposures, the process begins again with phone calls, questions and recommendations. Each case creates its own ripple effect of concentric circles of contacts with varying levels of exposure risks and notification procedures. During this outbreak, there have been nonstop calls, weekly alerts faxed and numerous letters sent to day care centers and schools. Stopping the disease from spreading depends on strong partnerships with schools, medical practices, hospitals, parents and community members.
A relatively "new tool in our toolbox" for containing whooping cough, says Fowler, is the Tdap vaccine. Just four years ago, this vaccine wasn't available, so much of the public may still be unaware of it. Not only does it provide the tetanus booster adults generally get every five to 10 years, it also protects the larger community. This adult population serves as the "reservoir" for pertussis, Fowler says, allowing it to spring up occasionally in various communities.
In addition to its regular Monday clinics, San Juan Basin Health Department has organized special pertussis walk-in clinics. One last week in Bayfield served 200 individuals. Another clinic is being held today in Ignacio.
It's a long afternoon at the health department. Fowler has contacted all the close contacts in the new case. He speaks with a mom who's just brought in her 4-month-old. The infant has pertussis and is experiencing worsening coughs with serious complications.
"Until people see the pain and burden on these children and parents, it's difficult to appreciate how serious this disease is and why it's so important to protect oneself and one another," Fowler said.
That's what ultimately is behind all the detective and preventive work - protecting our community.
Visit www.sjbhd.org. for more information, resources and updates.
Jane Looney is the communications director for the San Juan Basin Health Department.