Tuesday, March 17, 2009

We Want To Talk To You

Sometimes when we call people to investigative communicable disease reports, they get angry with us. They want to know how we got their info when it is supposed to be private. HIPPA does protect the privacy of your health records; however, it contains a stipulation which allows public health access to your information in regards to a public health investigation. One guy recently yelled at my investigator about invading his privacy. This was a guy with salmonella. He said, “Why are you bothering me? You people need to be doing something about the peanut butter!!”

Yes. He’s right. We do need to be doing something about the peanut butter. And we are. The thing is, how do you think we found out the peanut butter was a problem? We figured out through patient interviews. When we call and interview someone with salmonella, we ask them to name all of the foods they ate in the few days before onset of their symptoms. We find out every restaurant, and as much as possible about what else they ate, what exactly it was, and where it came from. That way we can identify patterns. If we have ten cases of salmonella reported to our health department within a short time span, and they all said they ate at the IHOP, we are going to go over to the IHOP and see if there is a problem. If CDC identifies a national outbreak through their lab surveillance system, then multiple jurisdictions get together on a conference call and compare notes to figure out what the likely culprit was. Once we’ve pegged down a possibility, we will conduct a case-control study to further confirm that’s what it is. Meanwhile, CDC alerts the FDA so they can start product tracing. All of this – ALL OF IT – is dependent on sick patients telling us what they ate.

Personal health information is private. But not at the expense of the public’s health. More about the balance between private and public interests later.

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