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County, state differed on fungus alert

County, state differed on fungus alert

August 15th, 2011 in News

SPRINGFIELD, Mo. (AP) - Greene County health officials wanted to issue a statewide alert about a potentially deadly fungus found in the wake of the May 22 tornado in Joplin, but state health officials chose to wait on issuing the alert, according to a newspaper report Monday.

County health officials on June 3 sought a statewide alarm about the aggressive fungal infection, mucormycosis, which kills tissue and was found in 13 people injured in the tornado. Five of those died. It's unclear if the fungus caused or contributed to their deaths.

The national Centers for Disease Control and Prevention said it was the first known cluster of the fungus occurring after a tornado. No cases of mucormycosis have been reported since June 17.

State health officials, worried in part about panicking the public, initially said no to a statewide alert about the fungus, according to emails obtained in a records request by The Springfield News Leader ( ).

The county ended up issuing its own limited alert on June 6, putting out the word to 43 health care contacts. Joplin health officials also alerted providers. The state then issued a health advisory on June 10, a week after the county's request and two days after the News-Leader first wrote about the fungal infections.

"Our only goal was to alert doctors who were treating people with the infections to keep people from dying from them," said Kevin Gipson, the county's director of health. "That's the role of public health."

Jacqueline Lapine, spokeswoman for the state Department of Health and Senior Services, said the agency "worked in close coordination with local health officials."

"We continue to work directly with local public health officials and health care professionals to provide the best care possible for victims and to protect public health and safety," Lapine said.

Kendra Williams, Greene County administrator for community health and epidemiology, said the county asked the state on June 3 to send out a message warning health care providers to watch for fungal infections, with an attached memo from St. John's Hospital. She said the county wanted the state to send out the message because the state can send it to all counties in Missouri and neighboring states.

"The purpose was to ensure that any hospital/health care provider would recognize the illness in a timely manner and begin aggressive anti-fungal treatment," Williams said.

In a June 3 email to Dr. George Turabelidze, acting state epidemiologist, and John Bos, a state epidemiology specialist, Dr. Philip Yi Chin Lo, an epidemic intelligence service officer for the state, wrote that he had talked to a doctor at St. John's in Springfield about the fungus.

"He agreed with me that it's not beneficial to panic the public without getting correct info first, so he'll tell his trauma colleague to hold that off ...," Lo wrote. "If necessary we can issue a health advisory to health care providers, but it will only be possible if we can have all the necessary information and make sure the messages are correct."

Kevin Gipson, the county's director of health, said when the state health department rejected the county's request for the health advisory, the county issued its own limited warning on June 6.

"We did it anyway without their blessing," he said.

Teri Koch, an infectious disease nurse at McCune-Brooks Regional Hospital in Carthage, which briefly treated one of the people with fungal infections, said officials with the state Department of Health and Senior Services acted appropriately.

"I don't think it (the timing) was going to make any difference. I think they were frantically working behind the scenes to find out what they were dealing with," Koch said.


Information from: Springfield News-Leader,