When a medical team realizes that they have an unusual pathogen on their hands, they may send samples to the laboratories at CDC to help them identify exactly what they’re dealing with. Reviewing medical records can be especially difficult after a disaster in many cases the information is hard to find because of the large number of critically injured patients treated during a short period of time. This involves meticulous review of medical documents, as well as interviews with patients or their families. Whenever a team goes into the field to investigate an outbreak, they focus on trying to find out how people who got the infection are different from people who didn’t. They worked in conjunction with other disaster relief and health agencies on the federal, state, and local levels. Robyn Neblett Fanfair and Sarah Bennett, along with epidemiology fellow Kaitlin Benedict, and medical student Tolulope Adebanjo. The team included two Epidemic Intelligence Service officers, Drs. CDC’s Mycotic Diseases Branch epidemiology team was alerted that further investigation was necessary, and within a day a team was on their way to Missouri. When the news of a potential outbreak of fungal infections reached the community, there was a lot of fear and concern, especially for relief workers who worried they might also be at risk. Once the local public health authorities and hospitals were notified of this unusual pattern of symptoms, more cases were discovered. The first people to report the fungus were the doctors who treated multiple patients with similar symptoms, which suggested an unusual fungal infection.
JOPLIN MISSOURI TORNADO AFTERMATH PROFESSIONAL
The investigation team shared with me their experiences from Joplin, including their professional challenges and personal reactions to this disaster. I have been fortunate enough to work alongside the CDC Mycotic Diseases Branch during the past few weeks while participating in an internship for my Master of Public Health degree from Tulane University.
JOPLIN MISSOURI TORNADO AFTERMATH SKIN
The CDC Mycotic Diseases Branch sent a team to Missouri to help with an investigation of a cluster of serious fungal skin infections that occurred among people injured in the Joplin tornado. This kind of medical conundrum is worthy of even House M.D. It’s not nearly as simple as it sounds there are thousands of germs that can cause an infection like this and many treatments to be considered. Then it becomes a mad rush for the medical team to figure out what is causing the infection. But when an unusual germ infects a wound, it can take days to notice that the standard treatment isn’t working. Because they are the usual suspects for types of wound infection, treatment for those infections usually begins right away. We’ve all heard of s taph infections, which can be extremely severe and hard to treat. The problem with these infections is that it’s not always everyday microbes that infect a wound.
Unfortunately, the events that occurred in Joplin created the perfect environment for exposure to these pathogens, and some injured survivors began showing signs of an unusual wound infection. When residents are scrambling to protect themselves during extraordinarily stressful and frightening circumstances, there is no way to avoid getting a little dirt in your wounds, much less getting it out once it’s in there. Unfortunately, during a disaster, skin injuries are something that comes with the territory. Cuts, scrapes, burns, and even a splinter can allow pathogens to enter the body through the skin. A pathogen can be any living thing that causes disease, such as bacteria, viruses, fungi, or even other microbes like amoebas. This paves the way for germs-also called pathogens-which can infect humans when the body’s natural defenses are weakened. When people sustain massive traumatic injuries, it puts so much stress on the body that it becomes difficult to fight off infections.
The physical and psychological damages the city of Joplin sustained are devastating, as was the traumatic injuries inflicted on many of the residents.
John’s Regional Medical Center, Joplin’s main hospital, was directly in the path of the three-quarter mile wide tornado, with almost 200 patients and even more medical staff inside. The tornado damaged more than 7,000 buildings, one third of the city. Almost 160 people were killed and thousands of lives were completely uprooted. On May 22, 2011, an F5 Tornado ripped through the heart of Joplin, Missouri, a city of more than 50,000 people.
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