How are public health officials in Clackamas County, Oregon responding to the rash and rise of sexually transmitted diseases?
They’ve decided to ask people with an STD to name their sexual partners to track them down, and this task has been given to two women – Liza Baca, a disease intervention specialist, and Mary Horman, a registered nurse. Most of the work is done by phone, letting partners know that someone they slept with has tested positive for an STD (no names are given) and they should be tested as well.
Since some people can’t be reached by phone, the pair have to go out in the public and knock on doors.
Baca said this can be a bit terrifying, especially in rural areas where they need to rely on the GPS and its directions can get you lost. The women said they have yet to get lost.
Baca also said many of the county’s outskirt residents own firearms and will show them off to protect their property. When going to a home in the area, she makes herself visible and doesn’t fidget. She tries to be as warming as she can, by saying who she is and where she is from and lets them know she has a nurse with her.
The women never go into a home and do keep a cell phone on them at all times.
In one instance, the pair left without informing a partner about a possible STD infection, as they were at a trailer park and a dog was charging at them. They also had no idea which door to knock on, and couldn’t do random knocks due to privacy.
They also reached out to another person, a 64-year-old male by the name of Larry, to talk to him about STDs. The pair explain to him about how some diseases such as syphilis had to be reported, which is why they were talking to him. According to Larry, he had penicillin given to him intravenously and was healing fine.
Come to find out, through their conversations, that Larry had been infected with syphilis for 10 years and never knew it.
This isn’t uncommon, unfortunately. Many syphilis sufferers don’t have any outward symptoms, which means they can carry the bacteria and spread it but never have symptoms of it.
There was a time that syphilis was nearly eradicated in the U.S., and for that reason, many young doctors don’t know what the signs and symptoms of the disease are.
Larry said many of his sex partners were found on Craigslist and he doesn’t remember their names.
Baca said, despite too much time having passed, she didn’t feel her time was wasted. She said they were certain people where you know public health intervention is a necessity.
National Coalition of STD Directors Executive Director David Harvey said the work that fieldworkers such as Horman and Baca are doing is important. He said they can help people get the care they need once they find and inform them.
Harvey said about 1,400 disease intervention specialists are working in the U.S. This is down from the previous 4,000 workers.
Baca said she wants to focus on the high-risk populations such as gay men and pregnant women.
Dr. Sarah Present, a county public health officer, said newborns with congenital syphilis can suffer major neurological complications and possibly die. She said there are multiple congenital syphilis cases in the U.S. today, compared to a decade ago.
This is why Clackamas County health officials are dedicating a plethora of resources to find partners and encourage them to get tested. It’s imperative, she said, for the first person to be diagnosed with an STD tell officials who their partner was to stem the rise in STD infections.
Written by Mark Riegel, MD
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