Epidemic Expert Spreads Warnings, Remedies Panic : Informing Public About Diseases Poses Risks

When a potential health threat surfaces, Orange County epidemiologist Dr. Hildy Meyers often finds herself trying to do two seemingly contradictory things: Warn the public and prevent panic.

“I always wrestle with the idea that when we’re going to make a public announcement about something, it can have negative consequences,” said Meyers, the 39-year-old medical director of Communicable Disease Control & Epidemiology for the Orange County Health Care Agency.

“One of the consequences of a public announcement is that doctor’s offices are flooded with phone calls and visits. It’s not good for someone with a contagious disease such as chicken pox to go to a medical office or a hospital, unless they are having a complication. At hospitals, you have sick people who are at high risk for infections, so you can do more harm than good.”

Meyers and staff monitor the health of Orange County residents by measuring trends in communicable diseases and taking steps to stop their spread in the event of a possible outbreak.

“Prevention is what our whole organization is really all about. By California law, physicians and some of the other health care providers are required to report certain diseases to us.

“And there’s also unusual occurrences and outbreaks that are supposed to be reported to us. That forms the basis of most of our information.

“Unfortunately, a lot of physicians are actually ignorant of this responsibility or they feel they’re too busy or whatever. That’s another area where we’re trying to constantly educate, so that we can get better, more complete information.”

When two Costa Mesa High School students earlier this year came down with meningococcus, a rare disease that invades the body’s organs and immune system if not treated promptly, Meyers found it necessary to notify the public. One of the girls died from the disease.

“We had a specific reason for going public, which was that the parents of kids who’d had contact with the two cases needed to know, so they could get preventive treatment. But it also had the unfortunate consequence of scaring a lot of people who were otherwise well or just had mild illnesses.

“There were a couple of subsequent cases who said they sought medical care because of the information that came out, so maybe we saved a couple of lives by doing that. But I also understand that we caused a tremendous amount of worry and people going unnecessarily to their doctors. I’m not sure there’s any way around that.”

The disease is serious, but there is no risk of a countywide epidemic, Meyers said.

“When we have a case of meningococcal disease, there’s only a small group of people who needs to take any action. We try to find the close contacts and make sure they get the prophylactic medication, although they still have a fairly low risk of ever developing the disease.”

Meyers faced the same dilemma in 1994 when a Stanton woman was hospitalized with the virulent strep infection known as the “flesh-eating disease.”

“They find a patient in Orange County with this very rare but horrible, awful disease that can deform you and kill you; [the media] show pictures of that and then they interview me saying, ‘Don’t worry.’ It’s always difficult to reassure people that they are at very low risk, because once that disease happens the consequences can be terrible.”

News reports of flesh-eating bacteria and the Ebola virus may be frightening, but the risk of an epidemic of any kind in Orange County is actually quite remote, Meyers said.

“There are really very few diseases that would pose an immediate epidemic threat. You’re really talking about airborne diseases, and there are not a lot of airborne diseases that are that big of a threat.

“You could have outbreaks of measles, but as long as we maintain high vaccination levels, that shouldn’t be a big problem. Tuberculosis is airborne, but it’s not that easily transmitted. You can’t just walk by someone who is coughing and get it. It usually takes prolonged contact.”

What worries Meyers most is the growing number of antibiotic-resistant disease strains.

“Antibiotic resistance is a bigger threat for this country than things like Ebola virus. When you are sick, you want everything to be done that can be done to make you well.

“But handing out antibiotics like water is harmful. We’ve always assumed that the development of antibiotics would stay ahead of the development of resistance, but today that’s not clearly the case. And that’s a pretty frightening prospect, really.

“Some people go as far as to say that microorganisms are smarter than we are. It’s probably because of their shorter regeneration times and that they are more adaptable.

“We can’t really afford to turn our back and walk away from this.”

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Profile: Dr. Hildy Meyers

Age: 39

Hometown: Los Angeles

Residence: Huntington Beach

Education: Bachelor’s degree in biology, Harvard University; master’s in public health, UCLA; medical degree, UC San Francisco

Background: Emergency room physician at L.A. County-USC Medical Center; medical residency with L.A. County Department of Health Services; physician and epidemiologist for Orange County Health Care Agency, Division of Health Promotion & Disease Prevention, 1987-1990; medical director of Communicable Disease Control & Epidemiology in Orange County since 1990

On likelihood of an OC epidemic: “There are really very few diseases that would pose an immediate epidemic threat. You’re really talking about airborne diseases, and there are not a lot ... that are that big of a threat.”

Source: Dr. Hildy Meyers; Researched by RUSS LOAR / For The Times

Los Angeles Times