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Changes in healthcare have caused a shift of care to outpatient settings and specialized services. This has not lessened the complex needs of some patients, however. These individuals rely on frequent and intensive use of outpatient care to maintain and improve their health. They are vulnerable to infection from the increased frequency of invasive procedures, use of antibiotics, immunocompromise, age, and multiple co-morbidities, such as diabetes, advanced renal disease, and obesity, to name a few.

Lyme disease is rarely acquired in Washington state, and when it is acquired in-state, it is almost always west of the Cascades. If a healthcare provider suspects a person has been exposed to Lyme disease in an endemic area, such as the upper Midwest region, Eastern US, or the West Coast, or to an animal from these regions, the CDC currently recommends a two-tiered process for testing. Both can be done using the same blood sample.

Ticks are a frequent source of conversation and irritation during summer months in the Inland Northwest. In Washington state, ticks carry few diseases and reported cases are few, as compared to other states. In the Spokane-area, only three tick-borne diseases are rarely locally-acquired: tickborne relapsing fever, tularemia, and tick paralysis. However, other diseases are noted.

In each issue of the Epigram, we are pleased to introduce to you a member of the Disease Prevention and Response team at SRHD. In this issue we feature longtime epidemiologist Dorothy MacEachern, MS, MPH, CIC, a dedicated employee of SRHD for 20 years. Dorothy is currently an Infection Preventionist funded by the CDC working with local healthcare facilities to prevent healthcare-associated infections.

Some of the largest and most publicized public health events of the last several decades are profiled in the CDC’s web series “We Were There” – Toxic Shock Syndrome, E. coli O157 outbreak of 1993, ending polio in America, the first Legionnaires’ Disease outbreak in 1976, and others. This fascinating lecture series outlines in detail the behind-the-scenes investigation process and the invaluable contributions from public health in solving and stopping considerable morbidity and mortality from disease outbreaks.