Miss. Health Department defends handling of West Nile cases

Published 4:46 pm Friday, September 1, 2006

Mississippi’s state epidemiologist says it is inaccurate to say the Department of Health failed to report 29 cases of the West Nile virus because physicians were told about the test results, even if the public was not.

Dr. Mills McNeill, during testimony before a Senate panel on Thursday, said the Health Department will soon conduct further tests that will conclusively show that the virus is West Nile and then those cases will be reported to the U.S. Centers for Disease Control.

Dr. Art Leis, a Jackson neurologist, told lawmakers about the 29 cases, most of them in Hattiesburg, on Wednesday. Leis said the agency has grouped the cases as flavivirus, which basically means indeterminate, but did not pursue further testing required to detect West Nile.

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McNeill insisted that the department had not done anything wrong by not including the 29 cases in the state’s running tally of West Nile patients. As of Aug. 29, Mississippi had 32 confirmed cases, not counting the 29 flaviviruses.

“It is really hard to know how to report an unknown lab test to the public,” McNeill said, adding that he personally contacted physicians and told them they had the option to get a second test.

McNeill said the Health Department is implementing a new testing system that will have the capability of detecting the West Nile virus without having to send the sample out-of-state.

The Senate Public Health Committee was holding a two-day hearing into the operations of the Health Department, led by Dr. Brian Amy. The agency has come under fire for everything from management style to the $40,000 salary increase Amy has received since he arrived in 2002.

Witnesses have testified that restaurant inspections are lax, the state’s trauma care system has been neglected and the agency has stopped administering a national test paramedics must pass to receive certification.

The Joint Legislative Committee on Performance Evaluation and Expenditure Review, or PEER, has issued a December 2005 report criticizing the department for undergoing four reorganizations since 2002.

Amy defended his handling of the agency, saying the criticism leveled against it was only one side of the story. He said his agency lost 40 percent of its state funding as 40 percent of its work force was reaching retirement age. He said the reorganizations reflected the evolving environment at the agency.

“If it didn’t work, we tried it another way,” Amy told lawmakers.

Sen. Billy Thames, D-Mize, said he was concerned that the committee only subpoenaed people who would make negative remarks about the Health Department.

“Surely to goodness, there are some people on the other side,” Thames said.

Sen. Hob Bryan, D-Amory, bluntly told Amy that is was time that someone else took over the agency.

“I have come to the conclusion that you being state health officer is not a good mix right now,” Bryan said.

The most incendiary testimony to come out of the hearing was about the West Nile cases, with some lawmakers expressing outrage that residents were not told about the cluster in Hattiesburg and warned to protect themselves.

“From what I heard, there is a drastic communication problem in that department from the top to the bottom,” said Sen. Tom King, R-Petal. “You’ve got to raise a red flag, you’ve got to make the public aware.”

Joy Sennett, director of the office of communicable diseases at the Health Department, confirmed Thursday that there was a flavivirus grouping, and said the agency also had failed to effectively alert the public about other potential health crises.

Sennett said Mississippi was one of 11 states associated with a mumps outbreak earlier this year. She said there were two Mississippi cases.

“We didn’t say anything. We didn’t alert the health care community,” Sennett said.

McNeill said the decision to keep quiet about the mumps cases “was a judgment call.” He said the cases were imported into the state and people who had come into contact with the patients were contacted.

“Do you alarm the public about cases of mumps that are well contained, and there are no secondary cases?” McNeill said.

Legislation authorizing the state Health Department is set to expire June 30, 2007.

Senate committee Chairman Alan Nunnelee, R-Tupelo, said lawmakers will make changes within the agency before reauthorizing the statute.