Simulated Public Health Crises Challenge Calif. Teens

Feb. 02--Bloody lesions and sores pocked the leg of a man slung up in a hospital bed. Next to him, a woman struck with diarrhea and extreme fatigue became so tired that she passed out and fell, gashing her head. Across from her, a woman bit by a goat was covered with vomit and blood.

Emergency dispatchers' voices echoed over radios:

"Local hospitals are experiencing an overwhelming influx of emergency patients. Hospitals around Bakersfield are activating mass casualty protocols in response to a high number of patients coming into the emergency room suffering from an unknown illness."

That was the chaotic, albeit simulated, scene a group of about 30 unsuspecting high school students encountered when they piled off a bus at the Kern County Department of Public Health Services Wednesday for what they thought would be a typical field trip to learn about the health field.

What they experienced was far from typical.

The students, who attend high schools across Kern County and are part of the Bakersfield Chamber of Commerce Youth Leadership Program, were thrust into the scene and assembled into epidemiological strike teams to determine the cause of the outbreak.

Public Health Director Matt Constantine described it as a "call to action" that could encourage Bakersfield teens to stay in the area after college and work in the public health sector, which doesn't draw a lot of homegrown talent.

"Unfortunately based on our location, we have to recruit outside of Kern County often to bring in those who have the degrees in epidemiology and environmental health and some of those skills," Constantine said. "The neat thing about Kern County is you can come back and make a difference ... and that's what today is about. To expose the kids that there's a need for them to help."

Within moments of stepping off the bus, students were jumping into Tyvek suits that mock-patient Nick Lidgett, who works as a paramedic, said made them look more "Breaking Bad" than Public Health.

Then he pulled up the covers of his hospital bed as a team of five teenagers began interviewing him, revealing a bloody boil seeping puss on his leg, obscuring his caduceus tattoo.

"Oh my gosh, that's, uh, not normal," a student from Valley Oaks Charter School said as she recoiled and laughed. (The Californian acceded to a request by the chamber that the students not be quoted by name because their parents hadn't signed releases.

Then one of the Valley Oaks student's teammates from Garces Memorial High School combed through a questionnaire and saw the words "symptom onset."

"So, when did this start?" she asked, a little unsure of herself.

"Cool story. You guys like the ink, right?" Lidgett said before telling a winding story about how he got a tattoo Friday and the artist didn't wear gloves or wash her hands.

"But she was really hot," Lidgett added.

It was the strike team's first red flag, and one it almost missed -- a spunky Ridgeview junior stopped him mid-story, not wanting to waste any time.

"Let's focus on the matter here," she said.

Across the room, another group of students attempted to diagnose a woman with diarrhea whose symptoms began after she visited Lake Constantine.

Students from separate strike teams rushed to create GIS maps charting locations where their patients suspect they were infected.

"The outbreak seems to be in a clustered vicinity," a brainy Centennial High student said.

They started looking for environmental clues, like whether the water at Lake Constantine could be contaminated, then ruled it out because not all patients were presenting the same symptoms.

"Just because he doesn't have all symptoms doesn't mean it's not definitely the cause," their team mentor, Environmental Health Inspector Elizabeth King, advised them.

The Garces teen got on the radio and called for tests on salmonella, anthrax, E.coli and staph infection. Across the room, another team investigating a patient who spent time at a dairy was drawing its own conclusions about what it suspected led to the outbreak.

An irresponsible dairyman caused the whole thing, members said.

He was dumping manure too close to a river, which flows into Lake Constantine, contaminating the water, one amateur sleuth reported to his peers at the end of the day. It was a staph infection outbreak.

That lake is the same one a goat at a petting zoo drank from before biting a woman; the same lake another woman swam in before becoming ill; and the same lake Lidgett's tattoo artist spent time at before inking his leg with an open wound on her hand.

"A lot of the times it's not this simple," Senior Epidemiologist Kim Hernandez told students at the end of the day. "A lot of the times we don't figure out what happened or where it happened, but the idea of public health is to make sure it stops happening."

So what's the solution?

Kids started hurling suggestions: Drain the lake! No, decontaminate it with chlorine!

Constantine laughed that last one off.

Chlorinating a lake might cause a whole other public health crisis.

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