Sarah Y. Park


POSTED: Friday, November 06, 2009

The better Dr. Sarah Y. Park is at her job, the less people may realize it.

As the state epidemiologist and chief of the Department of Health's Disease Outbreak Control Division, it's her job to spot emerging threats and shut them down. The effort includes educating people about how to avoid getting sick in the first place, including encouraging folks to keep up-to-date on vaccinations, practice good hygiene and be careful about what they eat.

“;The biggest thing in public health is that it's all about teamwork. Prevention and disease control ... only work if everyone does it together,”; said Park, who was promoted to her current post in September 2008 after four years as deputy chief.

That earlier job had brought her to Honolulu from Atlanta, where she was an epidemic intelligence service officer for the U.S. Centers for Disease Control and Prevention, and twice honored for outstanding work.

Park, 40, grew up in San Francisco and headed east for college, earning a bachelor's degree in biology from the Massachusetts Institute of Technology and a medical degree from Boston University. Fellowships took her back to California, for intensive training in pediatrics and pediatric infectious diseases at Stanford University and the University of California-San Francisco, respectively.

In her rare off hours, Park runs — she's done about 23 marathons, including Honolulu's several times — and has started outrigger paddling and surfing since moving to Oahu.

She expressed optimism that Hawaii would cope well with a second wave of the H1N1 virus, given the public response when the so-called swine flu first emerged last spring.

QUESTION: What are some public health threats in Hawaii other than the H1N1 virus?

ANSWER: Food-borne diseases are always a concern for us. ... The most likely reason that a person would call the Health Department is that they get sick after eating something. We investigate a big outbreak every few years. The last big one was at the end of 2007 — the salmonella-contaminated ahi poke. A health threat that is specific to Hawaii is Angiostrongylus cantonensis. It's a parasitic roundworm that is endemic in this state, found in mollusks, snails and slugs. We've had cases from as far back as the 1960s, but it's come into the public notice recently with some very prominent cases on the Big Island.

Q: How does it make you sick?

A: How you get infected with that is accidental ingestion, especially accidental ingestion of contaminated leafy greens. In one case, in 2004, four people were sharing a homegrown salad and they actually saw a tiny slug in the bowl, and they threw it away but continued eating the salad. All four became ill. I'm definitely a proponent of local agriculture, organic gardening, all that, but you have to wash your food really well, especially anything that is going to be eaten raw. ... A lot of infectious diseases go back to hygiene.

Q: So how should you wash leafy greens?

A: We're suggesting that you should separate each leaf and rinse each individual leaf very well. Cooking obviously is a good way to kill a lot of things, including this parasite, but most people don't prefer cooked lettuce.

Q: Has Hawaii dodged any bullets lately? I mean, has DOH contained any recent threats that left you sort of breathing a sigh of relief, thinking that could have been a lot worse?

A: There's always something. We try to be aggressive when we start to see a few cases of anything. With our big H1N1 vaccination push right now, we have the potential to dodge the bullet, to evade that second wave of H1N1 virus that has hit the mainland. But it's got to be a community effort: Vaccinate, practice good hygiene (including frequent hand-washing), stay home when sick. If we're successful, people might say then “;What was the big deal about H1N1?”; But it's preventing a lot of misery.

Q: With any public health issue, how do you keep the need for awareness and prevention from morphing into hype, alarm and eventual disinterest?

A: It is a constant challenge. Just look at all the vaccine-preventable diseases. This country is so lucky. Measles, mumps, rubella — those used to be the norm. And now we have vaccines that prevent them. Then you go to a continent like Africa (Park served on a World Health Organization team there). When the mothers in Kenya saw us coming around they would ask, “;Do you have measles vaccine?”; and practically throw their children at us. They desperately want the vaccine because they are still living with this disease.

In public health, the more successful you are at preventing disease, the more difficult it becomes sometimes to convince people to maintain that vigilance. When somebody vaccinates their own child, they are protecting their own child and everybody else's. And when they refuse to vaccinate, the opposite is also true.

Q: On the mainland, it seemed like the H1N1 outbreak was a few weeks ahead of the availability of the vaccine. Is that true here?

A: No, I hope not. Vaccine has already started arriving ... and we are fortunate that influenza activity does still seem to be baseline, not spiking yet.

Q: How did the DOH decide where the H1N1 shots would be administered?

A: Our biggest concern was ease of access for the priority groups to receive the vaccinations. We registered all sorts of providers, including a lot of pharmacies, because they have become more and more of an avenue for the general public to receive the flu vaccine.

The nice thing about pharmacies is that they tend to be scattered geographically around the state, people know where their neighborhood pharmacy is, and they tend to be open longer hours, after work and on the weekends. There's usually free parking. All those factors make it easier for people (to get the shots).

Q: The H1N1 vaccine is recommended for children, yet some parents seem reluctant. What would you tell parents who are on the fence about this particular vaccine?

A: First of all, this vaccine has been produced exactly the same way as the seasonal flu vaccine; the only difference is that it targets the H1N1 virus. It is as safe as the seasonal flu vaccine and it specifically targets this pandemic virus, so it should be close to 100 percent effective (against what can be a very serious illness). I'm saying to parents: Be informed, but rely on true scientific information, not some of the junk that's out there on the Internet.

Q: What about parents who resist having their children vaccinated at all, for anything, because they fear the shots may cause autism? What would you tell them?

A: Unfortunately I don't expect to change the minds of people who are already thinking that way. But what I would say to new parents, who understandably have questions, is that vaccines are absolutely vital to prevent truly horrible childhood diseases that are still out there. I would ask that they consider the consequences to the health of their own child and to everyone else's.

The National Network for Immunization Information has a great Web site (http://www.immunizationinfo.org) that provides a lot of important information. There is at this point no scientific evidence linking vaccines to autism.

Q: The Department of Health is closed on Furlough Fridays. Are the state budget cuts affecting the public's health?

A: Only time will tell. We are doing the best we can under the current circumstances.