STAR-BULLETIN / 2005 State Epidemiologist Paul Effler, shown here in his downtown office, will be leaving his post to work in Perth, Australia.

Isle disease specialist takes job in Australia

The epidemiologist says it has "really been a privilege" to work for the state

After 13 years of tackling Hawaii's health crises head-on, state Epidemiologist Dr. Paul Effler is leaving for Perth, Australia.

He will do almost identical work with the Communicable Disease Control Directorate in Western Australia, running immunization and disease outbreak programs.

"I do want people to know how much I've appreciated their support and working for Hawaii and how much that has meant to me," Effler said in an interview.

He said he was walking down the sidewalk two months ago when a woman he did not know walked up to him and said, "'Thank you, doctor, for all the hard work you do in the Health Department.' It almost made me want to cry."

He said it has "really been a privilege" to serve the people of Hawaii. "Through it all -- SARS, dengue fever, anthrax hoaxes and attacks, vaccine shortages and now the threat of H5N1 influenza -- I have always felt supported by the community, and I have worked hard to honor the trust placed in me."

Effler, also chief of the state Health Department's Disease Outbreak Control Division, said he is making the change for family reasons. His wife, Dr. Allison Imrie, a University of Hawaii assistant professor in public health sciences, was born in Tonga to a Tongan mother and Australian father.

She is an Australian citizen, and their daughter, 9, and son, 8, have dual citizenship, Effler said. His wife has siblings in Australia with children the same age, and they want their children to be closer to them, he said.

He said he obtained a license to practice medicine in Australia in 2001, knowing they might return there some day.

Effler earned a UH master's degree in epidemiology after medical school in San Diego, then worked at the U.S. Centers for Disease Control and Prevention in the Epidemiology Intelligence Service.

He was working in Papua New Guinea and the Philippines for the World Health Organization when a Health Department position opened in 1994.

"It turned out to be a wonderful experience, both personally and professionally," he said. "There is such a myriad of cultures here. We get such a wide variety of infectious disease issues to work on."

Effler recruited Dr. Sarah Park, former CDC epidemic intelligence service officer, to serve as his deputy chief in 2004, and she will replace him in an acting capacity.

"He has been such a great mentor and really great friend and supporter for my career and for everything overall," Park said. "It's going to be sad for me and the staff here."

Park arrived at the Health Department in time to help Effler deal with a flu vaccine shortage, one of his many challenges over the years.

Among others were the dengue fever outbreak in 2001-2002, with 119 confirmed cases, and the investigation of more than 80 potential cases of severe acute respiratory syndrome (SARS) in 2003. One Hawaii SARS case ultimately was confirmed in Taiwan, involving a flight attendant who had been here.

Effler said the SARS outbreak "really showed me the best of the department." The staff potentially put their lives on the line to investigate cases and collect samples and "still came through," he said.

The dengue fever and SARS threats had to be effectively contained without unnecessarily hobbling the economy, Effler said. "I took the long view that people's health really is dependent on people's socioeconomic status, and people out of work over unfounded fears is not good.

"At the same time, we need to do the job. We need to get the balance right and try not to unnecessarily alarm people."

A wide range of other health problems, from food poisoning and salmonella to flesh-eating bacteria and exposure to measles, also kept Effler and his team busy.

They did things that did not make headlines but were really important to public health, he said, such as a statewide hepatitis B vaccination program in 1996 for fifth-graders.

Effler emphasized that his division's accomplishments have been "a team effort," pointing to the award-winning statewide school flu vaccination program last fall involving the Health and Education departments and University of Hawaii School of Nursing and Medical Reserve Corps.

More than 50 similar programs are now being planned at mainland schools, he said.

Effler said he feels some decisions should be made about offering free vaccines to young girls to protect them from sexually transmitted human papillomavirus infection and cervical cancer. That is done in other countries.

The Health Department has made great strides with emergency preparedness for disasters and global diseases, working with the Healthcare Association of Hawaii and private partners, but it is a continual process, Effler said.

Toby Clairmont, Hawaii Disaster Medical Assistance Team commander and emergency services director for the health care association, said Effler "is the single most significant figure" in enhancing the relationship between Hawaii hospitals and the DOH.