Public Health in Action
Marion Kainer is being honored as a Champion of Change for helping Americans live healthier lives, reduce disease and contribute to lowering health care costs by focusing communities on public health and prevention.
I am an infectious diseases physician and epidemiologist and work as director of the Healthcare Associated Infections (HAI) and Antimicrobial Resistance Program at the Tennessee Department of Health. I have an awesome team and I love my job: making health care safer in Tennessee and nationwide.
Earlier in my career in Australia, a terrible outbreak of methicillin-resistant Staphylococcus aureus (MRSA) infections among surgical patients changed my career forever. Never again did I want to feel as powerless in an outbreak as I did during that experience. I was no longer satisfied with attempting to treat infections; I wanted to prevent them.
Last year, a fungal meningitis outbreak across the country devastated patients, their loved ones, and healthcare providers. Tennessee was right at the center and dealing with it required every tool in my toolbox as a clinician and epidemiologist.
More than 13,500 patients were injected with contaminated steroid injections from a compounding pharmacy. Nearly 750 patients developed meningitis and/or infections around the spine and 63 people have died. Many still struggle with complications. As horrendous as this outbreak has been, it could have been far worse without investments from the Affordable Care Act’s Prevention and Public Health Fund. The Affordable Care Act is helping public health departments prevent and fight infectious diseases by investing in tools like enhanced public health workforce training and improved information technology.
The six members of my HAI team, funded through the Affordable Care Act’s Prevention and Public Health Fund Epidemiology and Laboratory Capacity grants, not only quickly determined the cause of the outbreak, they also identified patients not yet ill but at the highest risk of getting sick. Lives were saved not only by halting the contaminated injections, but also by tracking down every affected patient and getting effective treatment to the sick without delay.
In Tennessee, 153 persons developed infections; 15 have died. Had we not acted as quickly as we did, and the use of contaminated medication gone unchecked by public health, we estimate that 368 additional Tennesseans would have been injected. An additional 99 would have developed serious infections and up to 69 more people may have died. Our success came from a massive team effort that required close collaboration among clinicians, clinics, hospitals, local and state health departments and federal agencies, as well as vital funding from the Prevention and Public Health Fund. This collaboration must continue in order to prevent such a tragedy from occurring again.
Dr. Kainer is an infectious diseases physician and epidemiologist. She is the director of the healthcare associated infections and antimicrobial resistance program at the Tennessee Department of Health and helped identify the source of the 2012 fungal infection outbreak.