Texas Department of State Health Services

The Austin City Council approved funding for an Ebola preparedness plan Thursday.
Photo Credit: Mariana Munoz | Daily Texan Staff

As the Austin/Travis County Health and Human Services Department continues to monitor two individuals for signs of the Ebola virus, nearly seven months after the first American patient was diagnosed, the Austin City Council approved supplemental funding Thursday for Ebola preparedness.

The City Council accepted $183,906 from the Texas Department of State Health Services to fund public health preparedness planning and responsiveness for Ebola and other infectious diseases, according to Janet Pichette, chief epidemiologist at the Austin/Travis County Health and Human Services Department.

“We receive public health preparedness dollars [every year], and this is extra money to help accelerate preparedness planning,” Pichette said.

The health department works with the University in times of emergency, such as last fall, when a UT student was monitored for Ebola after potentially being exposed. The department is the initiator of all emergency infectious disease response, said Bob Harkins, associate vice president for campus safety and security.

“In any infectious disease scenario, the lead and dictating agency ends up being Austin/Travis County Health and Human Services,” Harkins said. “For example, when Ebola situation erupted last fall, they notified us of the person.”

The University’s response protocol is the same for all infectious diseases, including the mumps case diagnosed in a student Wednesday, Harkins said.

“[The health department] usually talk about our responses and notifications and precautions and stuff,” Harkins said. “The UHS and the Healthy Horns’ side of the house are the ones that respond and pass information to the campus in terms of what we do.”

Public health junior Angela Yang said she thinks the public health information system at the University is adequate.

“I feel like UHS does a lot about general public health, and what things not to do and how to keep disease from spreading,” Yang said. “In the most recent case with mumps, there was only one case, but they sent out a mass email to everybody before it [got] out of hand.”

The department received $682,000 for the next fiscal year starting in July, in addition to the City Council-approved funding, Pichette said. The money will fund two temporary positions in the public health department for Ebola responsiveness.

“We pretty much have an idea of how to do it because of events in the fall,” Pichette said. “People don’t realize we continue to monitor people for 21 days after they come back from Ebola-impacted countries. Right now, we have two people in our community that we are monitoring twice a day.”

However, the health department is involved in much more than just responding to infectious disease emergencies, Pichette said. 

“There’s a lot that the people don’t realize the health department is involved in, and that’s okay,” Pichette said. “We’re doing our job; nothing’s happening, so you don’t hear about it. When something goes wrong, that’s when you hear about it.”

The funding will not impact the way the University responds to emergency situations, according to David Vander Straten, medical director of University Health Services. 

“We would [still] coordinate very closely with [the health department],” Straten said. “Our specific population would be the students. If there were concerns in terms of students traveling from countries [marked] by the [Center for Disease Control], we could be notified by the health and human services department.”

Photo Credit: Stephanie Tacy | Daily Texan Staff

Specialized clinics that offer breast and cervical cancer services, such as Planned Parenthood, will be the lowest priority recipients for women’s health care funding if the Texas legislature passes the proposed Senate budget for 2016-2017.

The Senate budget, known as SB 2, would require the Texas Department of State Health Services to distribute funds for breast and cervical cancer services based on a three-tiered system. The bottom tier includes non-public entities, such as Planned Parenthood, that provide breast and cervical cancer screening, but not comprehensive care.

The three-tiered system is built to ensure funding first goes to clinics unaffiliated with abortions, according to state Sen. Charles Schwertner (R-Georgetown), chairman of the Senate Committee on Health & Human Services.

“We always want to ensure that we have an adequate provider base to appropriately serve low-income Texas women who need access to comprehensive women’s health services,” Schwertner said. “At the same time, the people of Texas have clearly indicated that they don’t want to see their state tax dollars delivered to abortion providers. It’s really a question of resources.”

State Sen. Kirk Watson (D-Austin), a member of the Senate Finance Committee, said the tiered funding plan would be a blow for low-income women in the state.

“I’m very concerned that the only thing we accomplish by implementing a tiered funding mechanism in Senate Bill 2 is to limit access to cancer screenings that can help low-income women identify breast or cervical cancer at a time when it’s most easily and successfully treated,” Watson said. “We simply must stop playing politics with women’s health.”

According to Planned Parenthood’s 2013 report, 2.7 million patients in the U.S. received 10.6 million services, of which 3 percent
were abortions. 

Amanda Bennett, global policy graduate student and member of the student organization Feminist Policy Alliance, said she thinks legislators are hiding behind the words “comprehensive care.”

“What they say is they want to give women more comprehensive care by sending them to doctors not in these specialized clinics, but, often, these are the only places that women know about and are comfortable going to,” Bennett said. “I knew [at Planned Parenthood] they could answer my questions better than the guy at CVS.”

There are 31 clinics that offer breast and cervical cancer services within 50 miles of Austin, according to the Department of State Health Services’ clinic locator. The Rio Grande Valley region has only eight clinics within 50 miles of Rio Grande City. 

“A lot of the Planned Parenthood clinics are in places where there aren’t really other reasonable options,” Bennett said. “You see legislators in the Capitol deciding how far a woman should have to drive to get her pap smear … if you don’t have a car or public transportation, it can be really hard to get to the clinic you decide to [go to].”

A second health care worker has tested positive for Ebola, the Texas Department of State Health Services said Wednesday. The nurse is the third person to be diagnosed with the Ebola virus in the U.S.

At a press conference Wednesday, Dallas County Judge Clay Jenkins said the nurse reported a fever on Tuesday and has been placed in isolation at Texas Health Presbyterian Hospital in Dallas, along with Nina Pham, another nurse who tested positive for the virus on Sunday. Both nurses were involved in the care of Thomas Eric Duncan, who died from Ebola last week.

CDC director Tom Frieden said the new patient will be transferred to Emory hospital in Atlanta.

Jenkins said Texas Presbyterian Hospital is preparing for more cases of Ebola. 

"We are preparing contingencies for more, and that is a very real possibility,”  Jenkins said.

Daniel Varga, chief clinical officer for Texas Health Presbyterian Hospital, said the nurses contracted the virus after being exposed to Duncan, even though they were wearing protective equipment. 

“There was an exposure somewhere, sometime in the treatment of Mr. Duncan," Varga said. “Let’s be clear: We’re a hospital that may have done some things different with the benefit of what we know today. But make no mistake, no one wants to get this right more than our hospital."

The CDC and Frontier Airlines have confirmed in a statement that the new patient took a flight from Dallas-Fort Worth to Cleveland on Oct. 10 and returned to Dallas-Fort Worth on Monday evening, the day before she reported symptoms. The CDC is monitoring passengers who flew on the flight, even though the health care worker exhibited no signs or symptoms of illness while on the plane. 

Frieden said the new patient should not have traveled on a commercial airline, and that workers having contact with an Ebola patient will not be allowed to travel. 

The CDC also said it has sent a team to the hospital in Dallas to oversee infection control and monitor its use of protective equipment.

Although flu season only comes around in the fall, researchers on campus are continually working to learn more about the virus and how it spreads.

Several UT professors focus their research on the influenza virus, including studying the virus itself and tracking and forecasting new strains. Lauren Meyers, director of statistics and scientific computing, works with the Texas Department of State Health Services to help predict pandemic flu outbreaks. After the 2009 H1N1 pandemic, the department funded the Texas Pandemic Flu Toolkit, which Meyers’ research team created.

This month Meyers’ research team began four new flu-related projects. The team is creating two new tools for the online toolkit: an interface public officials can use to run exercises for simulated pandemic outbreaks and a new surveillance system for early detection of seasonal flu.

“It’s only been a few months since the full toolkit became available online and we haven’t been through flu season yet, but we are funding additional research and development of new tools for the toolkit,” department spokesperson Chris Van Deusen said.

The toolkit allows members to create their own simulations and forecasts or look at archived data. The toolkit is free for the public to access.

“The toolkit was created to look at pandemic flu, which are new strains that can spread from person to person,” Meyers said. “We’re probably still going to see H1N1 this year, but it’s not going to be a pandemic. It’s going to be seasonal since it’s not a new strain.”

Meyers said there won’t be another pandemic until a new strain begins to spread rapidly.

Meyers said her research is monitoring two strains, the H5N1 and H3N2V strains, for possible pandemics. She said the strains have been reported in humans, but neither strain has spread from person to person.

The reported cases have been in people who work in close proximity to livestock, including chickens and pigs.

Robert Krug, chair of the department of molecular genetics and microbiology, said flu pandemics caused by new strains like H1N1 can surprise researchers with unexpected molecular changes. Krug’s 13 years of research at UT has focused on the NS1A protein of the flu virus, which he said is common to every flu strain.

In his research on seasonal flu, Krug said he occasionally finds possible antivirals, which could be used to create preventative medicines for all flu strains with the same NS1A protein. However, he said the information is seldom used because the production of antivirals is expensive and unprofitable. 

“This is very basic research, but in the process we identify targets for antivirals.” Krug said. “It’s not easy to make antivirals. We don’t have the resources to do it right. That is something a pharmaceutical company could do, but they don’t.”

Printed on Wednesday, September 26, 2012 as: UT professors focus research on flu virus