The director of the El Paso City Health Department, Robert Resendes, has been on the job since May 2013, and says he’s happy to be here because El Paso has a lot to offer someone like him.
“I feel very fortunate to be in El Paso,” he said during a telephone interview last week. “I’m kind of a microbiology nerd, and when I look at El Paso, it has the border, the military and it’s a big college town.
“There’s lots of opportunities to see interesting things here that you wouldn’t see in, say, Des Moines, Iowa.”
At 52, Resendes has 20 years of experience as a public health director and a long list of credentials.
He’s a registered medical technologist and a licensed clinical laboratory scientist with a MBA in health-care administration and a bachelor’s degree in medical technology.
El Paso, he said, is a melting pot of people from all over the world.
“We see some real interesting things here, like malarias you wouldn’t normally see and interesting TB cases, unfortunately,” he said.
The Health Department has been busy lately tracking down all those babies and adults who were exposed to tuberculosis over a year’s period by an infected nurse‘s aide who worked at Providence Memorial Hospital until August.
Resendes is particularly proud of the fact that his department took only three weeks to track down nearly all of the 860 babies and others who may have come in contact with her.
He admits to being a little frustrated, as are health officials across the country, about all the worry Ebola is getting – when there are real, everyday health threats that people tend to ignore.
Resendes was quick to say yes when El Paso Inc. asked him to talk about the precautions people should be taking now to avoid the flu, STDs and things like measles and shingles.
Q: Tell us about yourself, how you got here?
I was appointed in May 2013, so I’ve been here almost a year and a half. Before coming here, I was a health director for almost seven years in Arizona. Before that, I was a public health director for 13 years in Utah. I’m originally from Massachusetts.
Q: What are the top diseases that we see in El Paso?
Our most common one, unfortunately, is chlamydia, a sexually transmitted disease. We’re seeing 5,000 to 6,000 cases a year. It’s easily cured if caught. Women have symptoms and the men don’t.
We ask them if they have a regular partner, and if they say yes, we are authorized to give the woman antibiotics that she can take home and give to her partner. Hopefully we can clear them both up. Otherwise they just keep reinfecting each other. Chlamydia is serious. It can lead to problems with childbearing and sterility.
Q: What’s next?
Influenza. We see about 3,000 cases a year. I should explain that health-care personnel are mandated to report to the health department diseases that are on the list. We assume they’re doing that. So we’re seeing 3,000 lab-diagnosed influenza cases a year. If you have the flu and you stay home and tough it out, we’ll never know. So, I suspect the 3,000 is a fraction of what’s out there.
Q: What’s third?
Third on the list is the clap – gonorrhea. We see close to 900 cases a year.
Q: Ebola has got Americans’ attention right now, but health officials like yourself are saying it shouldn’t be our biggest concern. But when you click on the El Paso Health Department’s webpage, there it is right at the top: Ebola virus! With a picture and the hotline number.
At the request of the City Council, we made that our lead banner.
Q: Are you getting any calls?
Let’s see, before the hotline, we had two. And since the hotline, zero.
Q: How old is the hotline?
One day. (As of Wednesday)
Q: Is El Paso’s medical community, particularly University Medical Center, ready to handle an Ebola case if one turns up here?
Absolutely. Every hospital is. They’ve been ready for years. UMC has actually announced that they have six isolation rooms.
Q: Should people on the border be concerned about Ebola?
No, they should be concerned about diabetes. There’s something about human nature that you get really concerned about stuff you have no control over that is a tiny risk. But the stuff that you can take hold of and make better, you kind of poo-poo.
We still have people getting sick from mosquito bites in El Paso and people dying of diabetes because it’s uncontrolled in El Paso.
Q: And smoking.
Yes, but our smoking rates are less than the national and state averages. Even though it’s not zero, it’s better than anywhere else.
Q: OK, what should people be most concerned about right now?
I would go with flu. Flu still kills 30,000 to 40,000 a year in the country. Some of the new thinkers would add heart disease and guns as a public health threat. Then, there are chronic diseases like diabetes. We have HIV and AIDS here, but not as much as you see in other places.
Q: How big is AIDS here?
Last year, we had 80 new infections of HIV but only 16 AIDS cases. What’s happening is people are living much longer with HIV because we now have the medication to treat it. Thank you, Magic Johnson. If you treat it, you’re fine, but if you don’t, it will still kill you.
Q: What else would you add?
I would add things you can do something about, like the West Nile virus, which you can avoid with mosquito protection. I don’t want to get down to the nitty-gritty, but wearing condoms is something you can do.
Anything you can do yourself to protect yourself from being exposed to a disease, whether it’s from a friend, family member, stranger or mosquito.
But I would also add anything that can be prevented with a vaccine. We live in the greatest country ever, with the best medicine ever and we either deny our kids or ourselves vaccines. We poo-poo them as being unnecessary and so measles and polio are making a comeback, which shouldn’t be happening.
Q: Measles? There’s a vaccine, right?
There are vaccines for children, right.
Q: Who should be the most concerned about getting the flu?
Seniors and babies.
Q: I understand we have a high rate of pertussis or whooping cough here.
Unfortunately, yes. It’s up 33 percent in 2013 from 2012. That’s very significant.
Q: Why the big increase?
People aren’t vaccinated. I hate to say this, but babies usually get sick with it from siblings or parents.
The people who love them the most are infecting them because they’re not vaccinated themselves. That’s tragic. Unintentional, but still tragic.
Q: There’s also shingles, but there’s a vaccine now.
There is. But it’s very expensive, about $200. Here’s a dirty little secret about vaccines – none of them are 100-percent effective. If you take the time to read the horrific small print on the package inserts that you can ask for when you go to the doctor, the shingles vaccine is only about 50-percent effective.
The good part is if you get the shot, it’ll be less severe than if you didn’t.
Q: And if you’ve had shingles, do you still need the vaccine?
Yes. You can get shingles over and over again. So, if you liked it the first time, don’t get the shot. You might like it more the second.
Q: Which varieties of the flu virus does this year’s vaccine protect against?
There are two vaccines out there, the regular trivalent vaccine, and this year at the Health Department, we’re providing the quadrivalents. But, it’s a guessing game, so hopefully the scientists guessed right this year.
Q: If I go to Walgreens, am I going to get the trivalent, which protects against three strains of flu or the quadrivalent that protects against four?
I don’t know, but it’s worth asking. If the trivalent is $30, the quadrivalent is $40. In the old days, the health departments would do all these things. But since the reimbursements got much better for flu shots, we only give a fraction of the vaccinations. Some health departments are getting out of the business. They can’t compete with Walmart, Walgreens and the gas station. Everybody’s giving flu shots.
Q: Do you give them free?
We do for children who qualify. For others, it’s at cost, $40. But we’re only doing 500 a year. I’ve lived in places where we do 20,000 a year. But since Walgreens and Walmart do it – and you get 50 percent off your cosmetics that day – we can’t compete with that.
But, I don’t care where people get their shot as long as they get it.
Q: What is the efficacy of the flu vaccine? That is, out of 100 persons who are exposed to the flu virus, how many will be protected from it?
I’m not sure. It changes every year. It’s a different vaccine every year. If they guess wrong, it’s horrible and if they guess right, it’ll be much better.
Q: If you get the shot and then get one of those flus, will it at least reduce the severity of it?
Yes, like the shingles shot.
Q: While Dallas’ Presbyterian Hospital has its Ebola panic, El Paso had its own scare over tuberculosis at Providence Memorial Hospital where an infected nurse’s aide was caring for babies. What’s the latest?
The latest I have is as of Oct. 16. Of the 860 babies identified, we’ve contacted 95 percent of the families. We did that in about three weeks. I have a great team and they did a bang-up job. It took a year for this lady to expose all those babies; it took us 3½ weeks to find almost all of them.
Q: A year?
Yes, we have the window of her infectability from September 2013 to August. When we have someone like that, we interview them and ask when these symptoms started.
When did you start coughing a lot, having night sweats and coughing blood? She wasn’t sure whether it was December or January. I said let’s be safe and say Dec. 1.
Then, the CDC protocol is whenever they started symptoms, you go back three more months and that’s why Sept. 1 was the start date.
Q: The number of babies potentially exposed is 860, and the number who have tested positive so far is 11, and some of them are false positives?
Most of them are false positives. We treat them anyway. We’ve got four babies that tested positive for TB with no good explanation why. We don’t know if they picked it up at Providence. Maybe the grandma who takes care of them and visits all the time has TB.
We go and test all of the household members and close contacts for each of these positive babies to see if maybe they picked it up somewhere else.
Q: Was it particularly dangerous because it involved babies?
Yes. Babies, little babies, exposed to TB is a whole different ball game than if this was at a high school. Babies don’t get pulmonary TB like adults do.
If they get it, it’s bad news. It goes into their spinal column and their brain. That’s meningitis, and it’s dangerous. Death can occur.
Q: With 860 potentially exposed and four cases, it sounds like TB is not that easy to get.
It’s not, it’s really not. The lady who was infectious? So far, none of the family that she lives with has tested positive.
Q: Has it been determined how or where the Providence employee might have contracted the disease in the first place?
Nope, and we’ll probably never find out.