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Clackamas County health officer outlines how local infectious disease team prevents and responds to outbreaks
Summary
Dr. Sarah Preston, Clackamas County health officer, described the county's infectious disease control and prevention program, how it handles reportable illnesses, and a 2014 hepatitis A response that used rapid public notification and a vaccine clinic to limit spread.
Dylan Blaylock, host with Clackoworks and Clackamas County Public and Government Affairs, interviewed Dr. Sarah Preston, Clackamas County health officer and family physician, about the county's infectious disease control and prevention work.
Preston said her statutory role is "to provide medical and clinical advice to the local public health director on all aspects of public health work" and that the infectious disease team takes reports of legally reportable diseases, investigates them and works to prevent spread. "The infectious disease control and prevention program is... where they are taking reports of reportable diseases, investigating them, and preventing spread," she said.
Why it matters: the county's team monitors dozens of illnesses that can cause outbreaks, from measles and mpox to foodborne infections and rabies exposures. Preston noted there is variation between state and federal reporting lists; she said the CDC maintains a federal list while individual states decide which illnesses they require to be reported locally.
Preston described the program as organized around three main teams: a tuberculosis team, a sexually transmitted infection team and a general communicable disease team that handles enteric (food- and waterborne) illnesses. She said enteric outbreaks often prompt inspections and targeted investigation into foodservice operations such as restaurants.
As an example of outbreak response, Preston recounted a 2014 hepatitis A exposure at a movie-theater concession stand in Sandy. She said the county issued a public notification, partnered quickly with a Providence-run primary care clinic and mobilized medical reserve corps nurses to staff a vaccine clinic. "Within 2 days, we had a clinic set up to give people vaccine," Preston said. She described post-exposure vaccination as effective: "If you get a vaccine after an exposure, it does a really good job of preventing people from getting ill."
Preston emphasized the county's public-facing materials: the Clackamas County website highlights the diseases of current concern so residents can find information when outbreaks arise. "So they can find more information," she said, describing the site as a way for people to learn about risks and protective actions.
The county also follows up on animal bites because of the small but serious risk of rabies and works with long-term care facilities during respiratory outbreaks such as severe flu seasons.
Preston closed by praising her team's regular prevention and case management work: "So much prevention happens... but also how much they do to help people manage the diseases that they have," she said.
The county did not provide immediate figures on staffing or annual budget for the infectious disease program during the interview; Preston's descriptions focused on operational practices and recent response examples.
