From COVID-19 to monkeypox, a team within the Baltimore City Health Department is responsible for tracking the outbreak of infectious diseases across the city.
It’s been a busy few years for the team, made up of a few scores of individuals. Their jobs took on new levels of urgency during the pandemic and they continue to monitor possible threats to public health, including the recent high-profile incidents of reported food poisoning at the “Best of Baltimore” event, and the detection of E. coli and coliform in the city’s water supply that led to a boil-water advisory affecting parts of Baltimore.
If the health department’s infectious disease trackers are in the spotlight, it’s usually because there’s “bad news,” said Mary Grace White, director of acute communicable diseases. However, she said, “we’re always working behind the scenes.”
Epidemiologist Jonathan Gross is among those always working behind the scenes. From his office on Fayette Street, Gross runs massive data sets through statistical analysis software and maps out disease clusters. One such program, Bad Batch Alert, was created to notify subscribers when areas of the city experience higher-than-normal rates of drug overdoses. Gross has also used a modified version of the code for Bad Batch Alert to track clusters of COVID-19 cases and violence.
Gross said the time he spends buried in data is all for a greater purpose: “The motivation is to really keep the city running and keep everything going,” he said.
White said she loves her work and serving the community. “I think it’s very fulfilling, but it’s been tough,” she said.
White reflected on the early days of the pandemic in 2020, when she and other leaders continued to come into the office and work through the weekends to coordinate the health department’s response to COVID-19 as Baltimore and other cities across the United States locked down. They scrambled to build up their contact tracing capacity.
“This was kind of like all hands on deck,” White said. “If you had that skill set of being able to communicate and speak to someone and gather information, we were pulling them to help with the investigations and contact tracing. It’s monumental to think back [on it].”
Disease case investigations go back to the roots of the health department, which was established during a yellow fever outbreak in the late 1700s, according to Dr. Letitia Dzirasa, the Baltimore City health commissioner. During the pandemic, the health department was forced to add tech infrastructure and expand its workforce — and as a result, officials are better prepared for other outbreaks, she said.
The health department has been monitoring an outbreak of human monkeypox, which appeared in Maryland in June. In Baltimore, there are more than 200 confirmed cases of the virus, according to a Maryland Department of Health dashboard. Monkeypox belongs to the same family as smallpox, but with milder symptoms, and people can spread it through direct contact with skin lesions, body fluids or contaminated materials. Although the outbreak seems to have plateaued, White said, it’s unclear what the coming months will bring as people travel and gather for the holidays.
The emergence of new diseases, such as monkeypox, or reemergence of diseases once thought to have been near eradication have been on the rise nationally in the past decade, said Jennifer Martin, deputy commissioner for the Division of Population Health and Disease Prevention. In recent years, Baltimore has seen the Zika virus, measles and growing numbers of syphilis cases, including congenital syphilis, which can cause stillbirths and serious health complications or death for babies.
Martin said the uptick in emergent diseases can be attributed to a number of factors, including the increasing ease of travel, more illnesses being transmitted from animal to human populations and climate change.
Although health departments are responding to the growing challenge of infectious diseases, public health resources are limited, she said. That means prioritizing populations that are more vulnerable and focusing on congregate settings, such as nursing homes, when it comes to outbreaks.
The city asks residents seeking to report a communicable disease during business hours to call 410-396-4436.
