State lauds custodian’s germ work Frankfort man honored for informing students

AUGUSTA – Public health officials typically concern themselves with the well-being of large populations. Big-picture issues such as immunization rates, HIV testing laws and the safety of drinking water supplies fall under their purview.

But on Tuesday in Augusta, Maine’s public health community took time to honor the work of Larry Hoyt, a custodian at the Reeds Brook Middle School in Hampden, for his efforts to bring the public health message home, one adolescent kid at a time.

Hoyt, 66, was among four Mainers honored at the state’s annual public health conference with an Epidemiology Recognition Award by Dr. Kathleen Gensheimer, state epidemiologist in the Department of Health and Human Services. Gensheimer praised the Frankfort resident for finding lighthearted ways to tell middle-schoolers about the importance of preventing disease transmission, including the awarding each year of his “Golden Plunger Award” to the student who throughout the year answers the most infection control questions correctly.

In accepting his award, Hoyt gave a small, gold-painted plunger to Gensheimer on behalf of the roughly 300 conference participants. His trademark blue T-shirt sported an image of the Lone Ranger and the words “The Lone Protector says Be Wise, Sanitize.” Around his neck on a blue lanyard he wore a small bottle of alcohol-based hand sanitizer.

Hoyt hosts a program called “Custodial Corner” each Friday during the morning announcements broadcast through the school, featuring the infection control question of the week.

For example, he said, “What has 400 times more germs than a toilet?” The answer is “your desk.”

How is good infection control like a right triangle? When you cough or sneeze into your elbow instead of your hand.

“Really, to get their attention, sometimes you have to do crazy things,” Hoyt said, evidently relishing the recognition.

The balance of Tuesday’s agenda was more serious, focused on the need to respond effectively to public health challenges such as HIV, whooping cough, Lyme disease and the spread of antibiotic-resistant organisms such as Clostridium difficile, called C. diff. for short, and methicillin-resistant Staphylococcus aureus, or MSRA.

Speakers and panelists included a number of national experts as well as physicians, nurses and other public health professionals from Maine. Jean Pottinger, an infection control specialist from the University of Iowa Hospitals and Clinics, said recent publicity over the spread of MRSA in health care facilities and other institutional settings underscores the need to identify people who may be “carriers” of the dangerous organism without exhibiting symptoms.

Hospitals, nursing homes, physical therapy clinics and other places where nonsymptomatic carriers may come in contact with susceptible individuals, such as patients recovering from surgery, must adopt consistent practices to prevent the spread of the germ, Pottinger said. Interventions such as requiring staff to wear gloves and practice strict hand-washing procedures between patients should be developed regionally, she said, so patients, family members and health care workers in a variety of settings know what’s expected.

In the session on HIV testing, Andrew MacLean, deputy vice president of the Maine Medical Association, told participants that Maine law recently was changed to make it easier to screen patients routinely for HIV, the virus that causes AIDS. Patients must still give informed consent but are no longer required to sign a lengthy document indicating their understanding of the test and its implications. Now, MacLean and members of his panel said, it’s up to physicians to take advantage of the new flexibility and incorporate routine HIV testing into their primary care practices.

Dr. Nathaniel James, director of the International Clinic Outpatient Department at Maine Medical Center in Portland, discussed the health needs of Maine’s growing immigrant population. Immigrants and refugees from developing countries may arrive at his clinic with a range of disorders, he noted, including tuberculosis, parasites, sexually transmitted diseases, malnutrition and war-related traumas such as amputations and mental health problems. Western notions of primary care, family planning, prenatal care and dental care are unheard of, he said, and language and cultural barriers abound. Trying to explain the need for a routine examination such as a colonoscopy can be very challenging, James noted.

Whooping cough in Maine is on the rise, said epidemiologist Alexander Dragatsi of DHHS, despite Maine’s traditionally high compliance rates with childhood immunization requirements. Those rates are falling off now, he noted, and in combination with waning immunity among previously vaccinated adults, are contributing to the growing number of cases. Stacy Martin of the federal Centers for Disease Control and Prevention discussed the availability of a new whooping cough “booster shot” for adults and evaluated different methods for confirming a diagnosis of the disease.

Cases of Lyme disease, contracted by the bite of an infected tick, are also on the rise, according to Dr. Robert Smith, an infectious disease specialist at Maine Medical Center. While the majority of cases are reported in southern coastal areas of the state, he said, cases are spreading northward and inland, with no reason to think the trend will reverse.

In her remarks, Gensheimer noted that public health challenges call for collaborative problem-solving and continuous reassessment. The state has hosted its infectious diseases conference annually since 1983.