Working with County Department of Health Services

Diagnosis of rabies
Enlarged Photos of Negri Bodies, specific viral markers for rabies, found in the brain tissue





The County Health Officer is charged by state law to preform the laboratory test for rabies in cases where a clinical persumptive diagnosis has been made.
This requires removal of parts of the brain.  In people the medical examiner does this.  In animals our laboratory does this.  The public health laboratory, under the Health Officer, has neither the facilities for removing parts of the brain nor, in the case of animals, for disposing of bodies.  Therefore, these services are provided for them. Where neither a physician nor a veterinarian has made a presumptive diagnosis of rabies, our laboratory performs the test, which is routinely done on all cases of animal encephalitis and for surveillance of our bat and animal population.  These surveillance tests  have provided all the positive cases in recent years and the only knowledge of the presence of the disease in our county.

Psittacosis in man, Ornithosis in birds, AKA Parrot Fever
A contagious pneumonia in people and birds of the parrot family and also of turkeys

The Tijuana Connection
The U.S. Dept. of Agriculture maintained an avian quarantine facility at the San Ysidro port of entry from Tijuana Mexico, the cost of which is paid for by the importer. Unfortunately this was only to prevent foreign Newcastle Disease from entering and was inadequate to control or prevent Psittacosis and often not used. A veterinarian from the state dept. of animal health, while on vacation in Tijuana, observed many parrot species on display for sale. When hustled to buy one, he declined on the basis that they were illegal to import without considerable cost and "red tape." The hustler in response assured him that would be no problem, and that they delivered.

When psittacosis is diagnosed in people, the health department refers the epidemologic investigation to our facility. In the 1960's shortly after joining the laboratory, Dr. Thackrey took advanced training in psittacosis diagnostics and control at the Hooper Foundation in San Francisco. This gave our laboratory the latest techniques in diagnosis and control of this disease, which was to prove extremely valuable in later years. In the 1980's the keeping of members of the parrot family as pets became an extremely popular fad. San Diego became a major port of importation of these birds, both legally and illegally. Dr. Miller, our veterinary public health epidemiologist, often working with U.S. Customs, was involved in several major bird smuggling busts. He was also mainly responsible for eliminating this disease as a problem in our county through public relations, quarantines, and providing help and advice to owners and retailers in treating and preventing the disease. He not only quarantined the affected flocks, but ensured they had access to the required disinfectants, antibiotics, and procedures necessary for treatment and elimination of the carrier state of the disease. He wrote the treatment protocol that became the basis for the state department of public health's publication on the treatment of Psittacosis, even though no specific recognition was given. During this period our laboratory was diagnosing Psittacosis so often that it was joked that it was the only diagnosis we ever made. Now it is extremely rare in San Diego County attesting to the success of Dr. Miller's efforts and the knowledge that essentially all cases will be detected, traced back to their origin, and quarantines enacted. 

Beautiful, but not without a risk. A $400,000 case of Psittacosis.
Psittacosis is a viral-like disease caused by a very small bacteria and infects primarily parrotlike birds, turkeys, and man. In 1996 Dr. Miller was contacted by a public health nurse to alert him of a human case. The ill person had spent 10 days in intensive care before psittacosis was confirmed. He spent nearly a month in the hospital recuperating. A secondary infection cost him five toes on his right foot. The patient had purchased a lovebird from a local pet store as a gift and taken it to his mother's residence. The bird appeared healthy at the time, but became sick and died 4 days later. Dr. Miller contacted the pet store and was told no lovebirds had been reported sick or returned during that time frame nor remained in the store. The patient's personal veterinarian was able to collect feces from the dead bird's cage, which tested positive for psittacosis. Dr. Miller then observed lovebirds in cages in an otherwise vacant upstairs room of the pet store. Although all appeared healthy, fecal samples were taken. These samples tested positive for psittacosis. The store owner admitted the birds had been present all this time. A jury found the pet store responsible for failing to warn about a disease transmissible to humans by pet birds.




Baluts, a Filipino Real Native Culinary Delicacy








Baluts are the embryos of duck eggs that are incubated up to the 18th day then boiled. Dr. Miller was contacted by Dr. Ginsberg, a M.D. with the health department, regarding a case of salmonella intestinal infection of a person. The source of the infection was thought to be from commercially sold baluts. Dr. Miller contacted the store where they were purchased and traced the source to a duck farm in the county. He collected swabs from individual ducks, the duck pond, and the incubator for bacterial culturing. These revealed the same serotype of salmonella as recovered from the patient. The problem was solved through treatment of the flock, disinfection of the incubator, and elimination of the duck pond. Boiling would normally kill any salmonella, if done long enough, but this apparently is not always the case. Balut is also the name of an island at the south end of the Philippines.  Perhaps that's where the custom originated.

Avian Influenze, aka, Bird Flu

San Diego County is the only county in the state with its own laboratory that tests animals and birds for human pathogens. Birds are tested for numberous illnesses including Avian Influenza (Bird Flu), Viral Encephalitis (West Nile Virus), and Psittacosis, all of serious public health concern. Elsewhere in California, such testing on poultry and wild birds is done only at a few state-run laboratories.  San Diego and Tijuana are epidemiologically the same city with a great potential for disease introduction. 


San Diego County Veterinarian, Dr. Nikos Gurfield, holding a chicken used
to monitor for Bird Flu, Newcastle, Psittacosis, and other avian infectious diseases.











Kimberly Williams, RVT collecting tissues for avian diseases including Bird flu.














Patty Lewis, a scientist who works with the County Veterinarian, examining eggs used for virus testing at the San Diego County Animal Disease Diagnostic Laboratory.
 










Fertile chicken eggs used at the San Diego County Animal Disease Diagnostic Laboratory for the detection of avian viruses.