Germs No Match For Montgomery's Nurse Detectives

Montgomery County's nurse detectives in the Disease Control team include, from left, Holly Conners, Cindy Edwards, Catherine Rasa and Celia Adams, who have more than 140 combined years of service. They investigate infectious-disease cases across the country to track down their causes and prevent larger outbreaks. (Photo: Kevin Clark/Post)
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When the adults were taken to Shady Grove Adventist Hospital with nausea and hallucinations, first reports blamed mint leaves from the family's yard, which medical technicians suspected were tainted with organophosphate pesticide. The nurse detectives weren't so sure.

"That didn't quite feel right," Conners said. As the patients lingered in serious condition, the Disease Control team began its own investigation, in consultation with state officials and attending doctors. Finally, with a botanist in tow, Edwards and Jordan talked a family member into giving them a tour of the scene.

"The pan with the stew was still on the stove," Edwards said. "It looked like no one had been there since the night of the dinner."

In the back yard, they found an overgrown garden and, off to one side, some strange, recently cut stalks. Edwards pointed them out to the botanist, Charles Schuster of the Maryland Cooperative Extension service. "That's jimson weed!" he cried.

In the kitchen trash, they found more jimson leaves mixed up with other food scraps from the stew. A state lab in Annapolis rushed an analysis and confirmed that the family, all of whom recovered after several days in intensive care, had been poisoned by a weed that packs powerfully toxic belladonna alkaloids.

"We don't get many of those 'Aha!' moments," Edwards said.

If the nurses' work is more office-bound, it is often more delicate. Much of the investigators' work is done after the physical symptoms are gone. And although the victims might still be contagious, they don't always have patience for prying questions.

"The health department doesn't usually call with good news," Wilby said. "We have to be tactful."

The nurses often have to tell people that, according to the law, their child might have to stay out of child-care for another week or 10 days after the symptoms have passed. If others in the house work in food handling, health care or other sensitive jobs, they, too, might have to miss work, even if they never show sign of illness.

"There's an art to these interviews," Conners said. "You want to get the name of the day-care provider up front."

Jordan remembers a recent case in which nurses were backtracking the movements of a woman who died of meningitis. When they learned she had been on a business trip, they interviewed everybody else at the meeting to see, basically, whether she had any kissing colleagues.

"Sometimes we have to have to be very personal in our questioning," Jordan said. "But it's in their best interest to be honest with us."