When Denise Sockwell accepted a job as an epidemiologist for the Virginia Department of Health three years ago, she barely noticed one line in her job description -- that she'd be involved in bioterrorism preparedness and response.
Now that little line has become a big part of her job.
Until recently, Sockwell, the department's regional coordinator for Northern Virginia, was a solitary soldier in the war against bioterrorism, the only epidemiologist for her agency in the region.
The world has changed dramatically in the last three years for disease detectives such as Sockwell. Because of the Sept. 11, 2001, terrorist attacks, the anthrax scare and the threat of biological or chemical terrorism, the health department is beefing up its corps of epidemiologists, hiring 35 statewide, eight of them in Northern Virginia. Sockwell will supervise most of the new disease specialists in Northern Virginia.
Epidemiologists are on board in Fairfax, Loudoun, Arlington and Fauquier counties and the cities of Alexandria and Fredericksburg. The hiring process is under way in Prince William and Stafford counties.
"Most of what we do is very quiet and behind the scenes," Sockwell said. "Right now, bioterrorism preparedness is taking up a great deal of our time."
Sockwell's job is to sniff out illness and disease. She works with hospitals, doctors and local health agencies, looking for signs of health emergencies.
"We are doing disease surveillance for our notifiable diseases," Sockwell said. "Those are the ones that physicians are required, by law, to report to the Health Department. But we also are proactive and tend to talk a lot to emergency service and primary care providers."
Daily reviews are done to stay ahead of a potential outbreak of disease and to search for patient symptoms that would indicate the region has been the target of a biological or chemical attack.
"For bioterrorism, we might not know that it occurred until people are becoming ill," Sockwell said. "The sooner the public health system can go into action with treatment, notification, vaccination, the more we can do to prevent illness and death. Our job is not really preventing an attack but minimizing the effects of an attack if one was to occur."
Sockwell said the addition of district epidemiologists is a relief to her and means more protection for the public. Every day, they check emergency room logs from area hospitals, looking for clues. If anything suspicious shows up, the attending physician and patient are contacted to check on treatment and medication and to obtain a list of people with whom the patient may have come in contact while infected.
Sockwell, who grew up in Montgomery County, said she enjoys the work despite the pressure and workload. She has always been interested in biology and decided to become an epidemiologist while at Penn State.
"I really wanted to know what the reasons were behind the health statistics of what was going on in our community," said Sockwell, an epidemiologist for 12 years. "I wanted to better understand the statistical aspects of disease because of the effects it has on our lives."
She went to graduate school at the University of North Carolina's School of Public Health and has worked for the Centers for Disease Control and Prevention and in the private sector.
In the last two years, demand for epidemiologists has skyrocketed in Virginia and nationally as the fight against bioterrorism has intensified.
"It has been difficult to find good people," Sockwell said. "In Northern Virginia, we have been very fortunate. I have been involved in the hiring of the district epidemiologists, and we have found some really good people. In that respect, Northern Virginia is faring quite well."
She and her fellow disease detectives must be on the lookout for existing diseases as well as plagues once thought to be eradicated.
"Smallpox has not been a concern until the threat of bioterrorism arrived," she said. "In school, smallpox was almost a history lesson. Now it is a topic of discussion on almost a daily basis."