What does a health officer do?



SOUTHWEST HARBOR — Marilyn Lowell has been trying to solve a mystery with the help of the town’s animal control officer that has to do with dog excrement in a public parking lot.

In the last four months, three different incidents have been brought to Lowell’s attention in her role as the local health officer (LHO) for the town. Three health-related incidents may not seem like a lot for the town of nearly 1,800 residents.

But, it can add a bit to her workload since Lowell also serves as town clerk, finance director, registrar of voters and welfare director.

Over in Mount Desert, Town Manager Durlin Lunt serves as the health officer.

“It’s just one of the many hats they make you wear because the state says you have to have one,” he said. “When you get a complaint it’s busy for awhile. You can go quite awhile between calls.”

According to state law, every municipality in Maine is supposed to appoint an LHO. Ideally, it is someone with an education or training in public health.

Health officers are required to serve a municipality for a three-year term and can serve more than one town. If the appointed person does not have a background in public health or health care, they are required to undergo training to earn a certification.

“We used to have real health officers at one time,” said Lunt, adding that the director of the Mount Desert Nursing Association used to fill the role. “It made a lot of sense to have someone in the health field.”

Neither Lowell nor Lunt has an education or background in public health, so they have both attended trainings and taken qualifying tests for certification.

As advocates for the public health of their town, health officers are required to document all incidents and cases that come to them.

“It’s both public and individual health risks,” said Lunt. “It can be anything from public health risks like Lyme disease to someone living in substandard housing.”

Donna Wiegle, who is the LHO for Swan’s Island, has dealt with both of those issues in the last few years. Wiegle has a degree in medical technology and runs a health clinic on Swan’s Island that is mostly funded with town money.

“Because of my multiple positions out here, the lines are blurred often,” she said. “My job as the local health officer yields no payment.”

There are informational workshops that health officers are encouraged to attend that are offered by state or county agencies.

So far in her four years as the LHO, Lowell has learned about hoarding, ticks and water health. Wiegle works with Chuck Lubelczyk from Maine Medical Center’s Lyme and Vector-borne Disease Laboratory to monitor tick activity on the island.

“They have 100s of them, or 1,000s of them, to analyze,” she said referring to a collecting process called ‘flagging’ where ticks are collected from Swan’s Island and analyzed for disease.

According to Wiegle, the island was listed as one of the top 10 places in the state with a high concentration of Lyme disease diagnoses. Ticks collected from Swan’s Island have tested positive for Lyme disease, anaplasmosis and Powassen virus, the illness that killed Maine artist Lyn Snow.

“It’s a treatable disease but you have to recognize it very quickly,” said Wiegle, who has been the LHO for about 15 years.

When there was an outbreak of Hepatitis A on Swan’s Island about 10 years ago that required assistance from the state’s Center for Disease Control it, too, was difficult to diagnose. After one woman, a seasonal resident, died and her granddaughter also tested positive, Wiegle and island officials called in the experts.

“It was a medical mystery,” she said, adding that a dozen people tested positive for Hep A. “What caused the outbreak where the woman died was they had a septic cross-contamination with their water … Everyone who stayed at that house had to be tested.

“Of course that house got closed down,” she said. “They had to get a new septic system … It was just a bad set of circumstances that took awhile to figure out.”

When Wiegle was appointed as LHO for Swan’s Island, she was instructed to bring all concerns that came to her to the Board of Selectmen. They would determine whether it was a situation worth pursuing.

Most recently, as the LHO, Wiegle was asked by selectmen to help them determine if a house needed to be condemned. It came to their attention after the family that had been living there moved out.

“It was the kind of place no one should have been in, let alone children,” said Wiegle. In order to confirm the condemnation she went to the property, took photos and eventually police tape was put up to keep people out. “It really wasn’t safe to be in there.”

Those are the type of issues LHOs deal with in town. They can be serious, life-threatening public health concerns or a less immediate concern brought to the town’s attention before it becomes a larger health issue.

Lowell was recently asked to address a trash storage issue on private property. When she went to the property to investigate, she found trash being stored in a Quonset hut — a structure with cloth or plastic walls.

“Trash was blowing into neighbors’ yards and going into a small stream,” Lowell said.

Attracting animals or possible water pollution were the reasons the situation came to the LHO. Once the situation was brought to the property owner’s attention, it was cleaned up.

State statute allows health officers to work with other town officials such as the code enforcement officer, animal control officer and, in some cases, police.

“Most of the time I take the code enforcement officer,” said Lunt, especially when dealing with a housing issue. “She’s the most likely one to know about these buildings.”

Often complaints that require health officer attention come to the town office first, according to Tremont Town Clerk Katie Dandurand.

When that town’s health officer decided to vacate the position before their term expired, a temporary LHO was appointed. After the trial period was up and that person decided not to take the job, the health officer’s responsibilities were in the hands of the chair of the Board of Selectmen, as required by state law.

In July, the town appointed Rosie Madeira as the new LHO for a three-year term.

“It can be like being a firefighter, sitting around waiting for a fire to start,” said Lunt about being an LHO. “You never quite know when it’s going to happen.”

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