'Still burning inside of me'

Steven Wiersma: West Nile inquiry

Epidemiologist Steven Wiersma, M.D., of the Florida Department of Health: "We're in the heat of the battle"

By Porter Anderson
CNN Career

(CNN) -- Fatigue eases him into the conversation, but adrenalin keeps him talking.

"You know, to be honest, I love it on days like today. My wife knows this about me. As soon as it gets a little quiet, I start thinking about a career change."

No need to start packing the china, there are few worries about things getting quiet for Wiersma soon.

Steven Wiersma, MD, has just turned 40. He's just been made Florida's acting state epidemiologist. And he's just in time to find himself determining that the state has a presumptive human case of West Nile virus.

"Presumptive" because it's gone to the Centers for Disease Control (CDC) in Atlanta for a confirmation of the diagnosis. Significant because it's the first case of the potentially lethal disease in Florida. A Madison County man over the age of 50 is said to have been in critical condition with fever, fatigue, dizziness, weakness, confusion, headaches and joint problems -- symptoms of the disease, which is spread by mosquitos feeding on the blood of infected birds.

QUICKVOTE What part of Dr. Wiersma's work as an epidemiologist might attract you the most? The field work -- outdoors and in touch with people. The urgency of investigating possibly dangerous outbreaks. The research and discovery of infectious disease. The human-service aspect of the work. View Results

Wiersma's in his element. In fact, he says, when the day comes on which he's ready to leave his position as Florida's chief of epidemiology, "I think it's going to be overseas for me again."

The son of a nurse in oncology and a social-worker father, Wiersma went into medicine at Wayne State University in Detroit, Michigan. "To my parents' chagrin, I turned down the University of Michigan for a more blood-and-guts setting. As part of my training, I went off to Zaire," now the Democratic Republic of Congo.

"I spent three months there with a surgeon. And, you know, it was an exciting way of doing it, I was cutting and doing things I'd never do in the U.S. But there was also a guy from Luxembourg there, who was a public-health doctor, also an MD.

"What struck me was that the surgeon would have to go home every now and then to see his family, and his work would grind to a halt. But this public-health guy was training other people in the villages. His programs continued, whether he was there or not. I was enthralled with that.

"I had a payback I owed the Air Force -- they'd paid for my medical school. So I decided that instead of specializing, I'd give the world of GP (general practitioner) a try. The international public-health thing had really attracted me.

"So I went into the Air Force, got assigned to Germany for four years, Rhein-Main, Frankfurt. Got stuck for eight months in the Gulf War, living in a tent. Got a lot of public-health training there, too."

Wiersma finished his service in the Air Force and went to Johns Hopkins University in Baltimore, Maryland. "I did a master's in public health. And I did my residency in preventive medicine and public health. And there, I studied epidemiology and international public health. It was the perfect mix for me.

"I said, 'I have to go back overseas' -- it was still burning inside of me. So through Johns Hopkins, I got connected to the World Health Organization (WHO), which was starting a new program. They said, 'How would you like to go to Zambia for a two year assignment?' It was USAID funding (United States Agency for International Development) through Johns Hopkins to WHO. So I was a WHO employee with a U.N. passport."

Into Africa

In Zambia, Wiersma worked for three years in "malaria, pneumonia, HIV, tuberculosis, population programs -- I really loved Zambia. My kids basically grew up there." Wiersma has two children, and his wife, a native of Germany he met at Wayne State, is in medicine, too.

When a life-threatening car crash prompted Wiersma's removal from Zambia, he went to Eritrea once his injuries had healed, "to be in charge of the USAID health, population and nutrition portfolio. A 30-year civil war, land mines everywhere. We had a wonderful year in Eritrea."

Recommendations for avoiding mosquito bites Stay clear of: Outdoor activities between dusk and dawn when mosquitoes are likely to be looking for blood meals Wear: Shoes, socks, long pants and long-sleeved shirts if you must be outdoors when mosquitoes are active -- cover up Use: Mosquito repellant Eliminate: Stagnant water in birdbaths and other receptacles in which mosquitoes might breed Source: Florida Department of Health

But one problem for field epidemiologists who are family people, it turns out, is education for their kids. "We had some schooling issues for my son that really brought us back. And that's when I started in Florida."

For four years now, Wiersma has been the deputy state epidemiologist in charge of infectious-disease epidemiology. "My boss just left, so now I'm in charge of all our epi-programs here. When I got here four years ago, we had a huge breakout of St. Louis encephalitis. I found myself doing the same thing I'm doing now for a couple of months then."

Wiersma has a younger brother who has gone into health administration. "And my sister said, 'I want to make some money, forget these guys.' She went into marketing. She's the smart one.

"I've been bumping all over the place, changing careers about every four years. As state epidemiologist, I work with a good network of people who do this. We're close to CDC. I like Tallahassee. But for me, it's going to be overseas again at some point."

For the moment, Wiersma looks forward to the chances he has to get back into the field. "The other night, when we realized we had a potential human case, I went out to the hospital to spend some time with the doctors. That kind of field work always pays off: We found some additional (patients) we ended up testing, still waiting for the results on those."

Wiersma's department trains CDC doctors in a profession many lay people see as dangerous. But it's not as risky, the doctor says, as it may appear. "We're armed with knowledge. We know how to prevent diseases, we're adequately equipped to protect ourselves.

"Certainly there were a lot of threats in Africa, say TB patients and not all the protective gear you might have wished you had. But here, by and large, it's not so dangerous. I mean, yeah, when I was in the field the other day to see how our mosquito collectors were doing, I had my lotion on."

You get the distinct sense, though, that Wiersma's a guy who'd rather have to wear that repellant than not.

"We're in the heat of the battle here, you know," he tells a caller. "Can I get back to you later?"