John Roughan: For a disease alert, take a healthy grain of salt

Typhoid sounded like something serious when I was driving home that Friday night and the radio reported an outbreak in Auckland, followed by a list of symptoms, some of which described my condition since returning from Singapore five days before.

The evening TV news was leading with the outbreak and websites, when I checked them, were no more comforting. "Untreated, can have serious complications, including death in about one case out of five." The bulletins were reporting 10 already in hospital from the outbreak, thought to have been brought by someone returning from the Pacific "or Southeast Asia".

Anyone with the symptoms described should see their doctor or go to a hospital emergency department. That is what they were saying.

So I got back in the car and drove to North Shore Hospital, feeling a mixture of guilt - for the people I'd been in contact with over the week - and nobility for deciding to turn myself in. This was not like me.

Normally I treat health warnings with a grain of salt. Modern diagnostics in my experience discover more than is good for you. I've come to trust my body over blood tests. But typhoid sounded like something you had an obligation to report.

So I drove in, wondering what the reception would be. Action stations, I imagined. I'd be quarantined for sure, and very likely swept into the maw of the system so fast I wouldn't know where I was. Steeled for it, I walked up to the emergency room desk and calmly told the nurse, "I think I may have typhoid."

She smiled indifferently and sent me to another window. There I gave my details. The staff went about their work as though nothing out of the ordinary was going on. The nurse taking my details hadn't heard the typhoid news and didn't seem particularly interested in it. She sent me back to the first window to get a form to take to the nearby private after hours clinic.

There the reception was the same. None of the staff, even the young ones, knew of a typhoid outbreak. So much for the immediacy of news on digital devices. Waiting with the genuinely injured and worried parents of bored children I felt like an habitual hypochondriac who has to be humoured and sent away.

But the doctor, when my turn came, was patient and cheerful.

She hadn't heard of a typhoid outbreak. Politely, she asked what the news was saying before she started describing what pills I could have for a new flu she said is around this year.

"I don't want any unless you think I really need them," I said. That made a difference. She turned to her computer, called up the website of the Auckland Regional Public Health Service and read about the typhoid outbreak. Then asked me to wait outside while she phoned the service.

"Don't encourage them," I said and she grinned. She knew I didn't want any fuss unless there was reason to be worried.

Eventually, on their advice she took a blood sample, along with a nasal swab for flu and prescribed a course of antibiotics just in case.

A week has gone by. I've heard nothing more. Whatever it was, I'm getting over it. But I'm left wondering what to make of that little insight to the health system. It seems strange it should issue a public notice about an outbreak of a communicable disease and leave emergency rooms in the same city unaware of it. Wouldn't there be some sort of all-points alert to medical centres throughout the region?

This week Health Minister Jonathan Coleman has complained that he first heard of the outbreak on the television news. The regional public health service is under fire for not mentioning a woman had died with the disease when it announced the outbreak, and for waiting until after her funeral on Monday to make her death widely known.

It would be easy to lend my experience to the criticism of the public health service but I'm not so sure it did anything wrong. More likely, the outbreak was simply not that serious.

Typhoid is a communicable disease so I suppose the service had to issue a public notice at some point. By the time it did so, it was fairly confident the infection was confined to the congregation of a Samoan church in Mt Roskill and those people could all be contacted.

The service did not exactly say that in its public announcement that Friday evening, but it nearly did. When I think back on it, there was a hint the disease was probably contained. I should have trusted my usual instincts where health is concerned. Next time I will remember to take that grain of salt.