Friday, April 10, 2009

The public health benefits of mobile phones

The bread and butter of public health on call is identifying contacts in the case of suspected meningococcal disease. On the whole this is straightforward but can occasionally cause difficulties. Most areas that I have worked in include several universities, and during October it is common to experience the problem of contact tracing in the student population.
There are two main problems. The first is how to define household contacts when the index patient lives in a hall of residence containing several hundred students. Finding the appropriate university protocol and not being too concerned about the different approaches adopted by neighbouring universities can reduce the number of sleepless nights. The second problem is harder. “Close kissing contacts” among 18 year olds who have been set free from parental control for the first time is a minefield. My experience suggests that it is best to assume there will be lots and that names and contact details will not necessarily have been obtained. By the end of a weekend on call, you will feel like a cross between a detective and an “agony aunt.”
One year I volunteered to cover Christmas weekend in the belief that at least the students would be gone by then. I could not have been more mistaken. To add a further difficulty, the index patient presented to hospital on the night of the last day of term, and all contacts had already set off to the far reaches of the country. I could not believe my luck when the friend accompanying the patient produced both their mobile phones and confidently reassured me that between the two of them they would have the mobile numbers of all 15 “household” contacts. She was right, and in just over two hours all of them had been contacted.
There has been much coverage in the medical and popular press about the potential health hazards of mobile phones, and if these fears are realised the 100% ownership among this small sample of students is worrying. However, in terms of contact tracing for suspected meningococcal disease, mobile phones have potential health benefits not just for their owners but also for the mental health of public health doctors. Of course, this may not solve the “close kissing contact” problem.

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