Alumna on the Frontlines of Disease Detection

photo of alumna Paige Armstrong ’11 (MED)

How does someone prepare for a career that can include a morning meeting with a foreign minister, followed by an afternoon investigation inside a cave full of bats?

The Career. The Preparation.

For Paige Armstrong ’11 (MED), her degree from UConn School of Medicine launched a career in public health that would take her across the globe to identify and stop deadly diseases.

Armstrong found her interest in public health early on, discovering a passion for science in grade school and finding a role model in her father, an emergency medical technician. “Caring for people has always been in my life,” she said.

Her father’s work, as well as a service trip she took as a teenager with Amigos de las Américas working to build latrines and stoves in Guanajuato, Mexico, led her to think about public health and the course her life could take. “When I returned from Mexico, I had my sights set on medicine,” said Armstrong.

She says UConn was a critical part of her plans to become a public health officer specializing in deadly fungal diseases. Before entering UConn School of Medicine, Armstrong earned a Master of Health Sciences (M.H.S.) degree, as well as a B.A. from Johns Hopkins University. “I wanted to make sure I got that foundation in public health and understood what kind of projects I should work on during my time in medical school and my residency at George Washington University,” said Armstrong.

“I have to give UConn School of Medicine a lot of credit for the way they structure their medical education,” she said. “It was a rigorous, intense four years of my life, but UConn was always supportive of developing and trying new things.” For example, Armstrong and some classmates sought and earned the support of the Dean to create a medical Spanish interest group.

Because of the strong interest in this group, the Dean also approved their request to create an elective focused on the communications needs and cultural considerations of Spanish-speaking populations. “We actually taught that elective and brought in guest lecturers,” said Armstrong. “This openness and willingness to let us take an idea and run with it allowed me to continue fostering my interests in public health. It gave me experiences I continue to use.”

Disease Investigation

Today, Armstrong applies her education and experiences in emergency medicine and public health to her role as an Epidemic Intelligence Service (EIS) officer in the Mycotic Diseases Branch at the Centers for Disease Control and Prevention (CDC). In her role, she investigates and analyzes outbreaks fungal diseases including Histoplasmosis, Coccidioidomycosis, Aspergillosis, Mucormycosis, Scedosporiosis in collaboration with international and domestic colleagues and government officials.

In recent years, Armstrong assisted in the Emergency Operations Center at the CDC on the Zika response, and worked alongside the Ministries of Health in El Salvador and Nicaragua to evaluate their national surveillance systems.

She also led two outbreak investigations, one of which focused on the outbreak of Histoplasmosis in tunnel workers in the Dominican Republic. The outbreak response focused on providing diagnostic support to confirm the diagnosis of Histoplasmosis and investigating and providing additional occupational and environmental recommendations.

A team of 35 men had the unenviable job of cleaning out bat guano from tunnels that allow access to a hydroelectric dam. Many of these men developed the respiratory form of the disease. Histoplasma capsulatum spores exist in bat guano, and when inhaled, can cause this respiratory disease that results in sickness and, in some cases, death. (In this case, 27 of the 30 men who became ill survived.)

The second investigation Armstrong led focused on Candida auris, a multi-drug resistant yeast, in Colombia. Armstrong co-authored the results of this research on this fungus that acts like a superbug bacteria and is difficult to identify.

While there are inherent challenges and potential risks in a field investigation, the CDC provides comprehensive resources. “We have amazing support systems that provide everything we need, from radios for our use in remote areas to mosquito repellant.”

When they arrive in a country, their teams are also supported locally by a ministry or hospital that devotes a group of staff to support their efforts. “We sit down with leadership to understand the significance of the event that’s occurring in the community,” says Armstrong. “You appreciate the gravity of the situation and want to make sure you are taking the steps necessary to identify the concern, address it, and relay the appropriate recommendations to the leadership to ensure they are implemented.”

The local staff and government officials are supportive and critical to their success. “Every interaction with them is constructive,” said Armstrong. “Our work wouldn’t be possible without them.”

It’s also true that this work would not be possible without those, like Armstrong, who possess the combined passions of medicine and public health. “Sometime during my residency, I realized that when I was able to work in a position that combined my UConn medical education with my passion for public health, I could a make a large-scale difference and affect the lives of a lot of people.”

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