June 5, 2003 - Ventura County Star: Malaysia RPCV Marilyn Billimek retiring as epidemiologist and public health nurse

Peace Corps Online: Directory: Malaysia: Peace Corps Malaysia : The Peace Corps in Malaysia: June 5, 2003 - Ventura County Star: Malaysia RPCV Marilyn Billimek retiring as epidemiologist and public health nurse

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Malaysia RPCV Marilyn Billimek retiring as epidemiologist and public health nurse

Read and comment on this story from the Ventura County Star on Malaysia RPCV Marilyn Billimek who is retiring after three decades as epidemiologist and public health nurse for the Ventura County Public Health Service at:

1375,VCS_226_2013234,00.html, Disease-tracking nurse for county retires*

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Disease-tracking nurse for county retires

By T.J. Sullivan, sullivan@insidevc.com
June 5, 2003

The residents of memory lane in Marilyn Billimek's mind hack with tuberculosis coughs.

Some itch with chickenpox and have feverish foreheads. Others have contracted rabies from dogs. One 10-year-old boy even put the head of a dead, rabid bat in his mouth to impress some girls.

Then there are the ones who unwittingly contracted illnesses at restaurants, like the outbreak of Hepatitis A that was traced first to a sewage backup at an apartment complex, and then to the restaurant cook who lived there.

It's a troubled boulevard, but one that Billimek, an epidemiologist and public health nurse for the Communicable Disease Division of Ventura County Public Health Service, has tried to improve for nearly three decades. She's quizzed those who suffer from communicable diseases, asking where they were and who they were with, what they ate and where they bought it. She's tried to impress the need for good hygiene, for seeking medical care and for taking prescription medication as directed.

Billimek, 64, has done the kind of work that many would likely support, though they may not necessarily invite her along to share a meal any time soon.

When people in Ventura County suspected recently that they'd contracted the mysterious SARS illness, or severe acute respiratory syndrome, Billimek was one of those who took the lead in investigating the possibility. Public paranoia was high. In April the number of calls to the Communicable Disease Division spiked, most of them regarding questions about SARS. None of the suspected cases turned out to be an actual SARS infection.

Last year, when 19 children from a Ventura County school began contracting Hepatitis A, Billimek was one of the officials charged with finding out how it happened. It turned out the children transmitted it to each other in school and playing at each others' homes. One was infected while painting pictures with pudding, dipping hands into a single dish, one transmitting it to the other.

"Little kids don't have good hand-washing technique," observed Lois Manning, director of nursing for Public Health Services.

Doing such disease detective work has been Billimek's charge for much of her career in Ventura County, but after 281/2 years, she's decided it's time for a change. She plans to retire Friday.

"The best you can do is take care of yourself," she said.

Public life

Billimek's experience in public health began in the early 1960s after she attended Incarnate Word College in San Antonio, a school run by the Sisters of Charity, whose focus included health care, among other pursuits.

Initially, she considered becoming a nun.

"The priest said, 'Why don't you go out and do something else first?'" Billimek recalled. "So I went out and did something else and didn't become a nun. I guess it was an insecurity, and I think the priest saw that ... I didn't know what I wanted to do."

Caption: Marilyn Billimek spent two years in Malaysia giving immunizations, providing prenatal care and performing well-baby checks.

At that time, the Peace Corps had recently been established, and a friend suggested that they join together. The friend never followed through on the idea, but Billimek did, spending two years in Malaysia giving immunizations, providing prenatal care and performing well-baby checks.

When that stint was over, she signed up for another adventure, in Iquitos, Peru -- The Amazon -- through Project Hope. She worked in the jungle and traveled on a boat, following a river to various homes and villages where she provided health care.

None of her co-workers spoke English, so she quickly became fluent in Spanish, a skill that proved invaluable throughout her career in Ventura County.

When her two years in the Amazon were up, Billimek bounced around a bit, working and studying tuberculosis in Colorado. Eventually she went back to college, earning her master's degree in epidemiology from Tulane University's School of Public Health and Tropical Medicine in New Orleans.

After a brief stay in Texas, she came to Ventura County in 1974, and though her initial focus was to be tuberculosis, "I didn't feel like I had enough to do," she said. So she volunteered to help out in communicable diseases, where she's been ever since, tracking dozens of diseases, from AIDS to toxic shock syndrome and tuberculosis.


Epidemiologists like Billimek are sometimes called disease detectives. They track the clues of illness.

When Simi Valley experienced several valley fever cases, she worked the team that linked it to a huge clump of earth that contained spores knocked loose by the Northridge earthquake in 1994. "People took pictures after the earthquake and in those pictures you could see this cloud of dust," she said, her face taut with a grin.

She later appeared on the Today Show to explain it all.

"She loves the mystery part of it, the detective work," Manning said.

Elizabeth Huff, a manager in Ventura County's Environmental Health Department who oversees 16 food and pool inspectors, enjoys it as well.

"We've done a lot of the investigations together," Huff said of Billimek. "She has a fun sense of humor. You kind of have to in our field."

Larry Dodds worked with Billimek for 10 years, including three years when he was the director of Public Health. Now retired and living in Philadelphia, Dodds said during a recent telephone interview that he recalls Billimek's vast experience, her ability to do what had to be done in delicate ways -- such as quarantines -- and to determine how exposure to a communicable disease occurred.

Sometimes that meant tracing the path of human interaction with bats, which are known to sometimes carry rabies. Like the time a 10-year-old boy apparently tried to imitate musician Ozzy Osbourne, who had been in the news at the time for biting the head off a live bat during a concert.

The boy put the head of the dead bat in his mouth to impress some girls, Dodds said.

"They checked ... and found out the bat was rabid and the problem is that saliva from the bat could have been on the bat fur and infected him," Dodds said.

Billimek did the research on the bat and the boy, and Dodds worked with the Centers for Disease Control to see what could be done if he'd been infected through the cranial nerves, the nerves of the head.

The boy received the rabies immunization. He was not infected.

"There's all kinds of unusual things that come up," Dodds said.

In another case, Billimek had to trace the path of a dog bite victim to Mexico, warning his family members to get the rabies vaccines because he had been infected with it for seven months without knowing.

"You worry about those people who have been in the line of coughing and saliva from the person who had rabies," Billimek said. "It turned out that seven months prior the man had befriended a dog in Mexico ... that was ill looking."

Through interviews, Billimek determined the man, who later died, had tried to feed the stray dog, which nipped him on the finger and ran away. "That's the only clue that we had as to how he got the rabies," she said. "They never knew the dog, or saw the dog again, but that was the recollection of the family."

Voice of caution

For many years Billimek has been the name behind communicable diseases in newspaper articles about rabies and hepatitis, food poisoning and measles.

She's explained the finer points of removing ticks after they've embedded themselves in their host's skin, and encouraged the thorough cooking of eggs to kill salmonella organisms. She has reminded county residents several times that, though diseases like bubonic plague may be rare, they're still out there, possibly in the bite of a flea that jumped from a squirrel to them.

She does the job many Public Health workers do each day, though their efforts are rarely noticed by the media.

"It's all behind the scenes, but it protects everyone else ... and they're not even aware they're being protected," said Dodds, who now runs a retreat center for missionaries.

Billimek said she has enjoyed it.

"There's a lot of satisfaction in it in being able to help people through things, and help prevent disease or the spread of disease to their immediate family," she said.

As she prepares to retire, Billimek, an Oxnard resident, is making plans to travel. She'll play tennis more, ride her bike and watch birds.

She envisions the possibility of perhaps working part time. She might volunteer for the Red Cross. She'll also focus on staying healthy.

"When you see disease all around you, you just don't want any part of it," she said.

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