In his last position before returning to Orlando, Kevin Sherin, MD, MPH, oversaw a staff of 376 and a budget of $275 million in his role as deputy director of the California Department of Public Health, Center for Chronic Disease Prevention and Health Promotion, in Sacramento. It was his first venture West, after being born in Rhode Island, growing up in Massachusetts, studying college in Indiana, and medical studies followed by private practice in Illinois.
Sherin's first taste of the Sunshine State occurred in 2004, after 17 years in family medicine private practice in Oak Lawn, Ill., morphed into a second career in public health. He served as health officer for Orange County from 2004 to 2013, when he was named interim director of the Division of Disease Control for the Florida Department of Health in Tallahassee. After a year on the west coast, Sherin returned to Central Florida. He was named director and health officer for the Florida Department of Health in Orange County last May. Since then, he's focused on many public health issues, including community preparations and response to the Zika virus and amoeba infections for Orange County's 1.2 million residents.
During his first stint in Orange County public health, Sherin led the department to national recognition for quality awards and federal grants, including a $6.6 million award for tobacco cessation. Shepherd's Hope Clinic honored him with the Ruth M. McKeffery Award for Outstanding Volunteer Service; Florida State University College of Medicine appointed him Guardian of the Mission Award, Class of 2014. FSU's medical school, where he also serves as a clinical professor of family medicine, also honored him with the Gold Humanism Honor Society Award in March.
Most recently, Sherin presented a Primary Meningoencephalitis (PAM) webinar to medical societies in Seminole and Orange counties, authored successful resolutions on Naegleria fowleri to the American Medical Association (AMA) and the Florida Medical Association (FMA), and in April co-authored a letter to the editor on Naegleria fowleri for the American Family Physician, reaching nearly 200,000 family physicians.
Nationally, he's treasurer of the American College of Prevention Medicine and past president of the American Association of Public Health Physicians. Statewide, he's been tapped for work groups too numerous to count, including co-chairing the Community Health Promotion Council from 2012 to 2014. Locally, he's past president of the Orange County Medical Society, and a volunteer for many healthcare-related organizations. Somehow, Sherin found time in his busy career to earn an MPH (1986) and MBA (2011).
Orlando Medical News spoke with Sherin about his upbringing, pursuit of family medicine and public health, and the health department's involvement in combatting the spread of the Zika virus and the almost always fatal amoeba infection.
When did your interest in becoming a physician begin to emerge?
My mother served on the board of a local hospital and my father was an attorney. Our community had two family docs who made house calls and both were completed burned out. Because of the physician shortage, my parents were asked to help establish a community health center, my dad for pro bono work and my mom as a volunteer. Both were very civically minded.
When I decided to pursue medicine, I remember looking at statistics for Notre Dame, which were quite good for students getting into medical school. Good football, to be quite honest, also influenced my thinking.
After specializing in family medicine, and working in private practice for 17 years, why did you decide to pursue public health?
I remember being a medical student when the HIV epidemic was breaking out. That made an impact on me. When I was in private practice, a student in my teaching hospital asked if I preferred family practice or public health and I told him I liked both. One involves looking at the big picture and focusing on the greatest needs in the community, and the other involves individual patient care and providing continuity to patients. I still do that with Shepherd's Hope, and medical students who rotate with me from Florida State University and occasionally the University of Central Florida.
Tell us about your department's involvement in combatting the spread of Zika?
Organized approaches make a difference. We started seeing travel-related cases of the Zika virus in February. From that point on, we began working with our medical community, leading stakeholder meetings, collaborating with infectious disease specialists, and working together in a coordinated fashion.
For the medical community, our issue is to recognize the symptoms of people who might have Zika, while at the same time realizing that four of five may not have any symptoms. If the doc is seeing a patient with red eyes, a diffused rash, joint pains and fever, it might be strep, dengue - or Zika. That's just the identification challenge. Unfortunately, until we have a vaccine, it's very much up to mosquito control. Residents must be good stewards of their property and look for standing water in places they might not think to check, like very small plants such as bromeliads. The Aedes aegypti and Aedes albopictus that spread the Zika virus are day-biters. Unfortunately, you can't avoid going out at dawn or dusk when they're most active. We can use bug spray, Deet. We can spray permethrin on clothing.
We think this virus is neurotrophic. It attacks the brain and we know the damage it can do to babies. It has the potential to establish a foothold, especially in Gulf states. Fortunately, the National Institutes of Health (NIH) is fast-tracking the vaccine. In the old days, we grew vaccines with agar and eggs and all sorts of things. This one is cutting to the chase. We're taking the DNA right out of the virus, injecting it into the animal model, producing immunity from that, and now we've gone to human trials. We'll be taking the genetic code of this virus and injecting it directly into humans.
What about the amoeba infection?
The first-ever case of someone surviving amoeba in Florida occurred right here (on Aug. 7. A 16-year-old traveling with his family from South Florida had contracted the infection after swimming on private property in Broward County.) He complained of a serious headache that worsened, and his parents took him to the Florida Hospital for Children's Emergency Department. The medical team killed the amoeba using medication, including miltefosine, (and reduced the swelling of the brain by draining fluids, inducing coma, administering steroids, and lowering the body's temperature.)
Miltefosine is used for cancer treatment, and the company that makes it is in Orlando. Remarkably, this child was only 12 minutes away from the hospital when he got sick, and the drug was available right here. It's important to note that in the last 50 years, only four people have survived the country's reported 138 cases. That's according to the CDC.