Day 36 Retrospective

Day 36 (yesterday) was an exciting day for the Northeast and US Germ Boats. New York’s caseload jumped to 76, prompting the governor to declare a state of emergency. Acela service between NYC and DC was cancelled until late May. Bloomberg reports bad times for our lobster industry, what with the bottom falling out of the Asian giant edible spider import market.

The Commonwealth of Massachusetts now has our own tracker, which still lists yesterday’s stats of 13 cases. An infectious disease conference in Boston (CROI) was moved online, because apparently not everyone in the biotech sector here is completely insane.

Vice President Pence accidentally announced 21 confirmed cases aboard Germ Boat #6, the Grand Princess. Also, a Germ Boat #7 was christened when a “medical matter” (that is, a suspected coronavirus case) trapped passengers aboard the Carnival Panorama in Long Beach, CA, until a negative test result could be obtained. (The following cruise was shortened by one day.) PlagueBlog recommends against taking cruises at this (or any) time. At least one more death has been recorded for #2, the Diamond Princess, as well, bringing the official total to 7.

Another LAX screener was diagnosed. The US hit 19 deaths and Brazil hit 17 cases (two in Rio). MasterCard closed its offices in NYC and São Paulo due to a coronaviral connection between the two. The SXSW conference that several tech companies pulled out of earlier in the week has been cancelled.

A relatively new Chinese hotel in Quanzhou housing quarantined case contacts collapsed, killing at least 10. The Pope started streaming to keep crowds from gathering to see him, and the Vatican confirmed its first case.

Poland’s sixth case apparently caught it from the first case on a bus. The leader of the Italian Democratic Party fell ill. A cluster of 60 cases in Spain was linked to a funeral. The Netherlands reported their first death and a total of 182 cases.

Day 34: Ex Boston

Channel 5 reports that we may have exported coronavirus to Tennessee in the person of a Williamson County (TN) man who flew from Nashville to Logan and back. Channel 10 reports he came to Boston for an international meeting "at Biogen" in Cambridge [reddit speculates this meeting was actually at the Boston Marriott Copley Square in the heart of Boston] last week, from which attendees took home both flu and COVID-19 (three positives so far). Our third Massachusetts case, also in Middlesex County (location of both Cambridge and yours truly) has been reported by the state as ex Italy but by NBC as ex Biogen, is awaiting confirmation by the CDC. PlagueBlog would like to thank you now for reading, because posting may come to an abrupt and possibly permanent halt at any time now.

Boston.com reports that the wayward New Hampshire medical worker "is now complying" with quarantine after exposing a bunch of Dartmouth Tuck Business School students at a mixer. One Tuck student "estimated that about a hundred business school students attended, along with 30 or 40 resident physicians associated with Dartmouth-Hitchcock, an academic medical center located near Dartmouth College."

In other local news, Governor Cuomo tweets that there are 5 new confirmed cases in New Rochelle, a couple in their 40's with three children who were friends of the previous family. There are also two untraced cases in New York City. New Jersey has two presumptive cases.

Texas has three new cases, two of them in Harris County (i.e., Houston). California is lousy with cases, but a notable one is one of the medical screeners from LAX. The CDC state-by-state map is updating daily again, possibly due to agitation from reddit. In less official but more accurate news-based counting, the US is up to 221 cases and 12 deaths.

An eight-month-old baby is a new Australian case, ex Iran. South Africa's first case is ex Italy.

On the bright side, the Diamond Princess has been downgraded to 696 cases and 6 deaths, due to some double-counting of cases.

P.S. Germ Boat #6 is another Princess Cruises ship, the Grand Princess. The story is similar to that of previous Germ Boats: passengers on a prior cruise later tested positive (including one death; these are some of the California mainland cases), so the current passengers have been condemned to a slow death by quarantine off the coast near San Francisco. Test kits are being flown in by helicopter.

Boston Day 2 (NYC Day 1)

According to MSN (via ProMED), our Boston patient has recovered and is voluntarily quarantined at home. Oh, and there's a suspected case in NYC.

Yesterday r/askscience on Reddit had an AMA (ask me anything) "about the novel coronavirus". (I'm hoping the WHO comes out with a handier name than 2019-nCoV soon.) In that haystack I found links to nice infographics at the New York Times.

BU's Leaky Biolabs

Via ProMED-mail: the Boston Globe reports on another BU researcher who accidentally brought his work home with him.

The genetic tests, conducted at the state laboratory in Jamaica Plain, compared a blood sample from the researcher with bacterial matter recovered from the lab where he was working on BU’s South End campus. “The bottom line,’’ said Dr. Anita Barry, top disease tracker at the Boston Public Health Commission, “is they matched.’’
The analysis erased any doubt about what caused the researcher to become sick last month and intensified investigations into precisely how he was exposed to a germ known as Neisseria meningitidis, which can cause meningitis.
The city’s biological lab safety division will review safety procedures in BU’s medical labs, to ensure that the school is doing everything possible to minimize researchers’ exposure to pathogens, Barry said.

I thought they did that last time.

PlagueBlog recommends moving to the suburbs before the new BU biolab opens downtown. And by "suburbs" I mean Maine.

The Pandemic in Boston

Declared a pandemic on Thursday, swine flu has already claimed its first casualty outside the Americas and its first death in Massachusetts.

On the bright side, at least we aren't warehousing the ill in a tent camp on Summit Hill...yet. (Massachusetts news via Universal Hub.)

Scabies at Logan

Via an unnamed source: WBZ TV reports on a small scabies outbreak among TSA workers at Logan Airport in Boston.

TSA officials say all their workers wear gloves so the public should not be concerned about getting scabies.
It is still unclear how the employees got scabies in the first place.
According to the CDC, scabies is caused by an infestation of the skin by human itch mites that burrow under the skin and lay eggs.

It's unclear to PlagueBlog how the gloves that failed to protect the TSA workers are supposed to have protected the public.

NIH Blue Ribbon Panel Biolab Hearing

Via Universal Hub: there will be a hearing this Tuesday in Roxbury about the biosafety level 4 facility BU still hopes to build right next to a million Greater Bostonians. From the Federal Register:

There will be a meeting of the NIH Blue Ribbon Panel to advise on the Risk Assessment of the National Emerging Infectious Diseases Laboratories (NEIDL). The meeting will be held on Tuesday, October 14, 2008, at the Roxbury Center for the Arts, Hibernian Hall, 184 Dudley Street, Roxbury, MA 02119 from approximately 6:30 p.m. to 9:30 p.m.
Discussions will focus on principles and strategies for effective community engagement. There will also be time allotted on the agenda for public comment.
Sign up for public comment will begin at approximately 5:30 p.m. on October 14, 2008. In the event that time does not allow for all those interested to present oral comments, anyone may file written comments using the address below.
For further information concerning this meeting contact Ms. Laurie Lewallen, Advisory Committee Coordinator, Office of Biotechnology Activities, Office of the Director, National Institutes of Health, Mail Stop Code 7985, Bethesda, MD 208927985, telephone 3014969838, email lewallla@od.nih.gov. Background information may be obtained by contacting NIH OBA by email oba@od.nih.gov.
Dated: September 16, 2008.
Kelly R. Fennington,
Special Assistant to the Director, Office of Biotechnology Activities, National Institutes of Health.
[FR Doc. E822313 Filed 92208; 8:45 am]

ACE also promises a webcast at http://videocast.nih.gov.

Biolab Follies

Via Universal Hub: the Boston Phoenix reports on BU's ongoing "Biolab Follies."

Throughout the past few years, and particularly during the past 12 months, the biolab’s backers have suffered a string of setbacks: legal, diplomatic, political. Boston University Medical Center (BUMC) may still end up hosting a BSL-4 facility, but this is hardly the sure thing it once was. In fact, given the current momentum of the debate, the smart money might actually be on the biolab not coming to fruition, at least as it was originally conceived.
So what went wrong, exactly? Or, for those who see things differently: what went right?

The story chronicles the political side of the biolab debate, with, perhaps, too much attention to race and too little to zombie protesters.

Beware the Stealthy Headache

Via Universal Hub: TS the EMT reports that we almost lost a building full of people in Boston to carbon monoxide poisoning:

Shortly after nine o'clock, a little girl crawled out of bed, tiptoed into the living room, and told her mother she wasn't feeling well.
A few minutes later, the girl's sister complained of a headache, too. Then the mother began to feel ill herself. Assuming they were all coming down with a bug of some kind, she picked up the phone and called 911.
[...]
Fortunately, nobody was found unconscious in an apartment. Workers from the gas company came to investigate, and apparently they located the source of the problem. The windows were opened, the building aired out, and the residents were able to return to their homes.
This could have been a real catastrophe. A few hours later, everyone would have been alseep. The rising carbon monoxide levels would have gone unnoticed. Dozens of people would have lapsed into unconsciousness, and by the time anyone noticed a problem, everyone in the building might have been dead.
In fact, this might have been a criminal negligence case in the making. Leaving the scene we heard talk that work was being done on the building, and that workers had temporarily disconnected the smoke- and carbon-dioxide detectors.

Zombie Protest at City Hall

I was lucky to see the latest zombie protest at Boston City Hall on my way home from work last night. Personally, I'd think zombies would be happy to have snackable Ebola victims lurching about the city leaking sauce, but perhaps that's the point. I didn't want to stick around for the explanation via bullhorn, so I read it today in the BU Daily Free Press:

With Boston Police Department officers close behind, the horde of protesters began their menacing march at the corner of Albany and East Dedham Streets and snaked toward City Hall, moaning, "We have been infected by the BU biolab" and "The BU biolab has infected me with a terrible pathogen." During the march - the newest form of protest in a seemingly futile battle to stop construction of the biolab - the zombies stuffed anti-lab flyers under the doors of nearby businesses and into the palms of curious onlookers.
Local activists have protested the biolab, under construction at the BU Medical Campus in the South End, since the National Institutes of Health granted BU $128 million for the project in 2003. The site will house some of the world's deadliest pathogens, including anthrax and the Ebola virus.

Salmonella Sushi

Via Universal Hub: Wicked Local Brookline reports on salmonella and vermin at Fugakyu:

Inspectors visited Fugakyu in late August after the Boston Department of Public Health told the town that one of the restaurant’s employees had contracted salmonella poisoning.
The restaurant, at 1280 Beacon St., reportedly had not told Brookline officials about the potential health danger. It was not clear from reports how Boston found out. [...]
Reports stated food handlers were also seen washing their hands with no soap for only five seconds. The worker with salmonella was allegedly handling food at the time of the visit, according to reports.

Let's hope Dice-K keeps away from his eponymous roll until the World Series is over.

Rock Snot in New England

Via Universal Hub: The Huffington Post reports on the dangerous advance of Didymosphenia geminata, or rock snot, into New England.

"We're starting to realize it's all over the place," said Karl Hermann, a regional waste monitoring and assessment coordinator for the Environmental Protection Agency in Denver.
What started out in Vancouver Island in British Columbia "has suddenly just skyrocketed," he said.
The algae has the potential to bloom into thick masses with long stalks, blanketing the bottoms of some streams, threatening aquatic insect and fish populations by smothering food sources.
In New England, it has turned up in the White River, Connecticut River and the Batten Kill, a trout fishing mecca in southern Vermont that's famed for its hard-to-catch fish. Quebec is grappling with it in Matapedia River in the lower St. Lawrence.
There's no easy way to get rid of it. Experts say the only hope is to keep it from spreading. But that's a lofty challenge, since a single cell carried on absorbent fishing gear or clothing can be transferred _ unknowingly _ into other waters.

Good Filoviruses Make Good Neighbors

Via Universal Hub: the Boston Globe reports on the NIH's Draft Supplementary Risk Assessments And Site Suitability Analyses for the National Emerging Infectious Diseases Laboratory Boston University. In short, there's no reason Boston University shouldn't build a new lab in the South End to play with Ebola:

Researchers at the State University of New York at Buffalo compared what would happen if germs migrated from the lab into its South End neighborhood with what might happen if the lab had instead been built on more secluded property owned by BU in Tyngsborough or Peterborough, N.H.
The report concludes that even if an accident happened in the lab "under realistic conditions, infectious diseases would not occur in the communities as a result." The study also concludes that "there was no difference in simulated disease transmission among the urban, suburban, or rural communities."

TB at the OCME

Via an unnamed source: The Boston Herald reports that state health officials will give a press conference later today about a tuberculosis outbreak at the Office of the Chief Medical Examiner.

The sources differed on whether the testing was routine or the result of a recent positive case within the troubled office.
Regardless, the two sources confirmed that at least three employees of the OCME tested positive. At least one employee has been prescribed a nine-month regimen of medication to treat the symptoms and will also undergo monthly liver testing.
“They are trying to test as many people as possible,” said one source. “People are back working. As far as I know they are not walking around wearing face masks. I dont know where they got it. They probably got it from the building.”
Another source, who is familiar with law enforcement issues, said that one or two medical examiners and at least three clerical workers were affected to some degree by the TB outbreak. The office employs about 60 people.
Dr. Joseph Prahlow, president of the National Association of Medical Examiners, said TB was known to affect medical examiners’ offices. “It’s a recognized potential hazard of the work that we do,” he said.

Necrotic Arachnidism

Via ProMED-mail: Press Peru reports 2264 bites, three of them fatal, by the Chilean recluse spider in 2006. Loxosceles laeta and related recluse spiders are also known as violin, corner, fiddleback, or domestic spiders.

Here's some recluse information from the Hobo Spider Web Site:

The recluse spiders, genus Loxosceles, belong to a unique family of arachnids known as the Sicariidae, or six-eyed sicariid spiders. The sicariids have six (rather than the typical eight) eyes, arranged in a horseshoe pattern in three clusters of two eyes each. The family consists not only of the recluse spiders, but also of the six-eyed crab spiders, genus Sicarius, of Central and South America, and South Africa. Recluse spiders were the first spider group to be recognized as a causative agent of the disease state now known as necrotic arachnidism, and this condition, when caused by a recluse spider, is properly termed loxoscelism. Loxoscelism was first recognized in 1872 when Chilean physicians linked a peculiar skin lesion known as the "gangrenous spot of Chile" to bites by the Chilean recluse spider, Loxosceles laeta. The brown recluse, L. reclusa, became the first U.S. spider associated with necrotic arachnidism in 1957, when it was linked to severe bites in the midwest. All recluse spiders, as well as the six-eyed crab spiders, are now considered venomous to humans.

Brown recluses are not as common in the United States as people imagine. Bites reported in areas outside its range, such as Massachusetts, are likely due to other causes---for example, the local Yellow Sac spider:

Cheiracanthium mildei was first identified as a cause of necrotic arachnidism in 1970, when it was linked with skin lesions in the Boston, Massachusetts area (where it is the most common spider found in houses); it is also common in houses in New York City, and may well be the cause of recent "brown recluse bite" rumors circulating there. In the late 1970's and early 1980's mildei produced a significant number of bites in the Provo, Utah area. C. inclusum has been reported responsible for bites in Georgia and southwestern Canada; bites by this species are probably far more common and widespread than this however, and it is likely that more reports will surface as Cheiracanthium species become better known as clinically significant spiders.

Gastroenteritis in Boston

Via ProMED-mail: the Boston Public Health Commission advises Bostonians to wash their hands during the current outbreak of Norwalk-like illnesses.

In addition to the increases seen in emergency rooms, an outbreak of GI illness has occurred at Simmons College in Boston. As of December 15, eighty-one (81) students and staff have reported experiencing nausea, vomiting diarrhea and stomach cramps. Many of the affected individuals have reported being ill for approximately two days after symptoms began. The outbreak at the school appears to be on a downward trend with only a few new cases having been reported in the last several days. Early implementation of control measures including education on hand washing, availability and use of hand sanitizer, and increased frequency of restroom cleaning appears to have decreased the transmission of illness at Simmons.

Big Whoop

Via ProMED-mail: The Boston Globe reports eight more staff members at Children's Hospital in Boston have been diagnosed with whooping cough, for a total of 33 to date.

Disease investigators have said they believe whooping cough was carried into Children's by a 19-month -old patient. They continue to investigate whether a 3-year-old girl who has the illness contracted it at the hospital or before she arrived there.
Barry said the eight additional cases reported yesterday do not reflect recent infections. Instead, she said, most of those staff members began displaying symptoms in mid-October. So far, no hospital workers or patients have faced life-threatening complications as a result of the outbreak.

Yet More Measles

The Boston Globe reports that the number of measles cases in Boston has risen to fourteen:

The patient, a woman in her early 20s, has recovered from the disease and is back at work at Hill Holiday, a communications company in the John Hancock Tower, where the outbreak began. No other suspect cases have been identified within Hill Holiday. For more information on measles, visit www.bphc.org, the Boston Public Health Commission's website, or www.state.ma.us/dph, the Department of Public Health's website.

More Measles in Boston

The Boston Metro reports a new case of measles in an employee of Investors Bank & Trust Co. at the John Hancock Tower. The outbreak, which health officials have traced to a visitor from India, is still confined to IBT. The Mass. Dept. of Public Health Measles Alert [PDF] has not been updated.

Measles in Boston

The Boston Metro reports that measles has broken out in the Hancock Tower:

Three people who work in the John Hancock Tower have been stricken with the highly-contagious measles, according to the Boston Public Health Commission.
All of the employess work for the same company and public health authorities have been working with officials there to try to identify co-workers who have been exposed to the measles. A second round of vaccinations are being offered to employees who are uncertain whether or not they were vaccinated in the past.