Interlude: What Killed the Wampanoag

This is an accidental interlude in the coronavirus news inspired by Taki Magazine columnist David Cole, who has paused his extremely spicy politico-disease commentary (e.g., Crazy Rich Asians Will Kill Us All) to reflect on the far older epidemiological mystery of what killed the natives of New England four centuries ago now. Cole cites a Slate article making seasonal hay of the story circa Thanksgiving 2012:

The Pilgrim leader William Bradford was already aware of the death toll from “Indean fever.” His scouts had ventured inland and noted “sculs and bones were found in many places lying still above ground, where their houses and dwellings had been; a very sad spectackle to behould.” It’s estimated as many as nine out of 10 coastal Indians were killed in the epidemic between 1616 and 1619.

What killed so many people so quickly? The symptoms were a yellowing of the skin, pain and cramping, and profuse bleeding, especially from the nose. A recent analysis concludes the culprit was a disease called leptospirosis, caused by leptospira bacteria. Spread by rat urine.

That "recent analysis" had been published in the CDC's monthly journal in February of 2010; it postulates "incremental, episodic, and continuous" exposure to leptospirosis introduced by Old World Rattus rattus as the most likely source of the deadly epidemic. PlagueBlog regrets having overlooked the theory at the time, but 2010 was a busy year of crazy Asians killing one another with melamine, and the mainstream press also seems to have missed it.

In defense of the natives contra Cole, PlagueBlog notes that though they eschewed hard-soled shoes, they did bathe far more than the invaders; this otherwise laudable practice was just as likely to give them a cryptic disease invisibly imported into their "sweet brook" as was their semi-shoelessness. It was a lose-lose situation, and not an appropriate metaphor for dangerous modern-day African or Asian superstitions.

Abortive Rabies

Via ProMED-mail: the CDC reports on a rabies case from last year in which the victim was intermittently symptomatic ("severe frontal headache, photophobia, emesis, neck pain, dizziness, and paresthesia of face and forearms") for two and a half weeks before rabies vaccine and immune globulin were administered. She soon appeared to recover without intensive care.

This is the first reported case in which certain clinical and serologic findings indicate abortive human rabies and in which, despite an extensive medical investigation, no alternate etiology for the illness was determined. The patient's positive serologic results offer evidence of rabies virus infection; IFA and Western blot assays indicated the presence of antibodies capable of binding to rabies virus antigens before the patient received rabies PEP. Rabies virus can crossreact serologically with other members of the Lyssavirus genus, distributed in Australia, Eurasia, and Africa (5) or, theoretically, with as yet uncharacterized rhabdoviruses. However, this patient had no history of foreign travel and no evidence of infection with KCV, the only other rhabdovirus associated with bats in North America.
[...]
Certain other clinical and laboratory findings also support a diagnosis of abortive rabies in the patient described in this report. First, the onset of acute encephalopathy approximately 2 months after exposure to bats is compatible with documented incubation periods after rabies virus exposure. Second, central nervous system (CNS) findings (e.g., fever, photophobia, emesis, neck pain, dizziness, paresthesia, limitation of visual field, and altered behavior with agitation and combativeness) are compatible with clinical aspects of rabies. Although this patient did not have classic symptoms such as laryngeal spasms (manifested as hydrophobia) or autonomic instability, the lack of such symptoms has been documented in other rabies patients (1,2,6). Finally, despite an extensive medical workup, no alternate infectious etiology was identified for the patient's neurologic symptoms, increased intracranial pressure, and CSF pleocytosis.

I should note that, after her apparent recovery, the patient returned to the hospital two more times complaining of headaches, and afterwards went missing. ("The current clinical status of the patient or [sic] her boyfriend is unknown.") Judging from the reporting state, the patient was probably in the country illegally. PlagueBlog would not jump to the conclusion that she is still here, or still alive.

Shaken Baby Syndrome

Radley Balko at Reason Online reports on growing doubts about "shaken baby syndrome":

The phrase shaken baby syndrome entered the pop culture lexicon in 1997, when British au pair Louise Woodward was convicted of involuntary manslaughter in the death of Massachusetts infant Matthew Eappen. At the time, the medical community almost universally agreed on the symptoms of SBS. But starting around 1999, a fringe group of SBS skeptics began growing into a powerful reform movement. The Woodward case brought additional attention to the issue, inviting new research into the legitimacy of SBS. Today, as reflected in the Edmunds case, there are significant doubts about both the diagnosis of SBS and how it's being used in court.
In a compelling article published this month in the Washington University Law Review, DePaul University law professor Deborah Teurkheimer argues that the medical research has now shifted to the point where U.S. courts must conduct a major review of most SBS cases from the last 20 years. The problem, Teurkheimer explains, is that the presence of three symptoms in an infant victim—bleeding at the back of the eye, bleeding in the protective area of the brain, and brain swelling—have led doctors and child protective workers to immediately reach a conclusion of SBS. These symptoms have long been considered pathognomic, or exclusive, to SBS.

If you're really interested, you can dig up some ideas about alternate causes of SBS at this blog.

Cold on the Trail of the Tylenol Killer

Via Universal Hub: Boston.com reports that the FBI and state police searched a Cambridge condo today in connection with the 1982 Tylenol tampering deaths.

The first-floor condominium belongs to James W. Lewis, 62, of 170 Gore St., who spent 12 years in federal prison for trying to extort $1 million from the painkiller's manufacturers but was never charged in the murders. The authorities spent most of the day inside the six-story blonde brick building and also searched a storage facility at an undisclosed location in the city.
The Chicago office of the FBI said in a statement late today that agents, the Illinois State Police, and several local police departments were "conducting a complete review of all evidence developed in connection with the 1982 Tylenol murders," which prompted dramatic changes in the way almost all food and medical products are packaged.

Morgellons Gets a Little More Respect

Via plime: the AP reports that the CDC has commissioned a study of Morgellons, a mysterious, possibly parasitic, possibly psychosomatic ailment that has been known possibly for centuries but dismissed as delusional parasitosis.

The study will be done in northern California, the source of many of the reports of Morgellons (pronounced mor-GELL-uns). Researchers will begin screening for patients immediately, CDC officials said Wednesday. A Kaiser official expects about 150 to 500 study participants.
Morgellons sufferers describe symptoms that include erupting sores, fatigue, the sensation of bugs crawling over them and — perhaps worst of all — mysterious red, blue or black fibers that sprout from their skin. They've documented their suffering on Web sites.

The Morgellons Research Foundation has more information, including pictures of the alleged neon threads that grow out of victims.

Exploding Frogs in Germany

Via ProMED-mail: the BBC reports on mysterious exploding German frogs:

Thousands of the amphibians have died in recent days in a pond in Hamburg's Altona district, with their bodies swelling to bursting point.
The toads' entrails are propelled for up to a metre (3.2ft), in scenes that have been likened to science fiction.
Scientists are baffled. Possible explanations include a unknown virus or a fungus in the pond.

Angola's Mystery Hemorrhagic Fever

Ebola has been ruled out as the hemorrhagic fever that has killed at least 77 people in Northern Angola since first appearing in November. A post on the ProMED-mail list suggested plague, but the geography of the outbreak makes plague spread from the Congo unlikely. Some reports claim that the victims have mainly been children under 5.

Unidentified Hemorrhagic Fever in Angola

Via ProMED-mail: Prensa Latina reports that at least 56 Angolans, including 2 nurses, have died of an as-yet-unidentified hemorrhagic fever:

A medical source from Huige hospital told journalists they have termed this illness gastric hemorrhage. It begins with fever symptoms for two days and then the patient begins to cough up blood, falls into a coma, and dies within four days, he explained.

Michigan Mystery Bug

Via ProMED-mail: a flu-like illness has broken out in a nursing home in Troy, Michigan. WXYZ News reports:

The outbreak occurred in the Alzheimer's unit, which has been quarantined. There are 39 people who live there, and 16 have fallen ill with the same flu like symptoms.
Paramedics were on the scene, suited up in biohazard in uniforms. Sick patients have been evacuated from the building to three area hospitals.
The outbreak started Wednesday night. 4 people became ill with flu like symptoms such as nausea, vomiting, and diarrhea. All of these people were taken to the hospital, where one man went into cardiac arrest and died.

Mystery Disease in China

The in China is, of course, redundant. Although India has a good number of mystery diseases, it's the ones from China that tend to, say, wipe out Europe. This week's mysterious respiratory disease has infected 28 at a children's hospital. Health authorities have ruled out SARS, Influenza A, and Influenza B. Read all about it at Reuters.

Jorethang Fever

The Statesman reports on the latest mystery disease in India:

A mysterious fever that’s stalking Jorethang town, Sikkim, near the West Bengal border has affected over a thousand people. According to reports here, the first outbreak of this disease, which the medical fraternity has termed as the Jorethang Fever, was reported on 15 August, this year. Since then more than 1,000 people have been struck by this mysterious virus, whose origin and identity has baffled the local health authorities here. According to health officials, the disease can be identified by symptoms of high fever, body-ache accompanied by repeated vomiting.

Thanks to ProMED for the link.