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Inspiration or Obsession?

Posted By Lauren Reeves, Thursday, September 11, 2014
This week's post is the third in our series of posts about Deadly Outbreaks , a book of outbreak mystery stories, written by Alexandra Levitt. The book is available for purchase at amazon.com .

Epidemiologists who investigate disease clusters and epidemics typically work in close partnership with laboratory scientists who identify pathogens that cause outbreaks. In many cases, infectious disease mysteries are quickly solved once the causative agent is known, because public health experts know how a particular pathogen is transmitted and what can be done to interrupt its transmission. But what happens when an outbreak is caused by an unknown pathogen for which there are no diagnostic tests? Here is what happened in a real-life outbreak story recounted in Deadly Outbreaks, entitled Inspiration or Obsession:

In August of the Bicentennial year of 1976, several people died of a flu-like illness after attending an American Legion convention at an elegant Philadelphia hotel. Public health authorities suspected that the Legionnaires might be the first victims of the dreaded “Swine Flu,” caused by a new strain of influenza, identified eight months previously. However, the ensuring investigation ruled out Swine Flu and a range of other respiratory, foodborne, and waterborne diseases. Instead, the epidemiologic data suggested an airborne chemical or microbe inhaled by people who walked in front of the hotel or entered the hotel lobby. Otherwise, the investigative trail yielded no useful clues. Some said it was a Communist Plot or a terrorist attack. Others thought that the cause might never be known.

At the end of the summer, after three and a half weeks of field work, the CDC team assisting the Pennsylvania Department of Health returned home with the mystery unsolved. Public health officials had identified 221 cases of the illness, which came be known as Legionnaires Disease (LD); 34 people had died. Although the outbreak had stopped, with no additional cases identified after August 18, public worry—inflamed by the Swine Flu scare—continued unabated. CDC was criticized by politicians, journalists, and local health officials for its failure to find the cause of the outbreak, as well as its decision to vaccinate the U.S. population against a pandemic of Swine Flu—a catastrophe that never materialized.
Enter Joseph McDade, a dedicated young scientist who began as a bit player in the drama, helping to rule out an animal-borne disease called Q fever as the cause of LD. With that task accomplished, McDade turned back to his day job, which involved developing methods for the detection of epidemic typhus. For most of the fall, he was uninvolved in the LD investigation and oblivious to the ongoing turmoil at CDC—at least at first. His natural bent was to screen out all distractions and focus single-mindedly the scientific problem at hand. Nevertheless, from time to time—especially when he came up for air after completing a round of typhus experiments—he had little, niggling thoughts about some tiny rod-shaped bacteria he’d seen on a few of his Q fever slides. At the time, he had dismissed the rods as insignificant contaminants. But now he was not so sure.
As recorded in Deadly Outbreaks [page 104], McDade thought of the rods as a “hook” on which his thoughts were snagged:
McDade felt more and more compelled do something, anything! …He had to go back and look at those rods once again. He decided to make himself stop what he was doing (a whole other set of typhus experiments) and re-focus [on the mystery disease]. He knew there was little chance that he would find anything that his colleagues had missed, but he was more and more bothered by the problem, almost to the point of obsession. Instead of worrying himself to death, he decided, he would “clarify the issue” one more time and then forget about it.
Alone in the laboratory over the Christmas holiday—nearly five months after the first LD cases appeared—McDade retrieved the Philadelphia specimens from deep-freeze and set out to figure out what had really happened…

Tags:  Deadly Outbreaks  infectious disease 

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