Tag Archives: CDC

Cockroaches, Dr. Gordon Short weighs in, Hand Hygiene, Laboratory Larvae, Lice, Mosquitoes

Dead Mosquitoes and Live Lice, Part 2

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Continued from “Dead Mosquitoes and Live Lice, Part 1“

So what about the live lice? When I went into the US Public Health Service in 1957, it was to fulfill my draft obligation after student deferments. Recall that the Korean War was from 1950 to 1953. Also that during WW II, DDT dusting powder was widely used to kill lice, especially in conquered civilian populations, to prevent the spread of typhus. But by the Korean War some lice had sneer at DDT and so something else was needed. Enter Dr. Wayland J Hayes and yours truly. Dr Hayes arranged for prisoner volunteers at the Federal Correctional Institution in Tallahassee, FL to be recruited to test the toxicity of malathion formulated as a dusting powder substitute for DDT. Malathion is an organophosphorus compound unrelated to DDT and was thought to have similar effectiveness and human toxicity.

Dr Hayes was the lead researcher and I was the lackey who did the cholinesterase analyses, etc. in the prison. (I have always enjoyed watching the expressions on people’s faces when I say I was in prison once.) The prisoners were told the possible adverse effects of the program and were given “good time” (reduced sentences) for participation. (After this one prisoner opted out but was later found to be consuming his own brew made with a smuggled, homemade still. Was that less toxic?)

The results were published in the Bulletin of the World Health Organization, (1960, vol 22, page 503-514) and on review I was impressed by one observation: “Although one of us (J.G.S.) had received, without injury, a 30-hour application of 10% malathion powder in preparation for the study of volunteers, . . . .” My small contribution to the advancement of science. Well, in retrospect I have to say that it was safer than dodging bullets in the Vietnam War, which was waging at that time.

Human infestation with lice is uncommon in this country and typhus is really rare. We have a lot to be thankful for in this country in spite of the vicissitudes of politics and the stock market. But there are still enough problems with antibiotic resistance and the lack of proper hand hygiene, etc. Maybe our watchwords should be Thankfulness, Vigilance, and Diligence. “May the Force be with you!”


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Cockroaches, Dr. Gordon Short weighs in, Laboratory Larvae, Lice, Mosquitoes

Dead Mosquitoes and Live Lice, Part 1

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Having recently talked about pigs from Jersey and trichinosis, I decided to see what other stories Berton Roueche had that might be of interest. Looking at the table of contents in his compendium called “The Medical Detectives” (1980), my eye was caught by “The Dead Mosquitoes.” Why did “dead mosquitoes” catch my eye? Therein lies a tale.

In August, 1957, having finished the course for the Epidemic Intelligence Service at the CDC in Atlanta, I headed down the road to Savannah and the Technical Development Laboratories, a branch of the CDC, on Oatland Island. (The drive, without air conditioning in those days, when the temp and humidity both hover around 90 is another story.)

TDL, as the lab was called, was set on a marshy island that bred mosquitoes in impressive battalions that found my blood especially delicious and inviting. I therefore found it ironic that inside the lab mosquitoes of several species were being raised by the millions. Why? To study their habits. Such as, how far do they range. Radioactively tagged mosquitoes of different species were released from a central spot and collection traps were spaced at a variety of distances. Turns out some species do not fly more than several feet high and have small ranges while others fly much higher and get caught by wind currents and travel much farther. (Thought you would like to know that.)

Mosquito larvae are so sensitive to insecticides that they were used for bioassays. Except when they weren’t. Also indigenous to the lab were great hordes of American cockroaches. (American cockroaches are up to 2 inches long vs the puny German variety at 1/2 inch). TDL was in a 240 foot long building. Someone at one end of the building decided to attack the roaches with a pyrethrum spray. The spray traveled 200 feet down the hall and wiped out the mosquito larvae in the bioassay lab. After that all insecticides were strictly verboten in the building which must have made the cockroaches deliriously delighted.

Anyway back to the Medical Detectives. It’s a complex story of poisoning by an organophophorus insecticide that was accidentally spilled on some blue jeans that were subsequently sold at discount in Fresno, CA. A pair of these were worn by a boy who then rapidly became violently ill. Another boy wore another pair of the blue jeans with the same result. (He was diagnosed by a classmate of mine, Merritt Warren, MD, who had heard about the first case.) Pinpoint pupils, low cholinesterase levels in blood and rapid response to atropine cemented the diagnosis. But which insecticide? While waiting for a chemical analysis in a research lab, the pants were left overnight in a room with some mosquito-laden cages. In the morning the mosquitoes were all stone cold dead, killed by insecticide vapors.

The insecticide was determined to be Phosdrin and it was later shown to have come from a leaking container being transported on the same truck as the package of blue jeans. One lesson to be drawn from this episode is that if the jeans had been laundered before being worn (they were not), the Phosdrin would have been washed out.


Continue reading (Part 2)

Infection prevention, Measles outbreak

How an Amish missionary & an amusement park visitor started measles hysteria

Measles: An unwanted guest at Disneyland

We considered opening with “an Amish missionary and an amusement park patron walk into a bar…” but the measles outbreak is most definitely not a joke.

Last year, there were 23 outbreaks of measles in the United States and 644 confirmed cases—the most since the disease was declared all but eliminated back in 2000. The 2014 outbreak was reportedly caused by an Amish missionary who’d traveled to the Philippines where he caught the measles, then returned to his community where many friends and family had refused the measles vaccine—and continued to pass along the disease.

Yesterday, new data released by the CDC shows that 288 cases of measles have been reported in the US since the beginning of the year and over 2,000 people are being monitored in Arizona after someone was exposed to an infected guest at Disneyland in December. And it may be far from over.

Measles is the one of the most infectious diseases known to man

A person with measles can cough in a room and then leave—and hours later (if you are unvaccinated) you could catch the virus from the droplets in the air that they left behind. No other virus can do that.

Measles is an entirely preventable illness

Nearly everyone who gets the proper vaccine will never get sick with measles, even if they’re exposed.

“The current increase in measles cases is being driven by unvaccinated people, primarily U.S. residents, who got measles in other countries, brought the virus back to the United States and spread to others in communities where many people are not vaccinated, says one assistant surgeon general, Dr. Anne Schuchat.

The measles and anti-vaxxers

It’s not just about “anti-vaxxers” (the people refuse vaccinations for a variety of reasons). It’s also about people who CAN’T be vaccinated.

Only about two percent of the U.S. population outright refuses vaccines. But every person counts. Vaccinations don’t just protect you or your children it protects everyone around you. People who are already ill and weakened immune systems, not to mention people who are unable to be vaccinated. The measles vaccine, for instance, is not licensed for use on babies younger than 12 months. That means that, for the first year of life, babies depend on the fact that everybody else around them gets vaccinated.

In most cases, measles isn’t deadly, but it’s almost always debilitating, bringing on a weeks-long fever, rash, and painful, watery eyes. According to an article from Vox, Up to forty percent of people experience serious complications, such as pneumonia and encephalitis (or swelling of the brain). One or two children in 1,000 die. Worldwide, measles kills 400 people a day, says Disease Daily. Yet it costs less than a buck to avoid.

The extremely high cost of a measles outbreak

The economic toll of measles is also astounding. Researchers at the Centers for Disease Control and Prevention (CDC) calculated that outbreaks in 2011—a total of just 107 cases—cost state and local taxpayers up to $5.3 million. And USA Today reports that a 2008 outbreak in San Diego cost taxpayers $10,376 per case to trace contacts and administer vaccinations. Why? Due to its high infectiousness and the potential severity of complications, a measles outbreak often constitutes a serious public health event entailing a vigorous response from local public health departments and can involve multiple states and counties. The World Health Organization (WHO) says during 2000-2013, measles vaccination prevented an estimated 15.6 million deaths making measles vaccine one of the best buys in public health.

Before the measles vaccine was introduced in 1963, there were four million cases (with 48,000 hospitalizations and 500 deaths every year). By 2000, the virus was declared eliminated in the U.S. because enough people were immunized so that outbreaks were uncommon—and deaths from measles were scarcely heard of. Take that, anti-vaxxers.

Do you have questions about measles and vaccines? Read this article by Julia Belluz: 9 things everybody should know about measles.