Aa
"New Virus Tied to Ticks ..." -- NY Times, 3 days ago
It's always something! Sigh .... now there's a 'Heartland virus'
=======================================================
"New Virus Tied to Ticks Poses Puzzle for Doctors"
The New York Times -- By DENISE GRADY
Published: September 3, 2012
For a year and a half, scientists have been swarming over a 100-acre farm in northwestern Missouri, catching ticks and drawing blood from raccoons, possums, turkeys and deer.
“They even bled my horses, and my dogs and cats,” the owner of the farm said. “They got to looking at me, and I said, ‘I already gave.’ ”
The scientists have been trying to find out how this farmer and another unfortunate Missouri man contracted a severe viral disease — a new one, never seen before. It put both men in the hospital for more than a week with high fevers, diarrhea, nausea, muscle pain, low blood cell counts and liver abnormalities.
Scientists at the Centers for Disease Control and Prevention think the men were infected by lone star ticks, meaning that there may be a frightening new addition to the list of tick-borne dangers that includes Lyme disease, babesiosis and Rocky Mountain spotted fever. But despite scouring the countryside, investigators have found neither ticks nor animals carrying the new virus. They have named it the Heartland virus, for the hospital and region where it was found. So far, the two men in Missouri are the only humans known to have been infected.
The cases are a stark reminder that new infectious diseases can still emerge, frequently from unknown bacteria and viruses that lurk in animals.
“This is a novel virus,” said Laura K. McMullan, a senior scientist at the viral special pathogens branch of the C.D.C. Now that it has been identified, she said, researchers can try to find out how long it has been around and how common it is, in part by testing stored blood samples from people who had similar illnesses in the past that were never diagnosed.
The disease first appeared in Missouri in June 2009, when Robert Wonderly, then 57, a factory worker who lives on a farm, suddenly fell ill. For several days he felt weak, feverish and irritable. Then his chest began to ache.
Tests at Heartland Regional Medical Center in St. Joseph ruled out a heart attack, but Mr. Wonderly just got sicker. His fever spiked to 104 degrees. When his wife told a nurse that she had found a tick embedded in his skin the day before he became ill, the nurse called in an infectious diseases expert, Dr. Scott M. Folk.
Dr. Folk immediately suspected ehrlichiosis, a bacterial disease that is carried by ticks and is common in the area. So he prescribed the standard treatment, the antibiotic doxycycline. In the meantime, he sent a sample of Mr. Wonderly’s blood to Atlanta to be tested at the C.D.C.
People with ehrlichiosis usually perk up after a few days of doxycycline, but Mr. Wonderly did not improve at first. Dr. Folk continued the drug anyway, worried and at a loss for what else to do.
Not surprisingly, the test for ehrlichiosis came back negative, and Dr. Folk was left puzzled and concerned by his patient’s strange illness. Mr. Wonderly gradually recovered, but he spent 10 days in the hospital.
Just a few weeks later, it happened again: a second patient, the owner of the 100-acre farm, seemed to have come down with a severe case of ehrlichiosis. Working outdoors in the weeks before, he had come home day after day with 20 or more ticks embedded in his flesh and had plucked them out. Again, doxycycline did not work, and the test for ehrlichiosis was negative.
But C.D.C. researchers found something else growing in the lab cultures: a virus — a member of a group called phleboviruses, which are carried by sand flies, mosquitoes or ticks. The new virus is closely related to one recently discovered in China that has caused severe illness and even some deaths. They are the only two tick-borne phleboviruses known to cause disease in humans.
Dr. McMullan and Dr. Folk, along with others, published a report on the Heartland virus last week in The New England Journal of Medicine. Mr. Wonderly was identified in the journal as Patient 1; the farm owner, Patient 2, asked that his name not be published for privacy reasons. Even so, he has made medical history.
“I could have skipped that part,” he said.
A version of this article appeared in print on September 4, 2012, on page D5 of the New York edition with the headline: New Virus Tied to Ticks Poses Puzzle For Doctors.
=======================================================
"New Virus Tied to Ticks Poses Puzzle for Doctors"
The New York Times -- By DENISE GRADY
Published: September 3, 2012
For a year and a half, scientists have been swarming over a 100-acre farm in northwestern Missouri, catching ticks and drawing blood from raccoons, possums, turkeys and deer.
“They even bled my horses, and my dogs and cats,” the owner of the farm said. “They got to looking at me, and I said, ‘I already gave.’ ”
The scientists have been trying to find out how this farmer and another unfortunate Missouri man contracted a severe viral disease — a new one, never seen before. It put both men in the hospital for more than a week with high fevers, diarrhea, nausea, muscle pain, low blood cell counts and liver abnormalities.
Scientists at the Centers for Disease Control and Prevention think the men were infected by lone star ticks, meaning that there may be a frightening new addition to the list of tick-borne dangers that includes Lyme disease, babesiosis and Rocky Mountain spotted fever. But despite scouring the countryside, investigators have found neither ticks nor animals carrying the new virus. They have named it the Heartland virus, for the hospital and region where it was found. So far, the two men in Missouri are the only humans known to have been infected.
The cases are a stark reminder that new infectious diseases can still emerge, frequently from unknown bacteria and viruses that lurk in animals.
“This is a novel virus,” said Laura K. McMullan, a senior scientist at the viral special pathogens branch of the C.D.C. Now that it has been identified, she said, researchers can try to find out how long it has been around and how common it is, in part by testing stored blood samples from people who had similar illnesses in the past that were never diagnosed.
The disease first appeared in Missouri in June 2009, when Robert Wonderly, then 57, a factory worker who lives on a farm, suddenly fell ill. For several days he felt weak, feverish and irritable. Then his chest began to ache.
Tests at Heartland Regional Medical Center in St. Joseph ruled out a heart attack, but Mr. Wonderly just got sicker. His fever spiked to 104 degrees. When his wife told a nurse that she had found a tick embedded in his skin the day before he became ill, the nurse called in an infectious diseases expert, Dr. Scott M. Folk.
Dr. Folk immediately suspected ehrlichiosis, a bacterial disease that is carried by ticks and is common in the area. So he prescribed the standard treatment, the antibiotic doxycycline. In the meantime, he sent a sample of Mr. Wonderly’s blood to Atlanta to be tested at the C.D.C.
People with ehrlichiosis usually perk up after a few days of doxycycline, but Mr. Wonderly did not improve at first. Dr. Folk continued the drug anyway, worried and at a loss for what else to do.
Not surprisingly, the test for ehrlichiosis came back negative, and Dr. Folk was left puzzled and concerned by his patient’s strange illness. Mr. Wonderly gradually recovered, but he spent 10 days in the hospital.
Just a few weeks later, it happened again: a second patient, the owner of the 100-acre farm, seemed to have come down with a severe case of ehrlichiosis. Working outdoors in the weeks before, he had come home day after day with 20 or more ticks embedded in his flesh and had plucked them out. Again, doxycycline did not work, and the test for ehrlichiosis was negative.
But C.D.C. researchers found something else growing in the lab cultures: a virus — a member of a group called phleboviruses, which are carried by sand flies, mosquitoes or ticks. The new virus is closely related to one recently discovered in China that has caused severe illness and even some deaths. They are the only two tick-borne phleboviruses known to cause disease in humans.
Dr. McMullan and Dr. Folk, along with others, published a report on the Heartland virus last week in The New England Journal of Medicine. Mr. Wonderly was identified in the journal as Patient 1; the farm owner, Patient 2, asked that his name not be published for privacy reasons. Even so, he has made medical history.
“I could have skipped that part,” he said.
A version of this article appeared in print on September 4, 2012, on page D5 of the New York edition with the headline: New Virus Tied to Ticks Poses Puzzle For Doctors.
... and on top of it is LymeMD's recent post about the mysteries of toxoplasmosis and how common it is.
Clearly we have not reached the 'end of medicine' (that is, the prevention or cure for all things, to riff on Fukuyama), but at least we're asking the questions.
Tally ho!
Clearly we have not reached the 'end of medicine' (that is, the prevention or cure for all things, to riff on Fukuyama), but at least we're asking the questions.
Tally ho!
My reaction exactly!!! ... and it just goes to show that docs should not act like everything worth knowing has already been written up and published, end of story!
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