Sunday, March 8, 2015

Smallpox in the drawer

     Although this happened last June 2014, about 8 months ago, it bears examining.  The CDC found smallpox in a storage room that probably dates back to 1950 when smallpox still existed in the United States.  I am told by longtime biodefense scientists that it was not unusual to put samples in drawers with the relevant file. 
Not so long ago, a museum in Richmond, Virginia discovered an old book in their collection which contained a note --- and a few other unidentifiable bits of material -- until they read the letter. The letter was written from a son to his father which read:

"Dear Pa…the piece I inclose is perfectly fresh and was taken from an infant's arm yesterday…" read the letter. "Dr. Harris says the inclosed scab will vaccinate 12 persons, but if you want more, you must send for it. I will pin this to the letter so that you cannot lose it as you did before."
     So much said with so few words. We know that there were smallpox scabs lost somewhere in addition to those folded in the paper letter sent with the intent of saving his father and others from the scourge of smallpox by giving them a slighter case with inoculation by the scab material, as was the practice. The museum thought it unique so they used it in their "bizaar bits" collection until CDC got wind of it. Reportedly,"CDC says it was just following rules. 'We really did not know what this was,' says Andrea McCollum, one of the two disease detectives who retrieved and drove the scab back to Atlanta in the trunk of their car." I find this part particularly ironic because driving with smallpox in the trunk of an individual's car is illegal and CDC violated its own regulations for transfer of select agents.  In fact, CDC was called to testify on authorizing other folk to drive around with deadly diseases in their trunk in the trial of Thomas Butler in 2004. CDC admittedly broke their own rules by recommending he drive with plague samples in his car to the CDC location in Colorado. (CDC is good at a lot of things, but self-regulation of their own activities was never a well thought-through plan.)  We should put more investment into institutional memory.
     It is really quite a miracle that we haven't had a case of smallpox since the last one in 1949 in the United States given the litter of historical memorabilia that could contain these relics.  According to a quote from Inger Damon, chief of CDC's poxvirus and rabies branch, "Over roughly the past decade, the CDC has been called to retrieve the remains of a man covered with smallpox lesions whose coffin was unearthed during construction near Louisville, Ky., as well as suspicious-looking scabs in a library book in New Mexico and a museum in Arkansas."
       Could these old scabs still be infectious today? We know some viruses are capable of waiting out a lot of harsh conditions before coming to life and infecting its target and I would not want to test it.  CDC said it probably was not dangerous as they wore biocontainment suits and handled it with mylar.
     Given these opportunities, the fact that smallpox turned up in a laboratory storage room in a government building is not all that surprising and I expect it won't be the last time.

Monday, March 2, 2015

Pham is suing the hospital for gross negligence, deception, and invasion of privacy

     The complaint alleges Texas Health Resources (hospital parent corporation) is liable for gross negligence, deception, and invasion of privacy. Pham claims they failed to provide her and the other nurses proper personal protective equipment (PPE), instructions and training in the context of a known threat of Ebola. 
     The Dallas Morning News reported that she plans to sue for damages because of the effects of the disease causing health problems that have lingered. A copy of the complaint is linked to the article.
     Typically, employees who are injured in the course of their employment must seek recovery through worker's compensation, which normally has categories of recovery in a very structured formula. But worker's compensation does not address these claims of gross negligence, deception and invasion of privacy leaving Pham free to file a complaint in the judicial system outside of the statutorily provided compensation system for employees.
      It is clear that the effects of the Ebola outbreak that came to America are not over for the victims of Ebola or for the U.S..