May 25, 2005

WHERE'S BERTON ROUECHE WHEN YOU NEED HIM?:

One doctor's hunch led to a chilling discovery (Stephen Smith, May 25, 2005, Boston Globe)

It was one of those moments that send shudders through even the most experienced physician.

Dr. Staci Fischer was already treating one patient at Rhode Island Hospital battling a virulent infection just 2 1/2 weeks after receiving a new kidney. He had fever and diarrhea and other symptoms that made Fischer think the man had contracted hepatitis.

Then, a few days later, Fischer encountered a second transplant recipient at the Providence hospital whose health had deteriorated precipitously. Like the first patient, the second had received a kidney, and, it turned out, the organs had come from the same donor. The patients' sudden illnesses were distressingly similar.

''So I called the organ bank that had provided the organs, and I said, 'I have these two patients, and they have very similar symptoms, and the strange thing is, it's only three weeks out from their transplant,' " Fischer, an infectious disease specialist, recalled in an interview yesterday. '' 'Is it time we have to worry that there was something transmitted with the organs?' "

It was. Fischer's call started an investigation that led to the discovery of two other transplant recipients gravely ill with mysterious infections at hospitals in Boston. In the end, all four patients, including three who died, would be connected to a single donor whose pet hamster carried the same type of virus that had infected the transplant patients.

The New England cluster of illnesses was discovered by a combination of luck and old-fashioned medical detective work. [...]

The organs given to the four patients had been taken from a woman who died from a stroke. Her kidneys went to the two Rhode Island patients, her lungs to a patient at Brigham and Women's Hospital, and her liver to a recipient at Massachusetts General Hospital.

Not long before her death, the woman, whose identity has not been disclosed by health authorities, had purchased a hamster from a PETsMART store. Unbeknownst to her and the shop, the animal carried LCMV.

The virus can be transmitted from rodents to humans, usually through dust from the animal's droppings. In most people, it causes little harm, with symptoms similar to a cold.

But in transplant patients, their immune systems intentionally ravaged so their bodies won't reject the organs, otherwise minor infections can turn lethal.

Lab tests have shown that the four patients had an identical strain of LCMV. Tests are underway to determine whether that strain matches the virus that infected the hamster.

At the same time, the Rhode Island Department of Health is collecting rodents outside the house of the woman who died.

''We're trying to track back where the hamster became infected and if the hamster of the donor family was in fact the source of the infection or if it could have come from some other animal," said Dr. David Gifford, director of Rhode Island's Department of Health.

But if it weren't for Fischer's original detective work, other doctors familiar with the cases said, the link among the patients might never have been established.

Fischer, during a telephone interview from Seattle, recalled the day in April when transplant surgeons and infectious disease doctors from the three hospitals where the operations had been performed compared notes about the patients.

''It was really, really eerie," Fischer said. ''It was really scary to hear everybody talk about it.

''By the time I talked to them, the lung recipient had died, and one of our kidney patients had died, and the liver recipient was imminently dying. And here I was left with the one surviving recipient. I've never been in a situation like that before in my career. ''


Posted by Orrin Judd at May 25, 2005 4:51 PM
Comments

Sounds like Fox's 'House.'

Meanwhile, I'll spend the evening eying my gerbil suspiciously...

Posted by: Timothy at May 25, 2005 4:55 PM

. . . . And Richard Gere's gerbil will be eying him suspiciously. Budumbump.

Posted by: Jim in Chicago at May 25, 2005 6:07 PM

Very tragic - I knew the recipient of the lungs. He had hung onto life by a thread waiting for those lungs...

Posted by: The Wife at May 25, 2005 6:44 PM

seems like they are trying to drum up some kind of panic with this thing, but i can't see where its anything new. they just had a couple of people in europe die of rabies infected transplants.

Posted by: cjm at May 25, 2005 8:03 PM

oj:
your headers keep getting more obscure. Is this an English lit blog?

More of this is going to cause the incurable wound to your readers' psyches.

Posted by: John J. Coupal at May 26, 2005 2:12 PM

John:

The headers are the point.

Posted by: oj at May 26, 2005 3:28 PM
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