A Pig from Jersey

The last Saturday of June, 1957, having finished my internship, I left Lansing, MI, about midnight in my little VW with orders to report to CDC in Atlanta at 8:00 AM Monday to begin my two years of service in the US Public Health Service. I was to audit the course for the Epidemic Intelligence Service before reporting to the Technical Development Laboratory in Savannah, GA. The EIS course was founded and taught by Alexander Langmuir. Langmuir was a bigger than life, charismatic story teller who quickly made me feel that epidemiology was the most fascinating subject available to mere humans. There were maybe 40 or 50 of us taking the course and in front of our assigned seats there was a stack of reading material that looked generally pretty serious. But on the top of the stack there was a small paperback book with the title “Eleven Blue Men” by Berton Roueche. It looked strangely out of place and unserious and I put it aside for later.

I don’t remember when “later” arrived, but when it did, I was treated to a series of fascinating articles of which the Jersey pig was the first. It concerned a schlachtfest being held at the New York Labor Temple, a German-American meeting-and-banquet hall. A schlachtfest, for those of you uninitiated, is a pork feast. The pig in question was purchased by a butcher in Staten Island and the carcass was taken to the Labor Temple in Manhattan where it was converted into sausage among other things. One of the men involved in this escapade had eaten some of the raw sausage to check on the seasoning, and the rest is history. The man became very ill with fever (he later died) and the physician, a Dr Levy, came to the diagnosis when he discovered an elevated eosinophil count in his blood smear. It was then confirmed by a muscle biopsy which showed numerous Trichinella spiralis parasites.

Trichinosis is one of the many parasites one studies about in Microbiology, but I had never seen a case until some years ago when I was assisting in an outpatient laboratory here in Salt Lake City. I didn’t see the patient myself but I heard her story second-hand. This young lady had been on vacation in Hawaii and had been invited to a luau. The luau was the genuine thing apparently with a whole roast pig on a rotisserie above a fire. Everybody enjoyed the fresh roast pork. Except that the young lady in question arrived somewhat late to the proceedings and her portion of pork was from a more interior portion of the carcass that had not been adequately heated to kill the larvae.

Here the details are sketchy but she apparently had the usual GI symptoms followed by severe muscle pain. By this time she was back home in Salt Lake City and her doctor ordered the usual lab tests including a CBC. Thus the blood smear that showed more eosinophils than I had ever seen before. This was some time in the 1970s and I don’t remember the percentage of eosinophils
but I think it may have been around 30%, about 10 times normal. The smear was lit up with red lights like a Christmas tree. That number of eosinophils doesn’t define trichinosis but it certainly is highly suggestive.

Today trichinosis is very rare, but it is just the rare diseases we don’t think of that can rear their ugly heads and bite us in the rear. Tricky trichinosis. Maybe the ancient Hebrews knew something important. Whatever. May Trichinella spiralis rest in peace and bother us no more.

Gordon Short, MD
Brevis Corporation


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Contributing Factors to the Flu Season

Except for it being “Flu Season”, I love the winter months.

If you live near 40°′N like I do, undoubtedly you’ve experienced some snow this season, to which not a single person has a neutral opinion. Personally, I’ve crossed zero several times in my life. Starting with love for fluffy white playful snow as a child, moving swiftly into a deep hatred for a biting, slushy, wintery death while walking to school in canvas shoes, and finally back to love for a nostalgically snowy day as an adult.

Currently I’m a huge fan of snow, though not for any of the reasons I could have predicted, much less reasons good enough to write a blog article, but here we go anyway. I like driving in the snow (though I hate when other people drive in the snow), I like watching the accumulation of a winter wonderland as snow falls across the streetlamps at night, and I enjoy the human surrender to nature as we dig all of our heavy clothing out of storage and attire ourselves ritualistically for the smallest tasks. I won’t go anywhere without my boots. If you see me in snow without them, destroy the imposter, or check for signs of meningitis.

New Posters

Heating Your Home

The heat in my house is off until the first sunny day in March. Some people find that strange. Nearly all others think it’s criminal. This habit serves me twice: I save quite a bit of money on utilities, and it dissuades nearly all pesky pop-ins. I own plenty of warm clothing that stays in storage most of the year, and I like to use it occasionally. I won’t go as far as to say I’m reclusive, but I do spend the majority of my time alone, in the dark, trying to stay warm. On the plus side, I rarely get sick. With so few people coming in and out of my house, the opportunity for germ transfer in these sickly winter months is highly reduced.

So why am I completely miserable, smelling like an herbal tea factory, sweating and shivering at the same time? Well it turns out that it could be my fault. Whoever said I can’t take accountability for my actions?

All About Germs

I didn’t grow up knowing a lot about germs, then again I didn’t grow up knowing a lot about most things. It turns out there are several factors that contribute to what we affectionately call “flu season”. Among these are the usual suspects: 

I don’t doubt the contributions of these well studied factors, but my lifestyle leads me to believe there’s another player in the game. I don’t spend time with anyone else, and it’s not like I see a lot of sun during the hot months anyway.

Winter Gear

It turns out that my beloved winter gear that keeps me alive for three months of the year, forgotten for nine, is a suitable suspect. It’s generally agreed, or at least intuitively good practice, that coats, hats, and gloves should be washed more often than most most people likely do. Not because you’re gross (though you probably are), but because those are often overlooked items that live in the back of a closet, emerging only in desperate times, and forgotten again just as quickly. I would venture a guess that most people don’t think to properly wash and store their winter clothing. Partly because the winter season often still makes brief and occasionally devastating appearances all the way through a stormy Spring, and partly because it’s not the kind of thing that comes to mind during the first blissfully warm day of the year.

While performing average activities during an unremarkable day, people have been shown to touch their faces up to 16 times per hour. That seems high initially, but I’ve been very conscious of my face since I started writing this article and at this point I think the number could easily be much higher. Most people could stand a reeducation on hand-washing. And though folks aren’t washing their hands well enough, or often enough, they’re certainly washing their hands more often than they’re washing their gloves.

Remember as you go about your day, touching things, that the same germs that you would normally collect on your hands are now on your gloves. The germ accumulation on gloves over the period of a few weeks is surely much higher than even improperly washed hands. So what can you do? Wash your gloves, hats, and coats! And while you’re at it, brush up on your hand washing habits in general.

I’ll be under the blankets until this whole thing blows over.

Can the holidays make you sick?

What makes us get sick more often during the holiday season?

Many theories have been postulated and studied over the years and many factors are blamed for being virus enablers. Closer proximity of hosts (us) within closed spaces makes transmission easier due to the shared air we breathe while indoors and the common surfaces we touch as people share confined areas. Further, foods are presented and ingested in areas with higher germ populations due to the foregoing.

Other theories suggest that inactivity and depression generally increases with the cold and gloomy weather and this coupled with decreased exposure to the sun may tend to inhibit our immune systems.

We suspect that all of these factors and more contribute to the seasonal spike in illnesses. But, there are some commons sense actions that can help reduce your chances of being the next holiday (infection) host. The most effective way to reduce your risks of seasonal sickness is to wash your hands often, especially after shaking hands, touching surfaces in common areas such as handrails and countertops and especially before eating.

In the spirit of holiday cheer (and microbial fear) check out these funny new flu and handwashing posters meant to remind with mirth and good cheer.

Healthy holidays to all.


New Flu & Handwashing Posters

 

Image of flu close up by cdc.gov.