The Virus Without A Name

On February 10th of this year, pianist Betsy Arakawa called a local health clinic to set up an appointment for some congestion. She had to cancel the appointment to care for her husband, actor Gene Hackman who suffered from Alzheimer’s disease. She called them again on the 12th for advice. That was the last anyone heard from her until her body was found on February 26th, along with that of her husband.

In May of 1993 a young Navajo man was driving through New Mexico. He and his family were headed to the funeral of his young finacee who had died suddenly after a brief illness. The nineteen year old man, a marathon runner, had also been ill for a couple of days but felt well-enough to travel. Before they reached the funeral, they had to pull over—he had developed severe difficulty breathing. He died a little while later in the local Emergency Department.

Local health authorities investigated his death, and what they found alarmed them—more cases of otherwise healthy people becoming critically ill or dying suddenly from a severe respiratory illness. They sent warnings to healthcare providers across the Four Corners Area about a potential new disease.

Local officials reached out to the best of the best—the CDCs Epidemiology Intelligence Service (EIS). Within a day, they had a team on the ground and along with the talented local doctors, came up with a preliminary definition for this possible new disease, and started looking for similar cases. They found them.

Ultimately, 33 cases of what we now call “hantavirus pulmonary syndrome (HPS)” were identified in 1993 in the Four Corners area. Nineteen died. Across the country that year forty-eight cases were found, twenty-seven of whom died.

The alarmingly high mortality rate of HPS is a bit less scary when you realize how rare it is. There have only been a few hundred cases in the last couple of decades. People contract it when dried dear mouse feces releases airborne particles. It isn’t transmitted from human to human.

This didn’t stop people in the Southwest back in 1993 from letting fear drive their behavior. News outlets called it “Navajo Flu”. Navajo people were turned away from restaurants and athletic events. There was already plenty of prejudice against Navajo and this certainly didn’t help.

The virus that causes HPS—from a family of viruses known as hantaviruses—was first called “Muerto Canyon” virus, after the region affected. This further stigmatized the local Navajo (and it’s a scary-ass name). The name was changed to the equally eerie but less stigmatizing “Sin Nombre virus”, which is what we call it today.

The rapid response and identification of the virus responsible for HPS was possible because of the quick thinking, intelligence, and curiosity of local health officials, and the vast experience of the CDC’s Epidemiology Intelligence Service. Samples flown to the CDC were able to be analysed using what was then a new technique called PCR. They used specialized laboratory tests to match the New Mexico samples with the vast virus sample bank maintained at the CDC.

Last month, the Trump administration planned to cut the Epidemiology Intelligence Service. This was later reversed but huge cuts at HHS and CDC are still planned. The success of the CDC and EIS are possible not just because of the resources available but the depth of knowledge and experience of the personnel. This cannot be replaced.

Ms. Arakawa’s death was determined to be due to HPS. We know this because we have continued to support one of the greatest institutions in the US, one that is called upon when health authorities anywhere in the world need the best.

As we have seen with the recent measles outbreak, when we let our public health guard down, people die. And it’s completely preventable.

Stay well.

-pal