Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: THURSDAY, August 5, 1993 TAG: 9308050188
SECTION: VIRGINIA PAGE: C5 EDITION: NEW RIVER VALLEY
SOURCE: MARK DAVIDSON NEWPORT NEWS DAILY PRESS
DATELINE: NEWPORT NEWS LENGTH: Long
Despite their tireless efforts, she died.
That was July 1989. During the six months that followed, seven more relatively young, seemingly healthy women from the Newport News area died under strikingly similar circumstances. Physicians were baffled; they feared an epidemic but kept their concerns quiet because they had no idea what they were fighting.
Then, as suddenly as the mystery illness emerged, it vanished. Doctors saw no more cases for three years, though they have worked since then to pinpoint the culprit. After a three-year silence, doctors in Newport News and in Washington, D.C., revealed Tuesday that the women suffered from a highly unusual infection - an illness similar to the Legionnaires' disease that killed 23 people and hospitalized dozens more in 1976. Though doctors could say for certain only that the disease killed two of the women, they are fairly sure the other six, as well as four more who survived, suffered the identical infection.
The discovery of the so-called mycoplasma fermentans - something between a virus and a bacteria - is expected to gain worldwide attention, and the Newport News cases are sure to be included in any future studies, said Stephen Green, an infectious disease specialist in Newport News.
"This is the only place in the United States where an outbreak of this disease occurred," Green said. "There were other isolated cases across the country, but none where there were multiple deaths."
Green spoke about the outbreak Tuesday, a day after an article he and two other doctors wrote about the mystery illness was published in an exclusive national medical journal called Clinical Infectious Diseases.
While there is no cause for public alarm, it's possible that hundreds of people who thought they had the flu may actually have had a milder case of the mycoplasma that either cleared up on its own or with drugs, Green said.
When Green was called in to examine the 53-year-old woman with the persistent chest cold, he thought it was either the flu or walking pneumonia - perhaps something she picked up in Germany. He soon found he was wrong.
"She had a cold that wouldn't go away. Right before our eyes, she continued to get worse. It looked like the flu, but the flu clears up on its own. No matter what we did, we couldn't save this woman."
That summer, two more women went to Peninsula hospitals with the same symptoms, and Green was called in to consult. Doctors pumped them with an array of drugs, but they, too, died.
"After three of these deaths, I really started to think something was going on. It was absolutely alarming," Green said.
One morning, after racking his brain trying to come up with an answer, he saw a small wire service story in the Daily Press quoting a medical journal that described several unexplained cases of Acute Respiratory Distress Syndrome. They sounded remarkably similar to the local cases.
He had a friend at the state Health Department track down that journal article and the doctor quoted prominently in it: Shyh-Ching Lo, from the Armed Forces Institute of Pathology.
It turned out that doctors from across the country had been sending Lo data and tissue from people who had died of unexplained respiratory infections. Green, along with Riverside Regional Medical Center pathologist Jacques F. Legier, agreed to help Lo crack the case. They sent tissue samples of the local victims to Lo and kept him apprised of any new cases.
At the same time, journal articles appeared about a Canadian outbreak of a deadly respiratory illness now believed to have been caused by the same organism. Thirty people were afflicted.
By January, five more women, all between 25 and 50, died in Newport News of what appeared to be the same disease. The deaths were occurring about every two to three weeks.
"By this time, it was becoming like another Legionnaires' disease or something," Green said.
Still, for fear of creating a hysteria, Green and other doctors who were aware of the situation did not contact public health officials.
"To report the outbreak at the time that it occurred might have resulted in panic. The public can act irrationally, especially when the medical community doesn't know exactly what it's dealing with."
Instead, Green contacted the Centers for Disease Control in Atlanta, which sent representatives to Newport News to investigate. They could find absolutely no link among any of the victims except that they were all women who lived in the area.
Four more women were hospitalized that fall with similar symptoms. In the latter cases, the women were given doxycycline, a common, mild antibiotic generally not used for serious respiratory infections, Green said. They survived. It then appeared that doxycycline might be the cure for the illness - if it ever surfaces again.
"We simply didn't know early on," Green said. "You just don't give that drug in the hospital, especially for this kind of illness."
In late 1990 or early 1991, working with data from Newport News and other places, Lo pinpointed the culprit: a mycoplasma. The organism is neither a bacteria, which can be killed with antibiotics, nor a virus, which cannot.
Because he didn't know where it came from or exactly how it was transmitted, he nicknamed it "mycoplasma incognito."
Green said the families of the victims know only what an autopsy found at the time: that a mysterious respiratory illness killed their loved ones. He said the relatives would have no way of knowing about the mycoplasma because it was not identified until well after the women's deaths. He declined to identify the victims.
To this day, doctors don't know why so many people in Newport News were afflicted in such a short time or why all the victims were women. At least one of Lo's confirmed victims of the mycoplasma was a man, according to the journal article.
Keywords:
FATALITY
Memo: shorter version ran in the Metro edition.