N.C. will test its suspected Pfiesteria victims Effort reverses state's stance on microbe

Md. work to be guide

November 14, 1997|By Douglas M. Birch | Douglas M. Birch,SUN STAFF

GREENVILLE, N.C. -- After years of dismissing claims that a fish-killing microbe might be making folks sick along this state's tidal rivers, North Carolina officials were surprised -- some say embarrassed -- when a medical team in Maryland turned up the first solid evidence linking Pfiesteria piscicida to human illness.

So it will be something of a milestone when a state-sponsored team of North Carolina doctors begins testing possible victims here tomorrow.

They'll employ a battery of tests patterned after those Maryland doctors developed and used to identify 37 people whose confusion and illness appear related to exposure to Pfiesteria and its cousins.

The outcome of North Carolina's tests could provide crucial evidence in the scientific debate over how big a threat Pfiesteria poses to human health. The tests could also determine whether it's worth spending millions of dollars to study the organism, protect the public against it and reduce the agricultural runoff that is thought to nurture it.

If North Carolina's testing doesn't identify possible Pfiesteria victims, Maryland could find itself bearing the stigma of being the only state where the microbe is suspected of having made people sick in its natural habitat. That could have a direct impact on Maryland's fishing and tourism industries.

Health officials here say their effort will be a scientifically rigorous look at whether any of the people claiming to be sick here really tTC are. But some scientists, environmentalists and self-identified victims say they fear North Carolina's effort may be futile.

Mainly, they point to the timing.

The study comes weeks after the season for blooms of the single-celled organism has ended, and long after anyone could have suffered massive exposure to the microbe's toxins. Typically, Pfiesteria outbreaks stop when the cold weather hits.

"I'm extremely concerned that North Carolina will find nothing conclusive," said JoAnn Burkholder, a North Carolina State University scientist who first discovered Pfiesteria and suffered a variety of symptoms, including severe memory and speech problems, for weeks after a massive exposure in her laboratory.

"While it is true that I am not a medical doctor, I am a victim of these toxins," she said. "Based on the experience that I've had, I think it's extremely critical that people be clinically evaluated as close in time as possible to a known Pfiesteria-related fish kill or disease event."

"The thing that I'm worried about now," said Rick Dove of the Neuse River Foundation, an environmental group, "is that a lot of these cases are old." In the past several years, Dove has acted as unofficial spokesman for many of the people who believe they've been sickened by Pfiesteria's toxins.

"Because they're going to be looking for old cases, they're likely not to find anything," he said. "And if they don't find anything, what they're likely to say is that we've never had a case in North Carolina. They're going to use the study to say, 'We've done the right thing all along.' That is my genuine fear."

Starting tomorrow, a team of physicians from the University of North Carolina, Duke University and East Carolina University plan to give a battery of medical tests to two types of subjects.

The first includes 10 people among callers to the state's hot line, set up for reporting suspected cases of Pfiesteria poisoning. The second is made up of 20 state employees -- workers with the state's Division of Water Quality or Transportation Department who work on Pfiesteria-affected waters.

Unlike their colleagues in Maryland, North Carolina's doctors will be looking at 30 healthy "control" subjects mixed in with the suspected cases. These healthy people will be closely matched in age, background and occupation, but have had no known Pfiesteria exposure, state officials say.

Like the Maryland doctors, physicians here will administer neurocognitive tests to measure short-term memory skills. The severe, though temporary, loss of short-term memory was the most striking symptom discovered among Maryland's Pfiesteria-related cases.

"This testing needs to be done after acute, significant exposure," said Dr. J. Glenn Morris Jr., an infectious disease specialist with the University of Maryland, who led the Maryland study. "And that may not be what's happening in North Carolina.

Dr. Stanley Music, North Carolina's chief of environmental epidemiology who helped design the study, makes no effort to hide his skepticism that Pfiesteria has made anyone sick along North Carolina's rivers.

"We have no plausible evidence yet of health effects in the environment in this state," said Music, an epidemiologist who worked for more than 20 years for the U.S. Centers for Disease Control and Prevention. "This is still smoke and no fire."

As for the wisdom of launching the study at a time when Pfiesteria is not active, the physician conceded that the medical team isn't likely to find acute cases.

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