Md. doctors write paper on Pfiesteria Team decides to avoid naming illness from '97, fearing stigma on state

August 14, 1998|By Douglas M. Birch | Douglas M. Birch,SUN STAFF

What's in a name?

When it comes to a scary new ailment, the answer is: trouble.

A team of Maryland physicians will publish the first scientific description tomorrow of the illness they linked to last summer's outbreaks of Pfiesteria. But their leaders says they decided against following tradition and naming the new syndrome after the place it was found for fear of stigmatizing the state.

Dr. J. Glenn Morris, an epidemiologist with the University of Maryland, said the 13 authors of the paper, who include state officials, talked about calling the ailment Pocomoke River Syndrome. But in the end, they decided not to give it any name at all.

"Any name we came up with had potential political ramifications," Morris said.

Last summer's outbreak of Pfiesteria on the lower Eastern Shore was blamed for lesions on thousands of fish. Morris and a team of Maryland and Johns Hopkins physicians identified 13 people, most of them watermen working on the Pocomoke River, who seemed to have clear-cut symptoms related to their exposure to Pfiesteria-infested waters.

Publicity over the outbreak hammered the state's fishing and tourist industries. Seafood dealers watched the bottom drop out of the market for their goods. Weekend anglers shunned charter boats. Tourists avoided the shore. In all, the single-celled organism may have cost businesses $127 million. The state's $400 million seafood industry took a $43 million hit.

State Health Secretary Martin P. Wasserman is listed as one of the authors of the paper, which is being published in the journal, The Lancet. He was not available for comment.

Karen Poe, spokeswoman for the state Department of Health and Mental Hygiene, said it wouldn't be accurate to give the illness a name that identified it with a region of Maryland, since outbreaks of Pfiesteria were first identified in North Carolina and have occurred as far away as Venezuela.

However, she conceded that there was concern that names like "Pocomoke River Disease," or "Eastern Shore Syndrome" could hurt the state.

"Something like that could have a particular impact on the economy," she said.

Naming diseases has long been a delicate matter. A deadly strain of the Hanta virus that struck the Southwest was initially called Muerto Canyon virus, for a section of the Navajo reservation in New Mexico where it was first found.

But the Navajos protested, and the virus was renamed "Sin Nombre," Spanish for "without name." Homeowners in Shelter Island, N.Y., feared for property values when another strain of Hanta was named Shelter Island-1.

Some residents of Lyme, Conn., welcomed the decision to name the tick-borne bacterial illness after their affluent suburb, figuring it would keep out the riff-raff.

To Morris, the name is less important than the fact that his team will publish in The Lancet the first clinical description of the illness.

Before his team's efforts, no direct scientific evidence existed that outbreaks of Pfiesteria could make people sick outside the laboratory, where the fumes from its toxins can accumulate. A number of scientists and health officials doubted that anyone was getting sick in the field.

North Carolina reports

Reports of Pfiesteria-related illness by fishermen and others working along the Neuse River in North Carolina, where the microbe was discovered in the early 1990s, have never been verified.

"What we do is provide evidence that people with high levels of exposure to waterways where there was known toxic Pfiesteria activity did indeed have a clinical syndrome," Morris said.

After an outbreak of Pfiesteria on the Pocomoke in early August last year, Morris and his team were dispatched to the Lower Shore.

Eventually, the physicians gave 13 people with moderate or heavy exposure to Pfiesteria-infested waters a battery of physical and neuropsychological tests and found that they suffered severe learning and memory problems.

The scores, Morris said, "were extremely low." Some tested in the bottom 2 percent of the U.S. population for being able to learn and recall information.

"That's really a profound impairment," Morris said.

Three months after exposure, 11 of the 13 victims had improved to normal levels on the neuropsychological tests. By six months, all 13 tested within the normal range.

One concern was unfounded

A big concern of researchers was that, perhaps, some of the people tested might have had neuropsychological problems to begin with. That proved not to be the case.

"The fact that they came back to normal ranges says that there was indeed an acute event that occurred," Morris said.

So far this summer, 44 people have called the state to report suspected health problems associated with contact with waterways, Poe said. Of those, seven were contacted for follow-up interviews, and five are being tested.

No suspected cases of Pfiesteria-related illness have been found, Morris said.

Poe said the state will use the national Centers for Disease Control and Prevention's description of the illness as "Estuarine Associated Syndrome" until a formal name is chosen.

Pub Date: 8/14/98

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