Funtabulously Frivolous Friday Five 232

Just when you thought your brain could unwind on a Friday, you realise that it would rather be challenged with some good old fashioned medical trivia FFFF, introducing the Funtabulously Frivolous Friday Five 232

Question 1

John Snow, the godfather of epidemiological medicine, showed that the pump on Broad Street in London was responsible for an outbreak. There was however an outlier, a woman and child died of cholera who lived in Hampstead.

Why did they die of cholera so far away from the pump in question?

Reveal the funtabulous answer

The ‘widow of Hampstead’ had lived in Soho before and loved the taste of the water. Her son kindly arranged for frequent bottled water from the pump to be carted to her house in Hampstead.

John Snow (1813-1858) was helped by Reverend Henry Whitehead who was the vicar of St Luke’s Church in Soho. He had an excellent memory of his parish and knew who was becoming ill. He told Snow about the widow in Hampstead succumbing to cholera. Not ignoring this outlier, Snow went to interview her son and discovered her love of the water at Broad Street and so evolved his theory. [Reference]

Question 2

How did Legionnaires disease get its name?

Reveal the funtabulous answer

Named after the Legion members who died in the 1976 outbreak.

On July 21, 1976, the American Legion opened its annual three-day convention at the Bellevue-Stratford Hotel in Philadelphia. 3 days later legion members were dying of a mysterious illness. All complained of tiredness, chest pains, lung congestion and fever.

The outbreak of the mystery disease generated intense media coverage. Newsweek called it the “Killer Fever,” while Time dubbed it the “Philly Killer” on its front cover. Most of the media, however, settled on another name for the strange respiratory illness—“Legionnaires’ disease.”

Within a week, more than 130 people had been hospitalised and 25 had died, totalling 34 by the end of the outbreak.

6 months later, in January 1977, Joseph McDade made the discovery that a previously identified bacterium was the cause of the outbreak. It had not been considered previously because it was believed to affect only animals. The air-conditioning unit was implicated at the hotel but due to intense cleaning after the outbreak it was never found. The hotel subsequently went in decline and despite restoration attempts finally closed its doors in 1986. [Reference]

Question 3

Mary Mallon (1869-1938) was a cook and managed to infect 51 people over her career. What was the disease she passed on and her nickname?

Reveal the funtabulous answer

Typhoid Mary

She was the first person in the United States to be identified as an asymptomatic carrier of typhoid and worked from 1900 to 1907 as a cook for affluent families. Outbreaks of typhoid occurred where she worked and she would often then move onto a different family.

In 1906 a family hired typhoid researcher George Soper, who believed Mallon might be the source of the outbreak, linking her to all the outbreaks but failed to convince her to provide urine and stool samples.

In 1907 she was finally arrested and quarantined for 3 years by which point she had large media attention and the nickname ‘Typhoid Mary’ was given.

On February 1910 Mallon agreed to change her occupation and was released. Unfortunately the provisions for a new career in a laundrette did not provide the same career satisfaction nor pay and she returned to cooking. She was arrested again and refused to have a cholecystectomy. Her second quarantine lasted from 1915 to 1938 when she died of stroke aged 68.


Question 4

What is the cause of Dum-dum fever?

Reveal the funtabulous answer

Visceral Leishmaniasis, also called black fever or kala-azar. The agent of the disease was first isolated in India by Scottish doctor William Leishman (who observed the parasite in the spleen smears of a soldier who died of the disease in Dumdum, Calcutta, India.

Visceral leishmaniasis is a disease caused by the parasite Leishmania donovani and L. infantum that is transmitted by sandflies. The Leishmania invades and replicates within the host’s macrophages, evading immune responses.

Many of the infections are asymptomatic but after a latent period of months to years, patients can present with fever, malaise, weight loss and splenomegaly. The disease is fatal if it is not treated with a combination of amphotericin B, sodium stibogluconate, paromomycin or miltefosine

Question 5

What is somnambulism?

Reveal the funtabulous answer

Sleep walking

Most frequent in children (2-14% of children), it is usually a benign. Sleepwalking often decreases with the onset of puberty, but at least 25% of children with recurrent sleepwalking may continue to sleepwalk in adulthood.

Treatment if required is usually lorazepam.

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Funtabulously Frivolous Friday Five

Dr Neil Long BMBS FACEM FRCEM FRCPC. Emergency Physician at Kelowna hospital, British Columbia. Loves the misery of alpine climbing and working in austere environments (namely tertiary trauma centres). Supporter of FOAMed, lifelong education and trying to find that elusive peak performance.

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