Joplin, MO tornado volunteer fighting a mysterious illness and wonders if other volunteers are sick

[Emily]

Joplin Tornado Volunteer Exhibits Mysterious Illness

Posted on: 5:19 pm, July 6, 2012, by Staff Writer, updated on: 05:00pm, July 6, 2012

 

[Emily]

Re: Joplin, MO tornado volunteer fighting a mysterious illness and wonders if other volunteers are sick

http://www.joplinglobe.com/topstories/x766459358/Tow-truck-driver-struck-by-mysterious-illness-in-wake-of-Joplin-tornado

The Joplin Globe, Joplin, MO

September 29, 2012
Tow-truck driver struck by mysterious illness in wake of Joplin tornado

By Wally Kennedy

JOPLIN, Mo. ? When he was asked whether he wanted to help tow some of the thousands of vehicles that were destroyed in the May 22, 2011, tornado in Joplin, Mike Forest jumped at the chance.

?The day after the tornado, he was there,?? said his wife, Dina, of Olathe, Kan. ?It was the third week he was there that it happened.??
[snip]
?His main plan in the second week was to go to the hospital (St. John?s Regional Medical Center) and recover vehicles out of the hospital,?? she said. ?He went to the hospital, but the haz-mat (hazardous material) crews were still going in there. They turned him away for several days.

?By the fourth day, these guys dressed in haz-mat suits said they were ready to start doing the parking lot,?? she said. ?It was the week after that he woke up with the nosebleed and blisters. He felt like his head was being crushed. He slept that whole day.??

Forest went to a makeshift hospital operated by St. John?s. He was diagnosed with the flu. He was given some medications, told to stay hydrated and to get some rest.

?He went back to where he was staying to sleep it off,? his wife said. ?He slept for four days ? not knowing that he slept for four days. The blisters started to go away, and he felt like he was on the mend. He went back to work. That?s when a volunteer called me and told me: ?I?m bringing your husband home. He is unable to do anything.???

His wife said they are now testing Forest for things they don?t normally test for.

?They have done tons of tests,? she said. ?We have two infectious disease doctors on his case right now...

 

[alert]

Re: Joplin, MO tornado volunteer fighting a mysterious illness and wonders if other volunteers are sick

Later in the article, it appears the man has tested positive for both Lyme and West Nile, both of which could cause long-term effects.

 

[Nika]

Re: Joplin, MO tornado volunteer fighting a mysterious illness and wonders if other volunteers are sick

do we know if they had any issues recovering the gamma sources for all x-ray machines? just wondering if there was ever any coverage on that issue.

 

[Emily]

Re: Joplin, MO tornado volunteer fighting a mysterious illness and wonders if other volunteers are sick

do we know if they had any issues recovering the gamma sources for all x-ray machines? just wondering if there was ever any coverage on that issue.

Good thinking, Nika. That would be a pretty unique risk among the many toxic exposures people could encounter in a disaster like an EF-5 tornado.

The hospital was hit directly. The tornado even sucked their big generator right out of the hospital. Electricity loss was actually the cause of some patient deaths, rather than debris or collapse, but areas of the hospital look like they were totally devastated in photos. The Reuters article says that every window in the building was blown out.

Looks like the NRC did an inspection and found enough nuclear contamination to condemn several buildings:

http://pbadupws.nrc.gov/docs/ML1129/ML112930551.pdf

Ms. Patricia PeJke, Chief -Materials licensing Branch
U. S. Nuclear Regulatory Commission Region III 2443 Warrenville Road, Suite 210 Lisle, Illinois 50532
License Number 24..01080?03
Dear Ms. Pelke:
Due to the conditions of the buildings following the May 22, 2011 tornado, a decision has been made that the buildings cannot be repaired and will be demolished. This Is an amendment request to release the radioactive "restrictive areas" that were located in the Main Medical Center (Hospital) and Medical Office Building as "unrestricted areas." Licensed sealed sources were removed from all restricted areas as detailed In the June 09, 2011, (Accountability of Nuclear Material) letter sent to Mr. Ken Lambert. After sources and radioactive material were removed, radiation exposure surveys were done. Attached are facility diagrams of the restricted areas where radioactive materials were used/stored. Due to the condition of the buildings and additional health risks, the building was not reentered by the Nuclear Medicine or Radiation Oncology staff for the performance of wipe tests in areas where unsealed radiopharmaceutlcals were used/stored. The close out of each area is addressed below...

The article about Mr. Forest does describe people still wearing Hazmat suits when he was given approval to do clean-up work on the hospital premises. I wondered why people were still wearing those suits if it was safe at that point.

I found one other risk factor somewhat unique to the general Joplin area. The city is built on old lead and cadmium mines and there were concerns about contaminated dust from that being stirred up, along with pulverized building materials that contained lead.

http://www.mnn.com/earth-matters/wilderness-resources/stories/savage-joplin-tornado-exposed-lead-contamination

But you would think a few more people would be showing similar symptoms from a more widespread exposure like that. I hope Mr. Forest's condition is diagnosed soon and he regains his health.

 

[Nika]

Re: Joplin, MO tornado volunteer fighting a mysterious illness and wonders if other volunteers are sick

Thank you for that simply awesome reply - excellent info - i really appreciate it.

Can you imagine keeping track of all the potentially exposed people in and around Joplin during the tornado and then all of the people who came to help afterwards? There may well be more affected people and they might never make the connection and self-report.

The gamma sources for the x-ray machines are small and if liberated might be hard to find. I hope that they did forensics to track down all of them. We do not want another "Goi?nia accident" incident on our hands but it would be extremely easy for it to happen. (link for info on that nightmare - http://en.wikipedia.org/wiki/Goi?nia_accident )

For all we know - this truck driver picked up a fragment of cobalt or material sufficiently contaminated to impact his health.

Unless the onsite hazmat ppl were wearing full NBC suits they were not protected from beta or gamma. If there were biohazard materials (vials of virus or bacteria from research labs?) then a full biohazard suit with respirator would be useful. It would be easier to find a gamma source (NOT easy) than to clear up biologicals in all that debris - what a complete nightmare.

Your heavy metal contamination idea is very likely as well - possibly even asbestos - that may have been left in place because its less expensive to wall off and quarantine it than to remove it.

 

[Emily]

Re: Joplin, MO tornado volunteer fighting a mysterious illness and wonders if other volunteers are sick

It would be easier to find a gamma source (NOT easy) than to clear up biologicals in all that debris - what a complete nightmare.

I'd imagine it could be very difficult to actually locate a source for radiation in tornado debris, but with modern technology it seems possible to at least know that even very low-level sources are in an area so people could be protected from the danger.

I was surprised to read that state police have detectors so sensitive that nuclear medicine patients driving past a patrol car on the highway can set them off.

http://skepticalscalpel.blogspot.com/2012/05/radioactive-man-milford-resident-pulled.html

Radioactive man? Milford resident pulled over by state police

So hopefully in the case of the Joplin tornado, all sources were accounted for and at least one toxic exposure danger was easily avoided. Securing and disposing of the waste would be very costly, though. I read that the clean-up costs alone were $20,000,000 in Goi?nia.

 

[Emily]

Re: Joplin, MO tornado volunteer fighting a mysterious illness and wonders if other volunteers are sick

Later in the article, it appears the man has tested positive for both Lyme and West Nile, both of which could cause long-term effects.

Alert, another article indicates West Nile is indeed being looked at as a big factor in this case.

http://fox4kc.com/2012/09/27/joplin-volunteer-finally-diagnosed-with-west-nile-virus/

Joplin Volunteer Finally Diagnosed with West Nile Virus

Posted on: 10:44 pm, September 27, 2012, by Abby Eden, updated on: 10:07am, September 28, 2012

That article and video present quite a different slant than the previous one posted. They do say doctors think the West Nile was complicated by something else, so a mystery remains about that factor.

I saw a recent posting on a forum attributed to Mr. Forest's wife and though unverified, it looked credible so I'll just list the symptoms posted there with the caveat that this is not verified:

Primary duty was removing cars from hospital parking garage - one week later:

• Woke up with a blood soaked pillow.
• Blisters on his legs.
• Terrible head aches.
• Flu-like feelings.
• Freezing cold sweats.
• Lost days of his memory.
• Pain has never gone away.

The article says that Mr. Forest is going to the Mayo Clinic soon.

 

[Nika]

Re: Joplin, MO tornado volunteer fighting a mysterious illness and wonders if other volunteers are sick

• Woke up with a blood soaked pillow.
• Blisters on his legs.
• Terrible head aches.
• Flu-like feelings.
• Freezing cold sweats.
• Lost days of his memory.
• Pain has never gone away.

As far as I know WNV doesnt lead to blistered legs nor blood soaked pillows.

If he had stepped over a gamma source he may well have experienced the bleeding, blisters, neuralgia and mental fog but that only happens in extremely bad exposures and he would have had serious GI disturbance and would have died well before now.

mysterious indeed

 

[alert]

Re: Joplin, MO tornado volunteer fighting a mysterious illness and wonders if other volunteers are sick

I believe WNV could cause low platelet count, which could result in a hemorrhage.

I have to wonder what the "blisters" looked like. It says he tested positive for Lyme Disease as well. I wonder if the "blisters" were his interpretation of the characteristic rash of that illness.

 

[Nika]

Re: Joplin, MO tornado volunteer fighting a mysterious illness and wonders if other volunteers are sick

the bulls eye of a lymes bite is nothing at all like blisters.

My husband almost died from lymes disease and it never presented in this way - his was like an acute flu like illness with meningitis like symptoms as well - they did multiple spinal taps to rule out all sorts of nasty possibilities. Our GP family doc had been off call - when we talked to him he put the husband on high dose antibiotics stat and then he got better quickly.

The real damage with lymes comes from a long term infection that was never detected initially and has had a long time to do subtle damage. Is also much less responsive to known treatments.

I am sure you all know the following but just for reference and review (source = wiki http://en.wikipedia.org/wiki/West_Nile_virus#Signs_and_symptoms )

West Nile symptomolgy:

The incubation period for WNV ? the amount of time from infection to symptom onset ? is typically from between 2?15 days. Headache can be a prominent symptom of WNV fever, meningitis, encephalitis, menigoencephalitis and it may or may not be present in poliomyelytis-like syndrome thus headache is not a useful indicator of neuroinvasive disease.(CDC)

West Nile Fever (WNF), which occurs in 20 percent of cases, is a febrile syndrome which causes flu-like symptoms. Most characterizations of WNF generally describe it as a mild, acute syndrome lasting 3?6 days after symptom onset.
Systematic follow-up studies of patients with WNF had not previously been done, so this information is largely anecdotal.

In addition to a high fever, headache, chills, excessive sweating, weakness, fatigue, swollen lymph nodes, drowsiness, pain in the joints and flu-like symptoms. Gastrointestinal symptoms which may occur include nausea, vomiting, loss of appetite, and diarrhea. Fewer than 1/3 of patients develop a rash.

West Nile Neuroinvasive Disease (WNND), which occurs in less than 1 percent of cases, is when the virus infects the central nervous system resulting in meningitis, encephalitis, meningoencephalitis or a poliomyelitis-like syndrome. Many patients with WNND have normal neuroimaging studies, although abnormalities may be present in various cerebral areas including the basal ganglia, thalamus, cerebellum, and brainstem.

West Nile virus encephalitis (WNE) is the most common neuroinvasive manifestation of WNND. WNE presents with similar symptoms to other viral encephalitis with fever, headaches, and altered mental status. A prominent finding in WNE is muscular weakness (30?50% of patients with encephalitis), often with lower motor neuron symptoms, flaccid paralysis, and hyporeflexia with no sensory abnormalities. "WNV is now the most common cause of epidemic viral encephalitis in the United States, and it will likely remain an important cause of neurological disease for the foreseeable future.("Carson PJ, et al. 2006)

West Nile meningitis (WNM) usually involves fever, headache, and stiff neck. Pleocytosis is present. Changes in consciousness are not usually seen and are mild when present.

West Nile meningoencephalitis is inflammation of both the brain (encephalitis) and meninges (meningitis).

West Nile poliomyelitis (WNP), an acute flaccid paralysis syndrome associated with WNV infection, is less common than WNM or WNE. This syndrome is generally characterized by the acute onset of asymmetric limb weakness or paralysis in the absence of sensory loss. Pain sometimes precedes the paralysis. The paralysis can occur in the absence of fever, headache, or other common symptoms associated with WNV infection. Involvement of respiratory muscles, leading to acute respiratory failure, can sometimes occur.

Nonneurologic complications of WNV infection that may rarely occur include fulminant hepatitis, pancreatitis, myocarditis, rhabdomyolysis, orchitis, nephritis, optic neuritis and cardiac dysrhythmias and hemorrhagic fever with coagulopathy. Chorioretinitis may also be more common than previously thought.

Cutaneous manifestations specifically rashes are not uncommon in WNV-infected patients, however there is a paucity of detailed descriptions in case reports and there are few clinical images widely available. Punctate erythematous, macular, and papular eruptions, most pronounced on the extremities have been observed in WNV cases and in some cases histopathologic findings have shown a sparse superficial perivascular lymphocytic infiltrate, a manifestation commonly seen in viral exanthems. A literature review provides support that this punctate rash is a common cutaneous presentation of WNV infection. (Anderson RC et al.)

Lyme Disease info (source = wiki http://en.wikipedia.org/wiki/Lyme_disease#Signs_and_symptoms )

Early localized infection

The classic sign of early local infection with Lyme disease is a circular, outwardly expanding rash called erythema chronicum migrans (also erythema migrans or EM), which occurs at the site of the tick bite three to thirty days after the tick bite. The rash is red, and may be warm, but is generally painless. Classically, the innermost portion remains dark red and becomes indurated (is thicker and firmer); the outer edge remains red; and the portion in between clears, giving the appearance of a bullseye. However, partial clearing is uncommon, and the bullseye pattern more often involves central redness.

EM is thought to occur in about 80% of infected patients. Patients can also experience flu-like symptoms, such as headache, muscle soreness, fever, and malaise. Lyme disease can progress to later stages even in patients who do not develop a rash.

Early disseminated infection

Within days to weeks after the onset of local infection, the Borrelia bacteria may begin to spread through the bloodstream. EM may develop at sites across the body that bear no relation to the original tick bite. Another skin condition that is apparently absent in North American patients, but occurs in Europe, is borrelial lymphocytoma, a purplish lump that develops on the ear lobe, nipple, or scrotum. Other discrete symptoms include migrating pain in muscles, joints, and tendons, and heart palpitations and dizziness caused by changes in heartbeat.

Various acute neurological problems, termed neuroborreliosis, appear in 10?15% of untreated patients. These include facial palsy, which is the loss of muscle tone on one or both sides of the face, as well as meningitis, which involves severe headaches, neck stiffness, and sensitivity to light.

Radiculoneuritis causes shooting pains that may interfere with sleep, as well as abnormal skin sensations. Mild encephalitis may lead to memory loss, sleep disturbances, or mood changes. In addition, some case reports have described altered mental status as the only symptom seen in a few cases of early neuroborreliosis.

The disease may also have cardiac manifestations such as AV block.

Late persistent infection

After several months, untreated or inadequately treated patients may go on to develop severe and chronic symptoms that affect many parts of the body, including the brain, nerves, eyes, joints and heart. Many disabling symptoms can occur, including permanent paraplegia in the most extreme cases.

Chronic neurologic symptoms occur in up to 5% of untreated patients.

A polyneuropathy that involves shooting pains, numbness, and tingling in the hands or feet may develop. A neurologic syndrome called Lyme encephalopathy is associated with subtle cognitive problems, such as difficulties with concentration and short-term memory. These patients may also experience profound fatigue. However, other problems, such as depression and fibromyalgia, are no more common in people who have been infected with Lyme than in the general population.

Chronic encephalomyelitis, which may be progressive, can involve cognitive impairment, weakness in the legs, awkward gait, facial palsy, bladder problems, vertigo, and back pain. In rare cases untreated Lyme disease may cause frank psychosis, which has been mis-diagnosed as schizophrenia or bipolar disorder. Panic attacks and anxiety can occur; there may also be delusional behavior, including somatoform delusions, sometimes accompanied by a depersonalization or derealization syndrome, where the patients begin to feel detached from themselves or from reality.

Lyme arthritis usually affects the knees. In a minority of patients, arthritis can occur in other joints, including the ankles, elbows, wrist, hips, and shoulders. Pain is often mild or moderate, usually with swelling at the involved joint. Baker's cysts may form and rupture. In some cases, joint erosion occurs.

Acrodermatitis chronica atrophicans (ACA) is a chronic skin disorder observed primarily in Europe among the elderly. ACA begins as a reddish-blue patch of discolored skin, often on the backs of the hands or feet. The lesion slowly atrophies over several weeks or months, with the skin becoming first thin and wrinkled and then, if untreated, completely dry and hairless.