Tularemia Death Suspected By CHRIS BURRELL The rare disease called tularemia has struck nine people on the Island since early June, and state health officials now suspect that the disease may have claimed the life of 43-year-old David Kurth, a housepainter and a member of a large Chilmark family, who died Saturday at the Boston Medical Center. A public health advisory has been issued by the state, warning Islanders of the risks and symptoms of the disease while also cautioning people to take preventive actions, such as wearing dust masks, when they are working outdoors near rabbit habitats. Tularemia is a bacterial disease transmitted to humans by a tick bite, by touching or eating an infected animal or - as is suspected in eight of the nine cases here - by breathing in contaminated particles. The animals most likely to be infected are rabbits and rodents such as squirrels, voles and muskrats, according to the state department of public health. Officials said that Mr. Kurth arrived at the Martha's Vineyard Hospital Friday morning "extremely ill" and showing signs of pneumonia, consistent with symptoms of pulmonary tularemia. His onset of symptoms was sudden. On both the Island and at the Boston Medical Center, to which he was airlifted on Friday afternoon, he was treated as having tularemia, according to the state Department of Public Health (DPH) spokesman, Roseanne Pawelec. But until blood tests are complete, that diagnosis cannot be confirmed. Blood samples have been sent to the national Centers for Disease Control, according to Alfred DeMaria, director of communicable disease control at the DPH. (An obituary notice for Mr. Kurth appears on Page Five of this morning's edition.) The nine confirmed cases have all been males, between the ages of 13 and 59. All were treated with antibiotics and recovered. Of those nine, five work as either landscapers or contractors, so health experts are unable to pinpoint one part of the Island where people picked up the disease. They do suspect strongly that being outdoors and mowing lawns puts people at greater risk. It was July when the DPH first reported five cases of tularemia, all related to exposures from early to mid-June. In a typical year, only one or two people get tularemia in the entire state. Scientists from the CDC came to the Island to investigate. Last week, the public health office confirmed another two cases. Yesterday, the DPH announced the total was nine with two additional cases probable. With the new cases, the DPH now knows the exposures to the tularemia bacteria have continued well past June. CDC investigators will come back to the Island in September, according to Dr. DeMaria. Experts have been surprised that that most of the cases are the pulmonary version of the disease, contracted by breathing in contaminated particles. Dust, soil or grass could be contaminated with the bacteria from the dog ticks which would have picked up the disease from an infected animal. The tiny deer tick which carries Lyme disease does not carry tularemia, according to the DPH advisory. Dr. DeMaria suspects the summer's rains have contributed to the sharp rise in tularemia this year, because with damp weather, the bacteria remains alive much longer than in dry weather, according to the DPH. "We're wondering whether this wet weather may keep things more viable. Only a small amount [of bacteria] can cause infection," said Dr. DeMaria. Officials have also speculated that a surge in the Island rabbit population this year could also account in part for the increase in infections among people. Regardless of the causes, the health care community is warning people to be on the lookout for symptoms and to be cautious when working outdoors in grassy or wooded areas where rabbits live. "We've tried to give a balanced picture of the risk. Thousands of people have mowed their lawn on the Vineyard and there are only a few cases, but because of the exposure, it might be reasonable to wear a dust mask in certain cases," said Dr. DeMaria. Symptoms, which come on very quickly within about seven days of exposure to the bacteria, include a fever, chills, headache, fatigue and a dry cough. Depending on whether the exposure was from a tick bite or from breathing in particles, symptoms can also include swollen glands, sore joints, chest discomfort, vomiting, sore throat, eye inflammation, abdominal pain and diarrhea. In the case of a tick bite, there will likely be an ulcer at the site of the bite. The health advisory urged anyone suffering from these symptoms to seek immediate medical attention. All primary care physicians and health clinics have been alerted to the tularemia situation. Although nearly all the tularemia cases involved breathing in the airborne particle, the advisory also recommended extra precautions against tick exposure, identical to steps taken to steer clear of the Deer ticks. People headed outdoors should wear light-colored long pants and long-sleeved shirts and stay on marked trails, avoiding high grass. Insect repellants containing DEET were recommended for adults and children but not infants. Repellants containing permethrin are intended only for clothing and not skin. If anyone must come into contact with wild animals, such as dead animals brought indoors by a cat, the DPH advised people to wear gloves and a mask when disposing of the dead animal. And finally, the advisory suggested that people lessen the chance of soil contamination in their yards by fencing off gardens, keeping woodpiles in sunny areas and off the ground and by making sure not to leave any food outdoors. http://mvgazette.com/1.htm <A HREF="http://www.ctrl.org/">www.ctrl.org</A> DECLARATION & DISCLAIMER ========== CTRL is a discussion & informational exchange list. Proselytizing propagandic screeds are unwelcomed. Substance—not soap-boxing—please! These are sordid matters and 'conspiracy theory'—with its many half-truths, mis- directions and outright frauds—is used politically by different groups with major and minor effects spread throughout the spectrum of time and thought. That being said, CTRLgives no endorsement to the validity of posts, and always suggests to readers; be wary of what you read. CTRL gives no credence to Holocaust denial and nazi's need not apply. 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