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Virus didn't cause death

Health officials blame bacteria

Friday, August 23, 2002

By Anita Srikameswaran, Post-Gazette Staff Writer

The death of an Upper St. Clair woman this week was not caused by the West Nile virus, as originally suspected by her doctors, but by an overwhelming streptococcal infection, Allegheny County Coroner Dr. Cyril Wecht and Health Director Dr. Bruce Dixon said yesterday.

 
 
Zoo owl tests positive for West Nile virus

A great horned owl at the Pittsburgh Zoo and PPG Aquarium is among the latest group of birds in Allegheny County to test positive for the West Nile virus.

Thirteen birds thus far have tested positive for the virus. Infected birds have been found in 30 Pennsylvania counties.

The zoo's owl may have been particularly vulnerable to the virus because it was elderly and was being treated for an intestinal infection, said zoo spokeswoman Connie George. The owl had been at the zoo for several years, obtained by the zoo after it had been rehabilitated following an injury but couldn't be released back into the wild.

The West Nile virus can't be transmitted directly from animal to animal or from animals to people without the help of a mosquito, so zoo employees are concentrating on eliminating mosquito breeding sites. They also have vaccinated all of the zoo's susceptible birds, though the vaccine is only approved for use in horses and may not do the birds much good. The zoo's zebras were vaccinated earlier this week.


Obituary

Pearl L. Simmons

Parenting specialist at Children's Hospital

   
 

Wecht said that the autopsy, performed on Pearl Simmons, 42, by staff pathologist Dr. Bennet Omalu, showed signs of a coagulation abnormality typical of the bacterial infection. There were many tiny clots in her organs, including her brain and the tissues lining it. The clots drew in more clotting factors from the blood, which in turn produced more bleeding problems.

Those findings, along with a skin rash, initially suggested that Simmons had a viral, not a bacterial, illness. But because West Nile had been found in 13 birds in Allegheny County, samples of Simmons' blood and spinal fluid were sent to Harrisburg to test for the virus. Those tests will still be done.

"We will look to be absolutely certain that it's not West Nile fever," Dixon said. "The likelihood is very little."

Dixon said that a human case of West Nile virus is sure to occur here.

"That's going to happen sooner or later," he said. "We need to reassure people that when it does happen, it's not usually an overwhelming illness."

Wecht pointed out that only one out of 150 people infected with West Nile develop serious neurological complications or die from it.

"It's a formidable disease," he said, but "we're not looking at another AIDS epidemic or possible anthrax-type scare."

The kind of strep Simmons had causes a variety of illnesses, including rheumatic fever, scarlet fever, necrotizing fasciitis, or flesh-eating disease, and even strep throat.

Dixon said that scientists do not know why some people develop widespread disease from what likely began as a localized infection. He added that the same bacterial infection causes perhaps a dozen deaths in the county annually.

The doctors could not say how Simmons became infected with strep. Close contacts, such as family members, do not need to be treated with antibiotics because the infection does not spread very easily between people.

Simmons and her husband picked up their son from a camp outside of Toronto, Canada, last Thursday and returned home the following day. On Saturday, she began having flu-like symptoms that got worse. On Monday she went to her physician, who concluded she had a viral illness.

No antibiotics were prescribed, and Dixon noted that it's impossible in retrospect to say whether the drugs would have made a difference.

At 6 a.m. on Wednesday, Simmons went to Allegheny General Hospital and died there nearly six hours later.

"The concern, of course, was that this could be our first case of West Nile virus," Wecht said. "We approached it with that in mind, making sure we did everything that was necessary and appropriately called for."

He added that his office sought assistance from the Allegheny County Health Department and obtained information from the U.S. Centers for Disease Control and Prevention.


Anita Srikameswaran can be reached at anitas@post-gazette.com or 412-263-3858.


Correction/Clarification: (Published Aug. 24, 2002) A story yesterday about the death of Pearl Simmons, of Upper St. Clair, inaccurately stated that the deadly coagulation abnormalities she suffered were typical of streptococcal blood infection. Studies indicate that the complication occurs at most in half of all cases.

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