Discussion in 'Epidemics (including Covid-19)' started by Kalliope, Jul 18, 2020.
This seems interesting.
Interesting way to learn about the outbreak. Very timely too!
Could someone post them for those of us not on twitter, please?
You don't have to have an account to read public pages on Twitter. Just click on the Twitter posts themselves to get taken to read what is there. It can take a bit of trial and error to work out what Twitter allows you to do without an account, but I worked it out. I don't have a Twitter account and have no plans to get one.
This Twitter link should work, just copy and paste it into a web browser:
Or for those who prefer the more private Nitter interface:
not from that twitter thread but article from BMJ 1957
An Outbreak of Encephalomyelitis in the Royal Free Hospital Group, London, in 1955
A personal account of the outbreak of ME at the Royal Free Hospital
Pauline Ovenden, President of Herefordshire Support Group
Interesting: newspaper were reporting the outbreak as glandular fever.
I have been trying to persuade people of that for some time but have not been believed. It's good to see some further evidence.
It's usually reported that the pathogen was never identified, but here EBV/mono is cited in multiple reports.
So was it later disproved, or simply went down the memory drain?
Yes so far it totally goes against the claims that some make that ME was seen as a form of polio. Let's see how the reporting evolves.
It will probably be suggested that there was a reluctance to cause potential anxiety by reporting a potential polio outbreak. Something of that sort was previously suggested. Non too persuasively.
At the time, glandular fever was the name for any infection where there were swollen glands. The EBV was not isolated and identified until 1964.
At the Tahoe outbreak it was initially thought to be mono as well, especially as it involved teenagers. Testing showed that it was not found in everyone (which is why Strauss, proponent of a long term EBV syndrome, was brought in by the CDC and why he was resentful when it was proved not to b the case.)
Viruses can be identified by the way they spread and the spread at the Royal Free does not match EBV. Though having previous EBV may be involved in infections becoming ME.
Many of the staff at the time thought it was flu. While the virus was never identified at the time, virology was still basic compared to bacteriology. Some of the polio viruses were not identified until after 1955.
The question that arises from the Pauline Ovenden account is whether there were contemporaneous recorded references to flu at the time of the outbreak. Notes from 40 years later are useful but not definitive.
It was definitely stated somewhere in one of the papers that the initial impression was that the cases were initially thought of as glandular fever. This is the difficulty. There was an unidentified pathogen causing people to be ill in a variety of indeterminate ways for indeterminate lengths of time.
It might be of interest to quote Rachel Jenkins in her Introduction to Post Viral Fatigue Syndrome 1991 eds Jenkins and Mowbray quoting Acheson
At the Royal Free Hospital, no patient with poliomyelitis had been admitted to the hospital prior to the outbreak, nor was the diagnosis entertained in the initial cases. There was no apprehension about poliomyelitis among the hospital staff, but rather about infectious mononucleosis which was the early diagnosis. In spite of this the course of the disease and the type of neurological involvement was similar to that found in Los Angeles.
Jenkins was BPS. When this book came out we felt Mowbray had gone to the dark side despite developing the VP1 test. It was another shock on top of the SW and Lloyd and Hickie nonsense.
She was not an authority and appeared from nowhere. At the time, Ramsay was not convinced that EBV resulted in true ME and he wanted Mowbray to present his evidence they were the same thing so the question could be settled. (I don't remember him being against the idea just that he wanted the issue examined scientifically)
It would have been interesting to have seen it all laid out but suddenly we had CFS and that was that. It would still be interesting to compare people with different infectious onsets. Just from social media, people who have glandular fever are often very sick at the beginning but then recover to a fairly normal life even after some years.
(I have a personal interest in this as a relative seems to have long term EBV but no apparent PEM and I would like to know if it is inevitable or not.)
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