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Can Diseases Cross Oceans By Wind?

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Aneurysms in the coronary arteries of a Kawasaki victim. Public domain; click for source.

That’s the question I examine in my first feature story for Nature, published today online and in the print magazine April 5. A bizarre disease of toddlers and infants called Kawasaki Disease — which only emerged in the 1960s in Japan — causes little kids to develop rash; fever; swollen hands, feet, and lymph nodes; red tongue and cracked lips; and, bizarrely, to develop coronary artery aneurysms that can kill them right away or years later by heart attacks in otherwise totally healthy young adults.

Here’s a story that didn’t make it into the final cut of the article that describes one such case:

In one case, a 42-year-old white triathelete keeled over of a massive heart attack 10 miles into a 100 mile bike ride. He had no classic risk factors: he was not a smoker, and he was an extremely fit elite athlete with inklings he might have heart disease. When the cardiologist, who happened to be Burns’s husband, injected die into the man’s arteries, he saw the telltale Kawasaki aneurysms immediately. When the patient’s mother was consulted, it was discovered that when the man was five, he had been diagnosed with “atypical scarlet fever” in Florida. The man lived, but suffered ongoing cardiac disability as a result.

Despite decades of searching, no one has ever been able to figure out what causes it, even though some sort of infectious agent has long been suspected. And now, it seems that whatever is causing it — whether dead or alive — might be able to cross the Pacific Ocean and sicken children in Hawaii, North America, and beyond. If this proves to be true, it will be the first time a human pathogen has ever been shown to do that. So head on over to Nature and check it out — and check out the podcast interview with me embedded in the story halfway through as well. You can hear what I sound like!

Dr. Jane Burns, who I interviewed for nearly two hours for the story and who graciously shared with me her lifetime of experience with the disease, was featured in the lead of the story about the infant from Wyoming. That baby was only 3 months old when she was airlifted to Colorado and died within 12 hours of arriving there. Occasionally when you report a story you encounter amazing details that just don’t fit within the context of the story you want to write, but are nonetheless powerful. Burns told me this further story about that baby’s parents. It really pulled on my heartstrings, so I wanted to share it with you:

A month later the physicians invited the family back to go over the autopsy and interpret the results for them. Burns attended the meeting along with the pathologist. The family handed her a brown paper bag with $1,500 in small bills. They had gone door to door in their town in Wyoming to collect the money.

“[They] said, ‘We hope you’ll take this money and do research on Kawasaki Disease,’” Burns recalled. “That was obviously a very powerful moment for me.”

Dr. Burns went on to devote nearly her entire career to Kawasaki Disease.

On a personal note, can I just say what a thrill it was seeing the color proofs of a page from Nature with my name on the story? I kept looking at the bottom of the page “Nature, Vol. x, Issue x”, and then looking back up at my name. Surreal. Very surreal.

Thank you to my editor at Nature for all the hard work on the story and for encouraging me at every step of the way. Couldn’t have done it without you, Mitch!



Jennifer Frazer About the Author: Jennifer Frazer is a AAAS Science Journalism Award-winning science writer. She has degrees in biology, plant pathology/mycology, and science writing, and has spent many happy hours studying life in situ. Follow on Twitter @JenniferFrazer.

The views expressed are those of the author and are not necessarily those of Scientific American.

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  1. 1. kdimoff 8:19 pm 04/4/2012

    aah! more interesting pathogen thoughts to keep me up at night :)
    great job, jennifer! i look forward to more!

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  2. 2. porwin 10:49 am 04/5/2012

    Great article. I’m wondering if people still think that Staph or Strep superantigens are involved? I was a grad student working on those toxins (late 90s), and given the relationship to Scarlet Fever (caused by SpeA producing strep) and the immune complications associated with the syndrome I thought that was a leading candidate. At the time it was thought so anyway. I’m not in the field anymore, so I don’t keep up with it. Doesn’t fit with the windborne idea, though…

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  3. 3. Jennifer Frazer in reply to Jennifer Frazer 6:30 pm 04/5/2012

    Dr. Burns mentioned to me the story of Rheumatic Fever/Streptococcus as one model of how Kawasaki *could* work. I originally put this into the article as well but it got cut for space (doesn’t all the good stuff! : ) ) The idea there is the “innocent bystander effect”: the immune system responds to an epitope of 7-8 amino acids that happen to resemble a string of amino acids in a protein in certain heart valves. So the body ends up inadvertently attacking the heart valve along with the pathogen. I don’t think that anyone seriously considers that Strep/Staph is a potential culprit in Kawasaki. Just that Kawasaki *may* operate under a similar M.O. Thanks for bringing this up!

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