CHAPEL HILL – A nationwide epidemic alert has been issued today by the Centers for Disease Control. According to the CDC, large portions of the U.S. population are currently endangered by the rapid spread of an influenza strain termed March Hare Syndrome (MHS), which has been observed in eight sites across the United States.
CDC experts, who have been working with researchers at both UNC and Duke, say they are not sure at this point if the outbreak can be contained.
Varying distinctly from previous flu-like disorders which originated in specific animal hosts, such as swine and birds, MHS began in a variety of animal species then jumped to homo sapiens. In previous seasons, dominant disease carriers have included 'gators and bruins.
This season's most widespread strain of March Hare Syndrome, commonly termed Rapid Rabbit Flu, follows the pattern of previous spring seasons filled with sporadic episodes building through the month of March, coming to a head in early April. The current incarnation of the disease is so named for what scientists think is the most "prime mover" of the trans-species transfer of the disease, the common rabbit (Tywonagus carolinus).
Dr. Robert Briggaman of the University of North Carolina’s School of Medicine, one of the area's leading experts on the disorder, says that susceptible individuals should be on the lookout for a series of telltale warning signs. These include, in MHS-H (the "high" or feverish strain of the disorder), splotches with a pale blue colorization, morning hoarseness, tick-like twitching, and aching in the neck caused by repeated rapid back-and-forth head movements.
MHS-H also can be manifest, says Briggaman, in physical manifestations such as fast breathing, bulging eyeballs, and involuntary utterances and exclamations, especially those with euphoric components.
Recently verified cases observed in Chapel Hill have shown fevers as high as 108 and 113.
Dr. Lawrence "Doc" Muhlbaier, faculty member in the Duke Department of Biostatistics and Bioinformatics and statistician with the Duke Clinical Research Institute, says that far more dangerous than MHS-H is MHS-D (the "low" or clammy strain of the disorder), commonly known as the Devil's Disease. Having personally measured both, Muhlbaier says, "The lows of MHS-D are far lower than the elevations of MHS-H are high."
Muhlbaier details the warning signs of the "D" form of the disorder. The primary indicator is a dark-blue colorization which sometimes infects the entire skin surface. Other symptoms include a hypomania manifest in exceptionally fast speech and sinus congestion leading to a nasal tone of voice. Similar to MHS-H, MHS-D is also characterized by morning hoarseness but with an associated verbal coarseness that tends toward blue, usually of the darker shades.
MHS-D has four distinct stages, what Muhlbaier calls "The Four D's": delusion, delirium, distress and depression. Delusion, says Muhlbaier, begins as unrealistic expectations, often based on previous experiences with MHS-H. Delirium sets in when the first symptoms match those of MHS-H, but the sufferer does not recognize the emerging signs of MHS-D.
Distress begins, says Muhlbaier, when the individual experiences a continuing clammy coldness that will not dissipate, that is unlike anything that occurs in MHS-H. Finally, the onset of the depression phase is typically marked by buzzing or ringing in the ears, alternatively followed by either an even louder roar or dead silence.
The most intense irruptions of this season of MHS-D are reported in Lexington, Kentucky; Bloomington, Indiana; and, as noted, locally in Durham.
MHS-D, despite the similarity in symptomology, and although genetically related, is apparently not the same disorder as the blue flu suffered by Duke coach Mike Krzyzewski, which also causes loss of voice and stamina.
For those who wish to keep up to date on this ongoing public health crisis, as a public service the CBS television network has been dedicating large swaths of broadcast time to covering the epidemic, with on-site reports from local infection hotspots, with break ins for any given broadcast with notable developments from other sites.
The CDC says if the epidemic follows its now standard course, this weekend's surge in Wake County will die down but there will be a further spate of cases in North Carolina later this week, with its expected epicenter to be in Mecklenburg County. The CDC says that this looks to be the worst outbreak in the state since 2005.
The CDC 's lead researcher on MHS, Dr. Campbell Finley, predicts that, based on local conditions, the next major MHS event will occur in west Texas within several weeks, with an expected ratio of MHS-D to MHS-H of three to one.
Gary D. Gaddy, whose household has been dealing with mild cases of MHS-H, would like to extend his condolences to the Witman family, and others, battling near deadly strains of MHS-D.
A version of this article was published in the Chapel Hill Herald Thursday March 27, 2008.
Copyright 2008 Gary D. Gaddy