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  #541  
Old 05-02-2019, 08:32 AM
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SPOILERS! (ok, maybe not)

CALIFORNIA
MEASLES
https://www.nbclosangeles.com/news/l...509328371.html

Quote:
'Avengers: Endgame' Crowd Possibly Exposed to Measles in Orange County
Moviegoers who think they have been exposed should contact their health provider or call 800-564-8448

Spoiler:
A woman who went to the midnight showing of "Avengers: Endgame" at an Orange County movie theater last week was diagnosed with measles, and now health officials are warning others in the crowd that they may have been exposed.

The Placentia woman in her 20s, who had just returned from an international trip, was infected with measles when she went to see the midnight showing of the finale in the Avengers saga.

The Orange County Health Care agency said the woman visited the AMC Theater in Fullerton Thursday, April 25, and other moviegoers may have been exposed from 11 p.m. in the evening until 4 a.m.

Health officials were advising others who believe they may have been exposed to check their vaccination history, and notify their health providers, especially if they haven't had measles before.


Symptoms include inflamed eyes, runny nose, high fever, and an unexplained rash seven to 21 days after being exposed.

Theater employees said the news comes as a shock, especially after such a busy week with huge crowds eager to see "Avengers: Endgame."

"The last place I would ever expect it was at my job. I wasn't even expecting Orange County," AMC Fullerton employee Carlee Greer-McNeill said. "People, if you know you have the measles, please don't come to a movie theater, let alone a public place."

Pratt Shares 'Illegal' Video From 'Avengers: Endgame' Set[NATL-AH] Chris Pratt Shares 'Illegal' Video From 'Avengers: Endgame' Set
Chris Pratt took to Instagram to share a video from the set of the Marvel film, "Avengers: Endgame." In it, you can see an awesome collection of stars. Watch to find out more!(Published Monday, April 29, 2019)
Another location where residents may have been exposed was in Fullerton is St. Jude Emergency Department between 7 and 9 a.m. April 27.

The woman who went to the theater was under quarantine after being diagnosed. She is considered infectious from April 23 to May 1.

This case is the fist reported in Orange County, on the heels of Los Angeles County announcing its sixth Tuesday.

The sixth case reported this week also occurred after a Southern California resident traveled to another country, and noticed symptoms after returning.

Health officials advise that if anyone believes he may have measles to contact his doctor by phone before coming in to the doctor's office.

Those with measles can also infect others before they are even aware that they have it. Measles is very contagious, and can stay in the air for up to 2 hours after the infected person has left the area.

Los Angeles County Exposure Spots

The following locations have been identified as potential measles exposures:

● LAX, Tom Bradley International Terminal, Gate 218 on April 23 from 4 p.m. to 7 p.m.

● Fox Auto Parks LAX Shuttle on April 23 from 4:30 p.m. and 7:30 p.m.

● Home Depot, 44226 20th St W, Lancaster, CA 93534, on April 26 from 8 a.m. and 11 a.m.

Orange County Exposure Locations

● 5 Hutton Centre Dr., Santa Ana, CA 92707, on April 23 — 25 from 7:45 a.m. to 7:15 p.m. daily

● St. Jude Emergency Department, 101 E. Valencia Mesa Dr., Fullerton, CA 92835, on April 27 from 7 a.m. to 9 a.m.

● AMC Movie Theater, 1001 S. Lemon St., Fullerton, CA 92832, on April 25 from 11 p.m. — April 26 at 4 a.m.

The majority of those with measles were unvaccinated.
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  #542  
Old 05-02-2019, 08:48 AM
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Scientology cruise ship is quarantined in St Lucia due to measles outbreak.

https://www.cnn.com/2019/05/02/healt...ine/index.html
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  #543  
Old 05-02-2019, 02:50 PM
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MEASLES
VACCINATIONS

https://www.popsci.com/measles-other-outbreaks#page-2

Quote:
Measles is an early warning sign for outbreaks of more serious diseases
We never achieved the vaccination levels necessary to prevent outbreaks.
Spoiler:
We’re not even four full months into 2019 and it’s already the worst year for measles in the United States since 1994. All over the world, in fact, places that had previously eliminated or drastically reduced these kinds of outbreaks are seeing flashes of the potentially-deadly virus, which causes dramatic fever, cough, sore throat, and a characteristic spotted, itchy rash.



To some, this came out of the blue. Prior to the invention of the measles vaccine in 1963, more than 90 percent of kids had gotten measles by their 15th birthday. But today, few parents of young children remember what that was like, and the rapidity with which measles spread has taken many people by surprise.

To medical experts, though, this was downright predictable.



“It’s sort of expected that measles is going to be episodic,” says Katrina Kretsinger, a medical epidemiologist who focuses on vaccine-preventable diseases at the World Health Organization. Once you have less than 95 percent of the population immune, you have enough people to keep the disease in circulation, Kretsinger explains. Most countries simply never attained that herd immunity level. Even if you maintained at 92 percent every year, as the population overall increases you’re increasingly likely to see an outbreak. “You get this accumulation over years, and then you introduce measles and it spreads. At some point it burns out of individuals and it goes away, and then the next epidemic will occur.”

Even if there weren’t an increasing pushback from vaccine-hesitant parents, the truth is that over the last nine years our global vaccination rates have flatlined for pretty much all vaccines. Vaccination rates haven’t been decreasing over that time, Kretsinger says, it’s just that we never really achieved the level we needed to. “And measles is so infectious it’s going to be the first disease that shows up,” she adds. “But it’s not just a problem with measles.”

Many countries give a combined vaccine called MMR, for measles, mumps, rubella. If measles vaccine coverage isn’t high enough, it could in theory be sufficient to prevent major mumps and rubella cases—you need 95 percent of the population vaccinated to guard against measles, but only about 85 to 90 for mumps and rubella. Globally, we’ve held steady at about 85 percent for both MMR and the DTAP vaccine, which protects against diphtheria and also requires 85 percent coverage for herd immunity. (Pertussis and tetanus, the other two viruses in the DTAP shot, can exist in the environment, not just the human body, making herd immunity less relevant).

Should those diseases come back, we may be worse prepared in some ways than before. For a long time, the older generations in our society grew up in the pre-vaccine era, which meant that the overwhelming majority of them were exposed to these viruses. Now we have much less circulation of viruses, but also not sufficiently high vaccine coverage to prevent transmission altogether, and the combination is worrisome. “I’m concerned that there are progressively more countries which have had many years of insufficient vaccine implementation,” Kretsinger says. “It’s hard to predict what will be next.”

If we really want to stamp out measles, along with the other vaccine-preventable maladies, Kretsinger says what we need is political will and for countries to have a sense of ownership of the problem. It’s been so long now since measles was a visible childhood killer that we’ve lost a lot of the fear that originally drove people to get vaccinated.

Without that motivation, many developed nations have prioritized other health issues. Coupled with a backlash against vaccinations, this shift in focus has given us the current vaccine stagnation. As a 2011 paper on the potential for measles eradication points out, “recent progress in reducing measles mortality may have reduced the perception of threat.” But the threat is very real. According to the same paper, “measles has been a disease of high burden historically, and as recently as 2000, an estimated 733,000 individuals, mainly children, died from complications of measles.”

What happens next is within our control; for most people in the United States, these vaccines are just around the corner. “If the case fatality were 50 percent, you can be sure measles would be eradicated quickly,” Kretsinger says. “There are some places where that fear still exists, because measles was recently one of the childhood killers.” Perhaps a little fear would do us some good.


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Old 05-06-2019, 01:12 PM
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MEASLES
NEW YORK

https://www.wsj.com/articles/what-ca...ls-11557077101
Quote:
What Can Stop the Measles Outbreak? Officials Lean on an Unlikely Band of Locals
Public-health officials are counting on community insiders for help, including a nurse who has taken a personal approach

Spoiler:
To fight the biggest measles outbreak in the U.S. in more than a quarter-century, public-health officials have tried robocalls, vaccination audits, vaccination orders and $1,000 fines. This is the standard playbook and it hasn't worked to stop the disease's spread.

Now, officials are increasingly counting on an informal network of community groups, religious leaders and local medical practitioners.

Blima Marcus, a 34-year-old oncology nurse practitioner, is working to counter antivaccination messages that have taken root in New York City's insular ultra-Orthodox Jewish communities where measles has spread. Dr. Marcus, herself a member of an ultra-Orthodox community in Brooklyn, has gathered mothers in living rooms and written and printed booklets that challenge antivaccination assertions line by line. She wants to set up a hotline to explain the science behind vaccines and take questions.

"Simple education in a respectful, hand-holding manner really is going a lot further than anything else so far," said Dr. Marcus, who has a doctorate of nursing practice.

It's a tactic that is hard to replicate, is time intensive and relies heavily on the goodwill of volunteers with other jobs. But these days, it's one of the best resources available to public-health officials who have struggled to contain the disease.

Standard public-health tools, which have been deployed successfully for years, are falling short in the face of an aggressive antivaccination campaign, growing exposure to measles in countries such as Israel, and a longstanding distrust of government or other outside sources of information. Since October, 423 cases have been reported in New York City.

Public-health authorities have had similar difficulties fighting measles in other close-knit communities in the U.S., including among the Amish in Ohio, Eastern Europeans in Washington state, and Somalis in Minnesota.

Grassroots approaches are becoming more important in public health, with infectious-disease outbreaks around the world -- including Ebola in Democratic Republic of Congo -- increasingly erupting in remote or insular communities, conflict zones and other areas where disease fighters have to grapple with economic, cultural or security challenges.

The Centers for Disease Control and Prevention has formed a work group to seek new ways to counter an increasingly vocal antivaccine movement. Trusted sources within a community's own networks "can be more effective than we can" in educating people about vaccination, said Nancy Messonnier, an expert on immunization and respiratory diseases at the agency.

Vaccination rates among children have now reached a record high in the Williamsburg neighborhood of Brooklyn, the epicenter of the outbreak, officials say, due in part to outreach and a mandatory vaccination order implemented last month. Roughly 14% of young children in Williamsburg remain unvaccinated, the city's health commissioner, Oxiris Barbot, said on April 17.

New public-health tools are needed, said Herminia Palacio, New York City's deputy mayor for health and human services, including an "aggressive counter-messaging campaign to really counteract the very intentional misinformation and disinformation that is being dangerously propagated by a small, but well-organized coalition of groups across the country."

The stakes are high. Measles may be on a path to gain a foothold once again in the U.S., CDC officials warn.

New York City's measles outbreak began when an unvaccinated child was infected on a trip to Israel. It wasn't huge at first, with fewer than 10 new cases every week. Early on, the city health department ordered more than 100 schools and day-care centers to exclude students who didn't have the measles, mumps and rubella (MMR) vaccine.

In February, an unvaccinated, infected child at a Jewish school that didn't enforce the health department's exclusion order infected other unvaccinated children, resulting in 28 new cases. That led to 17 secondary transmissions outside the school, fueling a surge in cases that continues.

Dr. Marcus, who works at Memorial Sloan Kettering Cancer Center, learned in October that antivaccination messages had taken root in ultra-Orthodox communities when a cousin invited her to join a text group. Many women weren't vaccinating their children, she said.

Alarmed by what she read, she did some research and began challenging claims that vaccines cause autism and cancer and that they can cause measles, citing scientific studies. "I hate liars," she said of her reasons for taking on the antivaccination campaign.

Skepticism about vaccines has quietly grown over the past few years, spread through written materials, conference calls and face-to-face conversations, according to city officials and local pediatricians. Some families have received religious exemptions to vaccination -- a pathway some New York state legislators are trying to close.

A group called Parents Educating and Advocating for Children's Health, or Peach, circulated a 40-page document titled "The Vaccine Safety Handbook: An Informed Parent's Guide." It mixed antivaccination claims with first-person stories and Jewish "points of interest."

Authors of the Peach document didn't respond to emails and calls for comment. Jennifer Margulis, a writer in Ashland, Ore., said the authors -- parents in New York City's ultra-Orthodox community -- asked her to speak for them because they are afraid to respond, believing they face a "double hate" of being Jewish and against vaccination.

Parents do not become skeptical about vaccines over any one document, said Ms. Margulis, who described herself as a children's health advocate who thinks parents should be able to choose whether they vaccinate their children. Instead, they start questioning vaccines when a child has a bad reaction to one. She said the parent authors don't understand why a magazine distributed five years ago has anything to do with the measles outbreak now.

Sholom Laine, who lives in the Crown Heights neighborhood of Brooklyn, hasn't vaccinated his six daughters and two sons, who range from preschool age to teenagers. He and his wife, Esther, filed a lawsuit last year against a local yeshiva over the school's reluctance to accept a religious exemption for their youngest, whom they had planned to enroll in fall 2018.

The child's enrollment is still pending for the next school year, said Mr. Laine, who declined to specify the basis of the request for a religious exemption. He said the decision to vaccinate should be a personal choice. "In the 1950s they had the measles. And everybody had the measles at a point in time, or whatever, and it was all good," he said.

Chaim Greenfeld, the father of two young sons in Williamsburg, takes issue with vaccine skeptics. "The people who don't want to get vaccinated, it's not acceptable to me. Totally not," he said. "They don't even have any Jewish reason that's telling them not to do it."

Several women in the text group Dr. Marcus had joined started messaging her privately after she responded to their concerns with scientific research, she said. They thanked her for her answers, saying they felt someone was taking their concerns seriously, Dr. Marcus said.

"It's the first time someone is giving us actual information, and doing it respectfully and not making them feel stupid," she said they told her.

Sensing a thirst for information, Dr. Marcus organized three workshops, gathering 10 to 20 people at a time and leading them through slideshow presentations explaining vaccine science.

In January, she stopped leading the workshops after starting her job at Memorial Sloan Kettering, with longer hours than a previous position. She began putting together a book to counter the antivaccination assertions in the Peach handbook and training more nurses to run workshops.

Other nurses in the Orthodox Jewish Nurses Association, of which Dr. Marcus was president at the time, wanted to help, too. She and a team spent weeks researching and compiling a 110-page manuscript, calling it PIE, for "Parents Informed & Educated."

The women at the workshops and in the text group had very detailed questions, so Dr. Marcus insisted on detailed responses. "The antivax movement has done a really good job," Dr. Marcus said. Her audience members "need to have real data. They need to have really good answers."

The nurses listed each claim they had found in the Peach handbook, followed by their findings and sources. Under "Having the measles will build my children's immune systems and make them stronger," they wrote, "False & Dangerous!" in big red letters, citing a 2015 study.

A section titled "Autism 101" featured a chart from a landmark Japanese study that showed autism rates continuing to rise even after the MMR vaccination rate declined significantly among children in one city.

Aware of Dr. Marcus's work and with measles cases surging, the city health department asked her to distribute a version of the manuscript for Passover. They were concerned that the virus would spread further with holiday travel.

Dr. Marcus and her team rushed to prepare and print 10,000 copies of a 20-page version, called "A Slice of PIE." The cover read: "Making PIEs Out of PEACH."

One afternoon during Passover week, Dr. Marcus scrambled for helpers to distribute 7,000 copies of the booklet that were sitting in a friend's garage, asking everyone she knew for help. Within a few hours, she found someone with a car, and another group with a shopping cart, to drop booklets into door slots, mailboxes and offices for $20 an hour.

The health department has asked Dr. Marcus to print 29,000 more copies of the PIE booklet to distribute to households.

Dr. Marcus and the group of nurses working with her have spent just under $12,000 of their own money covering costs so far. The organization she formed, called the EMES Initiative ("Engaging in Medical Education with Sensitivity"), has now secured funding from private donors to cover their costs, she said.

Dr. Marcus said it's too early to know whether her approach is working. A little anecdotal evidence "shows we're on the right path," she said. After one workshop, a woman got the MMR shot for her four children, she said. Another woman called a Google phone line Dr. Marcus's group had set up, asking questions about the flu shot. She later got the shot for herself and her family, Dr. Marcus said.

Another group, the recently-formed Jewish Orthodox Women's Medical Association, is launching a confidential hotline that families in the Orthodox Jewish communities can call to request vaccinations in their homes, for convenience and privacy. The group has formed a cadre of volunteer physicians to provide the service, said Eliana Fine, founder and CEO and a medical student at the Renaissance School of Medicine at Stony Brook University.

Steven Goldstein, a pediatrician in Williamsburg, found a handful of copies of the "A Slice of PIE" booklet when he returned to his office after Passover. He has asked for more copies to hand out to his patient families who questioned vaccines. "This is a little bit more approachable to the families in the community" than another booklet he has, he said.

Many parents still aren't heeding a health-department recommendation that babies between 6 and 11 months get an MMR dose, he said.

"I'm hoping it will get a lot of traction," he said of the booklet. "We're not making as much progress as we'd like to make."


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  #545  
Old 05-13-2019, 02:07 PM
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MEASLES
UNITED STATES

https://www.governing.com/topics/hea...s.html#new_tab

Quote:
Where the Next Big Measles Outbreak Could Happen

Spoiler:
Researchers who in 2015 correctly predicted where the Zika outbreak would strike in the U.S. say they think the country's next big measles outbreak is most likely to happen in Cook County.

A research project spearheaded by Sahotra Sarkar, a University of Chicago-educated professor at the University of Texas at Austin, revealed the 25 counties most at-risk for a widespread measles outbreak, like those seen in Washington, Oregon and New York. Sarkar and his former student, Lauren Gardner of Johns Hopkins University, determined Cook County was the most at-risk for an outbreak. That's based largely on the number of airplane flights to Chicago from global destinations where parents increasingly don't have their children vaccinated, he said.

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"Cook County turns out to be as important as it is, mainly because of the presence of O'Hare Airport," Sarkar said.

The study was published Thursday in The Lancet Infectious Diseases. The research took about six months to complete, using risk assessment models similar to one Sarkar and Gardner used when they determined Zika, a mosquito-carried virus that can cause serious birth defects, would first affect Texas and Florida when it emerged as a global threat to pregnant women.

Rachel Rubin, a senior medical officer with the Cook County Health Department, wasn't surprised by the study's findings. The seven measles cases reported in Illinois this year likely stemmed from one person who was infected overseas and traveled back to Illinois, she said.

"As we know O'Hare is a huge transfer point for travel within the United States, not to mention all of the international flights," she said. "I'm not surprised that their modeling would've predicted that Cook County and the city of Chicago would be such a hot spot."

Rounding out the top 10 counties identified in the study as most at-risk for a measles outbreak are: Los Angeles; Miami-Dade; Queens, N.Y.; King, Wash.; Maricopa, Ariz.; Broward, Fla.; Clark, Nev.; Harris, Texas; and Honolulu.

Since the 2015 work on Zika, Sarkar learned that a widely discredited former physician who claimed the vaccine for measles, mumps and rubella can cause autism has relocated to Austin and gained a following. Sarkar did the measles study to warn people what could happen if they choose "conspiracy theories" over science.

"It occurred to me that perhaps besides the vaccine resistance from people who bought into this false notion that the MMR vaccine has a link to autism ... the other crucial factor would be the volume of travel from countries outside the U.S. where there have been epidemics," including in European countries and the Philippines, Sarkar said.

Sarkar points to what happened in Brooklyn in October, after unvaccinated children visited Israel during a monthslong measles outbreak. They returned to their community, made up mainly of ultra-Orthodox Jews, many of whom have chosen not to vaccinate their children with MMR because they believe the vaccine is not kosher. What followed was one of the nation's largest outbreaks, prompting New York's Rockland County to declare a state of emergency, banning unvaccinated children from visiting public places.

The Illinois Department of Health recently announced it is working with the Illinois State Board of Education to conduct an in-depth analysis focusing on schools at risk for outbreaks. It also is taking steps to increase vaccination rates across the state.

Despite that, the state health department does not make public statistics on "vaccine avoidance," Sarkar said. It isn't clear whether there are enclaves of families who refuse to vaccinate based on religious beliefs or because they distrust vaccine safety.

"Estimated vaccination rates are low even though vaccination is mandatory and there are no nonmedical, nonreligious exemptions (allowed) in Illinois," Sarkar said.

"If there are pockets of resistance in Cook County like there were in Brooklyn with the ultra-Orthodox Jewish community, then there's a very serious worry."

Rubin doesn't know of any particular enclaves where people avoid vaccines because of religious edicts. But she does sometimes encounter objections to vaccines. When that happens, she tries to be diplomatic in explaining their safety and efficacy.

"It's a bad choice to refuse vaccination just because you feel that you don't want it, based on your own philosophical reasons," she said.

Rubin and Dr. Tina Tan, an infectious disease specialist at Lurie Children's Hospital, said having a high vaccination rate is most important for people who are allergic to vaccines or suffer from an ailment that suppresses the immune system, making it impossible for those children to receive a vaccine. For measles, more than 95 percent of the population needs to be vaccinated to guard against measles ourbreaks.

Sarkar said he now recommends infants get their first MMR vaccination at 6 months because of how many children remain unvaccinated in his area. The dose at 6 months may not be as effective as a dose given at 12 months, but when there's an outbreak, something is better than nothing, Sarkar said.

Countries that are particularly dangerous, Sarkar said, include India, China, Mexico, Japan, Thailand, the Philippines and a number of European countries. Those include Ukraine, the United Kingdom, France and Italy.


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Old 05-20-2019, 05:15 PM
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MEASLES
UNIETD STATES

https://www.reuters.com/article/us-u...source=twitter

Quote:
Measles outbreak spreads to Oklahoma as U.S. reports 41 new cases
Spoiler:
(Reuters) - The worst measles outbreak in the United States in 25 years has spread to Oklahoma, federal health officials said on Monday as they reported 41 new cases nationwide, raising the total number sickened this year to 880 people.

The U.S. Centers for Disease Control and Prevention reported a 4.9% increase in the number of measles cases from May 10 to May 17 in an outbreak that has now reached 24 states. The agency has been providing weekly updates every Monday.

The CDC said there had been one confirmed case in Oklahoma.

Most of the new cases were in New York, CDC spokesman Jason McDonald said, with 21 cases recorded in New York City and nine in Rockland County.

Health experts say the virus has spread among school-age children whose parents declined to give them the vaccine, which confers immunity to the disease. A vocal fringe of U.S. parents, some in New York’s ultra-Orthodox Jewish communities, cite concerns that the vaccine may cause autism, despite scientific studies that have debunked such claims.

Although the virus was eliminated from the country in 2000, meaning the disease was no longer a constant presence, outbreaks still happen via travelers coming from countries where measles is still common, according to the CDC.

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Experts warn that the outbreak is not over as the number of cases approaches the 1994 total of 958. That was the highest number since 1992, when the CDC recorded 2,126 cases.

More than 40 people in 2019 brought measles to the United States from other countries, most frequently Ukraine, Israel and the Philippines, federal officials said.
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Old 05-21-2019, 09:04 PM
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ADENOVIRUS

[this one is too long... so I have to delete parts]

https://www.washingtonpost.com/news/...rainbow&wpmm=1

Quote:
A dangerous delay
The University of Maryland waited 18 days to inform students of a virus on campus. That decision left vulnerable students like Olivia Paregol in the dark.
Spoiler:
t had been six days since Olivia Shea Paregol walked out of the University of Maryland health center without an answer for why she felt so awful.

Now, the 18-year-old freshman was curled up in the fetal position on the floor of her dorm room at Elkton Hall in College Park, her brown hair resting on the shaggy white rug. She warned her friends, Sarah Hauk and Riley Whelan, to stay away from a plastic bag where she had just vomited.

The teenagers hoisted Olivia up and shuffled to the elevator. Once inside, Olivia leaned against the wall and slid to the floor.

“Don’t sit down,” Riley said. “Come on, it’s just a short ride. You can do this.”

“I literally can’t,” said Olivia, the words slicing her sore throat like knives. “I have to lay down.”

Olivia had been sick most of her first semester living in an overcrowded dorm that was infested with mold. But her symptoms now were far worse than a cough and congestion.

Her skin was pale, and dark circles cupped her eyes. The lymph nodes in her neck had swollen so much they felt like golf balls. The freshman — who turned late-night trips to the dining hall into stargazing adventures, belted out Miley Cyrus songs on demand and easily flipped strangers into friends — was sprawled across the elevator floor.

Sarah and Riley linked arms with Olivia and made their way through the dorm lobby into the cool night of Nov. 8. They watched as Olivia trudged to a parking lot where her dad was waiting in his car. She didn’t turn back to wave goodbye.

As Olivia battled her mysterious illness, the University of Maryland was rocked by turmoil. Widespread mold that fall had forced the temporary evacuation of nearly 600 students in Elkton Hall after outraged parents besieged officials at the state’s flagship university.

The administration already was dealing with a full-blown scandal over the death of Jordan McNair, a 19-year-old football player who succumbed to heatstroke in June. Athletic trainers had waited more than an hour to call 911 after he showed signs of extreme exhaustion. His death exposed deep problems within the athletic department and led to the dismissal of the football coach, the retirement of the university president and resignation of the chairman of the university system’s governing board.


In November and December, the University of Maryland would become the epicenter of an outbreak of adenovirus, which can have symptoms similar to a cold or flu. But certain virulent strains can sicken healthy individuals and be particularly dangerous to people with weakened immune systems — people like Olivia, who was on medication for Crohn’s disease, a serious digestive tract condition.

In these cases, medical experts say, early detection can be key to treating severe adenovirus.

But the university waited 18 days to tell the community after learning the virus was present on campus. Officials discussed — but decided against — notifying students with compromised immune systems and residents living in Elkton Hall, according to records reviewed by The Washington Post.

As the days passed, more and more students fell ill.

Many parents and students have denounced the administration’s handling of the viral outbreak and the mold infestation, complaining its actions endangered thousands of students, faculty and staff on campus. In the end, more than 40 students were sickened with adenovirus, and 15 of them treated at hospitals, according to the university.

Mold does not cause adenovirus but can set the stage for other health problems. The director of the university health center, in emails to administrators, acknowledged that “mold can cause respiratory irritation that may increase susceptibility of any viral infection.”

.....

In early November, the virus was quietly spreading through campus. Only days after Olivia had slumped in the elevator at Elkton Hall, she was fighting for her life at Johns Hopkins Hospital.

On Nov. 13, her father frantically called the university from the intensive care unit in Baltimore. When McBride called back, Olivia’s father pleaded for information. What’s going on with the mold? Or was there something else on campus making students sick?


Late August 2018
Students move in
.....
During her senior year of high school, Olivia was diagnosed with Crohn’s disease, an incurable condition. She began treatment at Hopkins that left her immune system weakened. At college, she would give herself injections of Humira, an anti-inflammatory medication, every two weeks. Olivia’s parents, Ian and Meg Paregol, wanted their daughter, the baby of the family, to stay close to home.
....


Elkton Hall, an eight-story, red-brick dorm located in the shadow of the university’s football stadium, was bursting with students. Built in 1966, it was designed to hold about 530 students, but nearly 570 were squeezed into the building because of a large freshman class.

Study lounges had been converted to dorm rooms for four students and some rooms for two residents now housed three. Students crammed the narrow halls and communal bathrooms on each floor. They waited endlessly for elevators because one of the three was always broken.

Mid-September
Mold issues arise
It was one of the soggiest summers in Maryland history. By the end of September, more than 50 inches of precipitation had fallen. Eventually, 2018 would go down as the region’s wettest year on record.

Olivia’s room felt like a swamp, so humid that bath towels never dried. The air-conditioning unit in her room stopped working in the first week of September and had to be fixed repeatedly. By mid-September, Olivia and her roommate, Megan, had persistent coughs, and it seemed harder than usual to breathe.

A pungent odor hung thick, and it was impossible to ignore whenever Riley and Sarah, 18-year-old freshmen who lived together on the eighth floor, visited Olivia’s room.

Mold had surfaced earlier that summer in Elkton Hall and other dorms across campus. University officials dispatched housekeeping staff to wipe off visible mold before students arrived in August, according to workers interviewed by The Post. With damp conditions and overcrowding, it didn’t take long for the mold to return.

On Sept. 18, a resident assistant sent a message to students instructing them to check for mold.
....

“we got mold,” Olivia texted Riley later that day.

“how bad,” Riley asked.

“look under ur drawers on ur dresser,” Olivia responded. “that’s where we have it.”

The campus again sent housekeeping staff, who said that they were untrained in mold removal and without the proper protective gear, to wipe down desks and chairs with an all-purpose disinfectant. The workers were beset by scratchy throats, itchy eyes and headaches. Some called in sick and visited the health center.
....

“You have a sick building with 600 children,” one mother told university officials at the meeting. Students cried about being ill.

McBride, 50, handed out business cards and told the roughly two dozen parents and students in attendance to call him at the health center if they had concerns.

....

During the meeting at Elkton, housing officials insisted they only learned of the latest mold outbreak in recent days and blamed it on the unusually wet weather.


Mold under a desk in Olivia's room and on a sandal belonging to Megan Sassaman, her roommate, from late September. (Photos by Megan Sassaman)
What it’s like to live with mold
Hours after the meeting, administrators announced they would move students out of the dorm over the coming weeks and pay for them to stay in local hotels. They would hire an outside specialist to clean the mold and an engineer to examine the underlying cause.

That report would find that at Elkton Hall, there were “longstanding concerns for humidity levels.” Cooling systems installed in 2011 were not designed to remove moisture from the air and allowed humidity to rise, making the building susceptible to mold growth, the report said.

Mold outbreaks on campus were not new or confined to Elkton, according to workers; articles in the Diamondback, the student newspaper; and documents reviewed by The Post. Since 2017, the university has received reports of mold at all 38 residence halls in College Park, records show.

In recent years, other colleges have grappled with mold outbreaks. In October, the University of Tennessee closed a dorm housing roughly 600 students for the rest of the year. Last fall, Montclair State University in New Jersey tested mold spore levels before and after remediation even though there are no federal or state requirements to do so.

The University of Maryland, where in-state tuition, housing and other costs run about $25,000, took a different approach. It would rotate students out floor by floor while the remediation was ongoing, starting at the top of Elkton, where residents had made more complaints about mold. And, at the recommendation of the campus environmental safety team, the college said it decided against testing the type of mold, noting the Environmental Protection Agency has said such testing is unnecessary.

Late September
Students move out
Riley and Sarah, who both battled coughs and congestion, on Sept. 23 moved to the nearby Cambria Hotel with other eighth-floor residents. Contractors in hazmat suits and masks began cleanup efforts at Elkton.

A health and safety specialist who inspected Elkton on behalf of the campus labor union said the building’s condition was so bad that it looked as though it were filled with floodwater.

Workers placed dehumidifiers in the hallways throughout the building. On Olivia’s floor, a tube drained water from a dehumidifier into a drinking fountain. Olivia and her roommate, Megan, weren’t scheduled to move out for another 10 days.

Olivia, meanwhile, couldn’t stop coughing.

Olivia Paregol’s cough medication on a shelf in her dorm room. (Ricky Carioti/The Washington Post)
On Monday, Megan walked to the student health center, a red-brick building in the heart of campus, for the second time that month. Megan said that during a breathing test a physician assistant asked whether she was trying hard enough because her oxygen levels had dropped.

Megan complained in an email to university officials about how she had been treated. “[It] made me feel as though my symptoms were pushed under the rug yet again,” Megan wrote on Sept. 25 to University of Maryland President Wallace D. Loh and others. She mentioned Olivia’s illness and said: “I continue to live in an unhealthy environment. The lack of communication and lack of acknowledgement of the issue saddens me and comes across as if the University puts student health as a low priority.”

Let us know
Did you receive inadequate care at a college student health center? Tell us your story.
After more than a week of relentless coughing, Olivia now had a sore throat and chest congestion. On Sept. 26, she also visited the student health center at the urging of her parents. There, a doctor diagnosed her with an unspecified viral upper respiratory infection with a cough and “exposure to mold,” according to her medical records. She was prescribed cough medicine and a nasal saline spray.

In an effort to understand the effects of the mold infestation, health center staff, at McBride’s direction, had begun to take note of where students who came for treatment were living and if their respiratory symptoms were worse inside the dorms.

Megan, left, and Olivia apply face masks in their hotel room Sept. 28 after the mold forced them out of their dorm. (Megan Sassaman)
After the relocation plan was announced on Sept. 21, Megan’s parents, Kim and Kevin Sassaman, sent emails to top university officials asking why Megan and Olivia couldn’t be moved to a hotel sooner, given their poor health. With approval from a housing official, the two students moved into the Cambria on Sept. 26. The roommates stocked up on beauty masks and snacks for their makeshift dorm room.

Two days after they checked into the hotel, McBride, the director of the health center, wrote Olivia that a doctor there “let me know that you’re feeling unwell and that mold may be a factor. I know that you’re scheduled to move for cleaning in early October. Do you want for me to advocate for a sooner move to another location on campus until after the cleaning is complete?”

Olivia responded: “My roommate actually already had us moved. Thank you for reaching out, but I’m already in a hotel at the moment.”

After 11 days in the hotel, Olivia and Megan moved back into Elkton Hall, where the remediation was winding down.

Early October
Health center overwhelmed
Parents increasingly took to social media to vent about conditions on campus. On Oct. 8, they started to complain on Facebook that their children were misdiagnosed at the health center, were told they had unspecified viruses or couldn’t even get an appointment.

In an interview, Angela Hayes said her son, a freshman who lived in Easton Hall, repeatedly sought help for a sore throat and high temperature. Health center staff told him he had a virus. When he didn’t improve, she said, he went to a nearby urgent care center, where he was diagnosed with acute tonsillitis and prescribed antibiotics.

“It was almost like a factory,” Hayes said of the university health center. “They’d tell students, ‘You’re fine, you’re fine, you’re fine.’ ”

McBride told The Post that in October he noticed an uptick of fever-associated illnesses that were not the flu. He scheduled a meeting in early November of the Campus Infectious Disease Management Committee, a group that evaluates health threats.

In mid-October, Debbra Aiello’s 18-year-old son, who lived in La Plata Hall, called her at home in New Jersey complaining of a bad headache, sore throat and high fever. She drove down to College Park and brought him back to a pediatric emergency room in New Jersey. He had a 104-degree fever, and after a battery of tests, doctors determined he had an ear infection and adenovirus.

Aiello said she had never heard of adenovirus and had no clue that it could severely sicken a healthy teenage boy. It took him nearly a week to recover at home.

When his father drove him back to College Park, the son fell ill again, so they headed to the health center.

But there was a two-hour wait. They left campus and drove to an urgent care facility. Had the health center been able to treat the student, the university might have learned much earlier about the dangerous virus snaking its way through campus.

Late October
Another controversy
Midway through the fall semester, the death of Jordan McNair still dominated headlines.

In late October, the University System of Maryland Board of Regents huddled behind closed doors to discuss an investigation launched in the wake of his death that revealed poor management of the athletic department. During a May 2018 workout, Jordan had hyperventilated and complained of cramps, but athletic trainers waited for about an hour to seek emergency help. He underwent a liver transplant before dying in June.

Jordan McNair, then a high school football lineman, in 2016. (Barbara Haddock Taylor/Baltimore Sun/AP)
“You entrusted Jordan to our care and he is never returning home again,” President Loh told the McNair family.

The case led to a review of the university’s accreditation, which could threaten the school’s federal funding.

On Oct. 30, the Board of Regents recommended that football coach DJ Durkin keep his job, triggering a barrage of criticism, including from Maryland Gov. Larry Hogan (R). The next day, the university reversed course and dismissed Durkin. The chairman of the Board of Regents would also resign amid the turmoil.

As this was unfolding, Olivia languished. She bailed early from a Halloween party, where she was dressed as one of the Three Blind Mice. She had painted her glasses black, dark enough to cover her puffy eyes, and told friends it pained her to speak.

“i can’t swallow my own spit,” Olivia texted Sarah on Oct. 31, “and my neck is so lumpy bc my lymph nodes so swollen.”

That day she went to her family doctor, where a pediatric nurse practitioner tested her for strep but found none. Two days later, on Nov. 2, as her symptoms worsened, Olivia’s father urged her to visit the campus health center. There, she complained to a physician that she had a fever, fatigue and a sore throat and mentioned that a friend had mono. The doctor ordered a test for mono, but Olivia didn’t have time to wait at the lab.

That evening, she was headed to a birthday celebration for her sister. At the dinner, Olivia whispered in between coughs that she was sure she had mono. Her father worried about her weakened immune system and was determined to take her home from school. To his surprise, she did not object.

Olivia soon retreated to her childhood bedroom. Over the weekend, she complained of chills and took hot showers to soothe her shivering body.

“r u coming back today?” Riley texted her the afternoon of Nov. 4, a Sunday.

Olivia replied that she didn’t know.

“my fever won’t break,” she wrote.

Olivia's bedroom at her family's home in Glenwood, Md. (Ricky Carioti/The Washington Post)
Early November
Virus detected on campus
The university’s first warning of adenovirus among students came the day before Olivia’s Nov. 2 visit to the health center. McBride received an email from a physician at the University of Maryland Medical Center in Baltimore, who told him about a College Park student who had been hospitalized there and tested positive for the virus.

....

The virus was in the news: It had been linked to the deaths of children with weakened immune systems living at a long-term care facility in New Jersey. The outbreak ultimately killed 11 children and sickened more than two dozen others.


Certain strains can severely sicken healthy adults. The military has had multiple fatal outbreaks in barracks. A vaccine is available to military personnel but has not been approved for the general public.
...

On Nov. 7, McBride convened the meeting of the Campus Infectious Disease Management Committee, which included about a dozen officials from student affairs, athletics, communications, housing and other departments. They discussed updating the campus plan for disease outbreaks. McBride told them about the increase in fever-associated illnesses on campus and several cases of hand, foot and mouth disease, which causes a mild rash and mouth sores.

McBride, however, did not advise the committee of the confirmed case of adenovirus or the second suspected one, according to the minutes. Asked why he didn’t bring up adenovirus, McBride told The Post that it is “not currently a reportable condition . . . we were more focused on what we knew at that time.”

Unlike some other infectious diseases, adenovirus is not governed by mandatory state or federal reporting requirements — doctors or hospitals are not required to alert health officials or the public when the virus is discovered.

Two days later, on Nov. 9, Andrew Catanzaro, a physician at Washington Adventist, followed up with McBride and emailed him that he was concerned about “others coming into the hospital who are quite ill . . . Perhaps you have an outbreak of Adenovirus on the campus.”

That day, the campus health center began testing for adenovirus. The nasal swab used to detect adenovirus is significantly more expensive than a flu or strep test, and it is not available at many primary care and urgent care clinics.

That Friday evening, McBride sent out a campuswide email about flu and virus prevention techniques, such as washing hands, and noted that there had been several cases of hand, foot and mouth disease. He made no mention of adenovirus.

“This is no cause for alarm,” he wrote in boldface type, “but it does give us the opportunity to practice effective prevention techniques for these types of illnesses.”

By then, Olivia had been out of school and at home for a week, except for a brief visit to Elkton to pick up her medication. She kept Sarah and Riley in the loop, texting “i just puked blood.”

Olivia texted a friend, Riley Whelan, as her condition worsened. (Riley Whelan)
She returned to her pediatric nurse practitioner on Nov. 5. The following day, her parents took her to the emergency room at Howard County General Hospital, where doctors treated her as if she had bacterial pneumonia and sent her home with antibiotics.

But the medication wasn’t working, and her chest began to hurt when she coughed.

Three days later, Olivia’s parents brought her back to Howard County hospital. She was admitted and tested for influenza, respiratory syncytial virus (RSV), hepatitis and bacterial blood infections, records show. All came back negative. But physicians did not test for adenovirus.

They knew she had pneumonia but it was unclear as to what had caused it and why she wasn’t getting better. They continued to treat her with antibiotics.

Howard County hospital officials later declined to answer questions about why they did not test Olivia for adenovirus.

Ian and Meg Paregol traded off nights sleeping on a small couch next to Olivia’s hospital bed. Ian, an attorney who represents clients with disabilities, had learned how to advocate for patients under difficult circumstances. He barely slept as he watched his daughter’s oxygen levels dip well below normal on Saturday night.

Olivia’s left lung was filling with fluid.

Mid-November
10 days since virus detected
On Nov. 11, with her condition worsening, Olivia was moved into the intensive care unit. Doctors suggested puncturing her back with a needle to help drain fluid from her lungs.

Olivia, now struggling to speak, asked: “Will it hurt?”

Suddenly, her eyes rolled back and she suffered a seizure, thrashing against the bed. Medical staff rushed in, and Ian, fearing she was dying, ran from her bedside into the hallway. He fell to his knees and started to pray. Doctors intubated Olivia and administered sedative drugs.

That night, Howard County physicians planned to airlift her to Johns Hopkins in Baltimore, where she could undergo a Hail Mary treatment: the extracorporeal membrane oxygenation machine or ECMO. Tubes circulate and oxygenate the patient’s blood outside of the body, giving the heart and lungs a chance to recover.

Ian and Meg drove to Hopkins. They took the elevator to one of the top floors of the hospital and stood by the window. There, they stared into the night sky and waited for the flashing lights and whirring blades of their daughter’s helicopter.

Back on campus, Sarah’s text messages to Olivia went unanswered.

“Okay you’re scaring me,” Sarah wrote. “I just wanna know ur okay/coming home tomorrow.”

Olivia’s roommate, Megan, was too sick to leave their dorm room. Megan had tried to get an appointment at the campus health center, but nothing was available.

On. Nov. 12, Megan’s mother, Kim Sassaman, wrote to Loh and McBride about her daughter’s illness and questioned whether mold remained in the dorm room. She asked for “full disclosure” on what was making her daughter and other students sick.

Olivia's University of Maryland student ID sits in a card holder on her cellphone. (Ricky Carioti/The Washington Post)
“Her constant illness is not an isolated case in Elkton,” Sassaman wrote. She alluded to Olivia, saying that Megan’s roommate was hospitalized with pneumonia and another student — their 18-year-old friend Humza Mohiuddin — had been hospitalized with respiratory issues.

McBride responded quickly and traded emails with Megan’s mother. “We’ve discovered several cases of a particularly nasty strain of adenovirus (a typical cold virus),” McBride wrote in one message. “If Megan has not been tested for this, we can either perform a swab at the UHC for it or you can ask her current caregiver to test for it.”

By then the state Department of Health was aware of the outbreak. On Nov. 12, Catanzaro, the infectious disease physician at Washington Adventist, alerted the state about two students who tested positive for adenovirus. The next day, McBride learned that a student tested at the health center was also positive for adenovirus.

At Hopkins, doctors began the ECMO treatment for Olivia and ordered dozens of tests, including a screening for respiratory viruses that could detect adenovirus.

After Olivia showed no improvement on Nov. 13, Ian, in a panic, called the university.

The race to identify Olivia's mystery illness
When McBride returned the call later that day, Ian pressed him about her illness and any connection to mold.

“I need some answers,” Olivia’s father pleaded. “I need to know what’s going on because she should not be this sick.”

“We’ve had a couple of cases of adenovirus appear,” McBride responded, according to Ian. He said he told McBride to immediately call Hopkins to share what he knew.

Later that afternoon, McBride left a voice mail for Ian, saying he had spoken to medical staff at Hopkins: “The state health department is getting involved as well, so we can try to prevent further spread of the virus called adenovirus, which is actually a pretty common cold virus. But every once in a while it causes a more severe illness. So we suspect that’s what it might be.”

Suddenly, Ian had a sobering realization: For the past week, doctors had been giving her a cocktail of antibiotics, which would only be effective if a bacterial infection were the underlying cause.

But the true culprit had been a virus.

Although many people recover from adenovirus on their own, immunocompromised patients with severe cases, such as Olivia, can benefit from antiviral drugs, such as cidofovir. The drug carries significant risks, including kidney failure, and has not been studied in large-scale trials for use in treating adenovirus.

“You want to start it before the patient gets too sick,” said Ivan Gonzalez, a physician at the University of Miami who has studied the use of cidofovir in adenovirus patients with compromised immune systems.

In Olivia’s case, doctors didn’t wait. On Nov. 13, hours after tests confirmed she had adenovirus, they began to administer cidofovir.

That afternoon, Linda Clement, vice president for student affairs, wrote to Loh, “We have three cases of adeno . . . it is likely [Prince George’s County] will declare an ‘outbreak.’ ”

Mid-November
13 days since virus detected
About two weeks had passed since McBride learned of the first adenovirus case on campus. The unofficial tally of students with the virus was up to at least five, three of whom required hospitalization. There probably were many others who had not been diagnosed. The University of Maryland was now navigating one of the country’s first adenovirus outbreaks on a college campus.

Still, there was no announcement.

On Nov. 14, McBride sent an email to Richard Brooks, a CDC employee assigned to the state health department, and shared the university’s campuswide virus prevention email that was sent on Nov. 9. McBride asked Brooks, who works with state officials on outbreaks, if the CDC wanted the university to do more “adeno specific communication” with people on campus.

Later that day, Brooks responded by email: “Based on our conversation with CDC, we don’t think additional, more specific messaging about adenovirus is necessary at this point in time.”

On Nov. 15, McBride gathered the infectious disease committee — this time to talk about the growing number of adenovirus cases. The university’s plan for responding to low-level health threats states that officials should be “providing information to the community about the infection in question, increasing prevention measures in resident halls/dining halls/public locations.”


The group suggested conferring with Katie Lawson, the university’s chief communications officer, about sending a message to students who had compromised immune systems and to residents of Elkton Hall given “heightened sensitivity” over the mold, according to minutes of the meeting.

No message was sent that day alerting students, but McBride warned his counterparts at Georgetown, George Washington, American, Howard, Towson and other regional colleges. In an email, he told them about a “cluster” of adenovirus cases, noting that three students had been hospitalized, including one in “very serious condition.”

“Please keep your eye out for this on your campuses,” he wrote on Nov. 15.

Mid-November
15 days since virus detected
At Hopkins, additional tests soon revealed that Olivia had adenovirus 7, a virulent strain responsible for the deaths of children in New Jersey.

When Angela Crankfield-Edmond, a health official with Prince George’s County, learned on Nov. 16 that preliminary results showed Olivia had the pernicious strain of adenovirus, she wrote to McBride, “Please do not tell anyone until we get the final result.”

Crankfield-Edmond later said the state instructed her not to make anything public until final results were available.

Hopkins physicians continued to give Olivia cidofovir and also began a blood treatment designed to boost her immunity.

But it made no difference.

Fluid rapidly accumulated in her once slender 130-pound body. By Nov. 16, she had swollen to 232 pounds. Her blood pressure plummeted. Her kidneys and liver were failing.


Glenn Whitman — an ICU physician at Hopkins — gathered Olivia’s family in a conference room to explain the best chance to save her life.

An open abdominal surgery could release fluid and pressure. An adhesive film would temporarily hold Olivia’s organs in place. If she survived, she could face up to a year of recovery in a hospital bed.

Ian and Meg asked him: What would he do?

Whitman broke down into tears. He had children as well, he told them. And he would do everything to save the Paregols’ daughter, just as if she were his own.

On Facebook, Ian asked family and friends to pray as Olivia underwent surgery on Saturday, Nov. 17.

The pulse within her feet had become faint. Now doctors were struggling to pick up a pulse in her legs. Amputation was a possible last resort.

Ian and Meg tried to channel Olivia’s mind-set. At what cost would she be willing to live?

“Ultimately what we really need is a miracle,” Ian posted on Facebook.

Early Sunday morning, on Nov. 18, the Paregol family made the 45-minute drive home from Hopkins to shower and change clothes. A nurse called with grim instructions: Come back as soon as possible.

With permission from Ian and Meg, doctors stopped giving Olivia blood pressure medication. They warned that she could die within minutes.

Country music — Olivia’s favorite — played in the room as her parents and two siblings, Zoe and Evan, took turns by the teenager’s bedside. They remembered the vacation to Turks and Caicos and trips in the family Prius with Olivia crammed in the middle seat between her brother and sister.

One by one they held her hand for hours that Sunday afternoon and told her how much they loved her.

At 10:15 p.m. on Nov. 18, Olivia Shea Paregol was pronounced dead.

Doctors listed three causes of death: organ failure, acute respiratory distress syndrome and adenovirus.


Late November
Defending the response
Early the next morning, McBride wrote to Brooks, the CDC employee working with state health officials, saying he had an unconfirmed report that Olivia had died. Given that she had adenovirus 7, he wondered if they should go public.

“We’ve discussed internally here, and we don’t feel that this changes our plans to do any messaging,” Brooks responded an hour later. “To be clear, we are not recommending that you NOT put out any additional communications (i.e. if you feel the need to send any additional messaging, we are fine with that). We just aren’t recommending that you need to do so.”

After reaching out to the state, McBride faxed the result of Megan’s test at the campus health center to her family doctor — she also had adenovirus.

Around 2:30 p.m. that day, Nov. 19, McBride sent out a campuswide email that for the first time publicly acknowledged adenovirus, saying that there were six confirmed cases over the past two weeks. The next day, he revealed in another email to the campus that the virus had killed an unnamed student — Olivia — and urged others to take the virus seriously.

McBride privately expressed concern that an upcoming news article in the Baltimore Sun about the adenovirus outbreak might suggest that the University of Maryland “should have done more,” he wrote in an email to Crankfield-Edmond, the Prince George’s County health official.

“There was nothing else you could have done,” responded Crankfield-Edmond, who days earlier had told McBride to remain silent. “It’s a cold virus that is in the community.”

The next day, on Nov. 21, McBride appeared on a local television segment and defended the university’s response to the adenovirus outbreak.

“While we want to acknowledge that there are cases on campus, we don’t necessarily want to stir up unnecessary angst,” McBride said in the interview.

“We didn’t intentionally delay”: The university responds
The Paregol family spent Thanksgiving planning a funeral. Two days later, on a rainy Saturday, the ground so wet that heels sunk into the mud, Olivia’s family and friends gathered at the Good Shepherd Cemetery in Ellicott City, Md.

Olivia’s longtime pediatrician, Jacqueline Brown, attended the service. Brown kept revisiting the early days of November, when Olivia had come into her office, ailing without an apparent cause. Brown said she would have recommended an adenovirus test if she had known that the virus was circulating among Maryland students.

“If we were looking for it sooner, then maybe the treatment might have worked,” Brown told The Post. “I think by the time that that’s what we realized, she was already very sick. And I’m not sure that it started in time to have made a difference.”

The following Monday, McBride publicly announced that there were three more cases of adenovirus.

On Nov. 28, four days after burying Olivia, her father wrote to McBride, accusing the university of a “pattern of indifference” and questioning the failure to alert Olivia about adenovirus.

“The information could have saved her life and a proper course of treatment could have been identified well before we were told about Adenovirus on 11/13,” he wrote, referencing his phone call that day with McBride. Ian told McBride that had physicians known what to look for, the antiviral treatment “could have been initiated long before she became critically ill.”

The Paregols wanted to sit face-to-face with the university president and try to understand why their daughter was dead. Two teenagers within six months had lost their lives. Ian and Meg wondered: Had the school learned nothing from Jordan McNair?

In early December, the Paregols gathered around a coffee table in the president’s office. Ian sat across from Loh, and Meg faced Clement, McBride’s supervisor. By then, the University of Maryland had disclosed that adenovirus had sickened at least 30 students.

“My condolences to your family,” Loh said. “This is such a terrible loss.”

After an uncomfortable silence, Ian began peppering Loh with questions.

Ian Paregol waits to pick up records at the University of Maryland in College Park. (Jabin Botsford/The Washington Post)
Ian wanted Loh to understand the connection he saw between the mold infestation and the adenovirus outbreak. Ian said he knew that mold did not cause the virus, but the mold had made Olivia sick all semester. That made her more susceptible to other respiratory infections, such as adenovirus, he said. Her system was already compromised from her Crohn’s medication.

Ian asked Loh who had made the decision to stay quiet about adenovirus since it was discovered on Nov. 1, the day before Olivia visited the health center.

Loh, according to the Paregols’ recollection, responded that he had many employees and relied on their expertise for advice.

“You’re the president,” Ian said. “You’re the face of this university. You make the decisions. So this is all on you.”

After 30 minutes, the Paregols said an official began to usher them from the room. The family insisted on a few more questions but left unsatisfied with Loh’s responses.

In a statement to The Post, Loh, who is planning to retire in 2020, said: “I cannot speak to the medical care that Olivia received at emergency rooms or hospitals, or to whether or not an antiviral medication treatment could have saved her life. We care tremendously about student health and well-being, and we offer our condolences to the Paregol family for this tragic loss.”

Clement, in a recent interview with The Post, said she stood by the decision to take 18 days to publicly disclose the presence of adenovirus and felt reassured after two outside physicians reviewed the response to the outbreak. “We responded as quickly as we could,” she said. “They confirmed that the way we handled it was well done.”

A spokeswoman for Johns Hopkins Medicine, which operates both Howard County General Hospital and Johns Hopkins Hospital, declined to answer specific questions about Olivia’s treatment.

“We are deeply saddened about the death of Olivia Paregol,” the spokeswoman said in a statement. “Ms. Paregol was diagnosed with an adenoviral infection, for which there is no FDA-approved treatment. Her case was quite complex, and it would be difficult, if not impossible, to summarize it in a brief media statement.”

Family and friends remember Olivia
Late November – Early January 2019
The aftermath
At Elkton Hall, students were skeptical of the university’s efforts to eradicate the mold.

Days after Olivia’s funeral, her friends Humza and Megan returned to the dorm and found mold growing on the shoes in their closets. Housing officials gave Humza a humidity monitor for his room.

Megan eventually decided she had had enough and transferred to a school in another state.

In early January, Sarah and Riley joined Olivia’s family at Elkton Hall to clear out the rest of her belongings. Olivia’s parents and sister pulled up to the dorm on a cold, cloudy morning. They stood silently with housing officials and waited for the elevator, holding empty duffel bags.

Ian asked to go the eighth floor where Sarah and Riley had decorated a bulletin board with red construction paper and photos of Olivia’s brief time on campus. They wanted to feel like she was still a part of Elkton. As he looked at his daughter’s face, Ian broke down in tears.

In Room 3152, Sarah and Riley began to sort through Olivia’s clothes. They took some T-shirts, a pillow and folded up the tapestry of the world map. They planned to hang it on the wall of their on-campus apartment in the fall.

Sarah lay down on Olivia’s bed and stared at the ceiling. She wiped tears from her eyes.

Several days later, Sarah returned to Elkton Hall to move in for the spring semester.

She walked toward the elevator and looked up at the bulletin board. Olivia’s smiling face was gone. All of it had been taken down.



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Old 05-22-2019, 11:15 AM
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Quote:
Originally Posted by campbell View Post
ADENOVIRUS

[this one is too long... so I have to delete parts]

https://www.washingtonpost.com/news/...rainbow&wpmm=1
Holy crap!!!
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Old 05-22-2019, 11:27 AM
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Maybe we need a "University Officials Behaving Badly And I Say Fry Em" thread. This would be a good inaugural post.
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Old 05-24-2019, 02:46 PM
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Mary Pat Campbell
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MEASLES
UNITED STATES

https://www.nytimes.com/2019/05/20/h...-new-york.html

Quote:
Measles Outbreak Now at 880 Cases, With Fastest Growth Still in New York. Warming weather usually slows transmission of the virus, but it is not clear that this outbreak is fading, experts said.
Spoiler:
There have now been 880 measles cases reported in this year’s outbreak, already the largest since 1994, federal health officials said on Monday.
An additional 41 cases were reported last week, according to the Centers for Disease Control and Prevention. Of those, 30 were in New York State, which is having the country’s most intense outbreak, largely in Orthodox Jewish communities.
Most of those new cases were in New York City, and nine were in suburban Rockland County.
Cases have now been recorded in 24 states.
It is too early to tell whether the outbreak is slowing down, a C.D.C. spokesman said. In New York, transmission of the virus briefly appeared to slow in January, but then sped up in February.
An outbreak of geographically related cases is not considered to have ended until 42 days—two back-to-back 21-day incubation periods—have passed without a new case, the C.D.C. spokesman said.
Measles transmission tends to fade when warm summer weather arrives, other experts said. It is not clear whether that is because children are no longer gathered close together in school, because families spend less time indoors or because virus-laden droplets—like those containing influenza virus—stay airborne longer in cold, dry air than in warm, humid air.
In the Pacific Northwest, which has been experiencing an outbreak unrelated to New York’s, immunization rates have jumped upward even on Vashon Island, Wash., which has long been known for its large number of parents who refuse to vaccinate their children.
Vashon, a haven for artists and organic farmers only 22 minutes from Seattle by ferry, has seen more parents accepting the vaccine for a combination of reasons, The Associated Press reported.
Many are worried about the outbreak, and some have taken advantage of efforts to make shots more available. Some residents are tired of the island’s reputation as the epicenter of vaccine rejection; the population is changing as wealthier commuters have moved in.
Vaccination rates among kindergartners in the island’s public schools rose to nearly 74 percent in 2018 from 56 percent in 2012, according to the county health department. That is still well below the 95 percent rate needed to assure that measles does not spread widely if it is introduced.
On May 10, Washington State got rid of the parental right to claim a “philosophical exemption” to the measles-mumps-rubella vaccine for schoolchildren. The law takes effect in July.
Washington’s outbreak has not reached Vashon Island; it is centered in Clark County, which is on the Oregon border.

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