in the spring of 1993 an unexplained
illness struck the residents of
Milwaukee Wisconsin 400,000 people
developed serious gastrointestinal
illness 4000 were hospitalized and by
the time it was under control more than
100 people died
health officials suspected it was
influenza but it was something more
serious and much more difficult for
medical detectives to uncover
Milwaukee Wisconsin the 17th largest
city in the United States with a
population of almost 1 million people
it's a city known for its German culture
summer festivals and long cold winters
with plenty of snow
Milwaukee is the home of several large
breweries producing 11 million barrels
of beer annually but in the spring of
something else an unexplained outbreak
of gastrointestinal illness which spread
rapidly throughout the community four
thousand people rushed to area hospitals
all with the same symptoms severe cramps
diarrhea nausea and fever I read the
diary off and on all week
I miss two days of work and I thought it
was gone and came back again hardest-hit
were individuals with weakened immune
systems infants the elderly cancer and
AIDS patients and those who had organ or
bone marrow transplants four-year-old
Becky Furman suffered from a
particularly bad case she was just a
vibrant child she demanded the center of
attention but we gave it to her
willingly but very healthy kid once she
caught up on the normal things like
infants do she just went with it she was
highly intelligent very vivacious very
talkative very friendly just a normal
kid
Becky Fuhrman was born HIV positive
which made her particularly susceptible
to the mysterious outbreak this got to
be absolute water turning from brown to
yellow to green terrible odor and she
would have eight nine ten eleven twelve
movements a day forty year old Antonio
Claudio was also affected like Becky he
too is HIV positive but the severity of
the cramps and diarrhea he developed
during the outbreak was alarming every
time
like is this this what's happening to me
a nature course of the virus itself of
hiv/aids or is just something else the
illness spread rapidly throughout
Milwaukee pharmacies ran out of anti
diarrheal medicine schools were closed
and absenteeism was at record levels in
the business community
Maryland marchionne covered the outbreak
for the Milwaukee Journal newspaper for
us at the paper it was like having a
serial k*ller loose for a medical
reporter because it was a lot of
confusion not a lot of information about
what could be causing the outbreak
people were calling alarmed and
concerned the primary suspects were
Shigella Giardia can't blow back - or
salmonella
common bacteria and parasites which
caused these symptoms
stool samples from the infected
individuals were all negative we knew
this was big I mean we knew a lot of
people were sick we know a lot of kids
were sick we were beginning to get
reports from hospitals that patients
particularly the immune compromising
conditions particularly hiv/aids we're
having very difficult times shaking
loose of this outbreak and so we were
beginning to understand that this was in
fact an epidemic and health officials
had no idea what was causing it within
24 hours of the outbreak the mayor of
Milwaukee knew he faced a serious
dilemma no American city had ever faced
this type of crisis before the concern
in the health department was the
beginning of you know a real concern
what is this you know how could so many
people get sick all at one time
City Health Commissioner Paul nanus
learned that stool samples from the sick
patients were all negative
he had no scientific leads knowing that
for an outbreak of this size as we were
recognizing it was certainly large with
it would have either had to be food
water or air there's no other common
connector or vector that would have had
occasion to make so many people sick on
once if the outbreak was caused by a
contaminated food source stool samples
would contain the bacteria which caused
it and health officials can find no
common food source that all of the sick
individuals use
food illnesses usually center around a
common food distribution center
processing planet restaurant or grocery
store but one common element among all
of the infected individuals was water
officials analyzed the water quality
records at the city's municipal water
supply but all of the water quality
levels were within guidelines
established by the Environmental
Protection Agency for safe drinking
water everything that we saw told us
that our process was working real well
and that we were meeting all those
statement arrow mandates we went back
and indicated that to the Health
Department and they continued on with
their investigation into other areas
the only remaining element common among
the infected individuals was the air we
had initially suspected that perhaps was
some kind of fast-acting airborne virus
that might be out there because it
wasn't that flu season but when
scientists looked at the distribution
pattern of the outbreak they noticed
that most of the cases were clustered in
the south side of the city
normal uniform distribution of illness
head had been an airborne virus because
it would have started at a point and
moved outward since the outbreak seemed
to be centered in Milwaukee South Side
this narrowed the focus of the
investigation becky Fuhrman lived on
Milwaukee's Southside her doctors had no
idea what caused her illness and soon
discovered they couldn't cure it in
individuals like Becky who had HIV one
of the things was that she was limited
in what she could do as far as where we
could go and what we could do with her
as far as playing because she would have
these accidents another thing was the
general weakness because of the constant
diarrhea gastrointestinal illness is
usually caused by something that is
ingested once again pointing to food
water due to the widespread nature it
would be very difficult for a single
food to be eliminated and since the
widespread nature of illness in a
community whereas water gets to a lot
more people a lot quicker and on a much
more widespread basis and you expect a
single food item the water plant which
supplied Milwaukee's Southside reported
that the only unusual redoubt was a
Pekin turbidity one week before the
outbreak turbidity measures the amount
of foreign particles in the water after
a rainstorm or when snow melts turbidity
levels will temporarily rise storms
churned River and Creek bottoms and
melting snow will often gather particles
as it runs into streams health officials
wondered if the increase in turbidity
levels was cause for concern the
municipal water supply was disinfected
with chlorine was it possible that the
city's water supply was contaminated
with something that didn't show up in
water tests and the chlorine would not
k*ll if so the entire city would be at
risk and one of the city's largest
industries could also be affecting the
brewing industry
the breweries were among the largest
users of municipal water if there was an
unknown organism in the water was it
being shipped all across the country by
the tens of thousands of gallons a day
health officials suspected that
something in Milwaukee's water supply
was causing the outbreak of thousands of
cases of gastrointestinal illness the
water department insisted that the water
quality levels were all within standards
set by the Environmental Protection
Agency and that the water was safe to
drink hospitals and laboratories
throughout Nowacki continue to analyze
stool samples from the thousands of
individuals affected everything pretty
much was a dead end
everywhere we looked was everything was
negative sandy Schrader was doing some
of those tests at a local hospital as a
microbiologist she was performing the
routine tests on patients hospitalized
with the mysterious illness the standard
test was an iodine stain when added to
the stool samples the iodine would show
if parasites were present but all of the
iodine tests were negative on her own
sandy Schrader Asst decided to go one
step further she remembered something
she learned earlier in her training that
microbiologist should be on the lookout
for parasites which do not show up on
standard tests with that in mind she
noticed a number of unusual structures
in the samples structures which didn't
react with the iodine stain at that
point I knew and again it's more of a
feeling after so many years that this
means something that's more or less what
I get this can't be artifact I don't
know exactly what it is yet but it means
something that's your first cool so she
performed an acid fast stain she flooded
the stool sample with a red stain
then washed the sample with alcohol and
sulfuric acid during the final step an
additional green stain is added under
the microscope she thought she saw a
highly infectious potentially deadly
parasite first a success stain wasn't
real definitive this is probably our
first line it's easiest as quick as it's
done in about 10 minutes and I didn't
feel comfortable calling it on that so
we went on and did a fluorescent stain
the fluorescent stain introduces the
parasites antibody to the sample along
with the fluorescent agent under the
microscope
sandy Schrader us noticed a bright green
glow
it was the fluorescent agent attached to
the antibody proof that a parasite was
present
it was Cryptosporidium where little is
known about Cryptosporidium since it
first infected humans just over 20 years
ago
it's a one-celled organism a protozoan
parasite which is found in feces from
young farm animals particularly calves
Cryptosporidium is an 80% of surface
water largely due to animal feces washed
from farms into nearby streams by heavy
rains and melting snow when contaminated
water is ingested by humans
the Cryptosporidium are in small shells
called
hoses they attach themselves to the
intestines and sometimes the gallbladder
here you can see the tiny
Cryptosporidium is scaping from their
shells once they do
they multiply ivenn millions when they
spread throughout the gastrointestinal
system they absorb nourishment
preventing the body from retaining
fluids and causing severe cramps
expl*sive diarrhea and other flu-like
symptoms a healthy individual with a
healthy immune system and usually get
rid of the parasite within a week with
no lasting effects but it can be deadly
for those with weakened immune systems
like the elderly AIDS and cancer
patients and individuals with organ and
bone marrow transplants when lab
technicians retested other stool samples
they confirmed what sandy Schrader is
first discovered Cryptosporidium was
found in seven more stool samples once
you knew what you're looking for it was
everywhere I mean we knew that now we
had the agent now where was it coming
from that was the next step since
Cryptosporidium is a waterborne parasite
it renewed fears that the city's water
supply was contaminated the mayor called
an emergency meeting of both city and
state health officials during that
meeting the mayor noticed one of the
participants dr. Jeffrey Davis the state
epidemiologist was drinking diet soda
and not water when the mayor turned to
dr. Davis and asked if he would drink
the city's water
dr. Davis said no he wasn't difficult
once I asked dr. Davis if he drank the
water I mean if he suspect he's a
scientist he's an expert and in a very
honest person you know if he suspected
that there could be problems with the
water that's pretty good
test right there since the boiling was
the only way to get rid of
Cryptosporidium boys the mayor
immediately issued a boil water advisory
recommending that all water be boiled
for at least five minutes before use it
was a bold recommendation with
wide-ranging implication
since tests for Cryptosporidium in the
city's water supply have not yet been
completed dental offices were closed
since their drills were water cool
restaurants were also affected since
they use water for ice and washing
dishes
three days later tests on Milwaukee's
water
done by an independent laboratory
confirmed that could those Meridian was
present in the purified water from the
Howard Avenue water plant the news of
Cryptosporidium contamination was
especially terrifying to one segment of
the population people with HIV
infections or AIDS for these patients
that was life-threatening immediately
they knew what crypto was this was not a
new illness to them it was something
they dreaded that they may be heard or
seen and friends from around the country
and they knew exactly how serious it was
for them Cryptosporidium premised immune
system is a death sentence Doug Nelson
and the organization he directs the aids
Resource Center of Wisconsin went into
crisis mode
he knew that individuals with HIV AIDS
would never get rid of the parasite but
his goal was to make sure no one else
became infected when the local breweries
learned about the parasite in the water
they had no concerns about their product
the breweries have their own water
purification process which included
boiling the water before brewing this
would have eliminated Cryptosporidium
and any other parasites the Miller
Brewing Company made available to the
public emergency supplies of purified
water as a gesture of goodwill to the
commune
the Howard Avenue water plant was
immediately closed the water flushed out
and the entire plant disinfected from
top to bottom to remove any traces of
Cryptosporidium
a few days after the boil water advisory
the number of cryptosporidiosis cases
dropped significantly but the levels
discovered in Milwaukee's water supply
had been quoted one businessman
traveling through Milwaukee's Airport
reported getting sick after drinking
just enough water to swallow a few
aspirin
Antonio Claudio was living in Houston
when he tested positive for
cryptosporidiosis he believes he was
infected while visiting his mother who
lived on the south side of Milwaukee
since there is no cure for
cryptosporidiosis besides a healthy
immune system Antonio lives each day
with constant chronic diarrhea
once you discover you have this disease
there are life changes and there's just
no way to get around it
prayer helps a lot but we just can't
erase it it's reality no matter what
portion of it
and you're just waiting to die little
Becky Furman lost her fight with
cryptosporidiosis she died after
battling its effects for many months
becky was in a coma eyes closed but she
raised her hands to us and grabbed held
with our hands took three breaths and a
spirit and energy left
ripped the heart
what a gratefulness because she wasn't
pain anymore
she looked peaceful for the first time
investigators soon had a theory for how
Cryptosporidium contaminated Milwaukee's
water supply after an intensive
investigation
health officials developed a theory as
to how Cryptosporidium contaminated
Milwaukee's water supply in early April
of 1993 heavy rains and the spring
snowmelt caused water runoff the ground
was still frozen and unable to absorb
the water manure from the farms and
fields might have washed in the nearby
streams when your which contained
Cryptosporidium the Cryptosporidium n
made their way from the streams into
Lake Michigan the source of Milwaukee's
drinking water shortly before the
outbreak wind and water currents were in
a southwesterly direction pushing the
waters south towards the Howard Avenue
water plant which served the south side
of Milwaukee and away from Lynnwood
water plant serving the city's north
side in 1993 there were no filters or
masked disinfectants used anywhere in
the United States which could eliminate
the Cryptosporidium and water plants
chlorine was ineffective against it over
400,000 people who ingested water from
the Howard Avenue plant became ill four
thousand
were hospitalized 104 died that theory
held for four years during that time the
Centers for Disease Control in Atlanta
Georgia continued to investigate
Milwaukee's Cryptosporidium outbreak
since it was the largest waterborne
outbreak in United States history in
samples from individuals infected during
that outbreak they conducted DNA testing
on the Cryptosporidium and when they did
there was a shocking discovery the type
of Cryptosporidium found in the four
stool samples from the Milwaukee
outbreak did not come from farm animals
it was a new strain one which came from
human waste I was suggesting on the
basis of the limited number of samples
that we looked at that the Milwaukee
outbreak was not from pasture run off
but was from sewage contamination when
investigators looked more closely at
Milwaukee's water supply they found that
the Howard Avenue water plants intake
was less than two miles down current
from a sewage treatment plant overflow
valve in Lake Michigan
the CDC's discovery suggested that human
waste containing Cryptosporidium was
released from the sewage treatment plant
traveled the two miles downstream where
it entered the water intake of the
Howard Avenue water plant today sewage
from that plant is no longer released
into Lake Michigan and the Howard Avenue
water plant moved their intake further
out into the lake away from possible
pollutants and Milwaukee is building an
ozone ization facility ozone is a form
of oxygen which kills more
microorganisms than chlorine it's the
only mass disinfectant process known to
k*ll Cryptosporidium and water when the
facility is completed Milwaukee will be
the only major city in the United States
to ozonate its water since 80% of
surface water contains trip those fer
idiom Milwaukee health officials believe
it is an expensive but necessary step
within 24 hours of the outbreak the
mayor of Milwaukee knew he faced a
serious dilemma no American city had
ever faced this type of crisis before
the concern in the health department was
the beginning of you know a real concern
what is this you know how could so many
people get sick all at one time
City Health Commissioner Paul nanus
learned that stool samples from the sick
patients were all negative
he had no scientific leads knowing that
for an outbreak of this size as we were
recognizing it was certainly large it
would have either had to be food water
or air there's no other common connector
or vector that would have had occasion
to make so many people sick on once if
the outbreak was caused by a
contaminated food source stool samples
would contain the bacteria which caused
it and health officials could find no
common food source that all of the
second divisions use
food illnesses usually center around a
common food distribution center
processing planet restaurant or grocery
store but one common element among all
of the infected individuals was water
officials analyzed the water quality
records at the city's municipal water
supply but all of the water quality
levels were within guidelines
established by the Environmental
Protection Agency for safe drinking
water everything that we saw told us
that our process was working real well
and that we were meeting all those state
and federal mandates we went back and
indicated that to the Health Department
and they continued on with their
investigation into other areas
the only remaining element common among
the infected individuals was the air we
had initially suspected that perhaps was
some kind of fast-acting airborne virus
that might be out there because it
wasn't back flu season but when
scientists looked at the distribution
pattern of the outbreak they noticed
that most of the cases were clustered in
the south side of the city
normal uniform distribution of illness
had been an airborne virus because it
would have started at a point and moved
outward since the outbreak seemed to be
centered in Milwaukee South Side
this narrowed the focus of the
investigation becky Fuhrman lived on
Milwaukee's Southside her doctors had no
idea what caused her illness and soon
discovered they couldn't cure it in
individuals like Becky who had HIV one
of the things was that she was limited
in what she could do
as far as where we could go and what we
could do with her as far as playing
because she would have these accidents
another thing was the general weakness
because of the constant diarrhea
gastrointestinal illness is usually
caused by something that is ingested
once again pointing to food
water due to the widespread nature it
would be very difficult for a single
food to be eliminated and since the
widespread nature of illness in a
community
whereas water gets to a lot more people
a lot quicker and much more widespread
basis and you'd expect a single food
item the water plant who supplied
Milwaukee's Southside reported that the
only unusual redoubt was a Pekin
turbidity one week before the outbreak
turbidity measures the amount of foreign
particles in the water after a rainstorm
in New Orleans snow melts turbidity
levels will temporarily rise storms
churned River and Creek bottoms and
melting snow will often gather particles
as it runs industries health officials
wondered if the increase in turbidity
levels was cause for concern the
municipal water supply was disinfected
with chlorine was it possible that the
city's water supply was contaminated
with something that didn't show up in
water tests and the chlorine would not
k*ll if so the entire city would be at
risk and one of the city's largest
industries could also be affected the
brewing industry the breweries were
among the largest users of municipal
water if there was an unknown organism
in the water was it being shipped all
across the country by the tens of
thousands of gallons a day
health officials suspected that
something in Milwaukee's water supply
was causing the outbreak of thousands of
cases of gastrointestinal illness the
water department insisted that the water
quality levels were all within standards
set by the Environmental Protection
Agency and that the water was safe to
drink hospitals and laboratories
throughout Nowacki continue to analyze
stool samples from the thousands of
individuals affected everything pretty
much was a dead end
everywhere we looked was everything was
negative sandy Schrader was doing some
of those tests at a local hospital as a
microbiologist she was
forming the routine tests on patients
hospitalized with the mysterious illness
the standard test was an iodine stain
when added to the stool samples the
iodine would show if parasites were
present but all of the iodine tests were
negative on her own
sandy Schrader s decided to go one step
further she remembered something she
learned earlier in her training that
microbiologist should be on the lookout
for parasites which do not show up on
standard tests with that in mind she
noticed a number of unusual structures
in the samples structures which didn't
react with the iodine stain at that
point I knew and again it's more of a
feeling after so many years that this
means something that's more or less what
I get this can't be artifact I don't
know exactly what it is yet but it means
something that's your first cool so she
performed an acid fast stain she flooded
the stool sample with a red stain then
washed the sample with alcohol and
sulfuric acid during the final step an
additional green stain is acting under
the microscope she thought she saw a
highly infectious
potentially deadly parasite first a
success stain wasn't real definitive
this is probably our first line it's
easiest as quick as it's done in about
10 minutes and I didn't feel comfortable
calling it on that so we went on and did
a fluorescent stain the fluorescent
stain introduces the parasites antibody
to the sample along with a fluorescent
agent under the microscope
sandy Schrader Assad as the bright green
glove
it was the fluorescent agent attached to
the antibody proof that a parasite was
present it was Cryptosporidium where
little is known about Cryptosporidium
since it first infected humans just over
it's a one-celled organism a protozoan
parasite which is found in feces from
young farm animals particularly calves
Cryptosporidium is an 80% of surface
water largely due to animal feces washed
from farms into nearby streams by
02x13 - Deadly Parasites
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Documentary that reveals how forensic science is used to solve violent crimes, mysterious accidents, and outbreaks of illness.
Documentary that reveals how forensic science is used to solve violent crimes, mysterious accidents, and outbreaks of illness.