Just as the nation grapples with the worst measles outbreak in a quarter century, the University of Maryland and public health officials are drawing fire for the way they handled the strange confluence of mold infections in dorms and the spread of an contagious virus among students on the College Park campus.
The university and its advisers tried to keep a lid on public information about the dual problems, leading students and parents to assail the school and to blame its sluggish response and silence for the death of an immune-compromised coed.
Her death late last year — following the fall heat-stroke fatality involving Jordan McNair, a 19-year-old football player — has renewed concerns that the university and its staff may lack the expertise, training, and sensitivity to protect vulnerable young people, the Washington Post reported as part of its investigation of the confused health scenario involving Olivia Shea Paregol.
She was 18, a freshman, and looked forward to a fun, successful year at UM, despite her diagnosis for Crohn’s disease. It’s a serious digestive condition for which she was taking medication, and which left her immune system compromised.
Paregol and her roommates had the misfortune of matriculating in College Park during what would become a record-setting season for rain. Storms not only inundated the region and the campus, the damp, university officials said, was to blame for major mold problems in many of the school’s dozens of dorms, including the packed Elkton Hall where Paregol lived.
UM housekeepers tried to wipe down floors and walls to get rid of the mold. The problem worsened. Mold began to grow everywhere, including on students’ shoes left in closets. The university stepped up its janitorial efforts and added dehumidifying equipment to attack the mold. It didn’t work.
Students and their parents ramped up their complaints. And the university decided professional fumigation was the only answer. But officials decided they couldn’t shut big dorms down all at once, and they elected to bring in expert crews to go floor by floor, with students moved for short periods to nearby hotels at UM expense.
During the mold mess, university officials also began to learn the school also was experiencing an outbreak of adenovirus, an infection with symptoms like those of a cold or the flu. But the virus also can be virulent and pose special risks to the immune compromised, especially if they already are ill and weakened. It was implicated in the deaths of 11 immune-weakened children at a long-term care facility in New Jersey, where more than two dozen others also were sickened.
As the Washington Post recounts, the mold sliming dorms across campus didn’t necessarily make students sick. It didn’t benefit their health, either. And the student health service was besieged with illnesses in the fall, with patients complaining of sneezing, coughing, and other respiratory problems.
The situation worsened when students also started showing up at the health center with fevers and pneumonia, indicating not possible allergy symptoms but also an infection of some kind. Officials can test for adenovirus but do not do so normally. When students started showing up for care at nearby hospitals, doctors there began to test them for the virus, and they were quickly in contact with UM officials.
Campus leaders worked with the hospitals and experts from the federal Centers for Disease Control and Prevention as the number of adenovirus infections grew. How best to respond? The university decided to do so in limited fashion, advising students about generalized hygiene to prevent flu and declining, for example, to send targeted warnings to those on campus, like Paregol, with special health needs.
Her parents, the Washington Post reported, blame the university for their daughter’s eventual death. If the school had informed them, as well as other students about the adenovirus outbreak, they likely would have been tested for the disease. Olivia, her parents said, could have benefited from treatment with powerful and risky antiviral drugs, instead of the regimen of antibiotics she received early on.
The university and the CDC have defended their actions, saying they followed existing protocols. UM said two independent doctors also have reviewed their handling and found it sound.
But Kevin Kavanagh, a physician and founder and board chairman of Health Watch USA, a nonprofit patient advocacy and healthcare policy research organization, has written a timely and unrelated counterpoint Op-Ed in the Los Angeles Times. The piece is headlined: Collective ignorance and government timidity are public health threat. He reviews the perils of pokey and secretive public health responses to disease outbreaks around the world, concluding:
The public needs timely notification of infectious disease outbreaks, and epidemics need to be comprehensively tracked and aggressively confronted. All states should mandate vaccinations and eliminate religious exemptions. Our collective health depends on having public policy fully aligned with good science.
That may be a sound prescription for increasingly problematic times with rising number of infectious disease outbreaks.
In my practice, I see not only the harms that patients suffer while seeking medical services, but also the tragic damage that can be inflicted by injuries of many kinds on babies, children, and our young. After the bungled response to McNair’s football-related heat stroke and the young man’s death, UM officials, notably its president, said they hoped never again to have to meet with and explain bad circumstances to grieving parents. But here they were again, meeting and hearing a sad earful from Olivia’s mom and dad. University officials also may need to air for the public more about why they’re packing young people into mold-riddled dorms.
There is a fine line between panicking the public over disease outbreaks and providing needed and beneficial information, so individuals can protect themselves and their loved ones in appropriate fashion. A university might be an excellent spot to figure how best to share knowledge, information, and context about disease and experiences with their proper responses, so young people could leave campus as savvy consumers and users of health information. Bureaucrats like to talk about actions taken with “an abundance of caution.” But maybe with contagions, an abundance of evidence-based data and information is what’s called for?
It certainly must be the basis for why we need to persuade parents and young people to safeguard themselves and our communities from preventable diseases like measles, with more than 800 cases now confirmed. Get those shots, and let’s all figure how we can better communicate about communicable illnesses — because we must.