FIRST VICTIMS
In May 1993, in the Four Corners region of the US–a site of a Navajo reservation at the junction between New Mexico, Utah, Arizona, and Colorado–an engaged couple became ill with a mysterious illness that started with malaise and myalgias and resulted in massive fluid build-up in their lungs. They died within days of each other at different nearby hospitals. These sudden deaths of two otherwise fit and healthy individuals raised alarms among the in-house physicians. After reaching out to nearby colleagues, they discovered several similar cases of young, previously healthy people who had suddenly developed fatal pulmonary edema. Health authorities were promptly called to consult, and within days, experts from the Indian Health Services (IHS), Centers for Disease Control and Prevention (CDC) and the New Mexico Department of Health had gathered to the outbreak site to investigate.
A MYSTERY ILLNESS
Health experts explored potential causes of the novel disease, including Yersinia pestis (the pathogen responsible for bubonic plague and also a fatal pneumonia), a severe strain of the 1918 flu, and environmental toxins. Potential known agents were suggested and quickly ruled out due to this disease’s differing presentation, and ultimately, it was concluded that a novel pathogen must be responsible, but how could an unknown disease agent be discovered?
It was the Navajo elders that helped guide the scientists to the right pathogen. Although this disease had never been officially documented before, the elders noted comparable deaths recounted in their oral history. Similar disease presentations would occur after periods of “excess”: years where there had been excess rain, excess vegetation, and consequently excess rodents. This critical information guided the scientists to look into rodent-borne infections. Further testing of samples collected from the victims’ revealed DNA that matched previously-known hantaviruses. The causative agent–a novel hantavirus–had finally been found.
FALLOUT
Throughout the investigation, inhabitants of the Four Corners region suffered severe discrimination. The press immediately began describing a new disease that killed healthy young people without warning, calling it the “Navajo Flu.” This name was inaccurate (the disease wasn’t limited to Navajo individuals) and resulted in widespread panic and shunning of reservation inhabitants by outsiders. Restaurants adjacent to the reservation began banning Navajo regulars, and school field trips were canceled after their destinations refused to serve Navajo children. Even once the correct agent had been found, the stigma surrounding the disease persisted.
NAMING
As a consequence to the extreme turmoil victims of this new hantavirus faced, naming the new pathogen was a challenging task. Initially, “Four Corners virus” was suggested, but that was immediately rebuffed as the Navajo leaders argued a geographical name was inaccurate and would compound the stigma already mounted against their people. The CDC then intended to name it the “Muerto Canyon virus”, after a nearby landmark to the original outbreak site. However, this name was also problematic, both because of its geographical nature and the fact that San Muerto retained a tense history between the Navajo and Spanish conquistadors. Desiring to respect these requests, the CDC ultimately settled on Sin Nombre virus, Spanish for “Virus Without a Name.”
Taylor is a medical student at the University of Texas Medical Branch in Galveston. She is hoping to pursue her interest in infectious diseases by specializing in Internal Medicine or Pathology.
Sources
MacDonald, James (2018). Solving a Medical Mystery With Oral Traditions. JSTOR Daily. https://daily.jstor.org/solving-a-medical-mystery-with-oral-traditions/.
Schwarz, Maurine (1995). The Explanatory and Predictive Power of History: Coping with the “Mystery Illness” 1993. Ethnohistory 42:3, 375-401.
Radcliffe, C. (2021). The tragedy of names. The Yale Journal of Biology and Medicine, 94(2), 375-378. Retrieved from https://www.proquest.com/scholarly-journals/tragedy-names/docview/2724693858/se-2
Van Hook, C. J. (2018). Hantavirus Pulmonary Syndrome--The 25th Anniversary of the Four Corners Outbreak. Emerging Infectious Diseases, 24(11), 2056+. https://link.gale.com/apps/doc/A612030987/OVIC?u=txshracd2618&sid=bookmark-OVIC&xid=7458634e
This Podcast Will Kill You, Episode 18