00:00:05
[Music]
00:00:06
911.
00:00:09
I think the baby's choked.
00:00:11
Be right there.
00:00:13
>> Emergency squad needed a baby that's
00:00:15
choking 804 High Street.
00:00:18
>> In 1994,
00:00:19
an infant was rushed to a hospital
00:00:21
emergency room with a serious breathing
00:00:24
problem.
00:00:26
The baby's lungs were bleeding, a
00:00:28
life-threatening condition which is
00:00:30
extremely rare.
00:00:32
>> Within months, there were over 30 cases
00:00:35
in Cleveland, just like it, a rate 1,000
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times higher than anywhere else in the
00:00:41
world.
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>> Not all of the infants survived.
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>> Doctors had never seen anything like it
00:00:50
and frantically searched for the cause.
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[Music]
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On a chilly November evening, Nema
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Williams heated some baby formula. for
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her 6-w week old son, Brian.
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But during that feeding, something went
00:01:30
terribly wrong.
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>> I heard him regurgitate, so I figured it
00:01:34
was milk. But instead, when I picked him
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up, instead of seeing white milk, you
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know, I'm seeing bright red blood.
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>> Her baby was rushed to Rainbow Babies
00:01:43
and Children's Hospital in Cleveland,
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where doctors struggled to save little
00:01:48
Brian's life.
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X-rays revealed that Brian's lungs were
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filling up with blood. Unable to breathe
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on his own, he was taken to intensive
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care and placed on a ventilator.
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>> The suctions are still pretty bloody.
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>> I'm wondering it, but I'm not thinking
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it. You know, my baby's going to be
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okay. We going to get through this. So,
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but it's still in the back of your mind.
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You know, you know, he could die. Is
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this the last I'm going to see you,
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Brian? Is this my last look at him?
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Brian was quite sick. He had bled a lot.
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He had dropped his hematocrit almost in
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half and required an acute blood
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transfusion on top of having to be
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supported with a ventilator.
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>> Brian Mitchell's condition was diagnosed
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as idiopathic pulmonary hemocerosis
00:02:38
which means unexplained bleeding in the
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lungs. Lung bleeding is usually caused
00:02:45
by a heart problem, an infection, or
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child abuse. But in Brian's case,
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doctors eliminated these as possible
00:02:53
causes. The hospital's medical records
00:02:56
revealed two other babies had been
00:02:58
treated for unexplained lung bleeding,
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and one of those babies died.
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The incidence of lung bleeding in
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infants was 1,000 times higher in
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Cleveland than anywhere else in the
00:03:12
world. Brian Mitchell was fortunate.
00:03:16
After 2 weeks of improvement, he was
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released from the hospital. His doctors
00:03:21
suspected that his lung bleeding was
00:03:24
caused by an allergic reaction to his
00:03:27
baby formula, and they recommended his
00:03:29
mother change the type she was using.
00:03:32
But one week later, Brian Mitchell was
00:03:35
back in the hospital with more lung
00:03:37
bleeding.
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>> I was just to the point, what's wrong
00:03:40
with him? He starts bleeding. We bring
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him to the hospital. You leave him in
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the hospital for 3 days, but you can't
00:03:46
tell us why he's here. You can't tell us
00:03:49
what's wrong with him. Why does he keep
00:03:51
bleeding? I don't know.
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>> Dr. Dearbornne discovered that Brian
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Mitchell and the other sick babies all
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lived within a sixmile radius of the
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hospital on Cleveland's east side.
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>> It was probably an environmental
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component. It said not necessarily that
00:04:10
it was in their homes, but something in
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that in that part of the community was
00:04:15
um was problematic.
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>> But there was a complication. Brian
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Mitchell had a twin sister, Briana, who
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lived in the same house, ate the same
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food, and slept in the same room as
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Brian,
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and even shared the same crib. If Dr.
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Dearborn was right, and the cause was
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environmental, why did little Brian get
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sick while his twin sister was perfectly
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healthy?
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And there was another problem. Only
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infants were getting sick. None of the
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older children or adults in the same
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neighborhood or even in the same homes
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were affected. Dr. Dearbornne knew he
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needed help and called in the Centers
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for Disease Control in Atlanta.
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>> The fear is we were going to continue to
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have more uh more of these babies and
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that we wouldn't get them too late to
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save them.
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Something mysterious was happening in
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Cleveland, causing the lungs of infants
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to bleed for no apparent reason.
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It was an outbreak unlike any other
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before in medical history.
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And it was happening, ironically, within
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a six-mile radius of a children's
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hospital.
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The Centers for Disease Control assigned
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Dr. Ruth Zel to lead the investigation
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in Cleveland. Her job was to find out
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what caused the death of one infant and
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the life-threatening illness of seven
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others.
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>> The job of a medical detective is an
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awful lot like the job of a criminal
00:05:54
detective. That is, we're looking to try
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to track down the culprit of a specific
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unknown disease. And if we can track
00:06:02
down that culprit, we can prevent him
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from attacking again.
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>> Dr. Petsel reviewed all of the medical
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records of the infants with pulmonary
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hemoceterosis.
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One thing caught her eye. Many of the
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infants improved in the hospital, but
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started bleeding again after they
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returned home.
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>> Use soaps and things like that to clean
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it up.
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>> The families of the sick infants were
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interviewed using a 230 item
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questionnaire to see if they differed in
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any way from the families of healthy
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children.
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All of the homes were tested to see if
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the pesticides used were the type
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approved for residential use and air
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samples from the homes were also
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collected.
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Within days of the investigation,
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two more babies with pulmonary
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hemocerosis were rushed to the hospital
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from the same neighborhood. The total
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number of cases was now 10.
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>> Nine of those 10 were male and all of
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them were African-American.
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So this made us start thinking as to
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whether we were dealing with something
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related to the genetics of race, uh
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whether we were dealing with uh
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something that was particularly
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susceptible in males.
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Um,
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so it those were in the background of of
00:07:30
our considerations of still primarily
00:07:32
something in the environment was
00:07:34
probably causing this. But if the cause
00:07:36
was environmental, why was Brian
00:07:39
Mitchell sick while his twin sister
00:07:42
Briana was healthy. Both slept in the
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same room, in the same crib, ate the
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same food, and breathed the same air.
00:07:52
Here an infant who had no outward signs
00:07:55
of bleeding had had ongoing low-grade
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bleeding for several weeks. And yet at
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any time she could have had a stress and
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she would have bled to death.
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So this said to us not only frightening
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for her but frightening for the
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community. How many infants like Briana
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were out in the community that were
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showing no real significant problems?
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How deep was this iceberg?
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>> As the mystery intensified,
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so did the fear among parents in
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Cleveland's east side neighborhoods. The
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level of pesticides in the sick baby's
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homes were all within normal range. And
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there was no difference in air samples
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collected from the homes of the sick
00:08:40
children than those collected from the
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homes of the healthy infants.
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>> We want to prevent another death. We
00:08:46
want to prevent another case. and and we
00:08:48
didn't know where to reach out to next.
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So, uh I think all the public health
00:08:52
authorities involved, state, federal,
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local, were really uh trying to get
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together in the think tank and and
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figure out some answers because we
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didn't have any.
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>> But the data gathered from the
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questionnaires began to reveal some
00:09:04
important information.
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Seven of the 10 sick children lived in
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homes with cigarette smokers. All of the
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sick babies had been bottlefed. None had
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been breastfed. And all of the sick
00:09:18
babies lived in homes that had recent
00:09:21
water damage. Was it possible that
00:09:24
smoking, baby, or something in the water
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was causing the deadly outbreak of the
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bleeding lungs in infants? Or was it
00:09:35
something else?
00:09:39
Dr. Dr. Ruth Zel spent weeks trying to
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figure out what was causing the
00:09:44
mysterious lung bleeding among infants
00:09:47
in Cleveland. There had been 10 cases
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reported so far with one death and Zel
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was afraid there would be more.
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>> I really can't.
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>> During the investigation, Dr. Zel met
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with a friend for dinner. She was a
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physician and a fellow medical detective
00:10:05
from Brazil. She mentioned a lecture she
00:10:08
once attended and couldn't recall all of
00:10:11
the details but said the lecture
00:10:13
described how micotoxins caused the
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serious illness of some Brazilian
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children. After dinner, Dr. Zel rushed
00:10:23
to the library to read all she could
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about micotoxins.
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When she cross-referenced the words
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micotoxin with the word hemorrhage, the
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computer led to an article about a mold
00:10:37
called stakibbatras atra. The article
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described how stakibbatras atra found in
00:10:44
some grain in Europe over 40 years
00:10:47
earlier caused livestock to bleed
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internally and die. Stacky botras is a
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dark green almost black slimy mold. It
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often grows on cellulosebased items like
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straw and paper after coming into
00:11:04
contact with water.
00:11:06
>> I began to wonder if micotoxins could
00:11:10
make animals sick when they ate grain
00:11:12
that was moldy. Could it be possible
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that micotoxins could make babies sick
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if they breathed them in? To test her
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theory, Zel contacted Dr. Bill Sorenson.
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He's a micologist who had done some
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research on the stackibbotric mold.
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Sorenson knew that the only possible way
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that stakibbot could get into a baby's
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lungs was by the spores, the tiny,
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almost invisible seedlike structures
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which are produced in the mold. Once the
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mold dries, the spores become light and
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powdery and can flake away, traveling
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great distances through the air.
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>> And so therefore, it would be possible
00:11:57
if the spores are present in large
00:11:59
enough numbers in the homes and released
00:12:03
into the air that they could be inhaled
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and produce disease symptoms.
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>> There were 400 different types of spores
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found in the homes of the sick babies.
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The spores were placed on culture plates
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and left to grow for 10 days. When
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Sorenson analyzed the culture plates, he
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noticed that many contained a dark
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green, almost black mold. Under a
00:12:30
microscope, Sorenson noticed that the
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samples from the Cleveland homes were
00:12:36
structurally similar to the mold which
00:12:39
killed the livestock in Europe. It was
00:12:42
in fact stakibbatras atra. Investigators
00:12:46
now knew that spores from stakibbatras
00:12:49
atra were in the air of the sick baby's
00:12:52
homes. But they needed to know whether
00:12:55
the stakibbatra spores in Cleveland
00:12:58
contained the same toxins as those which
00:13:01
killed the livestock in Europe. To find
00:13:04
out, scientists grew the spores found in
00:13:08
the Cleveland homes in a mixture of
00:13:10
rice. Stackibbot grows well in rice
00:13:14
because of the moisture in the grains.
00:13:17
The mold was then ground and mixed with
00:13:20
a series of solvents to extract the
00:13:23
chemicals contained in the spores using
00:13:26
what is called high-performance liquid
00:13:29
chromatography. The physical
00:13:31
characteristics of the spore chemicals
00:13:33
were analyzed and scientists discovered
00:13:37
that the Cleveland spores were identical
00:13:39
to the highly toxic micotoxins that
00:13:42
killed the livestock in Eastern Europe.
00:13:45
They were a special class of micotoxins
00:13:48
called triccoenes.
00:13:51
>> The tririccoin micotoxins are among the
00:13:54
most potent protein synthesis inhibitors
00:13:57
known. By that I mean they disrupt the
00:14:01
ability of cells to make proteins and
00:14:03
without that ability a cell will die.
00:14:06
>> When scientists searched the homes of
00:14:08
the sick children they found the source
00:14:11
of the stackibbatra spores in mold found
00:14:14
growing in the basement. The mold was
00:14:18
found in all but one of the sick babies
00:14:21
homes. But stackibbot was also found in
00:14:25
half the homes tested where healthy
00:14:27
children lived. If it was stacky that
00:14:32
caused the death of one Cleveland infant
00:14:34
and the serious illness of nine others,
00:14:38
why didn't it affect all of the infants
00:14:42
who lived in homes where it was found?
00:14:48
Spores from the stackibbatric atra mold
00:14:51
were found in all but one of the sick
00:14:53
infants homes but were also found in
00:14:57
half of the homes of healthy children
00:14:59
living in the same neighborhood.
00:15:02
Scientists wanted to know why some
00:15:05
children developed lung bleeding while
00:15:07
others did not. They soon discovered
00:15:10
that the number of airborne spores in
00:15:12
the sick babies's homes were far higher
00:15:15
than in the homes of healthy children.
00:15:18
In effect, the homes of sick babies
00:15:20
contained more spores and more poison.
00:15:24
>> Stacotus is generally not considered one
00:15:26
of the major components in indoor air,
00:15:28
major fungal components in indoor air.
00:15:30
In fact, it's often not observed at all.
00:15:32
In a study in Canada just a few years
00:15:34
ago, they examined a few hundred houses.
00:15:37
I don't remember the exact number, but
00:15:38
they saw something like three colonies
00:15:39
in all of these houses combined. We
00:15:42
observed levels as high as 600 colony
00:15:44
former units per cubic meter of air in
00:15:46
some of the Cleveland homes.
00:15:48
>> Researchers found the source of the
00:15:50
stackibbotra spores in the basement
00:15:53
growing on walls, on boxes, and even on
00:15:57
the insulation behind the walls. For
00:16:01
stackibbot to develop, two things are
00:16:04
necessary. a cellulose product and
00:16:07
water. Researchers discovered that some
00:16:10
heavy rainstorms caused the sewer system
00:16:13
in the geographic cluster of case homes
00:16:16
to overflow which produced flooding in
00:16:19
many of the basements. In other homes,
00:16:22
the residents said they had some leaking
00:16:24
pipes. The water was not immediately
00:16:27
cleaned up and soaked through the
00:16:30
drywall and the insulation inside the
00:16:32
walls, creating the perfect medium for
00:16:36
stacky botras to grow in the warm,
00:16:39
moist, dark environment. But if the
00:16:42
stackibbot was in the basement of these
00:16:45
homes, how did the children come into
00:16:48
contact with the spores since none of
00:16:50
the sick children had been in the
00:16:53
basement? Researchers discovered that
00:16:56
when the mold dried, the spores flaked
00:16:59
away and became airborne. The furnaces
00:17:03
of these homes all drew air from the
00:17:05
basement instead of the upper floors.
00:17:08
The spores were sucked into the furnace,
00:17:11
traveled through the duct work, and made
00:17:13
their way into every room of the homes.
00:17:17
Tragically, they were blown into the
00:17:20
rooms where they could do the most
00:17:22
damage, into the infant's bedrooms where
00:17:26
the babies spent most of their time
00:17:28
sleeping. Once inside the infant's
00:17:32
lungs, the spores released the
00:17:34
miccotoxins called triccoenes,
00:17:38
which prevented the infant cells from
00:17:40
making the protein needed to hold their
00:17:43
tiny vessels together. With the vessels
00:17:46
now weak and fragile, an external
00:17:49
trigger may have caused the tiny vessels
00:17:52
to rupture and bleed. Since most of the
00:17:54
sick babies lived in homes with
00:17:57
cigarette smoking, this may have been
00:17:59
one of the triggers. And none of the
00:18:02
sick babies had been breastfed, leading
00:18:05
researchers to suspect that breast milk
00:18:07
offered some sort of immunity.
00:18:10
Older children and adults were not
00:18:12
affected by the stackibbot spores
00:18:15
because their lungs were better
00:18:17
developed. And once researchers found
00:18:20
how the stackibbot spores traveled from
00:18:23
the basement to the children's rooms,
00:18:26
they discovered why little Brian
00:18:28
Mitchell was so much sicker than his
00:18:31
twin sister Briana. Although the two
00:18:34
slept in the same crib, Brian slept
00:18:37
closer to the heating vent where he
00:18:40
probably inhaled more spores than his
00:18:42
twin sister.
00:18:44
By the time the investigation was over,
00:18:48
there were over 30 cases of pulmonary
00:18:50
hemocrosis in Cleveland and four young
00:18:54
infants died.
00:18:57
Health officials urged parents to remove
00:19:00
all visible mold with bleach and water
00:19:03
and to clean up water damage immediately
00:19:06
to prevent the mold from developing.
00:19:09
One year after this investigation, the
00:19:12
coroner in Cleveland reopened the files
00:19:15
of 117 babies who died from what had
00:19:19
been listed as sudden infant death
00:19:21
syndrome. lung tissue samples from their
00:19:24
autopsies were re-examined in light of
00:19:27
what doctors now knew about
00:19:29
Stakibbatraatra.
00:19:31
In six of those samples, the lung
00:19:34
samples turned blue, an indication that
00:19:38
the babies had bleeding in their lungs
00:19:41
prior to their death. Officials believe
00:19:44
that Stakiotraat may have played a role
00:19:47
in those six deaths.
00:19:50
Yolanda Po is the mother of one of those
00:19:53
six babies. Knowing the true cause of
00:19:56
her daughter's death helps bring some
00:19:59
closure to her family's tragedy.
00:20:01
>> I don't think that you could get any
00:20:02
worse than this outside of literally
00:20:04
going to hell alive. There's there's
00:20:07
nothing worse than this. It's not
00:20:10
because you'll never get over. This is
00:20:12
something you will never ever get over
00:20:14
and you'll always wonder what could I
00:20:17
have done? No matter how many times you
00:20:19
hear, there was nothing you could have
00:20:20
done.
00:20:22
>> I feel remorse. I feel I feel I feel
00:20:25
their pain because I was standing there
00:20:28
at one time, you know, wondering if my
00:20:30
son's going to die.
00:20:32
>> Nemo Williams is thankful that her two
00:20:34
children, Brian and Briana, both
00:20:38
survived their encounter with Stakiatra
00:20:40
Satra. When I see a little baby's face
00:20:44
who is doing well,
00:20:46
I think way beyond myself and thank the
00:20:49
help that has come to all of us in
00:20:51
trying to sort this out
00:20:54
because we didn't do it alone.
00:20:57
>> Something simple but so deadly. You
00:20:59
know, you don't you I mean, mother
00:21:02
nature has a bunch of stuff out there
00:21:03
that we don't know about yet and this
00:21:05
was one of them.
00:21:07
[Music]
00:21:16
[Music]
00:21:30
Hey.
00:21:35
[Music]
