Monday, April 4, 2011

Lest We Forget: Reye's Syndrome and DDT/Fenitrothione

Biological Warfare in New Brunswick
thalidomide
We so soon forget our mistakes and continue to move forward in a self-righteous way as at the Point Lepreau Nuclear Plant. This in the face of historical disasters and the current horrendous events in Japan. We act like we are infallible. So maybe we should revisit the past sometimes. Remember the kids like Timmy that dies from Reye's Syndrome and the link to budworm spray? Or the thalidomide kids without limbs and other birth defects?

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Biological Warfare in New Brunswick

By Russell Hunt

{as published in Weekend 26: 32 (August 7, 1976), [11] - [15] }

I. Timmy

LIKE lots of other children in the winter of 1972, 10 year old Timmy Keddy of Durham Bridge, New Brunswick, came down with the flu. No one thought much of it; the flu was running through the whole Keddy family at the time, and while it was uncomfortable, it was just the flu. Or it was until Sunday night, January 23, when Timmy's fever went to 106 degrees and he began repeatedly and violently vomiting, and became delirious. "Towards morning," his mother says, "he started complaining about pains in his lower back, and he was still running the fever, and at times he was still delirious." The next day, Timmy was taken to Victoria Public Hospital in Fredericton, a few miles away. Timmy's parents had a lot of faith in doctors, and they were relieved when they were told that it was just the flu and Timmy would be all right.

But later that day they received a terrifying call from the hospital. "They told us they couldn't get him to settle down," Mrs. Keddy says, "and asked for us to come to the hospital. We went to the hospital and by the time we got there he was in a coma."

It is not hard to imagine the Keddys' feelings that night, though they do not talk about them much. Their one and a half-year old daughter had similar symptoms and was also in hospital; and Timmy's elder sister appeared to be coming down with the same thing.

The next morning the hospital called again. Mr. Keddy took the call. "I don't know what they told him," Mrs. Keddy says, "but we weren't very long in getting there. And as soon as we got there we were met and asked if we wanted our minister, and our minister came, and performed the rites, and baptized him, and from there they put him in intensive care." During the day it was decided that nothing could be done for Timmy in Fredericton, and that he should be taken to Izaak Walton Killam Hospital for Children in Halifax. He was flown there by the Air Rescue Service on Tuesday, and his case was taken over by Dr. J.F.S. Crocker, a specialist with an interest in among other things kidney diseases. On Thursday night, the 27th of January, Timmy died. He had never regained consciousness.

II. Reye's Syndrome

For Dr. Crocker, Timmy's case was nothing new. There had been a number of similar cases in New Brunswick -- in fact, the province was in the midst of what could be called, in the case of a condition as rare as this, an epidemic. In the winters of 1971 72 and 1972 73, at least nine New Brunswick children suffered as Timmy suffered. Five of them died.

What killed Timmy Keddy [photo above] was not, technically, a disease, but a syndrome; that is, a series of symptoms which occur together but whose relationship is not clearly understood. The syndrome was defined in 1963 by Dr. R.D.K. Reye (pronounced "Rye") at the Royal Alexandra Hospital for Children in Sydney, Australia. It is apparently a modern illness. It attacks children almost exclusively, and as yet its cause (or pattern of causes) is -- as one medical report phrased it -- enigmatic. Although some progress in treatment has been made, through such drastic measures as replacing the child's entire blood supply, most victims still die.

It is a terrifying sickness in other ways as well. It usually follows some minor viral infection flu and chicken pox are common. Just when the child seems to be beginning to recover, he begins vomiting uncontrollably, develops a high fever, and shows central nervous system disorders ranging from irritability and depression, through hysteria and inability to recognize his family, to convulsions and coma. In a significant number of the cases in which the child survives there is damage to the brain or nervous system. But often the child does not survive: mortality rates ranging from 50 to 80 percent are common.

Just how the syndrome works is not clearly understood. Two primary disorders are involved. On the one hand, there is severe brain disease: on the other, there is marked degeneration and fat accumulation in the liver and sometimes the kidneys and other organs. Whether one causes the other or whether some outside factor causes both is uncertain.

The pattern has, in any case, come to be generally known as Reye's syndrome. In 1972, Dr. Crocker and his associates were beginning to find out a number of interesting things about Reye's syndrome. One was that at least some of the symptoms looked suspiciously title classical symptoms of common kind: of chemical or insecticide poisoning. The cases they had seen were concentrated in New Brunswick and seemed too close to each other and too similar not to be related in some way, possibly through environmental factors. They began trying to isolate some exterior agent. After Timmy's death, for instance, Dr. Cracker asked the Keddys for samples of all the insecticides and other toxic chemicals that Timmy might have come in contact with. Such attempts led nowhere.

The one condition that seemed common to all the cases was that all the patients came from areas which were consistently sprayed with insecticides by airplanes as part of New Brunswick's long standing war against the spruce budworm. But it wasn't just the geographic coincidence that was significant. Insecticides such as DDT are known to cause fatty changes in the liver, to alter immunological activity, and to have a toxic effect on nerve conduction -- all of which sounded suspiciously as though they might be related to Reye's syndrome. Equally important, combinations of insecticides were known to cause wildly different and more severe effects than any simple insecticide could cause.

Dr. Crocker set out to find out what was being sprayed in New Brunswick and to get some samples. It wasn't easy. The government department responsible for the spray, natural resources, regarded the contents of its spray program as "classified" and offered him no co operation whatever. So it was with everyone else he contacted in New Brunswick. Finally, through highly sophisticated tissue analysis they discovered the presence of an insecticide called Fenitrothion. Armed with this information, Dr. Cracker approached the distributors. They informed him he couldn't have a sample; they sold it only in carload lots. ("All I wanted was fifty CCs," he said later.) The National Research Council refused to confirm his identification of the pesticide. Finally, Dr. Crocker went to the provincial department of health, which procured him some samples.

Working on the hypothesis that the syndrome might be caused by some interaction between an insecticide (or a combination of insecticides) and a virus. Dr. Crocker's team painted mice with chemicals -- some with DDT, some with Fenitrothion, some with a combination of the two, and some with corn oil. The mice were then infected with a virus normally not fatal to mice. The team was excited by the results.

As was expected, none of the mice painted with corn oil died. But in various trials, between four and nine percent of the Fenitrothion treated mice died of the nonlethal virus. Of the DDT treated mice, between six and 17 percent died. Even more alarming and significant was the fact that of the mice treated with both, the fatality rate ran between 33 and 60 percent. Perhaps most important, there were fatty changes in the liver and kidneys, and death came after a sequence of paralysis and convulsions, a pattern familiar to researchers into Reye's syndrome.

The results of the experiments were published in the international medical journal, Lancet, in the summer of 1974. "The possible role of exposure to combinations of insecticides in human viral susceptibility requires further attention," said the authors. They concluded, cautiously: "The part that this interaction (between insecticides and virus) played in the Reye's like disease of the children that stimulated this work is still hypothetical, but it is now a theory which is chemically and virologically possible."

III. Aerial Attack

In 1952, New Brunswick was faced with a problem. It was clear that the province was suffering from an outbreak of the spruce budworm, a recurrent plague that had last attacked the province's timberlands 30 years earlier. The question was, would the province's newly invigorated pulp and paper industry have to sweat out the period while the budworm "harvested" the overmature stands of balsam fir and white spruce that the industry wanted but hadn't got to yet, or could some short term way be found to prevent the budworm from attacking those trees until the companies could get to them?

During the Second World War fantastic progress had been made in the chemicals industry. One of the "miracles," as everybody now knows, was DDT. It seemed likely to many people that if you could get DDT to the budworms you could probably wipe them out. The head of the Dominion Entomological Laboratory in Fredericton, R.E. Balch, had written a pamphlet in 1946 suggesting that "airplane spraying may be sufficiently perfected to provide a means of protecting limited areas of particular value." He added, prophetically, that "these methods do not reduce the necessity for adjusting forest management to meet the danger of budworm attack." But in the rush for a simple technological solution to the problem, his warning was ignored. Almost 200,000 acres of New Brunswick were sprayed from 21 aircraft, mostly Wasp Stearman trainers, in June of 1952.

In 1953, in conjunction with the pulp and paper industry, the government established a private corporation to handle the spraying. The statement of purpose in the letters patent of Forest Protection Ltd. said that it was organized "for the following purposes, namely, to protect the forests." That was all. Considering the range of possible threats to the forests, it must be one of the broadest corporate charters in existence. In practice, however, the company has limited itself to protecting the forests against only one threat, the budworm, and to one method of protection, the aerial spraying of pesticides.

From 1952 to 1953 the acreage sprayed increased tenfold. The $2.5 million budget of Forest Protection Ltd. was shared equally by the province, the federal government, and the pulp and paper industry. For the next 14 years, with the exception of 1959, large areas of the province were sprayed with DDT. In only two of those years were less than a million acres sprayed; usually the program covered more than two million acres annually.

During the 1960s, however, the scary truth about DDT attracted wide publicity. At length, six years after the publication of Rachel Carson's Silent Spring, with its graphic depiction of the devastation being caused by the New Brunswick spray program, DDT was finally abandoned. But the spraying did not stop. A new "miracle" had been found -- Fenitrothion. It was an insecticide which -- however little might be known about its effects otherwise -- had the reputation of breaking down rather more quickly than DDT. The possible effects of Fenitrothion on man had not yet been studied, and it was not registered for use as a commercial forest spray by either the Canadian or American governments. But it was not DDT, and no deleterious effects had been proven; so it was substituted and the program continued.

Both the acreage and the cost of the program began skyrocketing simultaneously. Four, five, then six million acres became normal. The cost steadily ascended and reached $8.5 million in 1975. Furthermore, after the DDT scare, the federal government pulled out of the financing of the program, which meant that the province of New Brunswick was paying two thirds of this staggering cost. Much of the increase in cost was due not to the increased area that was being sprayed, but to the high cost of Fenitrothion compared to DDT. Questions were also raised about its effectiveness: "No better than dishwater," industrialist K.C. Irving said on one of his infrequent visits to the province which he, more than any other man, can claim to own. Thus it was not an entire surprise when late last winter the Minister of Natural Resources, Roland Boudreau, announced that the province was considering returning to the use of DDT. The province, he said, simply couldn't continue footing the Fenitrothion bill.

Many people thought this was a political ploy, that Boudreau was simply trying to pry spray money out of Ottawa, which had used the original DDT scare to pull out of the program altogether. If the announcement was so intended, it worked: Ottawa soon announced that it had located some money that could be channeled into the spray program. With this assurance, the New Brunswick government settled into final plans for what was to be its biggest and best aerial spray program.

At a total cost of just under $20 million, almost half the province's total area -- 10.5 million acres -- would be sprayed by a fleet of 48 airplanes operating out of seven airstrips, most of which had been carved out of the bush in the course of previous spray operations.

IV. Noisy Spring

Politically, New Brunswick is a pretty quiet place most of the time. Thus it was something of a surprise to the current Tory government when its announcement of the biggest and best spray program ever was the cause of what looked like a wave of public protest. After all, hadn't New Brunswick been spraying, with little or no protest, since 1952? Wasn't it clear that if the budworm ate all the trees there would to no forest industry? That New Brunswick without a forest industry would be a Detroit without automobiles, an Alberta without oil?

It was clear that the protests had not been triggered by doubt about the spray's effectiveness -- though the protesters expressed that doubt regularly. (Many people had argued that the spray program actually encouraged the spread of the budworm because it forced it into unsprayed areas, killed its natural enemies and preserved overmature stands of trees. But these arguments had been known for years, and had been denied by the government and the pulp and paper industry.) Nor had the protests been set off by matters like bird and fish kill though the Canadian Wildlife Service's reports massive bird kills in 1975 had caused some stir.

No, what caused all the trouble in the spring of 197? seems to have been a combination of issues that -- perhaps like the "causes" of Reye's syndrome -- might individually have had very little effect. One was the announcement of a possible return to DDT, which pricked up the ears of environmentalists and conservationists, many of whom had been only vaguely aware the existence of the annual program.

Another was the Nova Scotia government's cancellation of its plans to spray 100,000 acres in the highlands of Cape Breton Island. The Nova Scotia government had originally been strongly committed to aerial spraying; had, in fact, overridden the recommendations of its own department of lands and forests in its original decision spray the highlands. And now, the decision was being reversed "for medical reasons" and as a result of public pressure and publicity, primarily in the Cape Breton Post, about the findings of Dr. Crocker's research team.

But most important was the death of Timmy Keddy four years earlier. In March, a Fredericton CBC radio program. "New Brunswick Folio" contacted Timmy's parents for an interview. Mrs. Keddy says that they were hesitant, because they knew about Dr. Crocker's reluctance to have his work used in public debate. But since his work was already being so used in Nova Scotia she decided to give the interview and air her conviction that Timmy's death had indeed been related to the aerial spraying program.

That interview was broadcast Saturday morning, April 3, and most people now active in what has come to be known as the Concerned Parents Group refer back to it as a turning point in their personal involvement. Birds, fish, ecological balances and forest management are all pretty remote issues; the death of a child -- particularly the sort of death Timmy Keddy met -- is another matter entirely.

And so began the first serious public debate about the merits of New Brunswick's spray program in the 24 years of its existence. For a month and a half the debate went on, in the press, in meetings with the government and in public demonstrations, while the machinery of government ground steadily toward the morning in mid May when the planes would lift ponderously off the runways with their 600 gallon loads of chemicals.

V. Cunits vs. Children

The debate has been conducted on a number of fronts but the basic issue can be divided into three areas: forest management, environment and human health. All them are complicated, all of them involve an "our experts against your experts" situation, and, in New Brunswick, all of them have developed the potential to bring people shouting to their feet. But only the third area is new to New Brunswickers.

Arguments over the proper methods of forest management, and whether or not the spray was necessary -- or effective -- have been going on for years. The pulp, companies, the government, and the spraying technicians have argued consistently that were it not for the spray the budworm would have destroyed New Brunswick's industrial base. New Brunswick Deputy Minister of Natural Resources Rudy Hanusiak, for instance, argues that had the spraying been stopped in 1972 the province would now be able to support only one pulp mill, instead of the present 10. Arthur Lalecheur, an official with Agriculture Canada who is responsible for granting the permit for the spray program, says that had the spraying been stopped "there'd be no budworm but there'd also be no forest. All insects usually build up till they eat their food supply and then they disappear. The food supply for the spruce budworm is trees, and if the trees are dead, there are certainly going to be no spruce budworms. But there would also be no trees -- and it takes a fair number of years to grow a tree."

Perhaps the clearest statement of the opposing point of view comes from Dr. Kenneth Watt, a zoologist who once studied the budworm for the federal government. He is now at the University of California at Davis. "It was my impression," he says, "from all the research that was done, that if spraying was continued, the budworm outbreak would continue -- and would if anything become worse -- and all the data that I have seen collected by the government tend to support the conclusion that that's exactly what has happened."

It is clearly an argument that goes on and on indefinitely, with each side bringing in its own battery of "experts" and staking out its own position. The only statement on which the two sides usually agree is that the forests in New Brunswick have been appallingly badly managed, and that that is one of the main reasons for the seriousness of the budworm infestation. Consistently, only the worst trees have been left to regenerate the forests. As Rudy Hanusiak points out, "when the King's Navy first came to the province of New Brunswick, they selected certain trees for masts. They made a choice. They chose the best and left the rest. And that is what forest management has been for the last two or three hundred years." More recently, "clear cutting" has become popular, so that 40 or 50 years later, all the trees in the area are overmature together and all are the same kind of trees, white spruce and balsam fir, a situation the budworm regards as a gourmet treat. For as long as they have been there, the large pulp companies have taken the wood that was easy to get at and left the rest to grow old and become prime breeding ground for the budworm. And for 25 years it has been economically foolish for the pulp companies to practise sound forest management because sound forest management is expensive and the spray program, financed as it is primarily by the taxpayer, is cheap.

Who Sprays Where

New Brunswick is not the only province with a spruce budworm problem. British Columbia, Manitoba, Ontario, Quebec, Prince Edward Island, Nova Scotia and Newfoundland also have severe outbreaks.

Besides New Brunswick, only Quebec is launching a massive spray program this year using Fenitrothion as the principal insecticide. Recent medical statistics indicate a significant increase in the incidence of Reye's syndrome in Quebec.

Ontario, Manitoba and British Columbia say they will limit their spraying operations to small areas. (They, too, use Fenitrothion.) The other provinces have cancelled any spray programs this year and will either allow the infestation to run its course or try to control it with selective cutting. Authorities in most provinces say they have taken note of studies indicating a possible link between insecticide sprays and Reye's syndrome.

All of these arguments are old hat to anyone who has been involved in the forest business. Now, the issue that counts for most people is whether the stuff is directly dangerous to human beings. It is on this issue that members of the Concerned Parents Group have based their position, and it is this issue that the government has tried hardest to avoid.

The government insists that because of the immense importance of the forests to New Brunswick's economy, a risk to human health would have to be unequivocally demonstrated in order to justify the abandonment of spraying. Thus officials are more interested in emphasizing the threat to the forest than in discussing the danger to human beings. After the Concerned Parents Group's fourth meeting with the government (at various times during the spring they have met with the minister of natural resources, the minister of health, the premier, and the entire cabinet), Jessie Davies, one of the group's earliest members, said, "We want to talk about human beings, and all they will ever talk about is their bloody cunits." (A cunit is a measure of wood which has begun to be used recently by the pulp industry. It works out to about one and a third cords.)

The group has pointed out the government's balancing of human factors against economics, and the government has been fairly frank about stating its position. "I don't like to see people dying," said the minister of natural resources recently. "This is one of the things that I really wouldn't like to see. But, at the same tune, knowing the forest as it is, my decision will have to be with the forest and with the future of New Brunswick."

VI. Pandora's Box

From its inception, the Concerned Parents Group has based its position on Dr. Crocker's work. Members argue that there is reason to suspect that a connection may exist between the spray program and Reye's syndrome, and that is reason enough to cancel the program. They have also argued that our state of ignorance about the chemicals involved is such that no one has any idea of the long term (or even short term) effects of the spray program on human health. Quoting Karel Wiesner, a University of New Brunswick chemist, they argue that chemicals for use in spray programs like this should be "considered guilty until proven innocent" that, as with chemicals in food and drugs, the onus should be on the producers to demonstrate their safety. They argue that nothing should be sprayed on the entire province until it has been proven to be perfectly safe.

The government has taken the opposite position, arguing that because the economic issues are so overwhelmingly important the onus is on the opponents of the spray to show that it isn't safe. But by April the government began to feel increasing pressure from the controversy being stirred up by the Concerned Parents Group, who turned out to be surprisingly good researchers. Among other things, they discovered a 1973 Health and Welfare Canada handbook on aerial spraying safety which warns specifically that such spraying should not occur in populated areas and that children particularly should be evacuated. In late April, the government convened a special panel, organized by W.G. Schneider, head of the National Research Council, to examine the situation.

The six member panel, composed of pesticide experts, NRC research people and pathologists, was asked "to review and evaluate the evidence . . . of a possible linkage between the incidence of Reye's syndrome and forest spraying for spruce budworm control in New Brunswick." The panel came to the conclusion that it could not prove such a linkage, and on May 6 the government announced that it had decided, again, to go ahead with the spray program.

The Concerned Parents Group pointed out vociferously that the panel had said no more than was generally known. Dr. Crocker suggested that if the panel had been asked, "Is there a possibility of a connection between mass spraying programs and changing biological susceptibility to a virus?" the answers might have been more useful. The really important implications of Dr. Crocker's work, the opposition argued, do not concern Reye's syndrome at all, but two tangential matters. First, there is mounting evidence in his work and elsewhere that a wide range of chemicals may interact in dramatic and complicated ways with viruses, perhaps triggering many diseases and complications which are not as easy to spot as Reye's syndrome. What was being done, they demanded in a meeting with William Cockburn, New Brunswick's minister of health, to monitor the health of New Brunswickers in other areas? Mr. Cockburn directed them to the department's annual report, which turned out to chronicle no such monitoring.

Even more important, perhaps, was another issue raised by Dr. Crocker's research. His more recent work has suggested that the most dangerous chemical being sprayed on New Brunswickers is not the insecticide at alt, but one of the emulsifiers which is used to render the insecticide soluble so that it can be sprayed. These chemicals, the group points out, have been universally regarded as inert, and yet there is substantial evidence that they are very dangerous, that in combination with common viruses they may well be fatal.

This possibility opens up a real Pandora's box. If it is not only obviously dangerous chemicals, but ones that are presumably totally inert as well, that have to be proven innocent, then it is going to be virtually impossible to spray anything, and the spray programs not only of New Brunswick, but of Quebec, Maine, Ontario and all the others will go down the pipe. As Dr. Crocker points out, "not even the most basic chemistry has been done on many such chemicals: we simply don't know what they are. The assumption has been that they are OK, but it's beginning to look as though we can't assume that."

VII. Liftoff from Blissville

As the opening of the 1976 spray program neared, the Concerned Parents Group began pressing the government to warn people when they were going to be sprayed, and to advise them of safety precautions. As astonishing as it may seem, no suggestion of any such measures seems ever to have been made in New Brunswick before. Presented with the suggestion that the government needed to advise people at least to get inside while the spray was coming down, Health Minister Cockburn gave it as his opinion that no such warning was necessary. "It's only common sense," he said. "I wouldn't stand outside and let them spray anything on me." Presented with the argument that the government had been going to some lengths to persuade New Brunswickers that it was perfectly safe to stand outside in the spray, he finally conceded that the government might look into the possibility of establishing some sort of system to let people know when they were likely to be sprayed, but did not think it necessary to warn them of the health hazard.

On May 7, the necessary licences from the federal department of agriculture were issued to Forest Protection Ltd. and to J.D. Irving Woodlands Limited, a company which does its own spraying of its own land. All was ready; the program was waiting only for the rainy weather to clear and for the budworm larvae to develop to the proper stage.

It is well known that one of the difficulties of human health research is that you can't experiment on human beings. "Obviously," Dr. Crocker observed in an interview with Fredericton journalist David Folster, "you can't just go out and spray a thousand children with emulsifier and then hit them with a virus that we know is connected with Reye's syndrome."

On May 17, 11 Second World War vintage Avengers lifted off from Blissville Airstrip in southern New Brunswick, inaugurating what the Concerned Parents and many other citizens of the province saw as precisely that experiment. The province would supply the spray; Mother Nature would supply the virus. Everyone fervently hoped that the experiment would not provide positive evidence, next flu season, of a linkage between the program and Reye's syndrome.

Image by Luciana Christante via Flickr

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