Mystery Illness Hits Infant Girl From Argentine Flight

An 8-month-old girl who was on the Aerolineas Argentinas flight that brought cholera to Southern California is in guarded condition at Children’s Hospital of Orange County with severe diarrhea and renal complications.

County and CHOC physicians say the baby has tested negative for cholera, but they are unable to diagnose the condition.

CHOC infectious disease specialist Dr. Antonio Arrieta said Monday that he is unable to rule out or conclude that the infant caught the mysterious illness on the Feb. 14 flight.

The baby became ill Saturday morning, eight days after arriving with her mother from their native Buenos Aires to visit relatives in Orange County. Since arriving, the mother has tested positive for bacteria that is suggestive of cholera. She apparently contracted the disease during the flight, even though she has had no symptoms.

Arrieta said he “couldn’t prove” that the baby also got sick during the plane ride. “You can argue that where there is cholera, there could be other bacteria,” Arrieta added. “But that is a long shot. The time interval from the plane’s arrival and her illness is a little prolonged to assume automatically this is something she got on the plane,” he said. In addition to Arrieta, the Aerolineas Argentinas company physician is closely following the baby’s condition--calling the CHOC physician or the child’s mother several times a day. But so far Arrieta has been unable to learn what type of organism has made the child so sick.

County epidemiologist Dr. Hildy Meyers, who for the last week has been tracking cholera cases from the Aerolineas flight, also said she “would doubt very much” that the baby’s illness was linked to the plane ride.

Still, Meyers said, she would “certainly keep apprised of this illness” and would like to know if it had any connection to the Feb. 14 plane trip.

Like Arrieta, Meyers said the time between the plane ride and the onset of the baby’s illness is an unusually “long incubation period.” She said she hadn’t heard of any other passenger with both diarrhea and renal problems.

The baby girl and her mother are among 21 Orange County residents or visitors who traveled on the ill-fated Argentine plane. The mother is also one of three people with Orange County connections who have tested positive for bacteria suggestive of cholera, Meyers said. One more test, by state health officials, is needed before final confirmation of cholera can be made.

Of 336 passengers on the Valentine’s Day flight, 13 are now believed to have had cholera, state officials said Monday.

In addition to an Orange County case--which is still in the “suspected” category but also described as “a red-hot probable”--they include eight confirmed cases in Los Angeles County, one in San Bernardino County, two in San Francisco, and one elsewhere.

Authorities became aware of the outbreak when a 70-year-old passenger died of cholera Feb. 18 at Arcadia Methodist Hospital. Though a cholera outbreak is highly unusual in the United States, numerous California residents have been hospitalized in the last week for cholera and at least 28 Los Angeles County residents are suspected of having the disease. Authorities have tied all the cases to the flight.

In contrast to South America where the disease is epidemic, there have been occasional cases in the United States involving people who ate contaminated seafood. But U.S. health officials have long thought that good hygiene and modern sewer systems kept Americans safe from cholera.

The disease is spread through ingestion of feces-contaminated water or by eating food contaminated by dirty water, human waste, soiled hands or flies. Raw or undercooked seafood from polluted areas often causes outbreaks.

The disease, which causes extreme diarrhea, vomiting and sometimes abdominal cramps, can kill its victims within hours through dehydration, although complete recovery is possible with intravenous fluids and antibiotics.

Cholera is currently epidemic in Argentina, Peru and much of South and Central America. Nearly 400,000 cholera cases were registered there in the last two years, and the death toll, also in the thousands, has been especially high in remote villages where there are no hospitals and residents drink from contaminated rivers.

As testimony to the seriousness of the Aerolineas Argentinas case, epidemiologists in half a dozen California counties are tracking the outbreak, and an investigator from the national Centers for Disease Control recently arrived in Los Angeles to study it.

Health officials in Los Angeles and Orange counties said Monday that so far investigators have been unable to pinpoint what food or drink was contaminated with cholera bacteria during the lengthy flight, which originated in Buenos Aires and also stopped in Lima, Peru.

In the case of the 8-month-old baby, Dr. Arrieta noted that the child had been breast-fed until shortly before the plane ride to Los Angeles but for that trip, he said, the mother had switched to bottle feeding.

A county laboratory test and one at CHOC had ruled out the possibility that the child had cholera, Arrieta said. Though the mother apparently does have cholera, he noted that the disease cannot be spread from a mother to her baby in breast milk.

“We do not have yet--and may never have documented--an organism” that has caused the baby’s serious illness, Arrieta said.

Arrieta described the mother as “stressed out” and in shock from the sudden onset of the baby’s illness, her hospitalization and the major renal complications on Monday that led to her being moved to intensive care.