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Shelton Mason County Journal
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Mason County Journal
November 18, 1971     Shelton Mason County Journal
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November 18, 1971
 

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e By JAN DANFORD A happy, healthy Shelton baby, on a February evening in 1966, was put to bed in the usual manner. In the morning the six-weeks-old child was found dead. Prosecuting Attorney Byron McClanahan, as coroner, then for the first time came into direct contact with the intangible horror that hovers over the households of small infants; the elusive killer that defies medical science; the spectre that haunts the lives of those involved - crib death. At least 10,000 and often as many as 15,000 babies, most of them between the ages of two and four months, succumb suddenly and unexpectedly each year in this country alone. "'What did 1 do? What did I fail to do? What tiny action did 1 ignore, or what feeble sound did I not hear? Why is my baby not alive today?" To the anguished heart-cries of the bereaved parents, physicians can say but this: "Don't blame yourselves." The pain encompasses also the doctors, who are unable to predict or to prevent the problem. The only symptom is death itself. In the case handled by Byron McClanahan an autopsy was performed at the University of Washington. Findings made it possible to assure the parents that they had been in no way negligent. Although previously well aware of the threat of crib death, child. First sought are the identifiable childhood killers - heart defect, brain damage, poison. If no cause of death can be determined they are actively dealing with sudden unexplained infant death. SUID. In less than three hours the team will have taken tissue samples and viral swabs, which are packed in ice and removed swiftly to Children's Hospital for immediate culturing in the virology lab. All is accomplished in utmost haste in the hope of catching viruses before they may escape undetected. Cooperative members of the child's family contribute their own blood samples and swabs, and the search for an SUID virus has begun. If it exists it will be recognized when it provokes a reaction from a particular tissue culture. It is believed that a virus is associated with crib death because SUID occurs most frequently during months when viruses in general are prevalent and in families where minor signs of infection are present. If such a virus is at work, it is thought that certain existing conditions in the child may make it possible for the killer to strike. For the first few months of life an infant lives in a state of transition as his immunological system is developing rapidly to replace the lessening protection of his mother's antibodies. As his nervous system matures, tissues showed signs of throat inflammation. Bergman stated that an infection most insignificant to an adult body might act on the autonomic nervous system of the immature infant. A theory advanced by Boston University School of Medicine pathologist Dr. Abraham Towbin proposed that a whiplash injury to the spinal cord could be the answer. In the course of a study conducted on birth injuries, Dr. Towbin had made post-mortem examinations of newborn babies some of whose spines showed hemorrhage as though twisted and strained during delivery. Seven of eight crib death cases examined had the same characteristic spinal hem orrhage. The doctor noted the similarity of the damage endured by these infants to that of adult victims of whiplash injuries. He was not, however, able to explain how the baby might receive the injury. Dr. Towbin pointed out that a newborn baby is very literally top-heavy, his head weighing approximately four times as much as that of an adult in proportion to total body weight. He considered it conceiveable that a baby's heavy head and weak spine might cause him to be susceptible to whiplash injury in the course of sudden twisting and turning movements in the crib or playpen. He stated that vital nerve cells in the spinal cord could thus be the stricken and shocked families who have experienced the tragedy of crib death. The more active groups include the Washington Association for Sudden Infant Death Study, in Seattle; the Mark Addison Roe Foundation with headquarters in Greenwich, Conn. and in Denver, Colo. ; the California Association for Sudden Infant Death Study in Fremont, Cal.; and the Guild For Infant Survival in Baltimore, Md. Members of these organizations strive to alleviate the punishing self-blame in which the afflicted families are entrapped. Charges of neglect by husband or wife may result in the breaking up of the family; the doctor is sometimes blamed for failure to find a problem during his routine examination; baby-sitters and grandparents have been accused of carelessness; siblings have been made to feel unwarranted guilt. Public misunderstanding has been a cruelty in the past, many suffering mothers and fathers having been suspected of child abuse; but the worst weapon of all is the self-denunciation with which the agonizing parents flay themselves relentlessly and indefinitely. In August of 1962 Jedd and Louise Roe, then of Greenwich and later moving to Denver, established a foundation named for their six-month-old son, Mark Addison Roe, who had died in October, 1958. Neither the Roes nor their larynx and windpipe of the dead infant have been ascertained and their shapes preserved with a silicone cast after which detailed microscopic sections were made. A sudden allergic reaction to cow's milk was once proposed and widely studied, especially by British doctors. American doctors did not readily accept this theory, pointing out that many victims had never been fed cow's milk. Crib deaths are more apt to occur in crowded neighborhoods where there may be a greater exposure to germs, thus bolstering the theory that an overwhelming infection could be the killer. Dr. James R. Patrick, pediatric pathologist at the Children's Hospital of the District of Columbia has stated that two or more viruses are probably responsible, rather than only one. Further support for the infection theory arises from the fact that the majority of crib deaths occur at an age when the infant's immune defenses have become dangerously low. Dr. Frederick C. Robbins, professor of pediatrics at Western Reserve School of Medicine in Cleveland and co-winner of the Nobel prize for his work in culturing polio viruses, points out that the protective antibodies received by the baby at birth from his mother are constantly declining throughout the first year of life. It is known that the polio antibody is low by three months of age. Dr. Beckwith hopes that vaccinating babies against crib from this day forward and cells undergo changes not as injured with no visible effect, doctor accepted the autopsy death viruses, once they are McClanahan has been extremely yet fully understood, and any resulting in a later and report of"bronchialpneumonia", identified, might restore active in the fight to gain failure in the maturing processunexplained death. They considered it merely a label protective levels as does information, in the efforts to might allow an opening for theThe Seattle research team applied to cover medical vaccination in polio. educate the public in the beginning of the death-dealingcompletely disproved this theory, uncertainty. A most disturbing question to recognition of the disease, and in sequence, reassuring grieving mothers who The Roes encountered callous be faced is that of how any germ the unceasing struggle to trace the Viruses are elusive. It is far feared that failure to support the attitudes toward those losing could kill with such frightening malady to its source, easier, according to virologists, to s m a I 1 he a d m igh t h a ve children to SUID, and determined speed. None of the infectious At least as old as the Bible is explain them than to isolate contributed to death, to work toward the banishment diseases such as diphtheria, crib death, to which, as them. Crib Death seldom occurs of the misunderstanding and thecholera or blood poisoning can "'overlaying," a reference is made - In the state of Washington, before the age of six weeks ormisconceptions surrounding crib act so swiftly. Only a fatal heart in i Kings 3 : 1 9. The term progress in the study of crib death after the age of six months. Clues death, attack, a chemical poisoning or originated at a time when adults was slow until coroner Leo M. to the mystery include an Even more appalling than the the occasional lethal allergic and infants often shared a bed, Sowers and Fred Dore of the state abnormal metabolic product effect on parents is the shock of reaction to penicillin, which can and it was thought that the legislature lost children to the which turns to red the alcoholthe tragedy upon little brothers occur within one or two minutes sudden deaths were due to sudden-death syndrome. They with which it is combined in and sisters. They cannot after injection, can match the suffocation. Many present-day added to the effort their certain chemical tests. This understand and they cannot speed ofcribdeath. parents, lending credence to this influence, and in 1963 Dore substance was found in 80% of accept. They are lost in grief for It would therefore appear that false belief, fear that they may p u s h e d t h r o u gh a b ill the brains of a group of crib death the baby and steeped in fear for involved viruses would necessarily have smothered their dead child appropriating $20,000 a year tobabies studied in Philadelphia. Of themselves. Death hangs heavy multiply with devastating through carelessness, finance the infant autopsies to be the infants dying of identifiable over their frightened heads, swiftness or would unerringly Others wonder if their babyperformed in the University of causes, only 20% produced the Research has been stimulated seek an unusually vulnerable spot choked on mucus or regurgitated Washington Hospital or the "red substance". The discoverer, by the parents' groups. Pioneers in the infant's body. Several food; some blame an unsuspected Children's Orthopedic Hospital. illness occasionally small brothers ~h,e ,Upjversity', .Anedical or sisters are heart-bre~ ,~school orgamzed in the sameyear accused. Post mortem findin~T~e international conference on deny such concepts. For almost two decades war has been constantly waged against SUI D Sudden Unexplained InfantDeath. In many major citiesnew techniques and advanced equipment assist detailedstudies, among the most dramatic of which are thos-e that have been conducted by doctors in the Children's Hospital in Washington, D.C. Backed by a grant from the National Institutes of Health, their plan of action has included the assistance of the district's homicide department and the coroner's office. Homicide detectives and representatives of the coroner's office are among the first to know of crib death cases. The information is given instantly to the concerned doctors, and a group known as an SUID team, the creation of Dr. James Patrick, chief of pathology at Children's Hospital, rushes into action. The three members, a pathologist and two assistants, one of whom is a viral specialist, are on call 24 hours a day and seven days a week. If a crib death occurs during the day, the message is relayed to an SUID office in the basement of the hospital; if at night, team members are notified in their homes. Dressing hurriedly and grabbing up their equipment, packed and ready, they hasten to the District of Columbia Morgue An immediate autopsy is performed on the body of the A I. TmR FRo/ FROM SANTA CLAUS SANTA CLAUS, INDIANA THE PROOF IS IN THE POSTMARK! Visit our Santa Post Office and select a colorful letter FREE! It's 0ur way of saying Merry Christmas to children of all ages. "Causes o{ ~Sudden Death in Infants" The published proceedings are available to every pediatrician in the United States. The Washington State research project received a three-year grant of approximately $1 20,000 from the National Institute of Child Health and Human Development with which Pathologist Beckwith and Pediatrician Bergman financed a thorough study of all crib deaths in King County and several from surrounding areas. Since 1965 every crib death in King County has been investigated by doctors Abraham B. Bergman, J. Bruce Beckwith and C. George Ray. Early in the program a typical pattern emerged; Most of the victims were less than four months old; more deaths occured in winter than in summer; the death rate was highest among low-income families. Do environmental factors set the stage for a physiological explanation of crib deaths? In each of the cases autopsies revealed that lungs were congested and contained many tiny ruptured blood vessels. Seattle investigators attributed the lung damage to tremendous pressure accumulated in the chest prior to death. They believe that the pressure was caused by the constriction of the child's vocal cords, whereby the passage of air was closed in the windpipe causing death by internal asphyxiation. Bergman explained that in an infant the autonomic nervous system which controls the vocal cords is unstable, and evidence indicates that many of the stricken children had suffered the virus infections common in winter. All autopsied infants Dr. Frederic Rieders, chief toxicologist in the office of Dr. Joseph Spelman, city medicsI examiller ~r l~atladelphia, ha, yet to determine the composition of the substance and he does not know how or why it is produced by the body. Dr. Marie Valdes-Dapena of St. Christopher's Hospital for Children in Philadelphia found a relationship between poverty and crib death. Dr. Spelman agreed that environment might play a role and also suggested psychological causes as a tentative idea. Crib death seldom strikes twice in the same family. However, in the years from 1949 until 1966, Arthur and Marie Nee, Philadelphia low income parents, lost nine children in infancy. Suddenly and unexpectedly, death has repeatedly occured in a definite and unchanging pattern with no discernable reason. Intensive investigation of the Nee case has proved beyond a shadow of a doubt that there was no neglect, no carelessness, no faintest suspicion of homicide. No signs of violence, no trace of poison, no lethal substance of any sort was ever found. The theory of suffocation was absolutely disproved by Dr. Paul V. Woolley Jr. of Detroit who has repeatedly tested and demonstrated the fact that a baby between the ages of two and six months - the period during which most crib deaths occur - can easily roll or lift his face from a mattress surface, and can wriggle from beneath a blanket. Crib death has been christened the "disease of theories"; but investigators press on in spite of discouraging forays in which false leads are followed down blind alleys. In the meantime in many cities parents have banded together to comfort and to assist Tasty Treats From Local Waters You'll Like Our Seafood Menu Come Out And Try... HOOD CANAL SHRIMP $2.75 If You Appreciate Choice Steaks Prepared to Perfection You'll Love Ours... 14 oz. ale SrtAK .. $3.75 New Luncheon Specials Daily OPEN 11 A.M. to 9 P.M. Except Monday Phone 077-9733 1 Mile $. of Hoodsport Page 8 - Shetton-Mason County Journal - Thursday, November 18, 1971 in the field faced resistance to the very necessary proml~t post mortem examinations.~ Pressure for a program requi~'ing ~:g'uch procedure in each and every crib death was begun in the state of Washington in 1956 by Dr. Sherod M. Billington, a pediatrician in the Seattle area and chairman of the Washington State Medical Society's committee on maternal and child welfare. Upon completion of an autopsy, parents are now promptly informed as to whether or not their baby's death can be explained. At one time a long wait was involved before results were released. Mrs. Margaret Pomeroy, graduate nurse and mother of three children, within two weeks after the funeral visits the crib death home for a tape-recorded interview. Working from an extensive questionnaire, she covers such details as the position in which the baby was found, when and what the child had last eaten, the type of bedding used, whether or not there had been complications during pregnancy, and various questions concernittg the medical history of the parents. Mothers often volunteer suggestions. Several had noted that deaths occured at exactly the age when the children w~e beginning to sleep through the night. Although doctors agree that crib death is death without noise, they are not certain that it ,is death without a struggle. Inflammation of the larynx is frequently found. In pursuit of this clue measurements of the researchers have suggested the .~. possibility of multiple causes. '~ According to Dr..Beckwith there is a chance that a child with a certain type of nervous system or a weakened state of immunity or both might become infected with a certain type of virus with the combination of all factors leading to death. Dr. Bergman has likened the crib death syndrome to an atomic explosion occurring when the critical mass has been reached. "It can be compared,.' the Seattle team has reported, "with a nuclear reaction in which a number of isolated events, each harmless in itself, must occur simultaneously to trigger the fatal explosion." Much of the mystery of the silent killer has been dispelled, although the general public is not yet fully aware of the true facts concerning crib death. Many writers, unable to correctly interpret medical terminology, have inadvertantly misquoted the statements of doctors and researchers. In approximately 15% of sudden infant deaths a standard medical cause such as pneumonia or meningitis can be found. The remaining 85% can be shown in the course of a skillful autopsy to follow a single specific pattern, according to Dr. Bergman. There are five pathological signs. In almost every case tiny hemorrhages are found on the inner surfaces of the membranes surrounding the lungs and on other surfaces within the chest cavity. Such hemorrhages are not found elsewhere in the baby's body and are found but rarely following death from other Made to Measure--Any Size Lined or Unlined NO CHARGE FOR LABOR Pay Only For Materials Choose from Immense Selection pcorator Fabrics ": Over 150 Patterns and Colors MATERIAL PRIIEII Open Friday EveningS Until 8:30 p.m. th causes. Edema fluid is found in the lungs, and the heart almost always contains fluid blood rather than the clotted blood to be found following death from most other causes. The bladder is empty, and a slight inflammation is apparent along the airway leading to the lungs. Such a pattern of multiple factors is known as a syndrome, and therefore the cause of crib death is called by researchers "sudden death syndrome", or SDS. Autopsy findings and other evidence have ted the Seattle team to propose an explanation of how a crib death occurs. They state that in a young baby the airway leading to the lungs is very small and that the area below the base of the throat is barely large enough to admit a pea. Half an inch lower the two vocal cords come together in the larynx, and there the passageway is not much larger than a grain of rice. Muscles in and around the larynx can close it off involuntarily, as occurs in a cough. The Seattle team has concluded that the most likely mechanism of death in SDS cases is a sudden involuntary spasm of the tiny larynx. Dr. Beckwith reached this conclusion by following the clues presented by the hemorrhages within the chest. Experiments conducted upon animals confirmed his view. "If a laboratory animal is number one cause of' death in infants after the first week of life. It cannot be predicted or prevented, even by a physician. The cause is not suffocation, aspiration or regurgitation, although sometimes death certificates use such terms in error. A minor illness such as a common cold may be present, but many victims are entirely healthy prior to death. There is no suffering; death occurs within seconds, usually during sleep. Crib death is not contagious in the usual sense. Although a viral infection may be involved, it is not a "kiUer virus" that threatens other family members or neighbors. It rarely occurs after the age of seven months. It is not hereditary; there is no greater chance for it to occur in one family than in another. The baby is not the victim of a ''freakish disease". Approximately 10,000 to 15,000 babies die in this manner every year in the United States. Crib death is at least as old as the Old Testament and was apparently at least as frequent in the 18th and 19th centuries as it is now, demonstrating that new environmental agents such as birth control pills, fluoride in water Supplies, and smoking are not to blame. Although the subject has received increased attention in recent years, the incidence of SDS is not rising. Recent research shows that Sudden Infant Death causes over 85% unexpected death At the Washington State NFSID held in Children's Orthopedic Seattle, Doctors Bergman, Ray and on the SIDS Reports included the cord blood study. Since August Seattle hospitals cord blood from child. Tests are baby becomes a crib Under a new grant of National Institutes three staff members 0! Orthopedic the research. will be Dr. C. specialist in virus Co-investigators will Bruce Beckwith, director of Paula Clausen, a trainee in mt They will be agents in the victims and in the umbilical cord blooa the children were born The Children's Hospital group more than 400 the Seattle area. be obtained by Washington state NFSID, 9326 Mercer Island, W" anesthetized and its airway clamped shut at the larynx," he Locol Trovelers Retorn stated, "Its breathing muscles promptly contractinaneffortto From Month Long Tour draw air into the lungs. The effort is unsuccessful, but a powerful Mr. and Mrs. Lawrence surrounding plain. vacuum is produced in the lungs. Carlson and Mr. and Mrs. Herbert not-to-be forgotten The negative pressure is so great Angle have recently returned was their contact that small blood vessels burst and from a month's tour that took Aborigines of Austr~ tiny hemorrhages occur, them to the South Seas, New They found tit, "Later, when the animal is Zealand and Australia. delightful, particur examined at autopsy, tissue Their itinerary included unspoiled island surfaces within the chest cavity Honolulu, Tahita, Moorea, Fiji, of their expecta are found to be mottled with Auckland, Waitoma, Rotorua, lege daryislandpar hundreds of these hemorrhages Sydney, Melbourne and numerous - just like the ones found in the side trips to points of interest. W lnn ers N' same places among babies who Both the Carlsons and the have died of SDS." Angles were greatly impressed in By Bridge Although this explanation New Zealand and Australia with Monday night deals with the "how" of crib the friendliness of the people, the Shelton Bridge death, it leaves unanswered the great question of"why", beauty of the scenery, and the B atchelor and The National Foundation For strength of the economy (which Lynn Rust and Sudden Infant Death with has virtually no unemployment). Tuey Schumache-r headquarters in New York City, A highlight of the trip was Mr. Quimby. has determined certain basic facts Carlson's climb of Ayers Rock, The club meets at concerning crib death, the largest monolith in the world. It is a definite disease and the This impressive feature of Central Australia rises 1,148 feet from the each Monday :In building. All bi'idg welcome. SHOE SALON PRE- THANKSGIVING Ladies'& Teens WHIP: VAL. TO $12.00 NOW REG. $13.00 NOW RAIN REG. TO $9.00 NOW VAL. TO $9.00 NOW WATCH FOR RED DOT SPECIALS