Steve Kass

For the record, I’m not particularly fond of small parties, either.

“That was our playhouse – that was its name,” Gerry said, as if there could be any other reason for the RUTGER above the door. I never asked why it was named Rutger, or if I did, she never told me, or I forgot.

The carpenters at the San built Rutger. The carpenters built a lot of things for Mom and Gerry: Rutger, the seesaw, the elephant table, a bookcase. Probably more, though nothing else was passed down or photographed. The carpenters were fond of Mom and Gerry.

Four hundred or so people lived at the San in the early 1930s. Almost half lived in dormitories and worked there – carpenters, bakers, nurses, engineers, attendants, waiters, horse keepers, farmers, chauffeurs, teachers, butchers, clerks, pharmacists, physicians, and a dentist. One of the chauffeurs drove Mom to school in Middleborough. My grandfather Manny was the dentist. Manny, Nana, Mom, and Gerry were one of only a few families at the San, and they lived in one of the few houses on the grounds.

Mom said she and Gerry could see the morgue from their bedroom window. Gerry said they couldn’t. Or maybe it was the other way around. Either way, the morgue was near the house, and no one shooed the girls out when they wandered in. Not there or anywhere else – the operating theater, the lab, the barn.

They might have been shooed off the playground if they’d tried to play on the swings when other kids wanted to, but Mom and Gerry knew the rules, and they always had Rutger and the seesaw. The playground was for the inmates.

Renewed concern remained high for the third consecutive month, setting a record in March, according to first-quarter figures released today. The data came as a surprise to analysts, many of whom expected 2009’s historically low levels to continue for at least 12-18 months.

“We’re surprised, but we’re still forecasting a positive outlook for the year,” said Trend Analytics’ Sandeep Singh. “Don’t forget that increasing optimism, though off its January peak, remains strong.” In his widely-read newsletter, “Pulses,” Singh calls for renewed concern to drop by 10-15% in Q2 and for increasing optimism to remain steady.

Spain (EUSE:ESP) agreed to buy Greece (WSE:HELL), the debt-straddled nation, for €11.6 billion, in what analysts are describing as a direct challenge to Italy’s (WSE:BOOT) stronghold on island tourism. The Greece deal moves Spain into contention with the world’s top island players, which, after Italy, include Canada (NASE:CNK), Ireland (FTSE:EIRE), and the East Indian Union (NTDQ:EIU).

Greece’s common citizens will each receive €38.54 in cash and a pocket Greek-Spanish dictionary, Spain said in a statement today. Carnival Cruise Line (LSE:CCL), Greece’s biggest investor, will receive a lump sum of €635,000 from the deal when Spain takes control of its Greek port privileges.

Shares in both Spain and Greece rose sharply in extended trading late Thursday, when a few analysts speculated that another country may make a bid. New Zealand and Indonesia were possible buyers, according to Mingshan Wu, a travel analyst at Kaufmann Moss.

Analysts we spoke with were uniformly bullish on Spain. “This is a low-price, low-risk way for Spain to become a leader in the island sector,” said Federico Altamonte, a takeover analyst for Raymond Jane and Associates. Altamonte (who holds no shares of Spain) upped Spain from the hold column to strong buy. “We always wondered why Spain had no global island strategy, given the consistent success of Ibiza and other small holdings,” he added.

Shares in Ireland were sharply down on the news, which came on the heels of last month’s blow to that country’s shaky islands standing. Ireland has struggled to remain in the game since its 2006 hostile takeover of Iceland, and most analysts downgraded its offerings after the eruption of Eyjafjallajökull clouded prospects. Eyjafjallajökull was also a linguistic embarrassment for the Emerald Isle, which has yet to fully overcome the unanticipated public confusion between “Iceland” and “Ireland.”

On Monday, CBS News leapt (or leaped, if you wish) onto the alarm bandwagon, writing (emphasis mine):

So far, the biggest outbreak has taken place on Vancouver Island in British Columbia, but the fungus has since spread past the order [sic] into Oregon where it’s become a "a major source of illness in the region," according to the online journal PLoS Pathogens.

Not to be snarky (translation: Imma snark (translation: sarcasm coming)), but besides misspelling “border,” the CBS News writer failed to read either my previous post here (highly forgivable) or my comment on the PLoS Pathogen article’s discussion page (less forgivable, being that there are only two comments on the article).

It’s interesting to think about where in the scientific peer review process a clinker like “major source of illness” should have been caught. (I’ll think to myself.)

For the record, a publications assistant at PLoS Pathogens who handled my comment deserves thanks. He offered helpful feedback on a first draft of my comment, and he followed up to suggest that PLoS Pathogens cares when their articles are misinterpreted.

Yesterday, I wrote about the emerging public alarm over the fungus Cryptococcus gattii. Alarm continues to emerge, though some welcome voices of moderation are also appearing. (Time magazine’s writer Alice Park, for example, insightfully explored both the fungus and the alarm in “The ‘Killer Fungus’: Should We Be Scared?”)

Today’s topic is another fungus, a fungus of my childhood.

Like every nerdy kid in the 1960s, I could say and spell the words “antidisestablishmentarianism” and “pneumonoultramicroscopicsilicovolcanoconiosis.” But unlike most nerdy kids outside the desert Southwest, I could also say and spell “coccidioidomycosis.” When I read about C. gattii yesterday, I couldn’t help but think about it — coccidioidomycosis, or Valley Fever. Like the killer disease du jour, Valley Fever infects humans and animals who inhale fungus spores. In the case of Valley Fever, the fungus is Coccidioides immitis, which resides in the local soil around Phoenix and other parts of the Southwest. After a dry spell, rain and wind dislodge the spores and carry them into the air, where they float, free for the breathing.

I breathed in my share. Whenever a dust storm rolled in, my brother and I would don our swim masks, run outside, and play in the carport until rain and lightning arrived, if it did. Driving through the desert on dirt roads or off-road probably kicks up spores, too, and Dad took us on more than a few dirt-road and off-road trips in the Wagoneer.

Like C. immitis, C. gattii, according to some sources, usually causes no symptoms or minor ones. Sciencemag.org’s Robert F. Service writes that “most of [Vancouver Island’s] 750,000 residents have been exposed to C. gattii multiple times with no symptoms.” That’s not to say these fungal infections are innocuous; serious infections have occurred particularly in the immunocompromised, such as transplant recipients or (especially before HAART) persons with AIDS.

I like a fair bit of what I read in Time magazine, despite the “Partners with CNN” thing. For example, in today’s Time, Alice Park insightfully explored both the fungus I wrote about yesterday and the alarm surrounding it in “The ‘Killer Fungus’: Should We Be Scared?”

There’s one thing that gets me, though. Time punctuates many of its online stories with red links to related articles — or to articles someone, or perhaps some bot, thinks are related. It’s not that they distract me; I don’t tend to click on them and forget to come back and finish what I’m reading, for example, which would be a problem. What annoys me is that they frequently seem incongruous with the article I’m reading. They make my brain go “Huh? Why did I just read that?” It happened again today.

Ok, I get that Morales is a leader, but does anyone else see a gay ↔ fashion subtext lurking here? Not that there’s anything wrong with that, but maybe a link to the best-dressed leaders would have been more gracious, if they’re going to call this out in the first place. Oh, and that shade of red is too, too Nancy Reagan — it should be really more Reba.

The popular press is beginning to report on an article that appeared in PLoS Pathogens today, and you can bet public alarm will spread incomparably faster than the “highly virulent fungus” discussed in the article.

The Los Angeles Times was one of the first to pick up on the scare. They interviewed the article’s lead author, Edmond J. Byrnes, III for their report. In PLoS Pathogens, Byrnes and his coauthors described an “increasingly fatal fungal outbreak” in their discussion, without providing statistical support or an inline reference. The Times knows what readers will glom onto, however, and they devoted a couple of paragraphs to this “more lethal” angle.

The spread is also a concern because the strain of the fungus that moved into the United States in 2004 has mutated to become more lethal than the original strain that invaded British Columbia in 1999.

Five of the 21 people who contracted the fungus in the United States have died (about 25%), compared with 8.7% of the 218 infected people in Canada. The fungus has also infected many different species of mammals.

These details aren’t in today’s PLoS Pathogens article. Today’s article focuses on the molecular biology of C. gattii, not its epidemiology. My admittedly cursory search for the source of the Times’s numbers turned up one mention of an “over 25%” U.S. fatality rate. That was in a previous article of Byrnes’s, where he referenced the figure as the “unpublished observations” of two other scientists. But let’s give Byrnes and the Times the benefit of the doubt and suppose the numbers are reliable.

Math time. If you know only a handful of small numbers about a disease, drawing any epidemiological conclusions — especially alarmist ones that might be misconstrued — is risky, but mathematics can still help us evaluate the numbers. There will be lots of ifs, but that’s to be expected when you have limited data. The standard way to proceed is to ask the following question: If in fact nothing scary is happening (meaning that the infections in the U.S. are not more deadly than they are in Canada), might we really see as many as five deaths in 21 cases?

Under the probabilistic assumptions of this kind of analysis, getting infected with C. gattii is treated like a crap shoot as to whether you die or not; you die with probability 8.7%, the Canadian fatality rate. If 21 people get infected and for each one God rolls the dice to see who dies, what’s the likelihood at least five of them will succumb? Well, it’s around 3%. To put that in context, imagine that tomorrow’s traffic is terrible, like once-a-month terrible. Would you chalk it up to bad luck or a real change in traffic congestion? I’d chalk it up to bad luck and assume a real change only if traffic was similarly terrible again tomorrow or maybe next week. (Even then I would probably look for other explanations, like an announced construction project or a visiting dignitary.)

Other factors should be considered when comparing fatality rates to test the hypothesis of increasing deadliness, particularly with such small numbers of cases. Were the U.S. persons infected by C. gattii diagnosed as promptly (or not) as the Canadians and given identical treatments? If not, the higher U.S. fatality rate could be due to late diagnosis or ineffective treatment. Were the U.S. persons infected or killed similar to the Canadians in age, general health, and other factors known to be independent predictors of mortality from disease? If not, the higher U.S. mortality might not be due to greater virulence.

PLoS Pathogens is a peer-reviewed journal, and that provides some assurance that the scientific conclusions were based on accepted scientific practices. Unfortunately, published science has the potential to affect society and policy via the popular press, and reviewers need to think about how a publication might be construed by a journalist.

To Byrnes’s credit and the Times’s, readers who ventured a few paragraphs past the alarming headline will read this more moderate assessment of the situation: “Overall, I don’t think it is a large threat at this time. But the fact that it is continuing to spread geographically and the number of cases is rising makes it a concern.”

Whether or not Byrnes et al. were more justified than I can tell in calling this a “increasingly fatal fungal outbreak,” sure, this could be the next black plague. So could any number of currently very rare or unknown pathogens. But based on the science I’ve seen, you shouldn’t be any more worried about C. gattii today than you were last week, when I’m guessing you’d never heard of it.

References

• PLoS: Emergence and Pathogenicity of Highly Virulent Cryptococcus gattii Genotypes in the Northwest United States
• LA Times: Potentially lethal fungus moves south from Canada

Updated at 2010-04-22 at 23:28. I added the words Deadly and Fungus to the post title hoping to get more play. A list of headlines on this story follows.

One rebuttal of the alarm: Ore. DHS questions article statements about deadly fungus
(DHS is Department of Human Services, not Homeland Security)

Alarm and alarm in all the other headlines, though.

• Airborne fungus claiming lives
• New strain of virulent airborne fungi, unique to Oregon, is set to spread
• New Deadly Fungus Found in US, Has Already Killed Six
• Potentially Lethal Airborne Fungus May Spread to California
• Deadly Oregon fungus may spread on West Coast
• Deadly airborne fungus in Oregon set to spread
• Killer fungus seen in Pacific Northwest
• Potentially deadly fungus spreading in US and Canada
• Deadly Oregon fungus may spread on West Coast
• Deadly Fungus In Oregon: New Strain Of Fungus Killed 6 in Oregon
• Fungus Cryptococcus gatti Threat to Healthy People
• New Likely Deadly Fungus Invading US & Canada – Signs & Symptoms
• Emerging Northwest fungal disease develops virulent Oregon strain
• Oregon Fungus Spreading South
• Toxic Airborne Fungus From Oregon Spreading Across West Coast
• New Concerns About Deadly Fungus Found in Oregon
• Deadly strain of airborne fungus spreading among healthy people and animals
• Life threatening tropical fungus seen in Pacific Northwest
• Fungus Spreading Throughout US, Canada
• Killer Fungus Migrates To The US
• Killer Lung Fungus Hits Northwest
• ‘Highly Virulent’ Strain of Killer Fungus Found in Ore

Yesterday, Neil Patrick Harris retweeted David Blaine‘s funny observation that "one of these things is not like the others."

My AOL data (see #836. How to be a sex goddess) was a little thin on "why is he" queries, but a broader "why is" search didn’t fail to disappoint. Here are a few; the full list in alphabetical order (not safe for work, as you might guess) is after the jump.

• why is the earth so important
• why is renaissance art emotional
• why is pi irrational
• why is a frog difficult to hold
• why is there dirt in my air
• why is the tympanum located in the abdomen of the grasshopper
• why is scary movie2 rated r

(more…)