Ah, it’s finally here – that bittersweet last post for a class marking the end of yet another semester. This is it; the very last of my sociology blog posts! This week’s assignment consisted of watching a medical drama and analyzing it’s depiction of a disease it presents compared to the true nature of the disease. Of course, I chose to watch my favorite show – House, MD! I’d be lying if I said that I don’t know every episode of that entire series inside out. I decided to watch a show at random and I ended up watching one of my favorite episodes: “A Pox on Our House”. The disease addressed in the show ends up being something called Rickettsialpox; a condition that according to the show closely appears like smallpox.
The CDC presents rickettsialpox as an infectious disease caused by the bacteria of the genus Rickettsia. It is categorized as being similar to spotted and typhus fevers. The bacteria appears in rodents (typically the house mouse) and it leads to mites on the rodents to become infected with the bacteria. Rickettsialpox is passed on to humans if they receive a bite from an infected mite – not directly from the rodents. There was an initial outbreak of Rickettsialpox, however it is not a disease that is even statistically defined. It is acknowledged on a case-case basis and all age ranges are effected by the illness equally. Again due to limited information regarding this disease, concrete statistics are not given regarding whether certain socioeconomic groups or races were affected more than others.
The greatest contributing factor to the disease is environmental conditions. Travelers, people in refugee camps, those dwelling in urban areas, and generally people in areas with high exposure to body lice are at greater risk of contracting Rickettsialpox. In essence, people that are in close contact with larger populations of rodents and mites of any sort are more likely to be infected with Rickettsialpox than those that are not (although again, this infection is RARE).
The initial symptoms of Rickettsialpox are evidence of a bite that tends to scab over. The other symptoms are flu-like in nature consisting of fever, headache, nausea, vomiting. The most distinct feature of course is the rash. The diagnosis of this illness is based on recognition of clinical symptoms and serology. However, the CDC notes that Rickettsioses are difficult to diagnose even by experienced health care providers. The nature of the illness makes it easy to be misdiagnosed. Rickettsial pox is typically treated with doxycycline – although chloramphenicol is used in some cases with less effective results.
The patient in House is a young girl who comes in contact with scabs in a jar while diving with her family. She ends up getting cut when breaking the jar and soon begins to present with extreme flu-like symptoms and blisters that appear to House and his team to be smallpox. They are certain of their diagnosis due to information that the scabs supposedly belonged to victims of smallpox on a slave ship travelling to Bermuda. The disease is recognized as smallpox until the presence of rodents and an infected cat who lost his fur and died on the ship directs House to realize that she actually has Rickettsialpox. The show is obviously dramatic in nature but not a horrible representation of the disease. The symptoms and diagnosis process were reflective of the true nature of the infection. It is easy to misdiagnose and projects relatively vague symptoms. The rarity of the disease is also reflected accurately. The transmittance via an open wound and ancient scabs is not as conventional as a tick bite – but again is forgivable. Everyone’s perception of the disease would probably not be far from the actual nature of it.