PINK DISEASE

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Bronchiectasis is a serious and incurable lung disorder in which the bronchi are irreversibly dilated generally as a result of an infection of the bronchial tree leading to obstruction of the bronchi. Causes of the infection include Whooping Cough, Pink Disease, pneumonia, measles, tuberculosis and cancer.   As stated above, mercury is quite toxic to the lungs.

 

Because of the obstruction of the bronchi, lung secretions accumulate, become infected and weaken the walls of the bronchi which dilate. The disease usually starts in childhood but may not show itself until adulthood.

 

As well as coughing up copious quantities of lung secretions, the symptoms may include -  

 

·          low grade fever;

·          breathlessness;

·          cyanosis (bluish skin colour);

·          a general deterioration of health with night sweats; and

·          severe chronic bronchitis and asthma.

 

Treatment

 

Treatment involves getting rid of the secretions which have accumulated in the dilated bronchi. This usually involves the use of antibiotics to prevent and/or treat infections and postural drainage, but in some instances, part of or all of the diseased lung is removed.  

 

Postural drainage involves using the force of gravity as an aid to coughing up the lung secretions. Lying with the upper body over the edge of the bed helps the secretions drain into the trachea (windpipe) and be coughed up.

 

Precautions

 

Sufferers should not smoke, should have a well-balanced diet and plenty of fresh air and be immunized against influenza. A precautionary note for any sufferer who had Pink Disease or mercury poisoning or is sensitive to mercury - the preservative, thimerosal which contains mercury, is used in most influenza injections and it is therefore important that your doctor or chemist ensures that the influenza injection you are getting does not contain thimerosal.

PINK DISEASE REVISITED

 

Pink Disease was and still is a very nasty disease with diverse and complex symptoms. The severity and duration of the disease vary. In the English speaking western world, the age of onset is usually between 6-14 months.  The most common cause of Pink Disease was teething powders containing mercurous chloride (calomel).  The use of mercury in teething powders was prohibited in Australia from 1953-7 (depending on the state).  The symptoms of classic Pink Disease for babies and toddlers include:

 

An itchy, burning rash

Hair pulling and/or loss of hair

Skin that peels off in layers

Teeth loosen and/or fall out

Photophobia (extreme light sensitivity)

Convulsive seizures and petit mal attacks

Muscle weakness and flaccidity (atonia)

Elevated temperature, blood pressure and pulse rate

Clumsiness (ataxia)

Excess salivation

Digestive problems including loss of weight,loss of appetite, vomiting and constipation

Enlarged lymph glands

Cold, clammy, swollen pink or bluish hands and feet

Low blood sodium level

Scratching and tearing at skin and sucking andchewing of fingers

General excess sensitivity of the skin to touch, temperature, water and UV light

Anaemia

Excess nasal discharge

Profuse sweating

Abnormal skin and muscle sensations

Ulceration of the gums

Numbness of the extremities

Insomnia

 

If circulation is really poor in the extremities, gangrene and auto-amputation can occur

 

The child is restless, irritable, miserable & anxious

 

Secondary infections particularly to the skin and lungs

 

The disease typically lasted between 3 months and a year and it sometimes recurred.  Although the disease is commonly called Pink Disease because of the swollen, pink hands and feet that are a noticeable feature of the disease, this symptom is not always present.  An abortive, less severe form of babyhood Pink Disease also occurs.  Pink Disease occurred in older children in Europe because the most common cause was worming preparations containing mercury.  The symptoms of Pink Disease in children over the age of 2 are similar to those mentioned above but are nowhere near as dramatic -

 

·          Irritability, failure to gain weight, sleeplessness and lack of energy are the most noticeable symptoms.

·          Light sensitivity and the pinkness of the hands and feet are not as noticeable.

·          Coldness and moistness of the extremities is evident.

·          Lack of muscle tone and high blood pressure are detectable.

·          The child becomes listless, doesn’t smile, and doesn’t want to play anymore and may simply sit around and rest all day.  The older child can become asocial, talk infrequently and be bad tempered, difficult and even violent. 

 

The loss of muscle tone was so severe that those who were walking at the time they contracted Pink Disease frequently stopped walking.  Those who hadn't started to walk tended to start walking later than average.

 

Although it has been estimated that between 10% and 33% of babies who got the disease died, a higher death rate is suggested by anecdotal evidence. Death was usually the result of secondary infections such as broncho-pneumonia, circulatory collapse, hyponatraemia and very high fever.

 

The mothers and other care-givers of babies with Pink Disease suffered severe exhaustion from lack of sleep, severe stress and loss of weight.  Family life was generally disrupted by the baby's constant crying.

 

It's generally accepted that chronic exposure to mercury was the cause of Pink Disease together with some other predisposing factor such as hypersensitivity to mercury, a molecular malfunction, or prior illness.  The predisposing factor is likely to be genetic or epigenetic.  It is estimated that only 1 in 500 babies who were treated with mercury-containing teething powders got Pink Disease. The next section "A Little History" mentions some of the early theories about what caused Pink Disease.

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A LITTLE HISTORY

Some Early Theories

 

Dr. H. Swift, of Adelaide, first recognised Pink Disease when he was a physician at Great Ormond Street Children's Hospital in London in 1885 and described the disease at the Australasian Medical Congress in 1914, calling it "erythroedema".  Selter referred to the disease in 1903 as "trophodermatoneurosis".  William Snowball of Melbourne described some symptoms of the disease in 1883. Charles Clubbe of Sydney used the term "pink disease" for the condition.

 

Dr. A. J. Wood of Melbourne detailed the symptomatology of Pink Disease at the Australasian Medical Conference in 1920.

 

The disease was also described independently by Bilderback in America in 1920, and by Feer in Germany in 1922.

 

While Pink Disease is the most common name for the Disease now, it also goes by the name acrodynia, Feer's Disease, Swift's Disease, erythroedema, trophodermanatoneurosis.

 

The symptoms of Pink Disease were well described by the early 1920's and the search for the cause began in earnest.

 

It's been commented that had any physician seen a Pink Disease baby earlier than about the 1850's they would have immediately recognised the symptoms as those of mercury poisoning because up to that time, mercury was in very common use and the symptoms of mercury poisoning were well known.

 

The Mercury Theory was first raised in 1922 by J. Zahorsky because the oral changes did not resemble any other disease except for poisoning from mercury or phosphorus.  He discovered a history of mercury ingestion in some of the children, but not in others.  He therefore eliminated mercury as a possible cause of Pink Disease. The mercury hypothesis was later retested by Warkany and Hubbard. Warkany's and Hubbard's theory is detailed below.

 

Others, including Byfield, Vipond, and Rodda suspected that viral infection caused the disease.  Rocaz concluded it was an inflammation of the nervous system and Littlejohn considered an infection involving the nervous system, particularly the vasomotor centres in the medulla and spinal cord might be the cause.

 

Despite studying cultures of bodily fluid and blood, Penfold, Butler, Wood and Gareau found no evidence of viral infection.

 

Mercury poisoning can cause blood disorders such as anaemia and another theory of Pink Disease was that it was caused by a vitamin deficiency - particularly of the B-Group vitamins.  This theory was discarded because most the children who had Pink Disease were well fed and well cared for children.  Children in countries with a low standard of living, where deficiency diseases were more common, did not get Pink Disease.

 

Another theory was that Pink Disease was caused by a dysfunction of the Autonomic Nervous System or that it related to an encephalic lesion because many of the symptoms of Pink Disease were suggestive of this.

 

Arsenic poisoning and poisoning from contaminated bread were also put forward as theories.

 

One of the reasons why there were so many theories about the cause of Pink Disease was that the symptoms of the disease were so diverse and were similar to the symptoms that could be caused by various infections, vitamin deficiencies, poisoning and so forth.  Looking back, it seems obvious that the cause MUST have been something that could cause a myriad of unpleasant and sometimes deadly symptoms.

 

Two theories are discussed in more detail below.  They are Warkany's and Hubbard's mercury theory that relates to what "caused" Pink Disease, and Cheek's and Hicks' theory which relates to the physiology of Pink Disease.  Both the theories and methods of studying them had problems but fortunately; fate stepped in and proved that mercury was the catalyst for PD.  Unfortunately, this meant that all research into the physiology of the Disease and the long-term side effects virtually ceased.  This is why the Pink Disease Support Group has been collecting and collating information from both Pink Disease sufferers and an age/gender matched control group over the last 20 years.

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