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| "A Pox on Our House" | |
|---|---|
| House episode | |
| Episode no. | Season 7 Episode 7 |
| Directed by | Tucker Gates |
| Written by | Lawrence Kaplow |
| Original air date | November 15, 2010 |
| Guest appearances | |
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"A Pox on Our House" is the seventh episode of the seventh season of the American medical drama House . It aired on November 15, 2010.
In the 18th century, the Sotos Oosterzoon, a Dutch slave ship, travels to Bermuda. There is an outbreak of smallpox among the African captives and, fearing quarantine, the crew throw the slaves overboard but it is too late: the ship is fired upon and intentionally sunk, along with its crew and captives, in order to contain the disease.
In modern day, a family on vacation dive into the wreckage of the slave ship. A teen girl brings a sealed glass jar back up from the wreck. She accidentally breaks the jar, cutting herself and exposing herself to the contents of the jar: scabs from the diseased captives.
House is certain that the disease is smallpox, coming immediately to the same diagnosis as the crew. The family is quarantined, the girl and father, being especially compromised, are put in an isolation room, and the team administers the smallpox vaccine to the two.
As soon as the tell-tale blisters begin to appear, the CDC is called per protocol and institutes a lockdown. As the lockdown is occurring, the team discovers a rash on the girl's armpits inconsistent with smallpox, causing House to change his diagnosis.
Dr. Dave Broda, the CDC official overseeing the case, blocks House's team from contact with the patients to make a new diagnosis, so they turn to the only other evidence they have: the captain's logs from the wrecked slave vessel. House enlists the aid of a translator, a Dutch webcam stripper he finds on the internet.
Based on the information in the logs, House is reconfirmed in his opinion that the girl does not have smallpox. House attempts to lie to get his team into the room to test his hypothesis, but is stopped. Masters, although unable to closely examine the patient, notices that the girl lacks the characteristic pustules that would be expected from smallpox.
Meanwhile the girl's father begins to develop smallpox symptoms as well, but more characteristic symptoms. House is confounded as to why it appears that the girl does not have smallpox after all, but her father does. He concludes that the father contracted the disease from the smallpox vaccine they gave him. Unbeknownst to them, the father's immune system has been compromised by the return of his kidney cancer (which had been in remission).
House demands they administer the treatment for the smallpox variola. When Broda refuses, House risks his own life by entering the containment room and administers the treatment to save the patient. However, the father does not respond to the medication and dies. House figures now that the disease was likely smallpox after all, and also realizes that he has consequently exposed himself.
The rest of the team is despondent, but Masters returns to the journal in desperate search for another diagnosis. She notes that a cat on the ship had lost all his fur and then died, strong evidence for rickettsialpox, a disease easily treatable with antibiotics. Masters tasks House with searching the father's body for eschars. When House successfully spots eschars on the body, Broda orders that the daughter be treated with doxycycline, saving her life.
In a subplot, Wilson and Sam reexamine their relationship while treating a young chemotherapy patient whose mother gets locked outside of the hospital during the lockdown. House and Cuddy also face relationship difficulties after Cuddy discovers House lied to her in "Office Politics" in order to administer an unconventional treatment of Hepatitis C (an injection of Hepatitis A) to a patient.
The A.V. Club gives this episode a score of B−. [1]
A quarantine is a restriction on the movement of people, animals and goods which is intended to prevent the spread of disease or pests. It is often used in connection to disease and illness, preventing the movement of those who may have been exposed to a communicable disease, yet do not have a confirmed medical diagnosis. It is distinct from medical isolation, in which those confirmed to be infected with a communicable disease are isolated from the healthy population. Quarantine considerations are often one aspect of border control.
Hepatitis is inflammation of the liver tissue. Some people or animals with hepatitis have no symptoms, whereas others develop yellow discoloration of the skin and whites of the eyes (jaundice), poor appetite, vomiting, tiredness, abdominal pain, and diarrhea. Hepatitis is acute if it resolves within six months, and chronic if it lasts longer than six months. Acute hepatitis can resolve on its own, progress to chronic hepatitis, or (rarely) result in acute liver failure. Chronic hepatitis may progress to scarring of the liver (cirrhosis), liver failure, and liver cancer.
Hepatitis C is an infectious disease caused by the hepatitis C virus (HCV) that primarily affects the liver; it is a type of viral hepatitis. During the initial infection period, people often have mild or no symptoms. Early symptoms can include fever, dark urine, abdominal pain, and yellow tinged skin. The virus persists in the liver, becoming chronic, in about 70% of those initially infected. Early on, chronic infection typically has no symptoms. Over many years however, it often leads to liver disease and occasionally cirrhosis. In some cases, those with cirrhosis will develop serious complications such as liver failure, liver cancer, or dilated blood vessels in the esophagus and stomach.
Post-exposure prophylaxis, also known as post-exposure prevention (PEP), is any preventive medical treatment started after exposure to a pathogen in order to prevent the infection from occurring.
The New World of the Western Hemisphere was devastated by the 1775–1782 North American smallpox epidemic. Estimates based on remnant settlements say at least 130,000 people were estimated to have died in the epidemic that started in 1775.
Ali Maow Maalin was a Somali hospital cook and health worker from Merca who is the last person known to have been infected with naturally occurring Variola minor smallpox. He was diagnosed with the disease in October 1977 and made a full recovery. Although he had many contacts, none of them developed the disease, and an aggressive containment campaign was successful in preventing an outbreak. Smallpox was declared to have been eradicated globally by the World Health Organization (WHO) two years later. Maalin was subsequently involved in the successful poliomyelitis eradication campaign in Somalia, and he died of malaria while carrying out polio vaccinations after the re-emergence of the poliovirus in 2013.
"The Mistake" is the eighth episode of the second season of House, which premiered on Fox on November 29, 2005. The episode is told in flashbacks when the hospital and Chase's career is on the line.
In immunology, passive immunity is the transfer of active humoral immunity of ready-made antibodies. Passive immunity can occur naturally, when maternal antibodies are transferred to the fetus through the placenta, and it can also be induced artificially, when high levels of antibodies specific to a pathogen or toxin are transferred to non-immune persons through blood products that contain antibodies, such as in immunoglobulin therapy or antiserum therapy. Passive immunization is used when there is a high risk of infection and insufficient time for the body to develop its own immune response, or to reduce the symptoms of ongoing or immunosuppressive diseases. Passive immunization can be provided when people cannot synthesize antibodies, and when they have been exposed to a disease that they do not have immunity against.
The 2007 tuberculosis scare occurred when Atlanta personal-injury lawyer Andrew "Drew" Speaker flew from Atlanta, Georgia, to Paris, France, and on to Greece and then Italy before returning on a flight from Prague, Czech Republic, to Montreal, Canada, where he crossed over the border and back into the United States while infected with multidrug-resistant tuberculosis. The Centers for Disease Control and Prevention believed at the time that Speaker was suffering from extensively drug-resistant tuberculosis (XDR-TB), but failed to inform Speaker of this worsened sickness before his travels abroad. The incident sparked a debate in Congress on the failure of federal customs agents to stop him. Upon Speaker's return to the United States, the CDC placed him under involuntary isolation using a provision of the Public Health Service Act. With this action, Speaker became the first individual subjected to a CDC isolation order since 1963.
Smallpox was an infectious disease caused by variola virus, which belongs to the genus Orthopoxvirus. The last naturally occurring case was diagnosed in October 1977, and the World Health Organization (WHO) certified the global eradication of the disease in 1980, making smallpox the only human disease to have been eradicated to date.
A sexually transmitted infection (STI), also referred to as a sexually transmitted disease (STD) and the older term venereal disease (VD), is an infection that is spread by sexual activity, especially vaginal intercourse, anal sex, oral sex, or sometimes manual sex. STIs often do not initially cause symptoms, which results in a risk of passing the infection on to others. Symptoms and signs of STIs may include vaginal discharge, penile discharge, ulcers on or around the genitals, and pelvic pain. Some STIs can cause infertility.
"Last Resort" is the ninth episode of the fifth season of House and the ninety-fifth episode overall. It aired on November 25, 2008. This episode is an "extended episode" as it runs for an extra seven minutes, taking the total episode's length without ads to 50 minutes.
Disease in colonial America that afflicted the early immigrant settlers was a dangerous threat to life. Some of the diseases were new and treatments were ineffective. Malaria was deadly to many new arrivals, especially in the Southern colonies. Of newly arrived able-bodied young men, over one-fourth of the Anglican missionaries died within five years of their arrival in the Carolinas. Mortality was high for infants and small children, especially for diphtheria, smallpox, yellow fever, and malaria. Most sick people turned to local healers, and used folk remedies. Others relied upon the minister-physicians, barber-surgeons, apothecaries, midwives, and ministers; a few used colonial physicians trained either in Britain, or an apprenticeship in the colonies. One common treatment was blood letting. The method was crude due to a lack of knowledge about infection and disease among medical practitioners. There was little government control, regulation of medical care, or attention to public health. By the 18th century, Colonial physicians, following the models in England and Scotland, introduced modern medicine to the cities in the 18th century, and made some advances in vaccination, pathology, anatomy and pharmacology.
African tick bite fever (ATBF) is a bacterial infection spread by the bite of a tick. Symptoms may include fever, headache, muscle pain, and a rash. At the site of the bite there is typically a red skin sore with a dark center. The onset of symptoms usually occurs 4–10 days after the bite. Complications are rare but may include joint inflammation. Some people do not develop symptoms.
Variolation was the method of inoculation first used to immunize individuals against smallpox (Variola) with material taken from a patient or a recently variolated individual, in the hope that a mild, but protective, infection would result. Only 1–2% of those variolated died from the intentional infection compared to 30% who contracted smallpox naturally. Variolation is no longer used today. It was replaced by the smallpox vaccine, a safer alternative. This in turn led to the development of the many vaccines now available against other diseases.
The 1947 New York City smallpox outbreak occurred in March 1947 and was declared ended on April 24, 1947. The outbreak marked the largest mass vaccination effort ever conducted for smallpox in America. Within three weeks of the discovery of the outbreak, the U.S. Public Health Service, in conjunction with New York City health officials, had procured the smallpox vaccine and inoculated over 6,350,000 adults and children. Of that number, 5,000,000 had been vaccinated within the first two weeks. The rapid response was credited with limiting the outbreak to 12 people, 10 of whom recovered, while 2 died.
Infectious diseases (ID), also known as infectiology, is a medical specialty dealing with the diagnosis and treatment of infections. An infectious diseases specialist's practice consists of managing nosocomial (healthcare-acquired) infections or community-acquired infections. An ID specialist investigates and determines the cause of a disease. Once the cause is known, an ID specialist can then run various tests to determine the best drug to treat the disease. While infectious diseases have always been around, the infectious disease specialty did not exist until the late 1900s after scientists and physicians in the 19th century paved the way with research on the sources of infectious disease and the development of vaccines.
Four laboratory-confirmed cases of Ebola virus disease occurred in the United States in 2014. Eleven cases were reported, including these four cases and seven cases medically evacuated from other countries. The first was reported in September 2014. Nine of the people contracted the disease outside the US and traveled into the country, either as regular airline passengers or as medical evacuees; of those nine, two died. Two people contracted Ebola in the United States. Both were nurses who treated an Ebola patient; both recovered.
Ebola virus disease in Mali occurred in October 2014, leading to concern about the possibility of an outbreak of Ebola in Mali. A child was brought from Guinea and died in the northwestern city of Kayes. Mali contact traced over 100 people who had contact with the child; tracing was completed in mid-November with no further cases discovered. In November, a second unrelated outbreak occurred in Mali's capital city, Bamako. Several people at a clinic are thought to have been infected by a man traveling from Guinea. On January 18, Mali was declared Ebola-free after 42 days with no new cases. There had been a cumulative total of eight cases with six deaths.
In 1721, Boston experienced its worst outbreak of smallpox. 5,759 people out of around 10,600 in Boston were infected and 844 were recorded to have died between April 1721 and February 1722. The outbreak motivated Puritan minister Cotton Mather and physician Zabdiel Boylston to variolate hundreds of Bostonians as part of the Thirteen Colonies' earliest experiment with public inoculation. Their efforts would inspire further research for immunizing people from smallpox, placing the Massachusetts Bay Colony at the epicenter of the Colonies' first inoculation debate and changing Western society's medical treatment of the disease. The outbreak also altered social and religious public discourse about disease, as Boston's newspapers published various pamphlets opposing and supporting the inoculation efforts.
