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"A Pox on Our House" | |
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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 Fox 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.
A vaccine is a biological preparation that provides active acquired immunity to a particular infectious or malignant disease. The safety and effectiveness of vaccines has been widely studied and verified. A vaccine typically contains an agent that resembles a disease-causing microorganism and is often made from weakened or killed forms of the microbe, its toxins, or one of its surface proteins. The agent stimulates the body's immune system to recognize the agent as a threat, destroy it, and recognize further and destroy any of the microorganisms associated with that agent that it may encounter in the future.
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.
The smallpox vaccine is used to prevent smallpox infection caused by the variola virus. It is the first vaccine to have been developed against a contagious disease. In 1796, British physician Edward Jenner demonstrated that an infection with the relatively mild cowpox virus conferred immunity against the deadly smallpox virus. Cowpox served as a natural vaccine until the modern smallpox vaccine emerged in the 20th century. From 1958 to 1977, the World Health Organization (WHO) conducted a global vaccination campaign that eradicated smallpox, making it the only human disease to be eradicated. Although routine smallpox vaccination is no longer performed on the general public, the vaccine is still being produced for research, and to guard against bioterrorism, biological warfare, and mpox.
In biology, immunity is the state of being insusceptible or resistant to a noxious agent or process, especially a pathogen or infectious disease. Immunity may occur naturally or be produced by prior exposure or immunization.
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.
A jet injector is a type of medical injecting syringe device used for a method of drug delivery known as jet injection. A narrow, high-pressure stream of liquid is made to penetrate the outermost layer of the skin to deliver medication to targeted underlying tissues of the epidermis or dermis, fat, or muscle.
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.
A vaccination schedule is a series of vaccinations, including the timing of all doses, which may be either recommended or compulsory, depending on the country of residence. A vaccine is an antigenic preparation used to produce active immunity to a disease, in order to prevent or reduce the effects of infection by any natural or "wild" pathogen. Vaccines go through multiple phases of trials to ensure safety and effectiveness.
A breakthrough infection is a case of illness in which a vaccinated individual becomes infected with the illness, because the vaccine has failed to provide complete immunity against the pathogen. Breakthrough infections have been identified in individuals immunized against a variety of diseases including mumps, varicella (Chickenpox), influenza, and COVID-19. The characteristics of the breakthrough infection are dependent on the virus itself. Often, infection of the vaccinated individual results in milder symptoms and shorter duration than if the infection were contracted naturally.
Hepatitis A vaccine is a vaccine that prevents hepatitis A. It is effective in around 95% of cases and lasts for at least twenty years and possibly a person's entire life. If given, two doses are recommended beginning after the age of one. It is given by injection into a muscle. The first hepatitis A vaccine was approved in Europe in 1991, and the United States in 1995. It is on the World Health Organization's List of Essential Medicines.
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.
"Last Resort" is the ninth episode of the fifth season of House and the ninety-fifth episode overall. It aired on Fox 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.
The history of smallpox extends into pre-history. Genetic evidence suggests that the smallpox virus emerged 3,000 to 4,000 years ago. Prior to that, similar ancestral viruses circulated, but possibly only in other mammals, and possibly with different symptoms. Only a few written reports dating from about 500 AD to 1000 AD are considered reliable historical descriptions of smallpox, so understanding of the disease prior to that has relied on genetics and archaeology. However, during the 2nd millennium AD, especially starting in the 16th century, reliable written reports become more common. The earliest physical evidence of smallpox is found in the Egyptian mummies of people who died some 3,000 years ago. Smallpox has had a major impact on world history, not least because indigenous populations of regions where smallpox was non-native, such as the Americas and Australia, were rapidly and greatly reduced by smallpox during periods of initial foreign contact, which helped pave the way for conquest and colonization. During the 18th century the disease killed an estimated 400,000 Europeans each year, including five reigning monarchs, and was responsible for a third of all blindness. Between 20 and 60% of all those infected—and over 80% of infected children—died from the disease.
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.
Vaccinia immune globulin (VIG) is made from the pooled blood of individuals who have been inoculated with the smallpox vaccine. The antibodies these individuals developed in response to the smallpox vaccine are removed and purified. This results in VIG. It can be administered intravenously. It is used to treat individuals who have developed progressive vaccinia after smallpox vaccination.
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.
Inoculation is the act of implanting a pathogen or other microbe or virus into a person or other organism. It is a method of artificially inducing immunity against various infectious diseases. The term "inoculation" is also used more generally to refer to intentionally depositing microbes into any growth medium, as into a Petri dish used to culture the microbe, or into food ingredients for making cultured foods such as yoghurt and fermented beverages such as beer and wine. This article is primarily about the use of inoculation for producing immunity against infection. Inoculation has been used to eradicate smallpox and to markedly reduce other infectious diseases such as polio. Although the terms "inoculation", "vaccination", and "immunization" are often used interchangeably, there are important differences. Inoculation is the act of implanting a pathogen or microbe into a person or other recipient; vaccination is the act of implanting or giving someone a vaccine specifically; and immunization is the development of disease resistance that results from the immune system's response to a vaccine or natural infection.
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.