Leukemia Treatment and Avian Virus Linked to Toddler’s Death

In a shocking and tragic turn of events, a 2-year-old girl from Australia has become the fifth known person to succumb to a rare illness, with medical experts identifying the cause as Newcastle disease, a highly contagious and typically avian virus.

The toddler, who remains unnamed, was admitted to Prince of Wales Hospital in Randwick, New South Wales, after enduring three weeks of persistent nausea, vomiting, and cold-like symptoms, according to a report from the Centers for Disease Control and Prevention. 

What makes this case particularly unusual is the absence of any known exposure to animals, illnesses, or travel history. The child had completed her second round of chemotherapy for pre-B cell acute lymphoblastic leukemia (ALL) just six months before the onset of symptoms, suggesting a potential connection between leukemia treatment, infectious triggers, and neurological complications, particularly in young patients. 

The young girl’s condition rapidly deteriorated, leading to the development of febrile infection-related epilepsy syndrome (FIRES) over a four-day period. Despite the administration of antiviral drugs, antibiotics, and anti-seizure medications to manage brain swelling and alleviate discomfort, her symptoms persisted, ultimately leading to her demise 27 days after hospital admission. 

Medical experts conducted an array of tests, including magnetic resonance imaging (MRI), autoimmune evaluations, genetic abnormalities assessments, and polymerase chain reaction (PCR) tests to identify bacterial, fungal, viral, or mycobacterial pathogens. However, all results yielded no concerning findings, leaving the medical team puzzled about the root cause of the young girl’s illness. 

Post-mortem tests revealed that she harbored a severe strain of avian paramyxovirus-1 (APMV-1), known to cause Newcastle disease in birds and poultry, particularly pigeons. Newcastle disease, first identified in 1926 and named after the city of its discovery, is highly contagious and often fatal among avian species. 

The medical community was taken aback by the revelation that the toddler’s fatal infection likely originated from exposure to infected pigeon feces or fluids. This finding represents the first documented association between FIRES, a rare epilepsy syndrome, and avian viruses. It underscores the intricate connections between leukemia treatment, infectious triggers, and unexpected neurological complications. 

Historically, the first recorded case of APMV-1 infection in humans dates back to 1942 in Australia. Since then, a total of 485 human cases have been reported globally, with the majority in the United Kingdom. Prior to this incident, only four human deaths had been documented, occurring in the Netherlands, the United States, China, and France. 

Experts emphasize that Newcastle disease in humans typically manifests as conjunctivitis, commonly referred to as “pink eye,” making this fatal outcome an extraordinary and unprecedented case. The medical community is now grappling with the implications of this rare occurrence, seeking to better understand the interplay between viral infections, underlying health conditions, and the efficacy of treatments, particularly in pediatric cases. 

This heartbreaking incident serves as a stark reminder of the complexities within the realm of infectious diseases and their potential to impact even the most vulnerable populations. The medical community remains vigilant, and further research is warranted to shed light on the nuances of such rare and unexpected connections between diseases and their outcomes. 

Journal Reference  

New York Post, Toddler, 2, dies from rare pigeon virus — only the 5th person to do so, https://nypost.com/2023/12/07/lifestyle/toddler-2-dies-from-rare-pigeon-virus-only-5th-person-to-do-so/.