Biology 101

The Fog
by Berton Roueche

Read more true stories of medical detection in The Medical Detectives, 2 vols., The Orange Man, Eleven Blue Men, and Annals of Epidemiology.
Reprinted by permission of Harold Ober Associates Incorporated.
Copyright © 1953 by Berton Roueche

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"At about eight-thirty on Friday Morning, one of Donora's eight physicians, Dr. Ralph W. Koehler, a tense, stocky man of forty-eight, stepped to his bathroom window for a look at the weather. It was, at best, unchanged. As he was turning away, a shimmer of movement in the distance caught his eye...he had never seen anything quite like it before.

Then there was an awful yell. I jumped up and dashed out into the hall. There was a man I'd never seen before sort of draped over the banister. He was kicking at the wall and pulling at the banister and moaning and choking and yelling at the top of his voice. 'Help! Help me! I'm dying!' I just stood there. I was petrified.

When Miss Stack came into the office a few minutes later, the telephone was still ringing. She had answered it and added the call to her list before she realized that she was not alone. 'I heard someone groaning,' she says. 'Dr. Roth's door was open and I looked in...he was slumped down in his chair...all I could think was, My gosh, if people are dying--why, this is tragic! Nothing like this has ever happened before!'"

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After reading the entire story, you should be able to answer the following questions:

  1. Was the diagnosis verified? How many cases were reported? How was the diagnosis verified?

  2. Was the outbreak considered an epidemic? Why?

  3. Describe the outbreak by Time, Place, and Person Factors. Describe the population at risk by age, sex, occupation, exposure to specific foods, ethnicity, and where the outbreak occurred.

  4. How many possible sources were considered (hypotheses tested)? Who was at highest risk of acquiring the disease?

  5. What was special about the fog in Donora this time? Why hadn't this happened before?

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