Did Mold Play a Part in a Student’s Recent Virus-Related Death? And, Does a Living in a Moldy Indoor Environment Negatively Influence Outcomes for Other Illnesses?
Whenever a young person dies from injury or sickness, it is a tragedy of great magnitude. We all struggle to come to terms with how little control we have over the causes or circumstances that contributed to such an event. I know my reaction to this kind of news is often colored by fear and worry for the safety and health of my own friends and family members. Tragedy, life’s greatest equalizer, makes me recognize, that my body, while resilient and recovered is also still very fragile and can succumb to outside stressors if they become too much for it to handle once again. So, when I heard of 18-year-old Olivia Paregol’s death, my fears and feelings stemming from our mold ordeal surrounded me. But, instead of being paralyzed by negativity, I have decided to try to contribute what I now know about mold and its influence on the body and its susceptibility to viruses and other illnesses to help others digest, dive deeper, and learn something from Olivia’s story.
For those of you who might not have read or heard about Olivia, she was a freshman co-ed at the University of Maryland who died last week due to complications from Adenovirus. After her death, it was revealed that at least 8 other students on the U of M campus were also diagnosed with the virus—leading the university to label it a viral “outbreak” at the time of this post. Symptoms of the virus include: sore throat, fever, and pink eye. It often presents as the common cold and most young people make a full and rather quick recovery.
Since Olivia’s death, cultures of the virus that were done on the other infected students have been sent off to various labs for analysis, and one strain that is present is rare and more virulent than most. The virus, which has more than 50 strains, can cause illnesses ranging from common colds to pneumonia. Fever, diarrhea, intestinal infections and neurological diseases are also possible, but usually rare, according to the Centers for Disease Control and Prevention.
Adenoviruses are spread by touching a contaminated person or surface, or through the air by coughing or sneezing. They are known to persist on unclean surfaces and medical instruments for long periods of time, and they may not be eliminated by common disinfectants, but rarely cause severe illness in healthy people. However, people with weakened immune systems have a higher risk of severe illness, and they may remain contagious with the virus for long after symptoms have subsided. There have even been studies done on adenoviruses showing that they can go into dormant phases where all symptoms disappear, but because of exposure (toxins, other viruses or bacteria), or another immune system stimulating event, they reignite in the host’s body and reoccur with greater virulence and symptom onset.
What does all this have to do with mold?
Well, if you read past the adenovirus details of the story and dig a bit deeper, it comes to light that Olivia was one of many students living in a mold-infested dorm (Elkton Hall) on the university’s campus. Apparently, the conditions in the dorm were so bad before the school finally intervened that there was visible mold growing on the walls and all over surfaces in many rooms. Olivia’s father reported that there was mold everywhere—on furniture, clothing, textbooks, etc., and that Olivia was becoming more and more troubled by her poor living conditions before she got sick.
According to Olivia’s parents, “You could see [the mold]. It was on her table. It was everywhere. It would collect on their shoes overnight.”
One student who also lived in Elkton Hall stated that it was difficult to sleep, because there was mold on the wall right next to her pillow that made her cough all night. Other students reported health symptoms that they attributed to the moldy living conditions, like fatigue, sinus infections, coughing, wheezing, headaches, and general malaise.
The university reported receiving “higher than normal reports of mold” (this leads me to wonder what “normal reports of mold” are) throughout the dorm beginning on Sept. 16. As a result, school officials began relocating more than 500 students from Elkton Hall to hotels in the area until crews finished cleaning on Oct. 10. Students were advised to take all of their belongings with them and were given the names of cleaners in the area where they could have their washables professionally cleaned. All that was supposed to remain in the rooms during cleaning and remediation was the university-issued furniture. Some students did leave throw rugs that are said to have been cleaned by the remediators as well. Details about the two environmental firms hired to perform the building inspections, to create the work plan and to perform the remediation work can all be accessed at this link on the university’s resident life website.
All of the remediation activity at Elkton Hall was going on at the same time that the university was learning about the increasing number of students on campus who were testing positive for adenovirus. Unfortunately, for the Paregols, those reports were not shared with the university community at large. For example, when Olivia first presented at the student health center with flu-like symptoms, she was never tested for adenovirus—a mistake that continued until her final hospitalization at Johns Hopkins University, where she ultimately died of pneumonia and complications from the virus. And, while I am not saying that the presence of mold in her living space caused the adenovirus or that the mold in her dorm room was what caused Olivia’s death, I do want to map out the link between living in a toxic and fungus-heavy indoor environment and the body’s decreased ability to protect itself from other infections, bacteria, and viruses. This is a link that the university has repeatedly refused to acknowledge, stating that many of the other reported cases of the virus were from students not living in Elkton Hall and that there is no clear link between mold and adenovirus. (Note: It is normally extremely uncommon for physicians to test for any virus during a routine visit. Seldom is there any lab work unless it is for strep, the flu, or pneumonia. With the high instance of known adenovirus on campus, though, the university should have disseminated the info to all of the area hospitals, so that they would have been more encouraged to test. In addition, most hospitals and physicians do not test for mold or fungal infections, they could, but don’t.)
The Indoor Mold-Viral Link
For me, I find the denial of a link between increased viral susceptibility and high levels of indoor mold puzzling. Not only has the link been clearly made in medical literature, but, in addition, this exact scenario (acquiring a minor virus or infection that turned into a major illness) happened to me multiple times when we were living in the mold—two of which times, I was hospitalized for up to a week.
The other correlation that I want to point out between the existence of mold in Olivia’s dorm room and how hard she was hit by adenovirus is that of the increased virulent activity of all microbes, viruses, and bacteria when present in an environment or a host with a high fungal load. This line of study was at the heart of the late Jack Thrasher’s work and is an area of toxicology and microbiology that warrants further exploration. Before his death, Dr. Thrasher was increasingly finding “sick” indoor environments where mycotoxin-producing mold was only one of many dangerous pathogens making the space sick and not safe for habitation. As a matter of fact, the presence of mold in one of these “sick” environments seemed to make all other airborne particulates, gases, and pathogens more dangerous.
Here is a quote from one of Dr. Thrasher’s papers that sums this concept up nicely: “Currently, it is recognized that the indoor water-damaged environment resulting from microbial growth is a complex mixture of mold and bacteria along with their by-products. Thus, the illnesses resulting from exposure cannot be defined by any specific component of the affected environment.”
To further explore this, let’s look at what we know about mold and about Olivia’s health on a very cursory level, since I only know what I have read: A fact that is now widely accepted about mold (a feat in of itself) is that high levels of some indoor molds are extremely inflammatory and dangerous to the health of individuals, but especially immunocompromised individuals. We also know that Olivia was one of those individuals, because she suffered from Crohn’s disease, a chronic autoimmune disease characterized by inflammation in the GI, and was on immune suppressant therapy to manage the inflammation and symptoms [ Do we know what she was taking; biological or pill?]. Further, immunocompromised individuals are more susceptible to fungal infections and to be colonized by the mold internally. This is why transplant and chemo patients have to be so careful about what they are exposed to during treatment. These patients are the ones who most often die from fungal infections that get into the bloodstream. When you put those pieces together, you can see that Olivia was primed to succumb to the virus as she was being constantly exposed to mold in her dorm, and was immunocompromised from the Crohn’s disease. It was probably the perfect storm, making her body the perfect host for the virus.
Where do we go from here and what can we learn from this?
Examining the Remediation Reports
Well, first, I took a deep look into the university’s published remediation reports for Elkton Hall.
I encourage you to read them yourself, but the main takeaways from these reports, as far I can see, is that the firms only did visual inspections throughout their work. There was no sampling of the mold or indoor air, nor sampling/testing done post-remediation to make sure the environment was safe for reoccupation. This disappointed me, because visual inspections, especially when it comes to mold are inadequate and many times deceiving as mold issues are often hidden and from airborne spores. The main cause of the mold growth was determined to be from a high humidity/inadequate HVAC issue, where the hot outdoor air (this was attributed to an unusually hot summer) was continually mixing with the cooled indoor air and creating levels of humidity that far exceeded the levels required for mold growth. Also, the HVAC units in the dorm rooms did not create adequate air flow or exchange to dehumidify the spaces and were actually creating more of a condensation problem, thus contributing to the mold.
The reports then describe the work done: moldy areas were cleaned with HEPA vacuums, mopping and wiping with a fungicide disinfectant, and air scrubbers were also used. The window units were all cleaned with the disinfectant/fungicide as well and all air filters were replaced. Containment was also employed during all clean-up efforts.
When I read all of this, I obviously examine everything with a very critical eye, because I have the benefit of our experience and my current knowledge to guide me. That’s why I see all of the red flags. Unfortunately, the most important piece of the mold equation was not addressed, though—the cause of the mold. Some small dehumidifiers were installed in rooms, but the reports state that the university was unable to institute any of the major changes required to fix the indoor humidity problems, because of expense or logistics. Thus, I read the reports and recognized that despite their efforts and attempts to make things right, the problem has not been solved, will likely arise again, and was never adequately measured in the first place to really know what they were dealing with. It is my opinion that information about what kinds of mold were/are present in the building would be helpful to know for proper, safe, and successful remediation. The report actually takes a very different perspective stating, “Mold growth in buildings consists of variety of types commonly present in the environment. Because all types involved with building growth present similar health risks, it is not necessary to determine the species of mold. The category of mold growth is important, and this can be deduced from appearance and pattern. Humidity-related growth is characterized by powdery surface deposits, often spotted. It occurs on materials in frequent contact with high humidity or at a cool temperature promoting condensation. This is readily distinguished from water damage mold, which was not found at Elkton.”
I disagree with this statement and logic, because I think that parents and young people living in the dorm have a right to know what kinds of molds they were being exposed to. For example, this lab analysis information on the mold found in the building, much like the information about the adenovirus being present on campus, could’ve helped Olivia’s family and those treating her during her hospitalizations.
What cannot be determined from any information that I can find is what living in a moldy environment does to the prognosis for an individual with adenovirus. Olivia’s father does say in multiple soundbites that when Olivia would leave the dorm and come home, she would get better, but would regress again upon her return to campus. I find that exact causal relationship (aka, the when I go away from home, I feel better thought process) to be often what leads people to first test their homes for mold as the cause of their failing health. Thus, the fact that Olivia reportedly was initially finding a reprieve from her symptoms at home leads me to make a similar conclusion. In addition, symptoms of mold illness can be things like difficulty breathing, allergic reactions, coughing, wheezing, sinus infections, pneumonia, and flu-like symptoms. All of which are similar or the same as the symptoms that Olivia was experiencing prior to her hospitalization. As a matter of fact, on the CDC website, it is stated that immunocompromised individuals are much more prone to fatal fungal infections. They must be monitored so that they can be properly identified and treated. Thus, I cannot help but connect the dots myself and worry that this tragic story shines light on a larger problem that is still being pushed under the rug and ignored—the fact that high levels of mold in indoor environments ARE problematic for human health, even though, repeatedly in the news reports and on their website, the University states that “mold is naturally occurring” is “everywhere” and is not a cause for sickness or disease.
To conclude, all I am really trying to do is to help build and foster knowledge about mold and about the importance of good indoor air quality for overall health and wellbeing. In no way am I trying to point the finger at the University of Maryland or say that they are doing things wrong or worse than any other university in this country. Money or the lack thereof determines what they will decide to do about these problems and what they will decide to do to prevent mold problems in other dorms in the future. What I am trying to say is that student housing and the standards that are currently acceptable in temporary living situations, like a dorm, are, on a large scale, not conducive to good health. This is not a new occurrence or real news, I realize. When I was in college, this was just as big of an issue. Dorm life from an air quality standpoint was the pits. Ironically, it is also interesting that some of the finest academic institutions in the US where tuition, room, and board are exorbitantly high have older dorms and have reportedly had mold issues.
This story just brings to light that we need to all be more vigilant about our environments and about speaking out if there are things in them contributing to poor health. Afterall the quality of the air you breathe is two times as important in determining your overall health and mortality than your genetics. Also, I hope that Olivia’s story will encourage you to share information about your environment with your doctors, especially when you see or suspect something like mold to be present and causing you health difficulties. When you suggest environmental factors as illness contributors, a physician can better see the big picture of your health and can better prescribe testing, treatment plans, and solutions that will help to make you better. Also, when you investigate and do things to manage and protect your indoor environment, you are also managing and protecting your health in ways that can make a very big and a very positive difference and that can hopefully help you to avoid major illness and tragedy.
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