As the swine flu outbreak spreads throughout the nation, the man who was Clark County's chief health officer for 36 years remembers a 4-year-old Southern Nevada girl who died of the virus in 1982.
It remains a case still shrouded in mystery, Dr. Otto Ravenholt said.
"We never could figure out how she got the virus," the 81-year-old physician said Wednesday from his home in The Lakes area of Las Vegas.
"What happened to her worried the public health establishment in the country that the civilian population might be thrown into a state of fear reminiscent of the 1970s."
In fact, while reporting the 1982 case, federal public health investigators -- mindful that the child died of the same type of influenza that set off an ill-fated national immunization program for millions of Americans in 1976 -- repeatedly assured the public and government officials that the girl's death had been an isolated incident and there was no danger of an epidemic.
"Just a few years before her death, many people were fearful we were going to see a pandemic along the lines of what happened in 1918," Ravenholt recalled.
The Influenza Pandemic of 1918 wreaked global havoc, killing 500,000 Americans and more than 50 million people worldwide.
When a Fort Dix, N.J., soldier died in February 1976 and more than 200 other recruits were quickly infected with a strain of influenza A thought to be similar to that which brought so much death decades earlier, government doctors warned that any flu able to reach that many people so fast was capable of becoming another worldwide plague.
With a panicky public demanding the best protection that medical science afforded, it wasn't long before the then head of the Centers for Disease Control and Prevention, Dr. David J. Sencer, had lined up most of the medical establishment behind his plan to call on President Gerald Ford to support a $135 million program of mass inoculation.
The 1976 effort went horribly wrong and was roundly criticized after 25 people died and hundreds of others were permanently paralyzed by the vaccine while only one person died from the swine flu.
So Ravenholt said he didn't know what to expect when reports surfaced that the Las Vegas girl died of the flu virus that years earlier had caused so much fear.
"People may have been critical of the program, but the concern about the virus was still there," said Ravenholt, who retired in 1998.
The girl's parents, who never wanted her publicly identified, brought the child to Southern Nevada Memorial Hospital (now University Medical Center) on Feb. 6, 1982.
She was suffering from a high fever and respiratory problems.
"This case was so hard on the family," Ravenholt said. "The little girl was in remission after chemotherapy for leukemia."
Hospital lab reports showed that the child had a type of influenza, but it couldn't be pinned down, so a sample of her virus was sent off to the CDC.
When she didn't respond to either antibiotics or antiviral treatments, she was transferred to UCLA Medical Center, where she died of the swine flu virus on Feb. 14.
Family and friends, basically anyone who came in contact with the girl in Nevada or California, were tested for the virus.
At that time, the girl's case was the first documentation of swine flu in the United States since 1979.
Ravenholt said he was practically in constant contact with CDC officials. They were worried that an outbreak of the sometimes deadly virus was soon to be found in Southern Nevada.
That possibility "can't help but linger in your mind, but you know you can't jump to conclusions," Ravenholt said.
More than 50 people were tested for the virus. No one had it.
A CDC report said the girl's case represented a "continuing pattern of occasional human infections with swine influenza virus currently circulating in pigs." The report also said sporadic incidents of swine influenza virus were found in children or young adults yearly from 1976 to 1979.
Ravenholt said that because no other cases of swine flu surfaced in conjunction with the death of the little girl, public interest in the case quickly waned.
The former health officer's interest continues to grow, however. Research he reads on the spread of the virus continues to raise questions.
So the 1982 case continues to mystify him. He doubts a scientific explanation will be provided anytime soon.
Whenever he thinks about the case, it makes him realize the difficult role public health officials play in the community.
"Sometimes there is no explanation for things in community health," Ravenholt said. "They remain a mystery. It's both challenging and frightening, and sometimes that drives the public health response. We don't know if what happened in 1918 is going to happen again today. That's just the way it is. But you have to do all you responsibly can to protect the public."
Contact reporter Paul Harasim at firstname.lastname@example.org or 702-387-2908.