Davio Danielson, a seasonal Island resident who was on the cusp of approval for the Lagoon Ridge housing development in Oak Bluffs, died August 27 from tularemia, according to his daughter, Maria Danielson.
Danielson’s attorney, Eric Peters, who was stunned at his client’s death, said Danielson was brushcutting land at Lagoon Ridge before he headed back home to Western Massachusetts.
“He was of a stoic generation,” his daughter said, and also, due to the illness, “delirious,” which are reasons why he opted to drive home to Haydenville with a fever that hit 104° Fahrenheit.
Peters said he spoke with Danielson on the telephone during his drive, and described his voice as sounding “terrible.”
An avid skier, cyclist, and dancer, his daughter said, “he was robust. He had more energy than anybody I know.”
“He was the Energizer Bunny,” Peters said. “He would have been 80 in December.”
“Davio had been on Martha’s Vineyard working on his development project when he fell ill,” his wife Deborah Watrous posted on Facebook. “I spoke to him on Friday the 17th Aug when he stated he had a ‘summer cold.’ While not responding to my calls over the weekend, he managed to drive himself home, as planned, on Tuesday evening.”
Watrous came home to find her husband burning up.
“When I returned home from work, I found him with a high fever and somewhat incoherent,” she posted. “We drove immediately to the [Cooley Dickinson Hospital]. Initial diagnosis was dehydration and appendicitis. They performed a simple appendectomy; however, the fever did not subside as expected. A previously undiagnosed heart condition was found along with a mass in his lungs which required a bronchoscopy for tissue studies. Over the next days he had an increasingly difficult time breathing, requiring a move from the cardiac unit to ICU. Despite three different IV antibiotics, his fever persisted throughout. Most, if not all, symptoms can be related to the tularemia. After loving visits from two of his daughters and three grandchildren, things cascaded even more rapidly … internal bleeding, which required transfusions and ultimately, sedation, where he needed mechanical breathing assistance. The procedure went well, yet 10 minutes later his heart gave out. A code blue was called. Initially, they were able to revive him, but he did not remain stable and coded a second time. This indicated that he was severely compromised. Despite their heroic CPR efforts, they could not elicit a strong enough heart rhythm to support his body, his life. However, it was enough to allow me to hold him and say my last goodbyes until his weak, yet tremendous, heart stopped a few minutes later.”
“We are being advised because we were in the room with him after he died to go on antibiotics,” his daughter said. “My doctor advised me to take prophylactic antibiotics.”
Maria Danielson later told The Times Tufts University tick and infectious disease researcher Sam Telford advised her such a precaution was unneeded unless she or her family members exhibit symptoms. Telford told The Times pathologists who examine the lymph nodes of deceased tularemia infectees are wise to take prophylactic antibiotics, however he could not be reached for confirmation and comment on his recommendation to Danielson’s family members.
The bacterium Francisella tularensis causes tularemia. Tick and deer fly bites can transmit it, as can dead rodents, especially when they are hit with lawn-mowing equipment and become inhalable. Telford said it’s widely and incorrectly believed the pneumonic form of tularemia only comes from inhaling the pathogen.
“You can get pneumonic tularemia from a tick bite,” he said.
Both the dog tick and the lone star tick transmit tularemia. A bite that delivers the pathogen can cause a lesion or ulcer on the skin, according to the CDC, but not always. One that causes an ulcer is known as ulceroglandular, one that does not is known as glandular. The CDC website confirms a bite can cause pneumonic tularemia.
“It can also occur when other forms of tularemia (e.g. ulceroglandular) are left untreated and the bacteria spread through the bloodstream to the lungs,” the site states.
“The bacteria normally goes to the spleen, liver, or lungs,” Telford said, who emphasized delay in treatment is dangerous. Proper treatment involves gentamicin or streptomycin, which must be administered in a controlled medical environment, he said, otherwise the patient runs the risk of losing his or her hearing.
Maria Danielson said the family does not know how Davio contracted the pathogen. She said he lived in a cabin when on-Island where mice were common, so contaminated food cannot be ruled out. However, upon conferring with Telford, she was told the chance on infection from food in his cabin was minute. Telford could not be immediately reached to confirm this.
The CDC describes ingested infection as oropharyngeal — ”[t]his form results from eating or drinking contaminated food or water. Patients with oropharyngeal tularemia may have sore throat, mouth ulcers, tonsillitis, and swelling of lymph glands in the neck.”
Oak Bluffs Health Agent Meegan Lancaster said the town has no immediate plans to investigate the woodlands of Lagoon Ridge. To guard against breathing in dusts that could contain Francisella tularensis, Lancaster said respirators are essential for Islanders using mowers, string trimmers, and brushcutters. Just any dust mask won’t suffice, she said; it should be labeled NIOSH-certified or N-95 to be effective.
Per a public health update for the Vineyard from the Massachusetts Department of Public Health’s Bureau of Infectious Disease Prevention Response and Services, people should check areas they will be cutting or mowing to ensure there are no dead animals. Dead animals should not be touched with bare hands. The bureau also recommends wearing a respirator, eye protection, and gloves when dressing or skinning animals. To keep ticks at bay, the bureau encourages the use of DEET or permethrin repellents.
“Tularemia is an ongoing issue,” public health nurse Lila Fischer said. “This is not a new thing for Martha’s Vineyard.”
Fischer, who represents the Island boards of health via Island Healthcare, said she and her colleagues are engaged in ongoing Island education about ticks and tick-borne pathogens.
The next education event will be at the Aquinnah Public Library on Sept. 27 from 3 to 4 pm.
Fischer said last year there were six reported cases of tularemia on the Vineyard. This year has produced four.