Forensic Files - Season 2, Episode 7 - Fatal Fungus - Full Episode | Forensic Files

[sirens wailing] 911 OPERATOR: 911. CALLER: Have a little emergency. I think the baby's choking.
911 OPERATOR: OK, we'll be right there. CALLER: All right. 911 OPERATOR: Squads needed for a baby
that's choking 804 Fife Street. NARRATOR: In 1994, an infant was rushed to a hospital emergency room with a serious breathing
problem. The baby's lungs were bleeding, a life threatening condition which is extremely rare.
Within months, there were over 30 cases in Cleveland just like it. A rate 1,000 times higher than anywhere else in the world.
Not all of the infants survived. Doctors had never seen anything like it and frantically searched for the cause.
[theme music] On a chilly November evening, Neema Williams heated some baby formula for her six-week-old son, Brian.
But during that feeding, something went terribly wrong. I heard him regurgitate, so I figured it was milk.
But instead, when I picked him up, instead of seeing white milk, I'm seeing bright red blood.
NARRATOR: Her baby was rushed to Rainbow Babies and Children's Hospital in Cleveland, where doctors struggled
to save little Brian's life. X-rays revealed that Brian's lungs were filling up with blood.
Unable to breathe on his own, he was taken to intensive care and placed on a ventilator.
These sections are still pretty bloody. I'm wondering it, but I'm not thinking it.
You know, my baby is going to be OK. We're going to get through it. But it's still in the back of your mind, you know,
he could die. Is this the last I'm going to see Brian? Is this my last look at him?
Brian was quite sick. He had bled a lot. He had dropped his hematocrit almost in half
and required an acute blood transfusion on top of having to be supported with a ventilator.
NARRATOR: Brian Mitchell's condition was diagnosed as idiopathic pulmonary hemosiderosis,
which means unexplained bleeding in the lungs. Lung bleeding is usually caused by a heart problem,
an infection, or child abuse. But in Brian's case, doctors eliminated these as possible causes.
The hospital's medical records revealed two other babies had been treated for unexplained lung bleeding,
and one of those babies died. The incidence of lung bleeding in infants was 1,000 times higher in Cleveland
than anywhere else in the world. Brian Mitchell was fortunate. After two weeks of improvement, he
was released from the hospital. His doctors suspected that his lung bleeding was caused
by an allergic reaction to his baby formula, and they recommended his mother change the type she was using.
But one week later, Brian Mitchell was back in the hospital with more lung bleeding.
I was just to the point, what's wrong with him? He starts bleeding, we bring him to the hospital.
You leave him in the hospital for three days, but you can't tell us why he's here.
You can't tell us what's wrong with him. Why does he keep bleeding? I don't know.
NARRATOR: Dr. Dearborn discovered that Brian Mitchell and the other is sick babies all lived
within a six mile radius of the hospital on Cleveland's east side. It was probably an environmental component.
It said, not necessarily that it was in their homes, but something in that part of the community was problematic.
NARRATOR: But there was a complication. Brian Mitchell had a twin sister, Brianna,
who lived in the same house, ate the same food, and slept in the same room as Brian,
and even shared the same crib. If Dr. Dearborn was right and the cause was environmental,
why did little Brian get sick while his twin sister was perfectly healthy? And there was another problem, only infants were getting sick.
None of the older children or adults in the same neighborhood or even in the same homes
were affected. Dr. Dearborn knew he needed help, and called in the Centers for Disease Control in Atlanta.
The fear is we were going to continue to have more-- more of these babies, and we would
get them too late to save them. NARRATOR: Something mysterious was happening in Cleveland,
causing the lungs of infants to bleed for no apparent reason. It was an outbreak unlike any other before
in medical history, and it was happening ironically within a six mile radius of a Children's Hospital.
The Centers for Disease Control assigned Dr. Ruth Etzel to lead the investigation in Cleveland.
Her job was to find out what caused the death of one infant and the life threatening
illness of seven others. The job of a medical detective is an awful lot like the job
of a criminal detective. That is we're looking to try to track down the culprit of a specific unknown disease.
And if we can track down that culprit, we can prevent him from attacking again. NARRATOR: Dr. Etzel reviewed all of the medical records
of the infants with pulmonary hemosiderosis. One thing caught her eye, many of the infants
improved in the hospital but started bleeding again after they returned home. So you use soaps and things like that to clean it up.
NARRATOR: The families of the sick infants were interviewed using a 230-item questionnaire
to see if they differed in any way from the families of healthy children. All of the homes were tested to see if the pesticides used were
the type approved for residential use, and air samples from the homes were also collected.
Within days of the investigation, two more babies with pulmonary hemosiderosis were rushed to the hospital from the same neighborhood.
The total number of cases was now 10. Nine of those 10 were male, and all of them were African-American.
So this made us start thinking as to whether we were dealing with something related to the genetics of race,
whether we were dealing with something that was particularly susceptible in males.
So those were in the background of our considerations, so still, primarily, something in the environment
was probably causing this. NARRATOR: But if the cause was environmental, why was Brian Mitchell sick while his twin sister
Brianna was healthy? Both slept in the same room, in the same crib, ate the same food, and breathed the same air.
Here, an infant, who had no outward signs of bleeding, had had ongoing low grade bleeding for several weeks,
and yet at any time, she could have had a stress, and she would have bled to death.
So this said to us, not only frightening for her but frightening for the community.
How many infants like Brianna were out in the community that were showing no real significant problems?
How deep was this iceberg? NARRATOR: As the mystery intensified, so did the fear among parents in Cleveland's east side
neighborhoods. The level of pesticides in the sick babies homes were all within normal range, and there was no difference
in air samples collected from the homes of the sick children than those collected from the homes of the healthy infants.
We want to prevent another death. We want to prevent another case. And we didn't know where to reach out to next.
So I think all the public health authorities involved, state, federal, local, were really
trying to get together in a think tank and figure out some answers because we didn't have any.
NARRATOR: But the data gathered from the questionnaires began to reveal some important information, seven
of the 10 sick children lived in homes with cigarette smokers. All of the sick babies had been bottle-fed,
none had been breastfed. And all of the sick babies lived in homes that had recent water damage.
Was it possible that smoking, baby formula, or something in the water was causing the deadly outbreak
of the bleeding lungs in infants, or was it something else? Dr. Ruth Etzel spent weeks trying to figure out
what was causing the mysterious lung bleeding among infants in Cleveland. There had been 10 cases reported so far with one death,
and Etzel was afraid there would be more. During the investigation, Dr. Etzel met with a friend
for dinner. She was a physician and a fellow medical detective from Brazil. She mentioned a lecture she once attended and couldn't recall
all of the details but said the lecture described how mycotoxins caused the serious illness
of some Brazilian children. After dinner, Dr. Etzel rushed to the library to read all she could about mycotoxins.
When she cross referenced the words mycotoxin with the word hemorrhage, the computer led to an article about a mold
called Stachybotrys atra. The article described how Stachybotrys atra found in some grain in Europe over 40 years earlier
caused livestock to bleed internally and die. Stachybotrys is a dark green, almost black, slimey mold.
It often grows on cellulose-based items, like straw and paper, after coming into contact with the water.
I began to wonder-- if mycotoxins could make animals sick when they ate grain that
was moldy, could it be possible that mycotoxins could make babies sick if they breathe them in?
NARRATOR: To test her theory, Etzel contacted Dr. Bill Sorenson. He's a mycologist who had done some research
on the Stachybotrys mold. Sorenson knew that the only possible way that Stachybotrys
could get into a baby's lungs was by the spores, the tiny, almost invisible, seed-like structures
which are produced in the mold. Once the mold dries, the spores become light and powdery
and can flake away, traveling great distances through the air. And so therefore, it would be possible, if the spores are
present in large enough numbers in the homes and released into the air, that they could be inhaled
and produce disease symptoms. NARRATOR: There were 400 different types of spores found in the homes of the sick babies.
The spores were placed on culture plates and left to grow for 10 days. When Sorenson analyzed the culture plates,
he noticed that many contained a dark green, almost black mold. Under a microscope, Sorenson noticed
that the samples from the Cleveland homes were structurally similar to the mold which
killed the livestock in Europe. It was in fact Stachybotrys atra. Investigators now knew that spores from Stachybotrys atra
were in the air of the sick babies' homes, but they needed to know whether the Stachybotrys
spores in Cleveland contained the same toxins as those which killed the livestock in Europe.
To find out, scientists grew the spores found in the Cleveland homes in a mixture of rice.
Stachybotrys grows well in rice because of the moisture in the grains. The mold was then ground and mixed
with a series of solvents to extract the chemicals contained in the spores. Using what is called high performance liquid
chromatography, the physical characteristics of the spore chemicals were analyzed,
and scientists discovered that the Cleveland spores were identical to the highly toxic mycotoxins that
killed the livestock in Eastern Europe. They were a special class of mycotoxins called trichothecenes.
The trichothecene mycotoxins are among the most potent protein synthesis inhibitors known.
By that I mean they disrupt the ability of cells to make proteins, and without that ability, a cell will die.
NARRATOR: When scientists searched the homes of the sick children, they found the source
of the Stachybotrys spores in mold found growing in the basements. The mold was found in all but one of the sick babies homes.
But Stachybotrys was also found in half the homes tested where healthy children lived.
If it was Stachybotrys that caused the death of one Cleveland infant and the serious illness of nine others,
why didn't it affect all of the infants who lived in homes where it was found? Spores from the Stachybotrys atra mold
were found in all but one of the sick infants' homes but were also found in half of the homes of healthy children
living in the same neighborhood. Scientists wanted to know why some children developed lung
bleeding while others did not. They soon discovered that the number of airborne spores
in the sick babies homes were far higher than in the homes of healthy children. In effect, the homes of sick babies
contained more spores and more poison. Stachybotrys is generally not considered one of the major
components in indoor air-- major fungal components in indoor air. In fact, it's often not observed at all.
In a study in Canada, just a few years ago, they examined a few hundred houses, I don't know the exact number, but they
saw something like three colonies in all of these houses. We observed levels as high as 600
coliform units per cubic meter there in some of the Cleveland homes. NARRATOR: Researchers found the source
of the Stachybotrys spores-- in the basements, growing on walls, on boxes, and even on the insulation behind the walls.
For Stachybotrys to develop, two things are necessary, a cellulose product and water.
Researchers discovered that some heavy rainstorms caused the sewer system and the geographic cluster of case
homes to overflow, which produced flooding in many of the basements. In other homes, the residents said
they had some leaking pipes. The water was not immediately cleaned up and soaked
through the drywall and the insulation inside the walls, creating the perfect medium for Stachybotrys
to grow in the warm, moist, dark environment. But if the Stachybotrys was in the basement of these homes,
how did the children come into contact with the spores since none of the sick children had been in the basement?
Researchers discovered that when the mold dried, the spores flaked away and became airborne.
The furnaces of these homes all drew air from the basement instead of the upper floors.
The spores were sucked into the furnace, traveled through the duct work, and made their way
into every room of the homes. Tragically, they were blown into the rooms where they could do the most damage,
into the infant's bedrooms where the baby spent most of their time sleeping. Once inside the infant's lungs, the spores
released the mycotoxins called trichothecenes, which prevented the infant cells from making the protein needed to hold
their tiny vessels together. With the vessels now weak and fragile, an external trigger may have caused the tiny vessels
to rupture and bleed. Since most of the sick babies lived in homes with cigarette smoking, this may have been one of the triggers.
And none of the sick babies had been breastfed, leading researchers to suspect that breast milk
offered some sort of immunity. Older children and adults were not affected by the Stachybotrys spores
because their lungs were better developed. And once researchers found how the Stachybotrys spores
traveled from the basements to the children's rooms, they discovered why little Brian Mitchell was so much sicker
than his twin sister Brianna. Although the two slept in the same crib, Brian slept closer to the heating vent,
where he probably inhaled more spores than his twin sister. By the time the investigation was over,
there were over 30 cases of pulmonary hemosiderosis in Cleveland, and four young infants died.
Health officials urged parents to remove all visible mold with bleach and water, and to clean
up water damage immediately to prevent the mold from developing. One year after this investigation,
the coroner in Cleveland reopened the files of 117 babies who died from what had
been listed as sudden infant death syndrome. Lung tissue samples from their autopsies
were re-examined in light of what doctors now knew about Stachybotrys atra. In six of those samples, the lung samples
turned blue, an indication that the babies had bleeding in their lungs prior to their death.
Officials believe that Stachybotrys atra may have played a role in those six deaths.
Yolande Prevo is the mother of one of those six babies. Knowing the true cause of her daughter's death
helps bring some closure to her family's tragedy. I don't think that you could get
any worse than this outside of, literally, going to Hell alive. There's nothing worse than this because this is something
you will never ever get over. And you'll always wonder, what could I have done? No matter how many times you hear it,
there was nothing you could have done. I feel remorse. I feel the pain because I was standing there at one time,
wondering if my son is going to die. NARRATOR: Neema Williams is thankful that her two children,
Brian and Brianna, both survived their encounter with Stachybotrys atra. When I see a little baby's face who is doing well,
I think way beyond myself and thank the help that has come to all of us in trying to sort this out
because we didn't do it alone. Something simple, but so deadly. You don't get it.
I mean, mother nature has a bunch of stuff out there that we don't know about yet,
and this was one of them. [music playing]

An infant was rushed to the emergency room with serious breathing problems. Within months, there were more than 30 cases. Doctors searched frantically for the cause and a cure. Originally aired as Season 2, Episode 7.

Forensic Files is the longest-running true crime series in television history. Evidence and interviews with experts help solve real crimes, disease outbreaks and accidents around the world.

Brief Summary

Cleveland infants suffered from lung bleeding linked to Stachybotrys atra mold, leading to a CDC investigation and tragic outcomes.

Key points

Mysterious Illness in Cleveland. An outbreak of unexplained lung bleeding in infants raises alarm in Cleveland.
Discovery of Stachybotrys Mold. Investigators find toxic mold linked to infant illnesses.
Closure for Families. Families find closure as the cause of their children's deaths is revealed.

Episode highlights

Episode quotes

You know, my baby is going to be OK.

A mother's hope amidst crisis.

2:05WatchMay 27, 2021

Tension

75/ 100High tension

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