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CDC Unknown Infection Disease

Case Surveillance Report


State Case No: 248

CSID No955..

Case No: 14--288

Patient name (last, first): Abril, Cecile


Date of Birth: 09/28/1998

Date of symptom onset of this attack:


(mm/dd/yyyy): 12/26

Is patient pregnant? Y N

Patient admitted to hospital:

Yes

No

Hospital: Northwest Hospital and Medical Center

Date: 12/26

Has patient traveled or lived outside the U.S. during the past 2 years? :

Yes

Country:

Unknown

Height __5__ft. and _2___in. Weight: __123__lbs

Physician name (last, first): Kapman, B

Sate reporting case: Seattle, WA


County: King County

Sex:
Male
Female

No

Unknown

If yes, specify:

1. _________________ 2._______________ 3. ________________

Date returned/arrived in U.S.:


Duration in country:
Did patient reside in U.S. prior to most recent travel?
Yes
No, (specify country): _____________________

Principal reason for travel for most recent trip:


Tourism
Visiting friends/relatives
Military
Airline/ship crew
Business
Missionary or dependent
Peace Corps
Refugee/immigrant
Unknown
Student/teacher
Other _____________________

Blood transfusion/organ transplant within last 12 months:


If yes, Date: ____/____/______

Yes

No

Unknown

CDC Unknown Infectious Disease


Patient Medical History

Name: ________Cecile Abril______________ Phone #__________N/A_____________


D.O.B. _____09/28/1998___ Height ___52__ Weight__123__ Date of Visit _12/30 ____
Address 725B 16th Ave, Seattle, WA 98122
Reason for visit: Unconscious, low grade fever, general malaise

Personal Medical History


Medication allergies: _________None_______

Reaction: ________None________

Latex Sensitivity
Heart Problem
High blood pressure
Valve replacement
Pacemaker/AICD
Stroke
Diabetes
Kidney Problems
Seizures
Liver Problems

Pregnant
Yes
No
Breast Feeding
Yes
No
Smoker
Yes
No
Breathing problems
Yes
No
If Yes, explain _________________
Sleep Apnea
Yes
No
Alcohol Use:
Yes
No
Cancer:
Yes
No
If Yes, type:
_________________

Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes

No
No
No
No
No
No
No
No
No
No

CDC Unknown Infectious Disease


Patient Medical History

Family History of illness:


Nothing significant

Recent travel (local and abroad):


None

Treatment: Visited ER via ambulance on 12/30 of last year after passing out at home. Treated with
fluids, oxygen, and IV antibiotics. Low grade fever present. There was an unknown agent present in her
blood. She did not respond to treatments and succumbed to an unknown disease on 01/08 of this year.

CDC Unknown Infectious Disease


Patient Medical History
Full Background

Cecile Abril was a pet sitter living in Seattle Washington. She has a small business where she takes care
of many animals while their owners are out of town or at work for the day. She currently has 25 clients
around the Seattle area: Simon and Wilma Oliver, Wanda Stone, Ora Silva, Kristi Cortez, Miranda
Thomas, Lee Harmon, Marvin Daniel, Madalyn Richer, Dominick Martin, Brett Mendoza, Josephine
Blake, Terry and Delores Horton, Israel Wade, Moses Sutton, Casey Gilbert, Jesse Guzman, Emanuel
McCoy, Yolande Geraghty, Celia Norman, Willis Paul, Roland Cobb, Donnie Campbell, Michelle Lamb,
Daniel Barton, and Wesley Jimenez. She is still quite young, however, and therefore doesnt have her
own car. She is able to bike around the city and get to the houses on a regular basis.
Her normal daily routine (when school is in session) involves leaving school and going directly to one of
the clients homes. She takes care of the animals, often playing with each animal for a few moments,
cleaning litter boxes, giving baths when needed, and sometimes taking dogs for walks. She has her own
stock of toys, bedding, treats that she carries with her in a backpack to take to animals whose owners
are out of town. When the owners return, Cecile will take the items back and use them for other
animals.
She tends to work until around 6 PM, after which she bikes home and has dinner with her parents. She
does not have any pets of her own, since she spends so much time caring for everyone elses. She takes
the evening to finish her homework and sometimes has an extra pet sitting job to do. On the weekends,
she will often borrow her moms van and round up several of the dogs to take to a local dog park for a
treat. Otherwise she spends her time at local shopping centers and outdoor markets with her friends.
Every once in a while she has to deal with an insect infestation in the home of one of her clients. Most
recently, she noticed that Simon and Wilma Oliver (owner of 12 cats) had a bad flea infestation. They
were out of town when the infestation became really bad, and Cecile had to bring in some newly
purchased cat beds while she took the old beds to be cleaned. She also gave all of the cats a flea bath,
and called in an extermination company, which was scheduled to arrive after the Olivers returned from
their trip. She saw the upside of the situation, however, since she got to keep the new cat beds for other
animals.
She had some more problems with fleas with several other clients. Her newest client, Madalyn Richer,
owned a very expensive and exotic looking cat that needed special care. Madalyn was out of town and
had just received the animal, and had a special cat tree/bed on back order. Cecile took it one of her
newest cat beds (which she had just retrieved from the Olivers home after she got back the newly
cleaned beds), some toys, and a blanket to snuggle with. The cat seemed to love the new stuff, and

Cecile was able to make it comfortable. A couple of days later, though, the cat was infested with fleas,
and Cecile had to give it a bath. That seemed to take care of the problem. The new cat tree arrived soon
thereafter, and Cecile replaced the borrowed cat bed with the new cat tree. Brett Mendoza also had a
nasty flea problem, and what seemed like some lice, but Cecile was unsure and was only ever able to
capture one specimen. Luckily, his animals (a dog and two cats) mostly stayed outdoors, and didnt seem
to have a really bad case. Mr. Mendoza took them to a groomer when he returned from his trip, and
there didnt seem to be any other problems. Yolande Geraghty also had a flea infestation on her dog, a
long haired Australian Shepard, and single indoor cat. Cecile was trying out different beds for the dog,
since Ms. Geraghty didnt have time to choose a good one. She found that the dog liked the cat beds
best, so she brought a couple over for Yolande to borrow. Ms. Geraghty was never one to wash her
animals too much, so Cecile gave them a bath every week to take care of a stubborn case of fleas. She
often saw fleas jumping in the carpet, and even noticed several fleas jumping around the cat beds she
brought over, which she had never seen happen before. After Yolande purchased some new beds, Cecile
took her own beds to be washed in hot water to kill the fleas. Yolandes cat was elderly and had to have
medical treatments on a regular basis. The cat was so sick that it ended up dying when Yolande was out
of town during Christmas. Cecile felt terrible, but the vet assured her that everyone expected the cat to
die, and that Yolande would be happy the cat died at home. The vet took the cat for cremation so Cecile
didnt have to worry about burying it. Finally, Donnie Campbell had lots of chickens and ducks in a coop
out back, and he ended up with a bunch of flea like things feeding on his poultry. Cecile didnt know how
to take care of these problems, and ended up wrapping one of the most infested chickens in a blanket to
take to the vet. The vet removed the pests and taught Cecile how to take care of the rest of them. It
took several days, but Cecile was able to remove all of the insects from the birds, although most of them
had to be wrapped in the blanket to keep them from flapping around. She found that the cats she took
care of at other houses really like the smell of the bird blanket, though, so she didnt bother washing it.
She also had to deal with an ant infestation in Marvin Daniels home, which isnt actually in her job
description, but was eating the dogs food. She cleaned them up as best she could and informed Mr.
Daniel of the problem. She dealt with some ticks on several of the dogs one weekend after she returned
from the dog park (the pets she had with her belonged to Moses Sutton, Casey Gilbert, Emanuel McCoy,
Yolande Geraghty, and Ronald Cobb), but a good bathing with flea and tick shampoo soon got rid of
them.
Cecile started to feel sick on December 26 of last year. She was off school, and had more time to take
care of the pets in the area. This was lucky, since so many of her clients were out of town for the
holidays. She found that she was getting dizzy while trying to ride her bike, and talked her mom into
loaning the car. Cecile went on for a few more days, but didnt get any better. On the morning of
December 30th, she had to stop working, and ended up having some of her friends take care of some of
the animals. Most of her clients had returned from their trips by this time, however, so it wasnt that big
of a deal. Cecile found she couldnt get out of bed at all that day, and had a very high fever, body aches,
and chills. She sometimes experienced a headache. Her mom took her to the hospital, where Cecile was
admitted to the hospital and given IV fluids. Blood smears revealed an unknown pathogen in her blood.
Tests for common pathogens were negative. She was given broad spectrum antibiotics, but failed to
respond. She succumbed to an unknown infection on January 8 of this year.