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Jun 21, 2011 5:04 PMPublication: The East Hampton Press

Montauk Doctor Dies From Rare Virus

Jun 22, 2011 4:48 PM

The Centers for Disease Control has confirmed that the sudden death of a 35-year-old Montauk man on Friday night—a little more than a week after he began suffering from muscle pain and flu-like symptoms—was caused by hantavirus, an extremely rare rodent-borne virus.

Dr. David Hartstein, a local chiropractor and father of three, died at Southampton Hospital on Friday evening, June 17, after being brought in by ambulance earlier in the day with a high fever and difficulty breathing. He had been intermittently ill for several days prior, according to his wife.

A family friend said that doctors at the hospital, in searching for a possible cause of Dr. Hartstein’s acute illness, suspected that he had contracted hantavirus from mouse droppings in the basement of his home, which he had been cleaning recently. On Wednesday, Dr. Hartstein’s widow, Heather Hartstein. said that hantavirus had been confirmed as the cause of his cascading illness.

On June 3, Dr. Hartstein started feeling pain and stiffness in his muscles and told his wife he feared he might have Lyme disease. One week later, he fell suddenly ill, with a high fever and nausea.

“He had a strong fever and was sweating profusely,” Mrs. Hartstein, said this week. “He had felt fine the whole day, it was just when we were getting ready to go out to dinner, it was both our birthdays the day before, that he got sick. He took some aspirin and felt a little better. He went home early that night and when he woke up Saturday he was feeling fine again.”

But the fever returned the next day, accompanied by shooting pains in his hands, and persisted, briefly diminishing at times, throughout the week. On Wednesday, Dr. Hartstein’s fever spiked to 104 degrees and, still suspecting Lyme disease, he went to a doctor who took blood samples and suggested that if the fever persisted he go to the hospital. Late on Thursday night, the fever spiked again and he started suffering from shortness of breath. At about 3 a.m., an ambulance brought him to Southampton Hospital, where doctors tried a wide range of treatments, to no avail. He died shortly before 7:30 p.m.

A close family friend, Shira Barzilay, said that as doctors tried to determine the source of Dr. Hartstein’s rapidly worsening illness, they raised the possibility of hantavirus and asked if he had been doing anything in a basement or shed recently.

“All the symptoms went along with the hantavirus theory and he had been cleaning out his basement,” Ms. Barzilay said. “The time frame also fit.”

Dr. Hartstein’s contraction of hantavirus is just the fourth confirmed case ever in New York State, according to the CDC. Just 568 cases have ever been identified in the United States, the vast majority in rural areas of the Southwest and mountain states. About 38 percent of those cases were fatal.

The virus is carried by rodents and can be transmitted to humans who come in direct contact with their feces or urine. Sweeping or vacuuming up dried mouse droppings from a basement or shed can disperse particles carrying the virus into the air, where it can be inhaled.

John Bennett, owner of Premier Pest Control in Southampton, inspected Mr. Hartstein’s house at the family’s request following the doctor’s death. He said he did find some scattered evidence of mouse droppings in the small basement but nothing that he thought was particularly alarming. He said he also inspected the vacuum that Dr. Hartstein had used to clean the basement and saw no evidence of mouse droppings.

“But you never know,” he said, noting that ceiling insulation can often conceal mouse droppings. “When we go in to do a clean-up we wear Tyvek suits and masks and we use a hepa-vac, which doesn’t kick out the dust. When you’re cleaning, if you see mouse droppings you should spray them down with water, or water and bleach. It’s better to work with them wet, you eliminate the dust particles. Hantavirus, the big issue is airborn.”

The early symptoms of the hantavirus infection include fatigue, fever, muscle aches—especially in the large muscle groups in the thighs, back and hips—and abdominal pain. Early diagnoses of the sickness is difficult because the symptoms are very much like the flu. Advanced stages of hantavirus-related sickness, known as hantavirus pulmonary syndrome, are shortness of breath and fluid in the lungs and, ultimately, severe respiratory distress. According to the CDC, the only known effective treatment of hantavirus pulmonary syndrome is to intubate the patient and administer oxygen—treatments that Dr. Hartstein received—early in the onset of the severe symptoms and within an intensive care unit, to help the patient survive the most stressful period. If treatment is not begun until a patient is suffering severe distress, treatment is rarely effective.

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RIP David You will be missed very much
By letskeepitreal (15), sagharbor on Jun 21, 11 6:38 PM
The CDC has not issued a press release on this yet, surprisingly IMO.

http://www.cdc.gov/media/index.html

The incubation period for Hantavirus may be 2-3 weeks [under heading Pathogenesis about 1/2 way down the page].

http://en.wikipedia.org/wiki/Hantavirus

Are the various East End health organizations including Southampton Hospital, clinics, and walk-in medical offices, tracking this?

Is the CDC "on this" or are we going to hear about a possible emergency ...more
By PBR (4917), Southampton on Jun 22, 11 5:56 PM
Apologies to the family, I am so sorry for your loss.
By PBR (4917), Southampton on Jun 22, 11 5:57 PM
My condolences to the family.

To everyone else:

When you do ANY type of clean up where rodents may have been present, ALWAYS wear a proper respirator. Proper PPE can mean the difference between life, and death. I usually opt for more than the N95 style mask when doing many things, including cleaning under the deck. I keep a full P100 style respirator in my backpack every day at work.

NEVER take any type of inhalant filth, or vapors lightly.
By Mr. Z (11367), North Sea on Jun 22, 11 6:55 PM
1 member liked this comment
Really a terrible tragedy!! Condolences to his loved ones.
By bayview (156), Southampton on Jun 23, 11 11:33 AM
David was one of the good guys. Such a nice man and always had a smile on his face. I'm so sorry to hear of his passing. My prayers and sympathies go out to his wife and children. God Bless him and his family.
By marybmary (53), east hampton on Jun 23, 11 1:29 PM
OMG! I was a patient of Dr. Harstein from 2003 - 2006. I can't believe this. I am so sad.
By Rich Morey (357), Brooklyn on Jun 23, 11 2:23 PM
NYS press release -- note the headline "Rare Human Infection Diagnosed in Suffolk County."

http://www.health.state.ny.us/press/releases/2011/2011-06-23_hantavirus.htm

No mention of a death!

No mention of Montauk or the East End as the location!

Further quote from sub-headline: "Case likely isolated." On what factual information is this conclusion made?

Come on NYS, whose side are you on?
By PBR (4917), Southampton on Jun 23, 11 7:47 PM
Is there no one working at the Southampton Press who remembers that there were at least two other cases of Hantavirus on the East End several years ago? I distinctly recall a resident of a house on Montauk Highway in Bridgehampton dying of hantavirus, and a case on Shelter Island. Rare, only 4 cases (ever? really?) in NY State does not fit with my recollection of the previous cases, identified as Hantavirus here in our area. Maybe a subscriber (I am not a subscriber) can search the archives ...more
By M. O'Connor (147), Southampton on Jun 24, 11 8:29 AM
1 member liked this comment
Most relevant of three search results:

http://www.27east.com/news/article.cfm/news/133499/Spring-Awakening
By Mr. Z (11367), North Sea on Jun 25, 11 12:57 PM
Yes, that is true. Two of three previous cases identified in New York State were on the East End. One on Shelter Island in 1994 and another in Bridgehampton in 1995.
By Michael Wright (25), Southampton on Jun 28, 11 1:22 PM
This comment has been removed because it is a duplicate, off-topic or contains inappropriate content.
By M. O'Connor (147), Southampton on Jun 24, 11 8:32 AM
This comment has been removed because it is a duplicate, off-topic or contains inappropriate content.
By Infoseeker (274), Hampton Bays on Jun 24, 11 9:47 AM
So sorry for the family's loss. What a terrible tragedy. It's a wake-up call that we have to be very careful when we clean up certain inhalents...
By Infoseeker (274), Hampton Bays on Jun 24, 11 9:48 AM
A quick Google search of the topic: "Hantavirus, Bridgehampton" brings up several news reports from 1994 and 1995. I wonder what was inapropriate about that?

Condolence and deepest sympathy to the family and friends of Dr. Harstein.
By M. O'Connor (147), Southampton on Jun 25, 11 7:18 PM