EC. Emergency contraception. Morning after pill. I thought that this would be resolved already. But lo and behold, when I looked through the news for the first time in weeks, it seems that the FDA is still sitting on their fat ass, hemming and hawing over whether to make EC available over the counter. They still seem to be forgetting that they are supposed to be working for the good of the population–they are not a political organization, are not supposed to be caving in to political pressure or special interest groups, and above all, they are supposed to make their decisions based on science.

I know, I’m dreaming.

Well, the latest is that the FDA will reach a decision by Sept 1st. Should we hold our breath?

Anyway, here is a really good website on EC that is operated by the Office of Population Research at Princeton University and by the Association of Reproductive Health Professionals. Not exactly a band of immoral and ignorant folks on the fringe. The website is designed to provide accurate information about emergency contraception derived from the medical literature, and is really is a treasure chest for anyone looking for the real story.

One exceedingly valuable aspect of this website is that is gives information on where to find provider, state by state in the US, who are willing and qualified to prescribe emergency contraception.

For those of you interested in infectious diseases, and especially, mystery illnesses which plagued populations centuries ago, today is a rather important date in the great annals of health history. On this date in 1485, initial rumors about a strange illness known as “sweating sickness” or “sudor Angelicus,” began to circulate in England.

In the summer of 1485, a rapidly fatal infectious fever struck England. A newe Kynde of sickness came through the whole region, which was so sore, so peynfull, and sharp, that the lyke was never harde of to any mannes rememberance before that tyme.(Don’t you love to read good old-fashioned English??)

English sweating sickness, was characterized by high fever, delirium and high mortality. Patients first suffered from headache, nausea and fever, then broke out within 24 hours into a smelly sweat, labored heartbeat and breathing. Four additional epidemics were reported in the summers of 1508, 1517, 1528, and 1551, after which the disease abruptly disappeared. Chroniclers at the time noted that healthy young males were most often afflicted.

The first outbreak occurred at the end of the Wars of the Roses, which has led some to believe that it may have been brought to England from France, by the French mercenaries which Henry VII used to gain the English throne. The mercenaries seemed to have been immune to the disease. Another interesting fact is that the disease, unless most others at that time, appears to have been more virulent among the rich than the poor. That may be why is was so well documented and outbreaks carefully recorded.

So what exactly is the English sweating disease? Good question, and one that hasn’t yet been figured out. Medical historians have distinguished this epidemic from diseases such as the plague, malaria, and typhus, and have suggested that it may have been a severe form of influenza, food poisoning, an arbovirus, or an enterovirus. Others have speculated whether it was encephalitis, an outbreak of relapsing fever (carried by ticks and lice), or a relative newcomer to the roster–hantavirus (which is carried by rodents).

Only two physicians of the time period provided recorded eyewitness accounts of the outbreaks in England. They were Thomas Forestier and John Caius. Dr. Caius of Gonville Hall, Cambridge, who was president of the Royal College of Physicians, eventually devoted an entire book to the 1551 epidemic, which is the first monograph in English to deal exclusively with one disease. It includes the following vivid description (again, with their delightfully difficult spelling):

First by peine in the backe, or shoulder, peine in the extreme parts, as arme, or legge, with a flusshing, or wind as it semeth to certaine of the patientes, fleing the same. Secondly by the grief in the liver and nigh stomach. Thirdly, by peine in the head, and madness of the same. Fourthly by a passion of the hart . . . it lasteth but one natural day

In modern language, Caius described what many contemporary physicians see as a typical viral prodrome of myalgia and headache, progressing to abdominal pain, vomiting, increasing headache, and delirium. That is then followed by cardiac palpitation, rapid heart rate, and worsening tachypnea with chest pain, prostration, possible paralysis with increasing breathlessness, and ultimately death — sometimes within 12 to 24 hours of the onset of symptoms.

The other physician, Forestier, emphasized “the panting of the breath” and the “difficulty of breathing,” in his writings, suggesting that the lungs were intricately involved in this disease. If it really was a viral pulmonary disease, then its clinical and epidemiologic features seem most closely to resemble those of the hantavirus pulmonary syndrome, which was first recognized in the southwestern United States in May 1993.

But of course, this is all speculation. Unless someone digs up the graves of known victims of the sweating sickness, and does some fancy molecular testing, we will never really know what deadly little germs were responsible for this mystery illness–which vanished nearly as suddenly as it first appeared.