In 2003, “Ben” and ”Lynn” were living in Pennsylvania with their one-year-old daughter, who was born four months premature and suffered from a weakened immune system. Ben and Lynn worked hard to provide the best health care and every possible comfort to their daughter. Lynn worked as a customer service representative, and Ben worked as a machine operator and as a part-time emergency medical technician for a local ambulance company.
On October 5, 2003, Ben and Lynn decided to take a break from their busy schedules for a dinner-date with their daughter at Chi Chi’s in the Beaver Valley Mall. At the restaurant, all three shared nachos for an appetizer, but only Ben and Lynn ate the salsa; for dinner, Lynn had the chicken quesadilla and Ben had lobster enchiladas. Afterward, they hurried home to put their child to bed.
Lynn’s Hepatitis A Infection
Lynn first fell ill on October 27. That evening, she stepped out of the shower after work and noticed that she felt hot and fatigued. She drank some juice and went to bed early in an effort to deflect the illness, which she then felt certain was an ordinary flu. Bed, however, did little to assuage the symptoms; Lynn’s temperature quickly spiked to 102° and she began to shake uncontrollably.
That night, as Lynn recalls, the virus “hit me like a ton of bricks.” Her fever remained high, she developed excruciating pains in her abdomen, her entire body ached, and she became so nauseated that she began to vomit. Needless to say, Lynn’s night was miserable. She arose on Tuesday morning feeling exhausted and ill.
As the mother of a little girl born four months premature, Lynn has little sympathy for those who call in sick to work for minor ailments. In fact, she takes pride in her desire to triumph over adversity. Thus, although her symptoms were already far from minor, she went to work on Tuesday morning. By the end of the day, she felt so ill and exhausted that she resolved to call in sick to work on Wednesday if she had not improved significantly.
After a hot, sleepless night, Lynn arose on Wednesday morning feeling worse than ever. Her stomach spun and churned from the intense nausea, sharp cramps bit into her abdominal muscles, and she was fevered and fatigued. Work would have to wait. By late morning, the cramps had become so severe that Lynn had difficulty just walking around. She scheduled an early afternoon appointment at Beaver Internal Medicine.
A Nurse practicioner suspected that the symptoms were caused by a viral syndrome and advised Lynn to continue taking Tylenol or Advil, push fluids, and refrain from working. Lynn was told to return if her symptoms worsened, but that the illness should resolve within a few days.
It did not. By Friday morning, every symptom that Lynn had suffered since Monday night continued unabated. Lynn recalls that “my fever was 103.7 degrees and I could not even stand up straight I was having so much pain in my abdomen.” She called a friend who took her to the emergency room at The Medical Center of Beaver.
To doctor’s assessment was, “[a]t this point I do not have a source for the fever, but certainly it could be an atypical pneumonia that is brewing, versus a probable viral syndrome.” Though certain individuals in the area, like Lynn, had begun to suffer from the effects of hepatitis A, the outbreak was obviously not yet well known in the medical community.
Lynn continued to suffer throughout the day on Saturday. On Sunday morning, Ben too began to feel sick. With her weakened immune system, the environment had become dangerous for the small child. Ben struggled by himself to stay apace with the child’s needs and wants; Lynn was too ill to do anything more than lay on the couch. That afternoon, Lynn’s mother came over to help but, upon seeing her daughter’s condition, she loaded Lynn into the car and made a beeline for the emergency room.
Lynn was immediately treated. A doctor concluded that, “[d]ue to the current ongoing local epidemic of acute hepatitis which is currently thought to be hepatitis A, I [feel] this is what is most likely in this patient.” Lynn was discharged around midnight with instructions to return if the pain, fever, or nausea worsened.
Lynn and her mother returned Lynn and Ben’s home, which with the onset of Ben’s illness, looked more like an infirmary.
At this point I was absolutely devastated. I was worried for not only myself but my fiancé, daughter, and everyone who was around us. As soon [as we] returned home my mom took my daughter from the house. The next 3 weeks were pure misery[.] The pediatrician stated that it would be best for her to get the gamma globulin and not stay in the home with us because her immune system is weak . . . The last thing I wanted to do was take a chance of her going through this.
Monday was a total mess at home. Lynn was horribly ill, vomiting regularly and suffering painful cramps, and Ben was catching up fast. Both already missed their daughter dearly and felt that they would do anything to see her, but they realized that she was much safer somewhere else.
Lynn returned to the emergency room again on Tuesday morning and was treated for nausea and dehydration. These medications brought significant, though fleeting, relief, and Lynn was discharged later that evening.
Mercifully, Lynn’s fever and nausea began to fade toward the end of the week. Over a week of vomiting and little appetite had left Lynn looking sickly and skinny. And she began to notice that her skin and eyes were taking on a yellowish hue. Also, abdominal cramps, general body pain, and extreme fatigue continued to hamper Lynn’s return to normal activity.
But on Sunday, November 9, Lynn began to notice a strange sensation in the right side of her face. Her eye hurt and would not close as tightly as the left, as if she had incomplete control of the muscles in her face. Also, she tried to eat some noodles that evening but was unable to safely guide them into her mouth. Instead, the fork repeatedly struck her face and lips; for some inexplicable reason, she was unable to open or close her mouth on the right side.
Lynn returned to the emergency room on November 11. There, she underwent several tests, including a CT scan of her head. Lynn was diagnosed with Bell’s palsy. The doctor explained that Lynn’s eye pain occurred because “the eye is . . . not closing and lubricating properly.”
Two days later, Lynn saw her primary care physician, who agreed with the Bell’s palsy diagnosis and the suggested course of treatment. He indicated, “[t]here is not much else we can do.” He also suggested that Lynn would have to remain off of work because working would require that she look, unblinking, at a computer screen all day, which threatened permanent eye damage.
I sat there and cried not knowing what to do. I couldn’t blink and had trouble eating because I could not fully close my mouth . . . That is when  it started getting really hard[;] not only were we financially struggling because of being off [work] from being so sick, but now I was starting to get depressed.
Lynn would not return to work until Monday, January 26, 2004. Until that time, she was constantly fatigued and deeply embarrassed by the odd contortions in her face.
The holidays were right around the corner. I didn’t have much energy, but went to spend Thanksgiving with our families anyway. By mid day I was totally exhausted and could not enjoy the time with my family, but Christmas was even worse. With my face being half paralyzed I could not get our family pictures done . . . I was ashamed and embarrassed to go anywhere or be seen.
Lynn began treatment for her Bell’s Palsy at Caton Chiropractic and Scoliosis Center in early December. She was treated from December to February with therapeutic activity and manipulation of the spine. Lynn remembers that “I started getting feeling back in my face and slowly the function started coming back. [But] [t]o this day I am still not fully healed.” Lynn’s right eyebrow still droops lower than the left, and she is unable to pucker her lips as if she were going to whistle.
Ben’s Hepatitis A Infection
The morning of November 1, a Saturday, Ben began to experience symptoms that were, in his household, all too familiar. Just like his fiancé, Ben first thought that he had come down with a minor flu. His body ached, he had a fever, and his stomach churned with nausea. By early afternoon, Ben’s fever had risen to 102.3°, and he had begun to shake from intense chills.
Soon, Ben was also beset by stomach cramps similar to those that Lynn had agonized over during the past few days. They attacked whenever he moved and sometimes required no provocation at all. Consequently, sleep that night was fleeting at best. Ben tossed uncomfortably from the fever and pain that coursed throughout his body, and Lynn’s palpable agony only made the night more unendurable.
On Sunday, Ben continued to feel nauseated and cramped, and his fever remained dangerously high. Nevertheless, because his fiancé was bedridden, Ben was the only person left to care for their daughter, who was, as usual, full of energy and life. Thus, he was forced to endure much of his pain and suffering while struggling with the demands of everyday life.
Eventually, however, the burden became too heavy, and Ben phoned Lynn’s mother and asked for help. She came at once but could offer no help because she had to rush Lynn to the emergency room.
That night, after he learned of Lynn’s diagnosis, Ben finally figured that his suffering was the result of a serious hepatitis A infection. He resolved to see his doctor the following day, Monday, if he was not significantly improved.
Ben managed a couple of hours sleep on Sunday night. Around 3:00 a.m., however, he was awakened by a wave of intense nausea. He painfully lumbered to the bathroom and leaned into the toilet for a spell of profuse vomiting. Afterward, he leaned back against the wall, dizzied and light-headed from the exertions and pain of the nausea. Ben got no more rest that night.
Early Monday morning, Ben scheduled an appointment with his physician. A Hepatitis panel was performed which confirmed his hepatitis A infection, and the doctor advised Ben to push fluids and get plenty of rest. Ben was told to remain off of work for at least a week.
Although the fever and vomiting mostly resolved over the next several days, Ben felt exhausted and ill for weeks. In fact, his debilitated condition persisted so long that doctors ordered him to remain off of work until December. Ben was only to rest and drink plenty of fluids. He could eat some, but his appetite remained diminished and anything except the mildest foods caused the nausea to return.
Ben recalls, the illness “put a real damper on my Thanksgiving. I couldn’t eat anything and was glowing like a star from the jaundice. I didn’t want to subject my family to my illness so we ate and went home.”
And just after Thanksgiving, Ben received more bad news: due to missed work, he had been fired from his job as an emergency medical technician.
Ben finally returned to work in the beginning of December. His fatigue and general body aches and pains finally resolved at about the same time. Fortunately, he did not suffer a recurrence of symptoms from his hepatitis A infection.