Men and women were equally affected and there was no apparent connection to occupation or school attended. The individuals obtained their meals at several different sources, and other individuals who lived elsewhere and purchased their food at these same places had not been affected. The water supply and milk consumed there were tested, with no unusual findings. There were dog kennels in the area and some tenants had dogs as pets, but an inspection of the animals found no ticks or insects.Many residents had reported the presence of mice in and around the apartments, especially in the basements of the buildings near the incinerators, where living and dead mice were found. Garbage disposed of through incinerator chutes was to be burned on a daily basis, with the ashes carted off by the New York City Department of Sanitation. Due to labor shortages, the material was not burned regularly, leaving ample food for the rodents. Mice were trapped in apartments and near the incinerators and antibodies to the rickettsialpox were found in their blood. Visiting the complex with pest-control specialist and self-trained entomologist Charles Pomerantz, Huebner peeled back wallpaper to find the walls swarming with mites, so much so that tenants had said that "the walls had movement". The mites were collected and rickettsial strains were isolated from some of them, with the name Rickettsia akari given to the organism.Public health officials took steps to prevent further outbreaks of the disease.
This is due to the presence of structures resembling platelets in the blood such as needle-like cryoglobulin crystals, cytoplasmic fragments of circulating leukemic cells, bacteria, and red blood cell microvesicles. These structures are counted as platelets by the automated machine counter; therefore, causing the platelet number to be falsely elevated. However, such error can be avoided by doing a peripheral blood smear. Diagnosis
Laboratory tests might include: full blood count, liver enzymes, renal function and erythrocyte sedimentation rate.If the cause for the high platelet count remains unclear, bone marrow biopsy is often undertaken, to differentiate whether the high platelet count is reactive or essential. Treatment
Often, no treatment is required or necessary for reactive thrombocytosis. In cases of reactive thrombocytosis of more than 1,000x109/L, it may be considered to administer daily low dose aspirin (such as 65 mg) to minimize the risk of stroke or thrombosis.However, in essential thrombocythemia where platelet counts are over 750x109/L or 1,000x109/L, especially if there are other risk factors for thrombosis, treatment may be needed. Selective use of aspirin at low doses is thought to be protective. Extremely high platelet counts can be treated with hydroxyurea (a cytoreducing agent) or anagrelide (Agrylin).In Janus kinase 2 positive disorders, ruxolitinib (Jakafi) can be effective. References
Schafer AI (March 2004). "Thrombocytosis". N. Engl. J. Med. 350 (12): 1211–9. doi:10.1056/NEJMra035363. PMID 15028825. == External links ==