Lincoln Brian Byers

Notes:

Sister of First Victim Speaks Out About Rare Disease's Canadian Connection

It's a rare but life-threatening infection spread to humans by tiny ticks encountered in the woods or backyard gardens. And this summer, a Powassan virus health scare in the U.S. prompted a New York senator, American medical authorities and even the New York Times to warn of an urgent need for better research, prevention and treatment strategies to combat a pathogen that's on the rise 'perhaps due to climate change' throughout the Great Lakes region.

But the virus that grabbed headlines south of the border in August has a tragic Canadian connection that explains its name and still haunts a Northern Ontario family that, in 1958, suffered the sudden loss of a four-year-old son and brother from what was then an unknown infectious agent.

At the same time, however, the child's death gave science what remains its key weapon against the virus: a test developed by Canadian microbiologists to identify the deadly organism, which attacks the central nervous system and can cause fatal or crippling encephalitis 'brain swelling' in about 30 per cent of those who develop symptoms.

For more than 50 years, the first documented victim of the disease, a preschooler from Powassan, Ont., a small town about 20 kilometres south of North Bay, has been referenced only anonymously in medical reports and scientific journals. In keeping with privacy rules, medical investigators kept descriptions of the boy and his final days clinically bare: During the afternoon of the fourth day after onset, noted the landmark 1959 study that announced the isolation of the Powassan virus, the patient suddenly stopped breathing. He was placed immediately in an artificial respirator. Spontaneous respiration did not recommence.

But now, the boy's 65-year-old sister, just 10 at the time of her brother's death, has spoken publicly for the first time about the anguish of a family tragedy now immortalized in the name of a fatal infection, one now expected to appear in more headlines in the coming years.

And when Sue Cossar remembers the September 1958 passing of her little brother, Lincoln Brian Byers, her words convey an enduring grief, but also a hint of solace that doctors, while initially confounded by the boy's death, were able to discover, at least, what took his life.

"He was an amazing little guy," said Cossar, who was second-youngest of the nine Byers children and had a special fondness for Lincoln, next in line and the 'baby' of the family.

"He loved picking berries," she said. "He was a really good kid. It was very hard on my Mom and Dad."

Mom and Dad are both gone now. But in 1958, the family lived on a farm about 12 kilometres west of Powassan, a property still owned by one of Cossar's older brothers. Lincoln, she recalled, loved animals and thrived in the rural setting: "We always said he was too good of a kid. We always grumbled that we had too many chores, but he was always out in the barn."

The first sign of trouble came on a late-summer afternoon, Sept. 17. "I remember him going to the barn with the boys, with my two older brothers. And they brought him up from the barn because his eyes had started twitching. He couldn't control his eyes."

Lincoln was taken to the family doctor in Powassan. "Dr. (J.E.) Dillane, I don't know how, he knew right away. He told Mom and Dad: "You get him to Sick Kids? Hospital as quick as you can.""

In those days, it was at least a six-hour drive to Toronto's renowned Hospital for Sick Children. "They took him down that night," Cossar said. "Two days later he went into a coma. I think that was on a Tuesday. By the Friday, he had died. It was very traumatic".

Dr. Donald McLean, a Sick Kids physician and medical researcher specializing in microbiology, along with his colleague, Dr. W.L. Donohue, had tracked Lincoln's deteriorating condition and sought permission from the Byers family for an autopsy. The two doctors detected an anomalous inflammation in the boy's brain tissue that would come to define a strain of virus new to the medical world.

The course of Lincoln's illness was summarized in a May 1959 article by McLean and Donohue in the Canadian Medical Association Journal.

"Twelve hours before admission the child's mother noticed blinking of his left eyelids," the study stated, "and his eyes moved rhythmically to the left. His father noted some tremor and unsteadiness of the boy's left arm. The child complained of dizziness".

By the time he'd reached Toronto, Lincoln had a 'right-sided headache' and a rising fever. Two days later, neck stiffness was noted for the first time, his temperature soared and the boy's increasing drowsiness deepened into a coma. He died on Sept. 23, 1958.

McLean and Donohue discovered, under the microscope, inflamed cerebral tissue and degenerating nerve cells. Later experiments with mice exposed to the infection confirmed Lincoln had died from a newly identified viral pathogen: Powassan virus.

Cossar recalls how McLean and his colleagues then travelled to Powassan and surrounding areas to conduct an emergency research study to learn more about the virus that had killed Lincoln. Park rangers and other outdoor workers were tested, but the Byers farm was ground zero for the medical probe.

The researchers found a high concentration of virus-carrying ticks in some squirrels in the area. The findings appeared in later editions of the CMAJ, which once called McLean a 'talented tick-hunter' and documented his success in profiling the presence of Powassan virus in ticks found on squirrels and other small mammals at various sites in Canada and the U.S. His findings even prompted a front-page story in the Globe and Mail in February 1960.

"My brothers, they would catch squirrels, and this is what the doctors figured had happened," Cossar said. "They would skin these squirrels. And Lincoln would hold them while they were skinning these squirrels. And this Dr. McLean from Toronto figured it was a tick that, you know, had bitten him."

The illness has remained relatively low on North America's public-health radar over the years. But a severe case in northern New York this summer and new studies showing a greater-than-expected reservoir of the virus in Hudson Valley ticks led the state's senior lawmaker in Washington, Sen. Charles Schumer, to declare war in August on the 'emerging Powassan virus threat'. Schumer also pressed the U.S. Centers for Disease Control and Prevention to do more to fight all tick-borne illnesses, including the more common but less virulent Lyme disease.

"The need for more research is clear and compelling. We need to bring Lyme disease and the Powassan virus out of the weeds and better educate the public about how to keep themselves and their families safe", Schumer said at the time.

The Times later editorialized in support of a stepped-up public-health strategy to fight Powassan virus. Lyme disease may be well known, the paper said, but "what most don't know is that the same family of black-legged ticks can also cause other diseases that are even more dangerous".

A CDCP study published in 2012 showed only 47 reported cases of Powassan virus since 2001 across the U.S., but nearly all occurred in the last half of the decade, mostly in the northern states of Minnesota, Wisconsin and New York.

While mild symptoms can be treated, there's no known cure when the virus takes strong hold of a victim, and the ratio of deaths to total cases, compared with other tick-borne illnesses, is extremely high. Five of 15 people in New York diagnosed with Powassan virus have died since 2004.

According to the Saskatoon-based Canadian Co-operative Wildlife Health Centre, Powassan virus has been diagnosed in people in Ontario, Quebec and New Brunswick. As in the U.S., the virus is fatal or leaves victims with debilitating effects in about one-third of all cases, though the number of documented cases is smaller in this country.

Ticks are most active between late spring and early fall, and experts have warned that climate change could increase the incidence of Powassan virus and other infections spread by ticks in northeastern North America.

A U.S. study published in the September issue of the CDCP's Emerging Infectious Diseases journal noted that 'because no vaccines or effective antiviral agents exist' to fight the virus, people should, above all, 'take precautions to prevent tick bites', wear light-coloured clothing with long sleeves and pants tucked into socks, use insect repellent and check themselves and pets for ticks after being outside.

The study also noted that doctors should become more familiar with the Powassan virus 'because this disease is likely to increase in areas to which it is endemic'.

Last week, the U.S.-based pest-control company Terminix also pointed to rising concerns about the Powassan virus to urge the public to take steps to avoid tick bites, including the possible use of backyard insecticides.

The thought of the virus becoming more common, said Cossar, is worrying: "It gives me goosebumps."

The recent public alarms about the infection contrast with the decades of quiet sorrow the Byers family endured following Lincoln's death. But Cossar recalls one other time, many years ago, when memories of her lost brother were stirred by talk of the Powassan virus.

She was working at a store in Powassan when a Toronto doctor and his wife dropped in to shop. They began discussing the link between the town's name and the viral infection. The place, Cossar remembers the man saying, "is well known for the Powassan virus. It was the disease that killed a young boy here."

"So this was just out of the blue," she said. "I'd never heard anybody talk about it before. And it was a weird feeling. This was my brother that he was talking about."

--The Ottawa Citizen, October 21, 2013

Died:
Powassan virus: Likely bitten from a tick while helping to catch and skin squirrels.

Enos married Elizabeth Francis Restoule on 4 Oct 1934 in North Bay, Ontario, Canada. Elizabeth was born on 20 Jul 1912 in West Nipissing, Ontario, Canada; died on 18 Sep 2003 in Powassan, Ontario, Canada; was buried in Nipissing Union Cemetery, Nipissing, Nipissing District, Ontario, Canada. [Group Sheet] [Family Chart]

Notes:

Birth:
Sturgeon Falls, Ontario

John married Florence Mary Perry on 8 Jun 1897 in Nipissing, Ontario, Canada. Florence (daughter of James Parker Perry and Eliza Jane Ayerst) was born on 18 Apr 1883 in Parham, Ontario, Canada; died on 9 Nov 1939 in Callander, Ontario, Canada; was buried in Nipissing Union Cemetery, Nipissing, Nipissing District, Ontario, Canada. [Group Sheet] [Family Chart]

Notes:

Birth:
Bromley Township, Upper Canada

William married Ellen Banning on 4 Nov 1859 in Renfrew County, Ontario, Canada. Ellen (daughter of Ozias Banning and Alice Mabel Kier) was born on 22 Mar 1840 in Lachute, Québec, Canada; died on 30 Aug 1907 in Nipissing, Ontario, Canada; was buried in Douglas Public Cemetery, Douglas, Renfrew County, Ontario, Canada. [Group Sheet] [Family Chart]

Notes:

PARKER PERRY - The death of James Parker Perry at the home of his daughter, Mrs. W. King Sr., at Nipissing on Nov. 21st, has removed another pioneer from our midst. Mr. Parker suffered a stroke of paralysis six years ago and has been an invalid ever since.
He was born at Sydenham, Ont., Feb. 5th, 1861, and was in his 80th year. He married Eliza Jane Ayerst at Parham in August 1878, and she died in June 1929. Eleven children were born to this union, of whom five have died, the youngest son, William, making the supreme sacrifice in France in June 1918. Two sons and four daughters are left, namely: George Perry, of Nipissing; Hiram Perry, of Cedar Springs, Mich.; Mrs. Anna King, Nipissing; Mrs. Maude Stark, Shingleton, Mich.; Mrs. Pearl Atwood, Rockford, Mich.; and Mrs. Nellie McCallum, Emsdale. There are 40 grandchildren and 83 great-grandchildren, and one great-great-grandchild. A brother, John Perry, lives at London, Ont.
Mr. Perry came to Nipissing Township and settled at Hotham about 56 years ago, and except for about 8 years spent in Michigan he has always lived in the township, so he was one of the township's oldest settles.
The funeral was held on Friday from the home of Mrs. King to the Nipissing Cemetery, and was largely attended by neighbours and other friends. Portius Johnson and Geo. Paige, ministers of the Followers of Christ, had charge of the service. The pallbearers were six grandsons - Joe, Simon and William King Jr., and Alex, Levi and Enos Byers.

James married Eliza Jane Ayerst on 3 Aug 1880 in Central Frontenac Township, Ontario, Canada. Eliza (daughter of Francis Erskine Perry Ayerst and Ann Maria Gates) was born on 30 Jun 1863 in Westbrook, Ontario, Canada; died on 13 Jun 1929 in Sundridge, Ontario, Canada; was buried in Nipissing Union Cemetery, Nipissing, Nipissing District, Ontario, Canada. [Group Sheet] [Family Chart]

Notes:

Mrs. J.P. Perry - The death of Eliza Jane Ayerst, beloved wife of Parker Perry of Nipissing Tp., occurred at the home of her daughter in Sundridge last Thursday. The funeral was held on Saturday from the home of her son, George Perry, Nipissing, and the remains were laid to rest in the Nipissing cemetery. Rev. Mr. Evans, Anglican minister at Powassan, conducted the funeral service, assisted by Rev. Mr. White of Sundridge. Many relatives and friends were present to pay their last respects to the deceased lady. The pallbearers were six grandsons.
Mrs. Perry was born at Westbrook, Ont., June 30th, 1862, and was married to Parker Perry at Parham, Ont., Aug. 8, 1878. This union was blessed with eleven children. Four died in infancy and the youngest son, William, paid the supreme sacrifice in France in June 1918.
Besides her husband the chief mourners are her seven sons and daughters, 36 grandchildren and 23 great-grandchildren; also her aged mother in Dayton, Iowa, and one sister and three brothers. One son and two daughters in Michigan were unable to attend the funeral, but they were here a month ago to see their mother.

Notes:

Married:
Hinchinbrooke Township, Ontario