Evil Over the Land

By Anastasia Toufexis

A bright green sign is taped to the glass doors at the entrance to the Indian health facility in Crownpoint, New Mexico: IF YOU HAVE HAD FEVERS, CHILLS, JOINT AND MUSCLE ACHES, COUGHING OR HEADACHES, PLEASE NOTIFY THE NURSE AT THE FRONT DESK IMMEDIATELY. Inside, the waiting room of the 39-bed hospital is jam-packed: the old, the middle-aged, children and even an unattended prisoner in flimsy ankle cuffs.

What has brought them crowding together is an illness that is baffling * scientists and panicking the 175,000 residents of the 17 million-acre Navajo nation. So far, 18 people have been struck with what is being called "unexplained adult respiratory-distress syndrome." Almost all the victims have lived on or near the reservation, which stretches across northwestern New Mexico and into Arizona and Utah. Of the 11 who have died, nine are Indians. The outbreak came to light last month, when a young Navajo man fell ill on his way to the funeral of his 24-year-old girlfriend, who had died from a curious flulike ailment. Five days later, the man himself was dead; the couple's infant son was also stricken but survives.

The malady begins with a fever and muscle aches in the legs, hips and lower back -- and coughing, red eyes or a headache. Within a few hours or days at most, it abruptly worsens. Lung tissue swells with fluid, making it hard for the patient to breathe. Despite antibiotics and ventilators, victims can quickly suffocate. Unlike most respiratory illnesses, which tend to strike infants or the elderly, who have immature or weakened immune systems, this one primarily attacks the young and healthy. "The pattern is different than anything I've ever seen," says Dr. Frederick Koster, an infectious-disease specialist at University Hospital in Albuquerque. The latest fatality was a 13-year-old Navajo girl, who collapsed after dancing at a school graduation party at Red Rock State Park outside Gallup. "I will see that scene for the rest of my life," says Sammy Trujillo, a park manager. "Her mother was screaming, 'Somebody save my child!' and there was nothing I could do."

Health officials from several states, the Indian Health Service and the National Centers for Disease Control and Prevention have mounted a frantic investigation to determine the cause of the illness. Health workers have fanned out across the reservation, taking samples of food, water and soil, as well as combing through the coats of cows, sheep and dogs for hair, ticks, fleas and fecal matter. "We've excluded the usual bacterial, fungal and parasitic infections," says Dr. Ron Voorhees, a New Mexico state epidemiologist. Ruled out are anthrax, plague and Legionnaires' disease, as well as insecticides and other toxins. Two bacteria are among the suspects: Mycoplasma fermentans and Chlamydia pneumoniae, both of which can cause fatal lung inflammations. But topping the list of possible culprits is a virus.

Investigators cannot dismiss the possibility that they are dealing with a new killer, given the emergence of such ailments as Legionnaires' disease, toxic-shock syndrome and AIDS over the past two decades. Modern life is constantly creating new opportunities for microbes, warns author and infectious-disease specialist Dr. Richard Krause of the National Institutes of Health. Legionnaires', he notes, developed because air-conditioning ducts created a new breeding ground for bacteria; toxic shock was linked with the introduction of highly absorbent tampons and AIDS with population shifts and changing sexual mores. At week's end investigators were focusing on the possibility that the illness might somehow be linked to inhaling a virus present in rodent droppings, though whether it is a new virus or an unfamiliar form of an old one was unclear.

The search for a culprit has been complicated by Indian customs. Navajos do not speak of the dead for fear it might slow the spirit's trip to the afterlife. Nor do they permit autopsies. Tribal members tend to view an untimely death with shame, since it might be interpreted as punishment for bad living. Indeed, some Indian elders were linking the illness to the adoption of fast food, MTV and video games. In radio broadcasts, Navajo president Peterson Zah beseeched his intensely private people to cooperate with health-care workers.

One encouraging note is that the illness does not appear to be highly contagious. But that has not stemmed concern on and off the reservation. Last week a private day school in Los Angeles canceled a long-planned visit of 27 Navajo third-graders from Chinle, Arizona, fearing the children might be carrying the disease.

To deal with Indian fears and bring people back into harmony with nature, the Navajos are calling on their medicine men. "Western medicine has its limitations," observes president Zah. Last week 69-year-old Mark Charlie carried two orange toolboxes filled with crystals, arrowheads and other totems into a canyon at Red Rock State Park to conduct a "blessing way." He lighted a fire of cottonwood, chanted prayers and read the ashes. When he emerged, he promised the park would be safe. At week's end there were no new cases of the mysterious illness. But no one was sure whether the blessing had taken hold or whether it was simply a lull before the evil descends over the land once more.

With reporting by Elaine Lafferty/Gallup and Scott Norvell/Atlanta