Exactly one year ago, on July 12, 2021, Oriana Pepper, British pilot in training, passed away. Last week, the extensive autopsy report became available: she died of septic embolism (blood clot) in the brain. Most common symptoms of this are a TIA or stroke.
She had been stung by a mosquito in Antwerp and the mosquito bite was going to ignite. The exact circumstances can no longer be determined from the media.
The coroner's conclusion is in any case crystal clear, according to the report of RTL Nieuws: "The coroner concludes that the blood clots arose after the mosquito bite." This conclusion inevitably follows from the observation that a mosquito bite preceded the development of blood clots. Actually, it's more of a reformulation than a conclusion.
Now correlation is not yet causation. That is why journalists are always careful to speak of 'vaccination mortality', for example, if someone dies after vaccination – a subject that is completely separate from this. The deceased was indeed pricked by a mosquito, but how long before that? And had she not had a prick, for example from a spider or a wasp? No wound on her knee?
Journalists don't get it clear
The coverage in various media creates confusion about the location of the mosquito bite: "on the forehead" or "above the eyebrow", "above the eyelid" and even "in the eye". (Some screen clippings to illustrate this.)
The period that elapsed between the crushed insect bite and the blood clots is also difficult to determine in the sourceless or referring messages. Some journalists mention "5 days after the bite", in other articles the infection that became fatal to her in early July is linked to mosquito bites in May.
"On July 5, Oriana was in Belgium for her pilot training. She reported pain in her eyebrow and a red spot after a bite, while also having a 'dull pain' in her back." You could infer from this that she reported the pain on June 5.
According to the BBC, she was bitten on July 7 and died on July 12.
Be that as it may, during the apparent development of the blood clots, the pilot also complained of low back pain. We only find this in a few messages and it is also not linked to the mosquito bite by immunologists. That would also be inconsistent with the explanation that a bacterium happened to end up exactly in the vein that leads to the brain, as we will see in a moment.
The BBC attributes the cause to a bacterial infection "and an insect bite on the forehead that also contributed to it". That sounds different.
In short, I don't know exactly how it was through the media.
Nine4news even writes that she would have been stabbed in the eye (!) and died of an unhinged blood clot that is infected with bacteria and gets stuck elsewhere in the body. (That description of septic embolism seemed exaggerated to me but can be found literally on the site of the thrombosis foundation.)
The Telegraph headlines above a short article: "Young pilot died of brain infection after mosquito bite: 'Never seen before'". As if with all the deadly brain infections no one was ever stung by a mosquito in the weeks before: that would be very coincidental. Or they mean the remarkable fact that it was a young pilot in training, who was nevertheless pricked.
Immunologist outlines causal chain
Immunologist Ger Rijkers creates clarity for rtlnieuws when asked; he knows how to sharply dissect causality:
- a certain bacterium was already present on the skin (that is not in the autopsy report, by the way)
- when the mosquito pierced the skin, the bacterium entered the bloodstream (that is not a quote from the autopsy report either, but that is how it must have gone)
- the bacterium caused infection with blood clots (otherwise there is no explanation for blood clots)
- the blood clots ended up in the brain because the prick was near the eye, causing the bacteria to end up in a vein that leads directly to the brain.
Irrefutable immunology.
Scientist reveals: "I don't think it's ever happened"
"The most important message for the people at home in this case is that it is 'super lonely'," says immunologist Rijkers. "I don't think this has ever happened in the Netherlands." That is a reassuring thought. The immunologist did not have to check this because as an immunologist he knows all the super lonely causes of death by heart, according to him. They are so rare that they are never reported. That is why it does not make sense to look them up.
But: not to be caught for one hole, Rijkers does not want to rule out that something else may be going on: it might have been a tropical mosquito that caused the infection: "There are thousands of species of mosquitoes, which can take malaria or the Zika virus with them, for example." The co-injected skin bacterium (staphylococcus aureus) is apparently not a 100% convincing candidate. So a Zika-like virus from Africa?
"Antwerp has a port and it may be that mosquitoes have come with it, but I don't expect it," says immunologist Rijkers.
A hard-hitting substantiation, which finds support from an English coroner: "Parsley commented that he had never seen a case like this before". Even if not...
Rivm and new insights
rivm
It rivm says about staphylococcus Aureus that especially the resistance of the patient is decisive. Blood clots are not explicitly mentioned as a result of the staphylocuccus aureus, but blood infections. Only in the elderly is there a suspicion of blood clot danger after infection.
But there was nothing wrong with the pilot's resistance.
New insights
Two weeks ago, a study in Science which describes how a defect in the OTULIN gene makes people vulnerable to these staphylococci. These patients often (from the age of ten) suffer from out-of-control infections and necrosis formation. Whether you become a pilot with that I wonder and then you do not let yourself be sent home with a course of antibiotics if you have a weird inflammation above your eye.
Author András Spaan (UMC Utrecht and The Rockefeller University) about his research: "We discovered that natural antibodies, directed against the staphylococcal α toxin, can protect the cells of the patients and thus compensate for the congenital defect of their cell-intrinsic immunity."
Maybe something had happened to her natural immunity that made it not quite right anymore?
The AD suggested that Oriana may have had the OTULIN deficiency, otherwise such an infection cannot be explained.
It's something. And other causes it could not have been because they are safe.
She was a pilot so almost 100% sure that she 'mandatory' had a jab known to be very safe.
So it must be another, albeit very far-fetched, cause.
Either way, it's sad for this young woman.
Indeed. I can also remember a letter (Pepijn van Houwelingen tweeted that) from desperate parents because their child was not allowed to continue pilot training without vaccinations. It was later said that Pepijn had just written that letter himself to be able to tweet because it was not true at all ... Unbelievable, that mass psychosis and you can't do anything about it.
Good that autopsy has taken place. Now the excess mortality can also be explained. Mosquito bites! A vaccine for this should be developed as soon as possible!
I always think it's so clever! How the media and science work together and then solve such difficult riddles so well and unambiguously. I have such a deep admiration for that! Pretty good though.
Mmm... they have (probably unintentionally) 'proven' that being pricked can be life-threatening.
One option could be that it is a special prick beast. E.g. a mutated mosquito. Taking into account the fact that a mutated mosquito that ends up in nature cannot simply be taken out again.
Also separately if infection in vein face comes that then the brain becomes infected with blood clot .... I have really learned with biology that veins branch into larger veins and find their way to the heart there the small circulatory begins to then enter the large circulatory system and only then possibly goes back to the brain but that blood clot was then long ago stuck in the fine branch of the lungs. Or am I missing something here?