Miners Lung (Flemings Cough)

After examining the man who collapsed yesterday, I can say with certainty that he has an illness of the lung. His cough has gone from rattling to producing sputum, and his fever has only worsened. As I write this, he is clammy, shaking, and delirious. I'm not sure if he knows where he is, and I am shocked that he continued to work in such a state. I gave him laudanum to soothe the chest pain and to help him sleep, though I fear it does little to improve his health. According to the other miners, he has worked in these mines for the past thirty years. These men often go days without seeing the sun, and the foreman only reluctantly allows me to examine them and only during their breaks.

Other miners came to me displaying symptoms of a high fever, cough, and chest pain. It is primarily the pain that prevents them from working, though I am grateful they came to me before collapsing. I believe their chances for survival are better. Fresh air seems to ease some of the symptoms, and the coughing is noticeably less violent than when they arrived a few hours prior.

--Adaline Stoker, Miners Lung; Journal from the Tungraad Mine

Transmission & Vectors

Miners Lung is an airborne illness caused by nano particles in dust getting into the airways. While typically associated with coal miners, the disease has also been documented among textile workers and iron and steel workers. It is not transmissible between people nor is it passed down to offspring.

Causes

Miners Lung is caused by dust and various particles entering the lungs and creating irritation and micro abrasions and lacerations. However, most of the severe cases and fatalities are caused by secondary infections, predominately pneumonia. Respiratory infections are generally either viral or bacterial in nature.

Symptoms

Symptoms generally take a long time to develop. It takes continuous exposure to dust particles in high quantities for years before any symptoms truly manifest. Early symptoms include shortness of breath, wheezing, and coughing. Later infections typically include a moderate to high fever, a productive or rattling cough, acute chest pain, shaking chills, fatigue, malaise, and an increased rate of breathing. Sputum may vary in color from whitish-yellow to rust red. Less than 2% of cases also include vomiting, diarrhea, and loss of consciousness. Less than 1% of cases present with blueish skin.

Post mortem, people with Miners Lung had blackened and heavily scarred lungs.

Treatment

The recommended treatment for Miners Lung is that the patient move somewhere with fresh air. Patients who smoke are encouraged to quit. There is no known cure for Miners Lung. There is also no way to reduce the irritants from the lungs.

Various home remedies exist such as inhaling steam, eating garlic, or pouring onion juice into the nose.

Prognosis

Patients who survive the first 5-7 days after the fever begins nearly always survive. Symptoms may persist for another 7-10 days though generally in a less severe state. The mortality rate is about 15%, however, most people who contract Miners Lung are elderly. Among younger people, the mortality rate is only 3-5%.

Sequela

Coughing and shortness of breath generally continue for the rest of the patient's life. Many patients report chest pain particularly after heavy exercise. Those who return to work in factories or mines are likely to contract Miners Lung again.

Affected Groups

The lower classes are affected the most heavily by Miners Lung. They often work in factories or mines, live nearby, and begin work in dangerous conditions at a young age. While Miners Lung is most commonly seen among the elderly, growing numbers of young adults are contracting the disease due to lifelong exposure to polluted air.

Prevention

The only known prevention for Miners Lung is to avoid working in places where the dust is thickest. Inhaling dust in the general atmosphere typically doesn't create enough buildup to cause complications.

History

The first confirmed case of Miners Lung was documented 4792 by Adaline Stoker , a nurse working near the Tungraad Mine . Three years later, Dr. Charles Fleming confirmed Stoker's findings and published them under the name Flemings Cough. Stoker, undeterred, continued her research and eventually died of Miners Lung herself. Ten years after her death, her son found and published her notes and argued that the disease should be renamed Miners Lung because of her more extensive documentation including autopsies.

In the subsequent years, more cases were identified among ironworks and textiles workers. As the country continued to industrialize, the number of reported cases rose. The number of cases among young adults also rose due to child labor and early exposure to heavy air pollution. There was a sudden spike in reported cases of Miners Lung 4844, though most physicians attribute it to an unusually harsh winter that kept people confined inside and an increased need of chimney sweeps.

Origin

Natural

Cycle

Chronic, Acquired

Rarity

Common