The Week That Wasn't: Face Transplant Failure, Salmonella Chickens, Amazon Care

Donavyn Coffey

September 27, 2019

Trending tales of a failing facial transplant, dangerous backyard chickens, and Amazon's foray into virtual healthcare swarmed the Internet this week. But you didn't see those stories covered by Medscape Medical News. Here's why. 

Failing Facial Transplant

Six years ago, Carmen Blandin Tarleton of Manchester, New Hampshire, received a face transplant as part of her recovery from a 2007 attack in which her estranged husband beat her with a baseball bat and doused her in lye. She is one of just 40 patients worldwide to undergo the procedure, according to the Associated Press. Tarleton has suffered treatable rejection episodes in the past, but now her immune system is rejecting the latest transplanted facial tissues for good. She and her doctors have two choices: find another face for transplant or reconstruct her original, disfigured one.

Tarleton is the first US patient to experience a full face transplant rejection. Last year a French man underwent a second face transplant after his body began to reject his initial transplant 8 years after the first procedure, according to the Boston Globe.

Tarleton's case will likely serve as an important experience for surgeons at Brigham and Women's Hospital in Boston, Massachusetts, where her transplant and eight of the 15 US transplants were performed. But because her case has not yet been published in peer-reviewed literature and the reports lack relevant medical data, we decided not to cover it just for the sake of novelty.

Backyard Salmonella 

The rising trend in backyard poultry has been linked to a nationwide Salmonella outbreak. The CDC has reported that an ongoing outbreak now affects more than 1000 people in 49 states: 175 have been hospitalized and 2 have died. Of the 850 patients whose age information was available, 23% were children, who might be more likely to touch, kiss, and cuddle with their feathery pets. 

The outbreak has been deemed the largest salmonella outbreak this year, but is not unlike a similarly widespread outbreak in 2017 that affected 1120 people and was also linked to backyard chickens and ducks. Because this year's outbreak was similar in magnitude and largely attributable to an already well-known carrier of Salmonella, it doesn't change how physicians should care for or advise families with backyard flocks, which is a relatively small population. In other words, it doesn't bring up anything new and critical for most Medscape readers. The CDC continues to recommend careful monitoring of young children (who might put their hands in their mouth) and thorough handwashing.

Amazon's Virtual Healthcare Venture

This week Amazon launched a pilot of a virtual healthcare clinic, Amazon Care. The program combines telemedicine with home visits and is intended as a benefit for the company's Seattle-based employees and their families. Via an app, employees can text a nurse with questions or video chat with a physician or nurse practitioner for diagnosis, referrals, and advice. If in-person follow-up care is necessary, such as for immunizations or diagnostic tests, registered nurses will make home or office visits. Initial news coverage has suggested that Amazon Care is an opportunity for the company to test new healthcare products that it could offer to a bigger market.

It's rare for the start of a new program or clinical trial, without any performance data, to be newsworthy. Amazon is not the first company to use telemedicine or set up an internal clinic for employees. Because the effects of this clinic and its practices are largely limited to Seattle-based Amazon employees at this point, we didn't think it mattered for Medscape readers. 

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