DURHAM — The killer that claimed two children in the town of Elkin early Wednesday was silent, invisible and more common in winter.
Carbon monoxide poisoning from a gas-power electric generator running inside their house almost certainly caused the deaths of a 7-year-old boy and 8-year-old girl and knocked unconscious a 39-year-old woman, said Johnny Shelton, the Surry County emergency services director. The survivor was first taken to a local hospital then later to a specialized facility at Duke University Medical Center, Shelton said.
Five other people were treated at Duke this week for carbon monoxide poisoning in an unrelated incident involving a generator run indoors, said Dr. Richard Moon, medical director of Duke’s Center for Hyperbaric Medicine and Environmental Physiology, which treats about 30 patients a year for exposure to the gas.
The unusual spike in cases underlines the dangers of carbon monoxide, which also can build up inside homes from sources such as faulty furnaces, cars left running in a garage or the use of improper equipment for indoor cooking or heating, such as charcoal grills and camping stoves.
The two children, who Shelton declined to identify, had just moved into a rented home in Elkin, 150 miles northwest of Raleigh, along with three women and two small dogs. The adults planned to have electrical service connected Wednesday. Meanwhile, they decided to run a generator inside the kitchen Tuesday night because they had food in the refrigerator they wanted to keep fresh, he said.
The adults started the generator about 11 p.m. Tuesday night, and two of the women left to sleep somewhere else. They returned about 5:15 a.m. Wednesday and found the other woman lying in a hallway. The Mount Airy News identified the woman as the children’s mother.
Emergency workers called to the home found the two children already dead in a bedroom, along with the dogs, which also were dead.
“A gasoline-powered generator should never, ever be run in an enclosed dwelling because it will start creating serious levels of carbon monoxide in just minutes,” Shelton said.
In this case, it ran until all its fuel was gone. The first emergency workers on the scene opened the windows and doors as they summoned a hazmat team, but there was so much of the poisonous gas inside the house that it was still at dangerous levels when the hazmat team arrived, Shelton said.
Nationwide, unintentional exposure to carbon monoxide causes an estimated 15,000 emergency department visits and 500 deaths annually, according to the Centers for Disease Control and Prevention.
The jump this week in poisonings is an early reminder not to use combustion-powered equipment, charcoal grills or camp stoves indoors and to make sure the pilot lights in gas cooking appliances are working properly, said Marilyn Parker, an industrial hygiene consultant with the state Division of Public Health.
Small spikes in carbon monoxide poisoning often come with bad weather, but one of the biggest sources of problems is malfunctioning furnaces or gas heaters. That’s why it’s a good time now, before the weather turns cold, to have your heating system inspected, Parker said.
It’s also smart to have a carbon monoxide detector installed, she said, particularly the kind with a readout of the level of the gas so that you can see a problem developing before it becomes bad enough to trigger an alarm.
Moon said there were jumps in cases involving generators during catastrophic weather events such as Hurricane Fran and major ice storms, but the resulting publicity seemed to educate people for awhile.
“Back then, everybody kind of heard about the problem,” he said. “But people forget, and then maybe they get worried about the noise bothering their neighbors, so they take it inside.”
The hyperbaric center where Moon works is a powerful tool for treating carbon monoxide victims and one of the largest in the country. It also is one of the most unusual health care facilities imaginable, with its seven interconnected hyperbaric chambers – five cylindrical rooms that look like sections of a submarine or airliner and two spherical ones – which have nearly three times the normal atmospheric pressure inside.
Carbon monoxide victims are treated there with the help of small ballon-like tents over their heads into which pure oxygen is pumped. The extra oxygen under pressure helps displace the carbon monoxide from their blood and tissues. That makes them feel better faster and helps prevent or reduce long-term effects, such as memory problems, Moon said.
The hyperbaric center also is used to treat victims of certain kinds of scuba-diving accidents, certain kinds of wounds that are stubborn to heal and for research.