Posted on 10/08/2008 5:52:23 AM PDT by Mother Abigail
Zambia: It's Not Ebola!
The Times of Zambia (Ndola)
8 October 2008
THE woman from Zambia who died in South Africa from a mysterious disease was in fact afflicted by cerebral edema and multi-organ failure, putting to rest suspicions that she was hit by the deadly ebola, experts have confirmed.
Five experts who carried out the investigations on two of the four deceased people revealed that the woman could have died from suspected viral infection from a tick bite that she incurred in Lusaka.
Experts from Specialty Emergency Services (SES) Corpmed Medical Centre (CMC) and Wilderness Safari said that the first victim of the disease, that had so far claimed four lives, owned horses and attended polo matches in Lusaka.
The woman is known to have walked barefoot most of the time and travelled within Africa frequently without seeking medical attention.
Between September 6-8 this year, she attended a wedding in South Africa where she might have had food poisoning along with six others all of whom had developed diarrheoa, vomiting and headache.
On September 10, she developed rash, fever and chest congestion and was attended to by a doctor at Care for Business Clinic, who told her that she had flu and sent her home.
The victim was flown to South Africa on September 12 after her condition deteriorated as she had seizures and died on September 14.
Most of the people she came in contact with, including her family, two doctors and employees at CMC had not shown any symptoms of the disease.
But a paramedic who had spent time with her during her seizure also died from multi-organ failure on October 1, almost two weeks after the meeting. He died at Morningside Hospital after being flown there.
The third victim was a nurse based at the clinic who had attended to the first patient.
The fourth one, a cleaner at the same health institution, died in the Charlotte Maxeke Johannesburg Academic Hospital.
Health Permanent Secretary, Simon Miti said in an interview yesterday that the health authorities in the country had been put on high alert against any symptoms similar to those that afflicted the four dead people.
Dr Miti said no such cases had been reported from the health institutions anywhere in the country and health officers were watching the situation.
He said apart from putting health institutions on high alert, authorities had also deployed officers at ports of entry to monitor the situation for symptoms of the disease.
He said that all the tests conducted in South Africa on the deceased people were negative to the initial suspicions and that the disease remained a mystery. "We still have no trace of the disease in Zambia and, therefore, the nation should be calm," he said.
Yesterday, the South African media reported that a 51-year-old woman was on Monday admitted to the Chris Hani Baragwanath Hospital in Johannesburg with symptoms of the unknown disease.
4 Sep 2008 - Index Case - female South African, (living in Zambia for many years) begins to suffer from flu-like symptoms.
9 Sep 2008 - She is slowly deteriorating. She sees multiple doctors in Lusaka.
11 Sep 2008 - She is admitted to hospital and deteriorates over night.
12 Sep 2008 - Paramedic is called in to evacuate her to South Africa. He does the transfer, along with another Dr assisting.
13 Sep 2008 - Index Case dies.
14 Sep 2008 Paramedic starts to develop flu-like symptoms.
14-27 Sep 2008 - Paramedic slowly deteriorates.
27 Sep 2008 - Paramedic is diagnosed as very sick and medivaced to South Africa. Nurse who treated Index case begins to get flu-like symptoms.
30 Sep 2008 - Paramedic dies.
1 Oct 2008 - Nurse who treated Index Case is admitted to hospital.
5 Oct 2008 - Nurse who treated Index Case dies.
7 Oct 2008 - 51-year-old woman was admitted to the Chris Hani Baragwanath Hospital in Johannesburg with symptoms of the unknown disease.
Did they eat monkey meat?
Soooo. Great it is not Ebola. So no worry? What IS the connection? The ‘now deceased’ all owned horses and walked barefoot?
Cleaner’s supervisor isolated
In a dramatic development on Monday afternoon [patient A]’s supervisor went to Chris Hani Baragwanath hospital and was put in an isolation ward.
Zanele Mngadi, spokesperson of the Department of Health, said the woman checked herself in at the hospital yesterday after hearing about [patient A]’s death. The woman told the hospital staff that she had been feeling ill for a few days, had flu-like symptoms as well as fever. “Her blood samples have been taken and we are waiting for the results,” Mngadi said. At the moment, the only people who have access to her are medical staff in protective gear.
Morningside Medi-Clinic spokesperson Melinda Pelser said the disease had been identified as a viral haemorrhagic fever, the exact strain had not been identified as tests for Ebola, [Crimean-]Congo fever and other likely possibilities had all returned [out] negative.
An outbreak of an, as yet, unknown disease has been identified in South Africa. To date there have been 4 probable cases, all of whom have died. The index case was a Zambian national, resident in Lusaka who had close contact with horses and a history of possible tick exposure. The subsequent 2 patients had close contact with the index case patient in a healthcare setting: a paramedic involved in her medical evacuation to South Africa and an intensive care nurse in Johannesburg.
These 2 patients became ill approximately 7 days after exposure to the index case.
Clinical and laboratory features common to all 3 patients include a prodromal illness of approximately 7 days with (38oC), a morbilliform rash in 2 patients, thrombocytopaenia and mild hepatic dysfunction in 2 patients.
An initial improvement was reported in the 2 latter patients, and all 3 patients had a sudden and marked deterioration in mental state, rhabdomyolysis in one case, and evidence of acute and severe hepatic necrosis.
Bleeding was not a marked clinical feature although oozing from venepuncture sites was noted as well as a petechial rash in one patient. Blood cultures to date have been negative. Tests for viral haemorrhagic fevers (VHFs) including Ebola, Marburg,
Crimean-Congo haemorraghic fever (CCHF), Hantaviruses, Rift Valley fever virus and Lassa fever virus, are negative to date. No further secondary cases have been identified and there is no indication of similar cases occurring in Zambia.
It seems likely that this is an isolated case with secondary transmission in the nosocomial setting. Given the high mortality, nosocomial transmission and clinical presentation, a viral haemorrrhagic fever remains possible.
Laboratory testing for VHFs has been conducted by the Special Pathogens Unit at the National Institute for Communicable
Diseases (NICD). Multiple nucleic acid and antigen detection assays as well as serological tests have been negative for CCHF, Ebola, Marburg, Lassa fever, Hantaviruses and Rift Valley fever virus. The final results for viral culture in animal and cell cultures are pending.
Only specimens from Cases 2, 3 and 4 were available for testing. The index case has been given a diagnosis of “tick-bite fever” and no specimens were available for testing (she died shortly after arrival in SA). Negative results to date may be explained by several factors.
These could include; the timing of collection (taken late - day 10 of illness), virus variants not detected by current molecular and serological assays. All contacts of cases, including healthcare workers and laboratory staff are under surveillance and are all currently well.
It would seem that it is at least as devastating as Ebola, and the means of transmission, whatever it is, is quite efficient.
Is it airborne?
If not this one, then sooner or later, one will be.
Lotsa luck on screening people with flu-like symptoms. If you suspect you have it and just want to go home to die you are not going to tell the authorities about it so they can quarantine you in a dirty tent somewhere and burn your body in a pit.
War, famine, pestilence, plague, financial crisis....a world in travail. Why, pretty soon someone is gonna show up and claim he has all the answers.
Cleaner’s supervisor isolated
In a dramatic development on Monday afternoon [patient A]’s supervisor went to Chris Hani Baragwanath hospital and was put in an isolation ward.
Zanele Mngadi, spokesperson of the Department of Health, said the woman checked herself in at the hospital yesterday after hearing about [patient A]’s death. The woman told the hospital staff that she had been feeling ill for a few days, had flu-like symptoms as well as fever. “Her blood samples have been taken and we are waiting for the results,” Mngadi said. At the moment, the only people who have access to her are medical staff in protective gear.
Morningside Medi-Clinic spokesperson Melinda Pelser said the disease had been identified as a viral haemorrhagic fever, the exact strain had not been identified as tests for Ebola, [Crimean-]Congo fever and other likely possibilities had all returned [out] negative.
An outbreak of an, as yet, unknown disease has been identified in South Africa. To date there have been 4 probable cases, all of whom have died. The index case was a Zambian national, resident in Lusaka who had close contact with horses and a history of possible tick exposure. The subsequent 2 patients had close contact with the index case patient in a healthcare setting: a paramedic involved in her medical evacuation to South Africa and an intensive care nurse in Johannesburg.
These 2 patients became ill approximately 7 days after exposure to the index case.
Clinical and laboratory features common to all 3 patients include a prodromal illness of approximately 7 days with (38oC), a morbilliform rash in 2 patients, thrombocytopaenia and mild hepatic dysfunction in 2 patients.
An initial improvement was reported in the 2 latter patients, and all 3 patients had a sudden and marked deterioration in mental state, rhabdomyolysis in one case, and evidence of acute and severe hepatic necrosis.
Bleeding was not a marked clinical feature although oozing from venepuncture sites was noted as well as a petechial rash in one patient. Blood cultures to date have been negative. Tests for viral haemorrhagic fevers (VHFs) including Ebola, Marburg,
Crimean-Congo haemorraghic fever (CCHF), Hantaviruses, Rift Valley fever virus and Lassa fever virus, are negative to date. No further secondary cases have been identified and there is no indication of similar cases occurring in Zambia.
It seems likely that this is an isolated case with secondary transmission in the nosocomial setting. Given the high mortality, nosocomial transmission and clinical presentation, a viral haemorrrhagic fever remains possible.
Laboratory testing for VHFs has been conducted by the Special Pathogens Unit at the National Institute for Communicable
Diseases (NICD). Multiple nucleic acid and antigen detection assays as well as serological tests have been negative for CCHF, Ebola, Marburg, Lassa fever, Hantaviruses and Rift Valley fever virus. The final results for viral culture in animal and cell cultures are pending.
Only specimens from Cases 2, 3 and 4 were available for testing. The index case has been given a diagnosis of “tick-bite fever” and no specimens were available for testing (she died shortly after arrival in SA). Negative results to date may be explained by several factors.
These could include; the timing of collection (taken late - day 10 of illness), virus variants not detected by current molecular and serological assays. All contacts of cases, including healthcare workers and laboratory staff are under surveillance and are all currently well.
Thank you for the update and ping. These emerging diseases are always a concern.
ALL the scary, potentially pandemic diseases are still “out there.” None of them have gone away...
Guessing this is another rodent carried virus probably shed in urine like so many others. If it was arthropod-borne it would not be so limited in distribution. It also appears to be contagious between humans either by direct contact or perhaps airborne, at least for a short distance. Many unknown viruses lethal to humans, are yet lurking and waiting to jump the species barrier as man continues to expand his boundaries.
Whew, well, that’s a relief.
We are at war with the microbial world.
Thanks for the ping :)
Where’s the DDT when you need it? Kill ticks.
That sounds like “tetnus”.
AIDS, Ebola, and all these other nasty killers used to just be lumped into something called “Jungle Fever”. Everyone knew that if you went into the jungle with all the insects and waterborne things that eventually you would get sick and stand a good chance of winding up dead.
Now we put names on these things and the press tries to scare us to death with tales of tbe boogie-germ.
What they don’t tell is that many of these boogie-germs kill so quickly they don’t spread well and are self-limiting in their infectiousness. It’s a bad deal for the guy who gets it and dies; it’s a good thing for the rest of us, because the chances of contracting it are nil.
Yeh, well, I’m off monkey meat for a couple of weeks just to be safe. BTT...
S Africa quarantines 100 over mystery virus
By Africa correspondent Andrew Geoghegan
Posted 1 hour 55 minutes ago
Health authorities in South Africa are on high alert, quarantining more than 100 people who are suspected of coming into contact with a mysterious virus that has killed at least three people in Johannesburg.
The World Health Organisation has been asked to help South Africa’s health authorities find the cause of the deadly disease.
They only became aware of the outbreak after the deaths of a paramedic and a nurse.
Both medical attendants treated a woman from Zambia who died with similar symptoms, including internal and external bleeding.
Doctors suspect the cause is a haemorrhagic fever, but they have so far failed to make a definitive diagnosis.
Authorities have reassured the public that the suspected virus has been contained. More than 100 people are under close medical observation.
Thank you, Mother Abigail, and welcome back. We’ve missed you.
Ping.
The 51-year-old woman admitted to the Chris Hani Baragwanath Hospital on Monday with symptoms of viral haemorrhagic fever has been discharged, the Gauteng health department said on Wednesday.
Maria Stuurman, a cleaning supervisor at Morningside Medi Clinic, was discharged in the afternoon after doctors ascertained that she had not contracted the fever, said spokesperson Pumelele Kaunda.
That is one interesting differential diagnosis.
MA
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