Posted on 10/08/2008 5:52:23 AM PDT by Mother Abigail
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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