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Re: UNDIAGNOSED FATALITIES - SOUTH AFRICA ex ZAMBIA: REQUEST FOR INFORMATION [ProMedMail.org]
Two more show signs of fever
12 October 2008, 10:39
By Eleanor Momberg, Myrtle Ryan, Liz Clarke and Niyantha Singh
Two more people have been admitted to the Morningside Medi-Clinic for observation after they showed signs of viral haemorrhagic fever.
The hospital confirmed on Saturday that a man was admitted on Thursday night and a woman on Friday. The woman is the second nurse to show signs of the disease.
At the same time, two relatives of Gladys Mthembu, the nurse who died after being admitted to the Sir Albert Robinson Hospital in Randfontein, were discharged after being given a clean bill of health. They were Mthembu's 11-year-old son and his 23-year-old nanny.
A cleaning supervisor at Morningside, who was admitted to Chris Hani Baragwanath Hospital in Soweto on Monday with symptoms of viral haemorrhagic fever, has since been discharged.
A total of 154 people remain under out-of-hospital observation for the signs of the mystery disease.
The outbreak has claimed three lives in South Africa since September 14, when Cecilia "Silky" van Deventer, a safari operator, died two days after being flown to Morningside from Zambia, apparently with tick-bite fever.
Hannes Els, the paramedic who treated Van Deventer, was admitted to the hospital on September 27, but died on October 2.
Mthembu, who also treated Van Deventer, subsequently went on leave and became ill at home. She went to her personal doctor, who referred her to the Sir Albert Robinson hospital, where she was admitted on October 1. Morningside was notified of her death on October 5.
Melinda Pelser, a Morningside spokesperson, said Maria Mokubung, a cleaner at the hospital who died at Charlotte Maxeke Hospital in Johannesburg, had a chronic illness for which she had been receiving treatment at Chris Hani Baragwanath hospital.
All the people who have been placed under observation have had direct contact with the people who died at Morningside.
Pelser said that, as a safety precaution, people who may have had direct contact with the patients who died at the hospital were being monitored and would continue to be monitored for 21 days from the time of their last contact.
"This number was initially 55 and has now been extended to 67 people. The monitoring consists of regular temperature checks and a daily check in with the Morningside Medi-Clinic. These people are not in isolation or quarantine and can continue with their daily activities," she said.
In addition, the department of health said that it was monitoring 66 people who may have had direct contact with Mthembu.
The World Health Organisation (WHO) said on Saturday that 23 people known to have had contact with the patients who died were being monitored in Zambia. None were symptomatic.
Clinical features common to the three patients include fever, headache, diarrhoea and muscle pain, which then developed into rash and hepatic (liver) dysfunction, followed by rapid deterioration and death, the WHO said.
"There is no indication at this point of the need for any restriction of travel to or from Zambia or South Africa and no special measures are required for passengers arriving from these countries," a WHO statement said.
What virologists were still trying to determine was which of the haemorrhagic viruses was responsible for the outbreak.
There was still concern about the family of Mthembu, who died last week in a Randfontein hospital. Mthembu had been urged to return to Morningside for treatment, but had chosen to be admitted to a local hospital, close to her family. Little is known about follow-up steps by the hospital to isolate those who came into contact with her.
Zambian authorities said they were still trying to trace people who had had contact with Van Deventer.
Blood samples from all three victims who died in South Africa have been sent by the National Institute for Communicable Diseases to the Centres for Disease Control in the United States. The results are expected before the end of the week.
South African specialists are also continuing their tests.
Professor Alan Smith, an eminent virologist, said the reason why virologists at the Special Pathogens Unit in Johannesburg - the only Level 4 laboratory in Africa - were taking so long to come up with an answer was that it was probably an emergent disease.
If it were Congo fever, it would have been identified in a few days, he said. "Ebola was one such emergent disease and in 1975 another was Marburg disease.
"There is no need to panic. Humans can only be infected through direct contact with the blood, urine or faeces of an infected person," he said.
Two more show signs of fever
12 October 2008, 10:39
By Eleanor Momberg, Myrtle Ryan, Liz Clarke and Niyantha Singh
Two more people have been admitted to the Morningside Medi-Clinic for observation after they showed signs of viral haemorrhagic fever.
The hospital confirmed on Saturday that a man was admitted on Thursday night and a woman on Friday. The woman is the second nurse to show signs of the disease.
At the same time, two relatives of Gladys Mthembu, the nurse who died after being admitted to the Sir Albert Robinson Hospital in Randfontein, were discharged after being given a clean bill of health. They were Mthembu's 11-year-old son and his 23-year-old nanny.
A cleaning supervisor at Morningside, who was admitted to Chris Hani Baragwanath Hospital in Soweto on Monday with symptoms of viral haemorrhagic fever, has since been discharged.
A total of 154 people remain under out-of-hospital observation for the signs of the mystery disease.
The outbreak has claimed three lives in South Africa since September 14, when Cecilia "Silky" van Deventer, a safari operator, died two days after being flown to Morningside from Zambia, apparently with tick-bite fever.
Hannes Els, the paramedic who treated Van Deventer, was admitted to the hospital on September 27, but died on October 2.
Mthembu, who also treated Van Deventer, subsequently went on leave and became ill at home. She went to her personal doctor, who referred her to the Sir Albert Robinson hospital, where she was admitted on October 1. Morningside was notified of her death on October 5.
Melinda Pelser, a Morningside spokesperson, said Maria Mokubung, a cleaner at the hospital who died at Charlotte Maxeke Hospital in Johannesburg, had a chronic illness for which she had been receiving treatment at Chris Hani Baragwanath hospital.
All the people who have been placed under observation have had direct contact with the people who died at Morningside.
Pelser said that, as a safety precaution, people who may have had direct contact with the patients who died at the hospital were being monitored and would continue to be monitored for 21 days from the time of their last contact.
"This number was initially 55 and has now been extended to 67 people. The monitoring consists of regular temperature checks and a daily check in with the Morningside Medi-Clinic. These people are not in isolation or quarantine and can continue with their daily activities," she said.
In addition, the department of health said that it was monitoring 66 people who may have had direct contact with Mthembu.
The World Health Organisation (WHO) said on Saturday that 23 people known to have had contact with the patients who died were being monitored in Zambia. None were symptomatic.
Clinical features common to the three patients include fever, headache, diarrhoea and muscle pain, which then developed into rash and hepatic (liver) dysfunction, followed by rapid deterioration and death, the WHO said.
"There is no indication at this point of the need for any restriction of travel to or from Zambia or South Africa and no special measures are required for passengers arriving from these countries," a WHO statement said.
What virologists were still trying to determine was which of the haemorrhagic viruses was responsible for the outbreak.
There was still concern about the family of Mthembu, who died last week in a Randfontein hospital. Mthembu had been urged to return to Morningside for treatment, but had chosen to be admitted to a local hospital, close to her family. Little is known about follow-up steps by the hospital to isolate those who came into contact with her.
Zambian authorities said they were still trying to trace people who had had contact with Van Deventer.
Blood samples from all three victims who died in South Africa have been sent by the National Institute for Communicable Diseases to the Centres for Disease Control in the United States. The results are expected before the end of the week.
South African specialists are also continuing their tests.
Professor Alan Smith, an eminent virologist, said the reason why virologists at the Special Pathogens Unit in Johannesburg - the only Level 4 laboratory in Africa - were taking so long to come up with an answer was that it was probably an emergent disease.
If it were Congo fever, it would have been identified in a few days, he said. "Ebola was one such emergent disease and in 1975 another was Marburg disease.
"There is no need to panic. Humans can only be infected through direct contact with the blood, urine or faeces of an infected person," he said.
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