DRC: Fourteen die of bloody diarrhea (ex Angola?)

[alert]

Hat-tip Pathfinder.

http://radiookapi.net/actualite/2012/08/07/tshikapa-une-epidemie-inconnue-tue-14-congolais-retournes-de-langola/

Tshikapa: an unknown epidemic kills 14 Congolese returned from Angola
ago published 7 hours, 8 minutes | Last Update August 7th, 2012 at 8:25 | under News, Kasai Occidental, Health and Society.

Not yet an epidemic has already killed fourteen known Congolese among three thousand and fourteen returned to Angola via the border crossings and Kandjaji Tshitundu, localities 180 km south of the town of Tshikapa (Kasai Occidental). Sources of instead indicate that the Congolese out of Angola voluntarily flee the spread of this disease manifested by bloody diarrhea in communities Tshinguvu, Lukata and other mining areas of Lunda North province (Angola).

Reliance on the report of the health zone Kamonya, the chief medical officer of health district Tshikapa, Jean-Pierre Okambio, says the health status of three patients supported by the hospital Kamonya developing positively.

Jean-Pierre Okambio also asked health services operating at the border to take steps to prevent the spread of this epidemic unknown.

Local health authorities say that the patients reported are already supported in hospitals near the borders.

[alert]

Re: DRC: Fourteen die of undiagnosed disease (ex Angola?)

There's not enough information here to determine what this is. The article seems to mention that there is an ongoing outbreak of this in Angola. We do not have a good enough estimate of a denominator of cases, a full symptomatic description, or a time frame to determine whether this might be a VHF outbreak, or something more common like dysentery, typhoid, or cholera. Both Ebola and Marburg have previously been reproted from both Angola and the DRC.

It is not clear either what the "3014" people represent. The total number ill? The total number screened? Or some kind of typo (that number is awful large and precise)?

The reference to mining areas of the Lunda North province might also suggest a heavy metal poisoning, something that has been reported before from that region.

[Laidback Al]

Re: DRC: Fourteen die of undiagnosed disease (ex Angola?)

machine translated from an Angola travel site . . .

http://viajar.sapo.ao/descubra-o-pais/dicas-de-viagem/tome-nota

Take note

Consultation of the traveler

22/07/2012 Source: Institute of Hygiene and Tropical Medicine

Diarrhoea associated with consumption of water or adequate food (traveler's diarrhea) is most often self-limited.
It may be accompanied by nausea, vomiting, abdominal pain and fever, with recovery in a few days.
The most important is to avoid dehydration. Must consume more fluids than usual: tea, green coconut water, rehydrating beverages allows and water in order to maintain normal urine.
If diarrhea persists for more than three days, the number of stools does not diminish, has mixed blood in the stool or there is fever above 38 ⁰ C should begin antibiotic treatment.
Check with your doctor to find out which antibiotic is most appropriate for your case.
The antidiarrheals (loperamide, racecadotril), should not be used as a routine treatment but are exceptionally admitted for symptomatic relief. Discuss their use with your doctor.
In case of very severe nausea may require an anti-emetic (preferably domperidone). It is useful to take a medication for colic (Buscopan).
Avoid contact with potentially contaminated fresh water. In many destinations, you should avoid bathing in collections of freshwater lakes and rivers.

[Vibrant62]

Re: DRC: Fourteen die of undiagnosed disease (ex Angola?)

It is not clear either what the "3014" people represent. The total number ill? The total number screened? Or some kind of typo (that number is awful large and precise)?

From my reading this is the total number of soldiers who returned from Angola or 'fled' from the infection.

Perhaps more worrying is the term 'fled' as this implies that there may be more cases amongst local populations within Angola itself. As Angola is still a conflict zone I doubt we will get much accurate information about the situation there.

[alert]

Re: DRC: Fourteen die of bloody diarrhea (ex Angola?)

The original article has been edited slightly, and now reads (omitting mention of the 3014 people, and of the phrase "unknown disease"):

The translator is mangling the direction of migration; I believe the original French indicates the patients are returning to the DRC from Angola.

http://radiookapi.net/actualite/2012/08/07/tshikapa-une-epidemie-inconnue-tue-14-congolais-retournes-de-langola/

Kasai Occidental: 14 revenues of Angola Congolese die of bloody diarrhea
ago published 16 hours, 6 minutes | Last Update August 8, 2012 at 8:04 |

Fourteen Congolese nationals who have returned to Angola via the border crossings and Kandjaji Tshitundu (Tshikapa) died from bloody diarrhea. Local sources indicate that these Congolese out of Angola voluntarily flee the spread of this disease which is spreading in communities Tshinguvu, Lukata and other mining areas of Lunda North Province (Angola).
The district medical officer of health Tshikapa, Jean-Pierre Okambio, says the health status of three patients treated at the hospital Kamonya developing positively.

Jean-Pierre Okambio also asked health services operating at the border to take steps to prevent the spread of this disease.

Local health authorities say that the patients reported are already supported in hospitals near the borders.

[Vibrant62]

Re: DRC: Fourteen die of bloody diarrhea (ex Angola?)

There is always the possibility that the Ebola outbreak in Uganda was imported; it would be good to have an Ebola diagnosis positively excluded, just to eliminate the possibility, however unlikely.

[alert]

Re: DRC: Fourteen die of bloody diarrhea (ex Angola?)

There is always the possibility that the Ebola outbreak in Uganda was imported; it would be good to have an Ebola diagnosis positively excluded, just to eliminate the possibility, however unlikely.

You wouldn't need to import Ebola or Marburg from Uganda; both viruses are enzootic in both DRC and Angola. A large Marburg outbreak hit Angola in 2005:

http://www.promedmail.org/direct.php?id=20051108.3269

and the most recent Ebola outbreak in DRC was in December 2008:

http://www.promedmail.org/direct.php?id=20081225.4068

If this is a VHF outbreak, local animals, not the Uganda outbreak, would be its most likely source. This is hundreds of miles from Kibaale.

On a related note, there is something still inconsistent with the reporting. We have a report of 14 imported fatalities in DRC, but little idea what is going on in Angola. We know from the 2003 SARS outbreak that it takes a rather large outbreak somewhere to produce a single exported case elsewhere. To produce 14 fatalities in DRC, I would expect a massive outbreak in Angola. I realize surveillance in Angola might be weaker than in DRC, but I would not expect it to this degree. So I think we are still missing a piece of the puzzle here, something that might bias cases toward fleeing migrants/soldiers.

[alert]

Re: DRC: Fourteen die of bloody diarrhea (ex Angola?)

Hat-tip Pathfinder. We'll here's the diarrhea in Angola. And it sure looks more like dysentery than VHF:

http://www.portalangop.co.ao/motix/fr_fr/noticias/saude/2012/7/33/Diarrhee-inconnue-tue-cinq-personnes-Dande,99157c4a-521f-4fca-a10e-69efca10e58b.html

15/08/12 11:35

Caxito
Diarrhea kills five people unknown to Dande

Caxito (Angola) - Sixty-four cases of acute diarrhea (DDA) unidentified have been reported since July 22 up to date in the municipality of Dande, reported Monday, in Caxito, the Provincial Director of Health, Mbala Kussunga.



Speaking to the press, the unknown disease that has already killed five people, Mbala Kussunga explained that the health authorities of the province have control of the situation.



He said qu'ub emergency service program was established, a program that distributes bleach to people in affected areas and supplies stockpiled drugs (particularly serum) in health facilities in sensitizing the population on preventive measures against the disease.



The official advised the population to adopt preventive measures, including boil water or disinfect it with bleach, build latrines and avoid open defecation and close to the water source.



Cases of acute diarrheal disease were recorded in the municipality of Dande, then Sungui Puerto Kipiri.

[alert]

Re: DRC: Fourteen die of bloody diarrhea (ex Angola?)

And now this gets puzzling. Cholera is not bloody, so if the illness in Angola really is cholera, it is not related to whatever caused the deaths in the first post of this thread.

Unless, of course, the first report is incorrect about the diarrhea being bloody. We are now 10 days from that initial report with no follow-up.

http://www.promedmail.org/fr

Published Date: 2012-08-16 3:05:34 p.m.
Subject: PRO / EDR> suspected Cholera - Angola: (East), ICR
Archive Number: 20120816.268790

SUSPECTED CHOLERA - ANGOLA: (IS), REQUEST FOR INFORMATION
************************************************** ***********************

A ProMED-mail

http://www.promedmail.org

ProMED-mail is a program of
International Society for Infectious Diseases

http://www.isid.org

Date: Wed, 15 August 2012Source: AngolaPress


Diarrhea kills five people unknown to Dande
----------------------------------------
64 cases of acute diarrhea (DDA) have been reported unidentified
since July 22 [2012] up to date in the municipality of
Dande, reported Monday [August 13], in Caxito, the provincial director
Health Kussunga Mbala.
Speaking to the press, the unknown disease that has already been 5
deaths, Mbala Kussunga explained that health authorities
province have control of the situation.
He said a program of emergency department has been established,
program, which distributes bleach to people in areas
affected and supplies stockpiled drugs (especially
serum) in health facilities by educating
population on preventive measures against the disease.
The official advised the population to adopt
preventive, including boil water or disinfect with
bleach, prevent build latrines and defecation
Outdoor and close to the water source.
Cases of acute diarrheal disease were recorded in the
municipality of Dande, then Sungui Puerto Kipiri.

-
Communicated by:
ProMED-


[These cases have resulted in five of diarrhea deaths since July 22, 2012
are strongly suspected to be cholera cases. Authorities
health of the country would be adequate analyzes on these
diarrhea. Any additional information that clarifies
the national and international opinion on these cases of acute diarrhea
will be welcome. Incidentally, Dande is very close to the
border between Angola and DR Congo. Cholera is on the way
to be endemic in the DRC, the boundaries between the two countries being
porous, it is likely that these cases of diarrhea are
genuine cases of cholera.

The interactive map HealthMap / ProMED-mail is from Angola
Available at: http://healthmap.org/r/00BZ. - Mod. BM]
......................bm / lmi / sc