Published Date: 2018-01-10 18:27:48
Subject: PRO/EDR> Scabies - Liberia: susp., RFI
Archive Number: 20180110.5550277
SCABIES - LIBERIA: SUSPECTED, REQUEST FOR INFORMATION,
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A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
Date: Mon 8 Jan 2018
Source: Front Page Africa [edited]
A rare skin disease appears to be causing panic amongst many Liberians after over 600 people were diagnosed infected. The disease appears like heat-bumps on the surface of the skin of patients and causes severe itching. It has been almost a month since it was first diagnosed in the country, according to the national public health institute of Liberia (NPHIL).
"The scratching thing here is a serious business (problem), so it is call "Be serious" but some people call it 'Ebola fanfan', because it comes on your skin like heat bumps, but when you starch it, it turns to sore," explains Pandora Hare, a resident of God Bless You community located near the Ministry of Foreign Affairs in Monrovia. Mrs. Hare is infected with the disease and uses hair comb and hard brush to scratch her skin in order to ease the itching reaction. "I was using a comb to scratch it before it satisfied me because when it is really itching, your fingers cannot scratch well enough and when you use the comb or brush to scratch it, you can go off and forget about yourself altogether," she said. The itching irritation embarrasses patients most especially when you are among other people, she said.
NPHIL has launched an investigation to map the "burden of concerns" in affected communities across the country. Currently, surveillance officers are investigating more cases, it says. Last month [December 2017], they reported 631 cases from four counties. Rivercess County has reported 315 cases, Margibi County, 185 cases, 16 from Bong County and 115 from Montserrado counties.
District surveillance officers alerted NPHIL about the increasing cases of the rare skin disease in early December 2017 after it began spreading and affected more people.
Dr. Ralph Jetoh, deputy director of the division of infectious disease and epidemiology at NPHIL, says earlier signs and symptoms of the disease pointed to scabies but lab results proved negative. "So far we've done a concept note; we've sent case investigators in the field to actually try to identify the case and also try to do mapping," he said. "There's actually community-to-community mapping going on to determine w the burden of those retches."
Dr. Jetoh described the disease as "contagious" and said it has the "symptoms of a viral infection," although he could [not] say the cause or name of the disease.
There has been no mortality, he said, but the public health concern of the situation now points to discrimination of affected people. The disease causes uncontrollable itching on the skins of its patients, and constrains them to keep scratching the surface of their skin even in the public.
"You will scratch for over a month because it lasts on you for over a month. It can itch and burn at the same time. When it is itching, you cannot think straight and anything you lay your hands on, you will use it. I went to the extent of using baboon oilmen, temple of heaven (balm) and other burning lotions," said Hare.
"When I went to the clinic, the doctor said it was not in my blood but he prescribed that I take some antibiotics for over a month."
Investigation to improve preventive care based on support from the Ministry of Health is ongoing in order to manage the number of cases so far, he added. The disease is not a public health situation, but it remains a concern because of its mode of transmission, "mainly skin to skin, clothes you are wearing or towel you share with others."
Joyce Cooper, another resident of Monrovia and her 2 daughters, is ashamed and embarrassed by the skin infection. "I do not know how it was given the name, but I can attest that when you are scratching it, you can really be serious. It is so enjoyable and painful at the same time, that you won't notice it when you are on the street among people and start scratching," she said, adding that the disease also affects patients' genitals.
More than 170 patients have reportedly recovered from the skin disease in Rivercess County after they were treated with skin ointments, according to the NPHIL. But there is now shortage of required treatments to provide first response to infected patients across the country.
Misinformation is already spreading about the disease as some people describe it as 'Ebola fanfan'. They claim it is an aftermath of the Ebola virus. Dr. Jetoh refuted the rumor linking the skin infection to Ebola and said it is now a challenge to dispel the rumor, adding, "I don't want to compare a rash related situation with a very violent hemorrhagic disease."
"First to determine a crisis you must have what we call an outbreak threshold; you don't want to say it's an outbreak but the good thing about it is there's no lost lives. We are very concerned about the stigmatization that it brings amongst our citizens especially people of school going ages," he said.
Health promotional messages are being prepared to inform the public about the skin disease while further investigation about the infection continuous, he said.
[Byline: Alpha Daffae Senkpeni and Mae Azango]
--
Communicated by:
ProMED-mail
[We agree with Dr. Ralph Jetoh, deputy director of the division of infectious disease and epidemiology at NPHIL and cited in the text, that the symptoms strongly points to scabies even though the tests -so far- have been negative. The intense itching, the affection of the genital area is compatible with scabies and it would be interesting to know if scabies treatment improves the condition.
Scabies can be treated with ivermectin, and Liberia is endemic for onchocerciasis which is controlled by bi-annually ivermectin administration so ivermectin should be available in the country.
It is highly unlikely that the condition has anything to do with the Ebola outbreak, but if scabies is ruled out it should be investigated.
The highly contagious nature seems to rule out other infectious itching skin conditions in particular onchocerciasis. ProMED will be happy to post further information. - Mod.EP
Subject: PRO/EDR> Scabies - Liberia: susp., RFI
Archive Number: 20180110.5550277
SCABIES - LIBERIA: SUSPECTED, REQUEST FOR INFORMATION,
************************************************** *****
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
Date: Mon 8 Jan 2018
Source: Front Page Africa [edited]
A rare skin disease appears to be causing panic amongst many Liberians after over 600 people were diagnosed infected. The disease appears like heat-bumps on the surface of the skin of patients and causes severe itching. It has been almost a month since it was first diagnosed in the country, according to the national public health institute of Liberia (NPHIL).
"The scratching thing here is a serious business (problem), so it is call "Be serious" but some people call it 'Ebola fanfan', because it comes on your skin like heat bumps, but when you starch it, it turns to sore," explains Pandora Hare, a resident of God Bless You community located near the Ministry of Foreign Affairs in Monrovia. Mrs. Hare is infected with the disease and uses hair comb and hard brush to scratch her skin in order to ease the itching reaction. "I was using a comb to scratch it before it satisfied me because when it is really itching, your fingers cannot scratch well enough and when you use the comb or brush to scratch it, you can go off and forget about yourself altogether," she said. The itching irritation embarrasses patients most especially when you are among other people, she said.
NPHIL has launched an investigation to map the "burden of concerns" in affected communities across the country. Currently, surveillance officers are investigating more cases, it says. Last month [December 2017], they reported 631 cases from four counties. Rivercess County has reported 315 cases, Margibi County, 185 cases, 16 from Bong County and 115 from Montserrado counties.
District surveillance officers alerted NPHIL about the increasing cases of the rare skin disease in early December 2017 after it began spreading and affected more people.
Dr. Ralph Jetoh, deputy director of the division of infectious disease and epidemiology at NPHIL, says earlier signs and symptoms of the disease pointed to scabies but lab results proved negative. "So far we've done a concept note; we've sent case investigators in the field to actually try to identify the case and also try to do mapping," he said. "There's actually community-to-community mapping going on to determine w the burden of those retches."
Dr. Jetoh described the disease as "contagious" and said it has the "symptoms of a viral infection," although he could [not] say the cause or name of the disease.
There has been no mortality, he said, but the public health concern of the situation now points to discrimination of affected people. The disease causes uncontrollable itching on the skins of its patients, and constrains them to keep scratching the surface of their skin even in the public.
"You will scratch for over a month because it lasts on you for over a month. It can itch and burn at the same time. When it is itching, you cannot think straight and anything you lay your hands on, you will use it. I went to the extent of using baboon oilmen, temple of heaven (balm) and other burning lotions," said Hare.
"When I went to the clinic, the doctor said it was not in my blood but he prescribed that I take some antibiotics for over a month."
Investigation to improve preventive care based on support from the Ministry of Health is ongoing in order to manage the number of cases so far, he added. The disease is not a public health situation, but it remains a concern because of its mode of transmission, "mainly skin to skin, clothes you are wearing or towel you share with others."
Joyce Cooper, another resident of Monrovia and her 2 daughters, is ashamed and embarrassed by the skin infection. "I do not know how it was given the name, but I can attest that when you are scratching it, you can really be serious. It is so enjoyable and painful at the same time, that you won't notice it when you are on the street among people and start scratching," she said, adding that the disease also affects patients' genitals.
More than 170 patients have reportedly recovered from the skin disease in Rivercess County after they were treated with skin ointments, according to the NPHIL. But there is now shortage of required treatments to provide first response to infected patients across the country.
Misinformation is already spreading about the disease as some people describe it as 'Ebola fanfan'. They claim it is an aftermath of the Ebola virus. Dr. Jetoh refuted the rumor linking the skin infection to Ebola and said it is now a challenge to dispel the rumor, adding, "I don't want to compare a rash related situation with a very violent hemorrhagic disease."
"First to determine a crisis you must have what we call an outbreak threshold; you don't want to say it's an outbreak but the good thing about it is there's no lost lives. We are very concerned about the stigmatization that it brings amongst our citizens especially people of school going ages," he said.
Health promotional messages are being prepared to inform the public about the skin disease while further investigation about the infection continuous, he said.
[Byline: Alpha Daffae Senkpeni and Mae Azango]
--
Communicated by:
ProMED-mail
[We agree with Dr. Ralph Jetoh, deputy director of the division of infectious disease and epidemiology at NPHIL and cited in the text, that the symptoms strongly points to scabies even though the tests -so far- have been negative. The intense itching, the affection of the genital area is compatible with scabies and it would be interesting to know if scabies treatment improves the condition.
Scabies can be treated with ivermectin, and Liberia is endemic for onchocerciasis which is controlled by bi-annually ivermectin administration so ivermectin should be available in the country.
It is highly unlikely that the condition has anything to do with the Ebola outbreak, but if scabies is ruled out it should be investigated.
The highly contagious nature seems to rule out other infectious itching skin conditions in particular onchocerciasis. ProMED will be happy to post further information. - Mod.EP
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