Seven babies die in Annaba in several months after being infected by a virus

[alert]

Re: Seven babies die in Annaba after being infected by a contagious flu virus

One other possibility worth mentioning, in light of the mention of seasonal virus, also in light of the large number of "milder cases": RSV. There are many threads here on FT (http://www.flutrackers.com/forum/sho...d.php?p=342642, for example) indicating that RSV can be much more severe in infants, which would explain the pattern in this outbreak,

[Gert van der Hoek]

Re: Seven babies die in Annaba after being infected by a contagious flu virus

INFLUENZA VIRUS, INFANT DEATHS - ALGERIA: (ANNABA) REQUEST FOR INFORMATION
*************************************************


Date: Tue 16 Mar 2010
Source: Tout sur l'Algerie (TSA) [in French, trans. Mod.SC]

http://www.tsa-algerie.com/divers/sept-bebes-decedent-a-annaba-apres_9918.html

A total of 7 babies have died in the last 48 hours after being
infected by a contagious flu [virus] in a pediatric hospital in El
Bouni, in the province of Annaba.

This flu, which practitioners have diagnosed as severe bronchiolitis,
was detected shortly after the hospitalization of a baby from Tebessa
province. Mainly concentrated in the EHS [hospital for maternal and
child health] of El Bouni, which covers the provinces of Annaba,
Guelma, Tarf, Souk Ahras, and Tebessa, this contagious disease has
affected all hospitalized babies and those brought by their mothers
for ambulatory care.

The information, which spread rapidly, has upset the people of Annaba
and the neighboring provinces. Mestouri Monji, director of Health,
Population and Hospital Reform in Annaba, while avoiding mention of
an epidemic, confirmed that several babies had acute bronchiolitis
and that 7 of them had died.

"All steps have been taken to prevent this contagious disease from
spreading outside the walls of EHS hospital," he said. Early Tuesday
evening [16 Mar 2010], the condition of 2 other babies infected by
the same virus aroused strong concern. Specialized disinfection teams
are on site at the EHS.

[Byline: Samir Rahim]

--
Communicated by:
Sharon Saunders
Editor-In-Chief, FluTrackers
ftcom@embarqmail.com


[This report does not indicate if the virus responsible for these
infant deaths was A/H5N1, A/H1N1, or some other seasonal influenza
virus. [In fact the term "flu" may have been used loosely and the
illness may not be related to influenza virus at all. - Mod.DK]. The
WHO report of 15 Jan 2010 (cited in ProMED-Mail archive no.
20100119.0221) stated that, "In North Africa, limited data suggest
that transmission of pandemic influenza virus [A/H1N1] remains active
throughout the region, particularly in Morocco, Algeria, and Egypt."
The number of infant fatalities seems high, but denominator numbers
are not provided. Nor is there any information about contact with
sick or dead poultry that would suggest infection by the more serious
A/H5N1 virus.

ProMED would appreciate receiving additional information concerning
the specific virus involved in these cases.

The provinces mentioned are all in the northeastern corner of Algeria
and can be located on the map at
http://www.lib.utexas.edu/maps/afric...ia_admin01.jpg.
A HealthMap/ProMED-mail interactive map of Algeria can be accessed at
http://healthmap.org/r/01aI. - Mod.TY]

[see also:
Influenza pandemic (H1N1) (09): WHO update 20100119.0221]
...................................dk/sc/mj/ty/mj/dk

http://www.promedmail.org/pls/otn/f?p=2400:1001:3123859965839098::NO::F2400_P1001_BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,81803

[alert]

Re: Seven babies die in Annaba after being infected by a contagious flu virus

http://www.lesoirdalgerie.com/articles/2010/03/18/article.php?sid=97241&cid=2

Six infant deaths were registered during the period from 1 to March 15 stream at the hospital specialist (EHS) of the mother and child of El Bouni, in the wilaya of Annaba. Ces décès ont été à l'origine d'une véritable psychose au sein des familles des enfants hospitalisés. The deaths were originally a real psychosis in families of hospitalized children.
Et pour cause, la rumeur sur la place publique à Annaba a lié ces décès à une grave épidémie de bronchiolite. And because the rumor on the public square in Annaba linked those deaths to a serious outbreak of bronchiolitis. Pour avoir de plus amples informations à ce sujet, nous nous sommes rendus sur place où nous avons pris attache avec le docteur Boukertouta, chef du service de pédiatrie de cet EHS. For more information about this, we went on site where we have taken places with Dr. Boukertouta, Chief of Pediatrics at the EHS. Cette dernière, qui nous confirmera les six décès, nous expliquera que parmi ceux-ci, trois seulement sont dus à des complications liées à la bronchiolite, alors que les trois autres présentaient d'autres complications sous-jacentes à cette pathologie (problèmes cardiovasculaires et anémie aiguë sévère.) Elle nous apprendra que durant les 15 premiers jours de ce mois de mars, son service a effectué 2 776 consultations dont 170 pour des infections respiratoires aiguës (IRA basse). The latter, which we confirm six fatalities, we explain that among these, only three are due to complications related to bronchiolitis, while the other three had other underlying complications to this disease (cardiovascular and Severe acute anemia.) It will tell us that during the first 15 days of the month of March, his department has made 2 776 consultations including 170 for acute respiratory infections (ARI bass). Sur les 39 cas, toutes causes confondues, ayant nécessité une hospitalisation, on a dénombré 26 cas IRA basse. Of the 39 cases, all causes requiring hospitalization, there were 26 cases lower IRA. La totalité de ces cas est prise actuellement en charge par ce service. All of these cases is being taken over by this service. «En période automno-hivernale, on enregistre des épidémies IRA qui sont dues essentiellement à des infections virales, notamment des VRS (virus respiratoire synticial). "In automno-winter period, we recorded epidemics IRA are mainly due to viral infections, including RSV (respiratory virus synticial). Cette année, il ya eu plus de cas que lors des années précédentes», nous fera savoir le docteur Boukertouta qui tient à tranquilliser les familles des enfants hospitalisés en nous affirmant qu'il n'ya pas lieu de s'inquiéter «la situation est loin d'être alarmante », affirmera-t-elle. This year, there were more cases than in previous years, we will inform the doctor Boukertouta who wishes to reassure the families of children hospitalized in us saying that there is no need to worry about "the situation is far from being alarming, "says she.
A. A. Bouacha Bouacha

[Shannon Bennett]

Re: Seven babies die in Annaba after being infected by a contagious flu virus

Does anyone know if the infected babies were already in hospital for another reason? Or, did they became infected outside the hospital? I am not sure if I am reading this right. I think there are both infants with prior health problems already admitted and babies that got sick outside the hospital. Anyone else able to figure this out?

[alert]

Re: Seven babies die in Annaba after being infected by a contagious flu virus

I don't think this is spreading within the hospital; otherwise mothers and HCW would be taking ill too (unless this really is something like RSV that would be much milder in adults). I think these babies are being admitted with respiratory illness, despite what the first article seemd to indicate. That said, I think bacterial contamination within the hospital itself might be a contributing factor.

The ProMED post does explain that an "EHS" is apparently a hospital for maternal and infant health, which might explain the age distribution - only infants are treated in such a hospital.

There do seem to be three different time frames for this event: 48 hours, 15 days, eight months. The first one of the three is almost certainly wrong.

[Gert van der Hoek]

Re: Seven babies die in Annaba after being infected by a contagious flu virus

google translation

Thursday, March 18, 2010)

The Department of Health rejects the possibility of an epidemic

7 children died of acute bronchiolitis el Bouna (Annaba)


The persistent rumor of the deaths between Sunday and Tuesday from 7 infants following a
infection with influenza virus in the service of pediatric specialty hospital in El-Bouni
(Annaba), was partly contradicted yesterday by the local Department of Health.

The head of the health sector confirms that if, indeed, seven babies died
Following an affection for acute bronchiolitis, these deaths were recorded during a period of
eight months, between July 2009 and March instant, and not this week as reported by the vox
populi. Without diminishing the gravity of the situation found,
Mr. Monji Mestouri refuses to speak of an epidemic and ensure that practitioners who diagnosed this
form of bronchiolitis in small patients were done whenever necessary to save their lives.

Mr. Mestouri explain that "EHS El-Bouni, including his service pediatrics, has a radiation
Strategic wilayas at least five of the Far East Algeria and that sometimes babies from
Souk Ahras, Guelma, Tebessa and El-Tarf for outpatient treatment and admitted in emergency
are suffering from viral diseases.

These patients are cared for under conditions
particularly serious to avoid precisely that there is any spread of the disease. The
Director of Health is categorical in stating that at no time was there any question of early
Epidemic of bronchiolitis in Annaba or mentioned in wilaya.

http://www.liberte-algerie.com/edit....ouni%20(annaba)

[alert]

Re: Seven babies die in Annaba after being infected by a contagious flu virus

Consider this entire article bold and red. This fits the description of what we are seeing here PERFECTLY. And post #18 above seems to indicate that RSV may actually have been detected.

http://www.nlm.nih.gov/medlineplus/ency/article/000975.htm

Bronchiolitis
MedlinePlus Topics
Bronchitis
Images

Bronchiolitis

Causes
Bronchiolitis usually affects children under the age of 2, with a peak age of 3 - 6 months. It is a common, and sometimes severe illness. Respiratory syncytial virus (RSV) is the most common cause. Other viruses that can cause bronchiolitis include:

Adenovirus
Influenza
Parainfluenza
The virus is transmitted from person to person by direct contact with nasal fluids, or by airborne droplets. Although RSV generally causes only mild symptoms in an adult, it can cause severe illness in an infant.

Bronchiolitis is seasonal and appears more often in the fall and winter months. It is a very common reason for infants to be hospitalized during winter and early spring. It is estimated that by their first year, more than half of all infants have been exposed to RSV.

Risk factors include:

Exposure to cigarette smoke
Age younger than 6 months old
Living in crowded conditions
Lack of breast-feeding
Prematurity (being born before 37 weeks gestation)
Symptoms
Some children have infections with few or minor symptoms.

Bronchiolitis begins as a mild upper respiratory infection. Over a period of 2 - 3 days, it can develop into increasing respiratory distress with wheezing and a "tight" wheezy cough.

The infant's breathing rate may increase (tachypnea), and the infant may become irritable or anxious-looking. If the disease is severe enough, the infant may turn bluish (cyanotic), which is an emergency.

As the effort of breathing increases, parents may see the child's nostrils flaring with each breath and the muscles between the ribs retracting (intercostal retractions) as the child tries to breathe in air. This can be exhausting for the child, and very young infants may become so tired that they have difficulty maintaining breathing.

Symptoms include:

Bluish skin due to lack of oxygen (cyanosis)
Cough, wheezing, shortness of breath, or difficulty breathing
Fever
Intercostal retractions
Nasal flaring in infants
Rapid breathing (tachypnea)
Exams and Tests
Signs include:

Decreased blood oxygen
Wheezing and crackling sounds heard through stethoscope exam of chest
Tests include:

Blood gases
Chest x-ray
Nasal fluid cultures (to determine which virus is present)
Treatment
Sometimes, no treatment is necessary.

Supportive therapy can include:

Chest clapping
Drinking enough fluids. Breast milk or formula are okay for children younger than 12 months. Offer warm lemonade or apple juice if your child is over 4 months.
Breathing moist (wet) air helps loosen the sticky mucus that may be choking your child. You can use a humidifier to moisten the air your child is breathing. Follow the directions that come with the humidifier.
Getting plenty of rest
Do not let anyone smoke in the house, car, or anywhere near your child.
Antibiotics are not effective against viral infections. Most medications have little effect on bronchiolitis. Children in the hospital may need oxygen therapy and fluids given through a vein (IV) to stay hydrated.

In extremely ill children, antiviral medications (such as ribavirin) are used in rare cases.

Outlook (Prognosis)
Usually, the symptoms get better within a week, and breathing difficulty usually improves by the third day. The mortality rate is less than 1%.

Possible Complications
Airway disease, including asthma, later in life
Respiratory failure
Additional infection, such as pneumonia
When to Contact a Medical Professional
Call your health care provider immediately, or go to the emergency room if the child with bronchiolitis:

Becomes lethargic
Develops a bluish color in the skin, nails, or lips
Develops rapid, shallow breathing
Has a cold that suddenly worsens
Has difficulty breathing
Flares nostrils or retracts chest muscles in an effort to breathe
Prevention
Most cases of bronchiolitis are not easily preventable because the viruses that cause the disorder are common in the environment. Careful attention to hand washing, especially around infants, can help prevent the spread of respiratory viruses.

Family members with an upper respiratory infection should be especially careful around infants. Wash your hands often, especially before handling the child.

At this date, there is no RSV vaccine available. However, there is an effective product, called palivizumab (Synagis), for infants who are at high risk of developing severe disease from RSV. Ask your child's doctor whether this medication is right for your child.

References
Watts KD, Goodman DM. Wheezing, bronchiolitis, and bronchitis. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 388.

American Academy of Pediatrics Subcommittee on the Diagnosis and Management of Bronchiolitis. Diagnosis and management of bronchiolitis. Pediatrics. 2006;118:1774-1793.

Update Date: 11/2/2009
Updated by: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

[Ronan Kelly]

Re: Seven babies die in Annaba after being infected by a contagious flu virus

A post purportedly by Dr Ghamri, President of the medical council at el-Bouni on annabacity.net located here:

http://www.annabacity.net/news/breve_5912_annaba+direction+sante+ecarte+leventualite+dune+epidemie+.html?PHPSESSID=3b84b1cbd3305cfced3c5ddca018e269

suggests six fatalities spread over a number of months due to various diseases.

[alert]

Re: Seven babies die in Annaba after being infected by a contagious flu virus

A post purportedly by Dr Ghamri, President of the medical council at el-Bouni on annabacity.net located here:

http://www.annabacity.net/news/breve_5912_annaba+direction+sante+ecarte+leventualite+dune+epidemie+.html?PHPSESSID=3b84b1cbd3305cfced3c5ddca018e269

suggests six fatalities spread over a number of months due to various diseases.

Excellent find, RoRo!!! He also noted that several of the deceased babies had co-morbid conditions (possibly the severe anemia mentioned elsewhere in this thread). He also mentions that the hospital has handled over 3,000 pediatric cases in the past 15 days (which would greatly reduce the apparent CFR).

I still think a lot of this is RSV.

[Ronan Kelly]

Re: Seven babies die in Annaba after being infected by a contagious flu virus

EHS = Etablissements hospitaliers sp?cialis?s

EHS El Bouni de Gyn?cologie

Adresse: ANNABA

T?l?phone: 038 52 28 69 / 21 78

[Pathfinder]

Re: Seven babies die in Annaba after being infected by a contagious flu virus

French to English translation (Google)
<OBJECT class=inlineimg id=tts_object title="Big Grin" codeBase=http://download.macromedia.com/pub/shockwave/cabs/flash/swflash.cab#version=5,0,0,0 height=18 alt="" width=18 data=data:application/x-oleobject;base64,IGkzJfkDzxGP0ACqAGhvEzwhRE9DVFlQR SBIVE1MIFBVQkxJQyAiLS8vVzNDLy9EVEQgSFRNTCA0LjAgVHJ hbnNpdGlvbmFsLy9FTiI+DQo8SFRNTD48SEVBRD4NCjxNRVRBI Gh0dHAtZXF1aXY9Q29udGVudC1UeXBlIGNvbnRlbnQ9InRleHQ vaHRtbDsgY2hhcnNldD13aW5kb3dzLTEyNTIiPjwvSEVBRD4NC jxCT0RZPg0KPFA+Jm5ic3A7PC9QPjwvQk9EWT48L0hUTUw+DQo = border=0 classid="clsid</OBJECT>
Death of 7 babies in El Bouni (Annaba): Minister confirms sending inspectors to investigate

19 March 2010 10:00:00 Souhila H.

Following the death of 7 babies in 48 hours at the EHS El Bouni in the wilaya of Annaba, the Minister of Health has confirmed the sending of a commission of inquiry.

"Since this morning (all day Thursday), experts and inspectors are on site to conduct an investigation and explain what happened," says Barkat.

http://www.horizons-dz.com/actualite/8319.html

[alert]

Re: Six babies die in Annaba of various illnesses

This article was published on the 23rd (and we missed it). Seeing as it explicitly rejects the fifteen day version, agrees with RoRo's post from the doctor on teh 18th above, and the story went silent, I would take this as the final word on this outbreak (and might change the thread title as in this post).

http://translate.googleusercontent.com/translate_c?hl=en&sl=fr&u=http://www.elwatan.com/Deces-de-bebes-a-l-EHS-El-Bouni-La&prev=/search&#37;3Fq%3D%2522el%2Bbouni%2522%2Bgrippe%26num%3D20%26hl%3Den%26lr%3D%26sa%3DX%26tbo%3Ds%26tbs%3Dqdr:y&rurl=translate.google.com&usg=ALkJrhhHTLkrCluNLuzii4E8Z2ofbOSv2A

Death of baby EHS El Bouni: The thesis of the epidemic is baseless
La th&#232;se de l'&#233;pid&#233;mie, qui serait &#224; l'origine du d&#233;c&#232;s de plusieurs b&#233;b&#233;s &#224; l'h&#244;pital d'El Bouni est, si l'on en croit le milieu m&#233;dical, sans fondement. The thesis of the epidemic, which is causing the deaths of several infants in the hospital of El Bouni is, if one believes the medical community, without foundation.




Le pr&#233;sident du conseil m&#233;dical de l'EHS confirme bien le fait qu'il y ait eu six d&#233;c&#232;s d'enfants en bas &#226;ge, mais ceux-ci s'&#233;talent sur une p&#233;riode de plusieurs mois, contrairement &#224; l'information r&#233;pandue faisant croire que ces d&#233;c&#232;s sont survenus en l'espace de quinze jours. The Chairman of the EHS medical confirms the fact that there were six deaths of young children, but they are spread over a period of several months, contrary to information spread by pretending these deaths occurred in the space of fifteen days. Le Dr Ghamri explique qu'ils sont dus &#224; des pathologies vari&#233;es, particuli&#232;rement graves, le plus souvent chez des nourrissons porteurs d'autres affections morbides, notamment cong&#233;nitales. Dr. Ghamra says they are due to various pathologies, particularly severe, most often in infants holders of other morbid conditions, including congenital.

Il faut savoir aussi que l'unit&#233; des urgences p&#233;diatriques de l'h&#244;pital a enregistr&#233; pas moins de 3 000 consultations en 15 jours, ce qui est une v&#233;ritable performance. He must also know that the pediatric emergency unit of the hospital has recorded no fewer than 3 000 consultations in 15 days, which is a real performance. Le m&#234;me m&#233;decin appelle &#171; &#224; la vigilance devant ce genres de rumeurs et fausses informations &#187;. The same doctor called "vigilance before the kinds of rumors and false information". Celles-ci se sont propag&#233;es &#224; la vitesse de la lumi&#232;re &#224; travers la ville, mais heureusement sans susciter de panique chez les usagers de l'&#233;tablissement hospitalier. They were propagated at the speed of light through the city, but fortunately without causing panic among users of the hospital.