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Zamboanga, Philippines: Four die, 16 others ill with unknown illness - leptospirosis identified

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  • #16
    Re: Zamboanga, Philippines: Five die, 20 others ill with unknown illness

    The article ProMED has chosen here is one of the more unusual in this thread as to the symptoms described; I am not sure that this is the correct description.



    Archive Number 20110707.2053
    Published Date 07-JUL-2011
    Subject PRO/EDR> Undiagnosed disease, fatal - Philippines (02): (ZN)

    UNDIAGNOSED DISEASE, FATAL - PHILIPPINES: (02) (ZAMBOANGA DEL NORTE)
    ************************************************** ******************
    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: Tue 5 Jul 2011
    Source: Inquirer News [edited]
    <http://newsinfo.inquirer.net/21500/mystery-disease-afflicts-zamboanga-del-norte-village>


    Mystery disease afflicts Zamboanga del Norte village
    ----------------------------------------------------
    Health officials in Western Mindanao are in a quandary as to what has
    killed at least 4 people and downed more than 2 dozen other people in
    a fishing village in Sibuco, Zamboanga del Norte, since late April
    [2011].

    Dr Aristides Tan, director of the Department of Health in Western
    Mindanao, said they have been searching for answers to the mystery.
    "We are very puzzled. Even our toxicologists are wondering what this
    disease is," he said.

    Tan said laboratory samples from the victims and the village's
    surroundings had been gathered and sent to Manila for analysis.

    Dr Romeo Ong, director of the Zamboanga City Medical Center where at
    least 16 residents of Mantebo village have been admitted since May
    [2011], said they were expecting the results from Manila to come in
    next week [week of 11 Jul 2011].

    Ong said the patients showed the same symptoms, such as coughing,
    fever, and mild paralysis of the lower body.

    Those who succumbed to the mysterious illness died within a short
    period after being hospitalized, Sibuco health chief Derileen Edding
    said. She cited the case of a 23 year old victim who died 18 hours
    after being hospitalized on 11 Jun 2011.

    "All the patients, according to their relatives, complained of cough,
    fever, then numbness of the lower parts of their bodies," Edding said.
    "The illness progresses so fast."

    Tan said they had initially suspected, based on the symptoms
    manifested by the patients, that it the ailment could have been caused
    by be some kind of marine toxin.

    But then the manifestations were also symptoms of heavy metal
    poisoning and Guillain-Barre syndrome. The latter is a serious
    disorder that occurs when the body's immune system attacks parts of
    the nervous system. This would result in nerve inflammation and causes
    muscle weakness, Tan said.

    "That is why we need to determine first what is causing the problem
    so we can address it," Tan said, adding that the samples extracted
    from patients for laboratory analysis included spinal fluids.

    Sibuco mayor Norbideiri Edding said health experts were expected to
    go to Mantebo on 7 Jul 2011 to conduct further investigation. He said
    the local government was informed that at least 20 more patients were
    being treated by relatives at home.

    Mantebo is a remote village in Sibuco and residents travel by sea
    because the road that leads to it from the town's center was so
    dilapidated nobody uses it.

    [byline: Julie S Alipala]

    --
    communicated by:
    HealthMap Alerts via ProMED-mail
    <promed@promedmail.org>

    [This mysterious disease seems not to have abated, so it is likely
    that the source has not been identified. However, this article gives
    us little information aside from a few additional clinical signs. We
    know it produces fever, coughing, and numbness in the lower portion of
    the body.

    In the previous positing I suggested cassava root as a toxic cause.
    However, I do not know of cassava root causing fever and coughing.
    Lathyrus poisoning also comes to mind but likewise, I do not know of
    it causing fever and coughing.

    It would be useful to have a description of which foods had been
    consumed, what the quality of the water is, to receive some
    inforamtion about the sources of the food and water. We hope to have
    some results soon. - Mod.TG

    The HealthMap/ProMED-mail interactive map of the Philippines can be
    seen at <http://healthmap.org/r/10XR>. - Sr.Tech.Ed.MJ]

    Comment


    • #17
      Re: Zamboanga, Philippines: Five die, 20 others ill with unknown illness

      This appears to be an official release from the government, and suspects a marine toxin (and contains the lower case counts).



      Filipino to English translation

      PIA Press Release
      Friday, July 08, 2011
      Cebuano News: reportedly victims of marine toxin poisoning in Sibuco, escaped to the hospital
      by Alfonso T. Ruda

      Dipolog City, July 8 (PIA) - escaped the hospital residents in the village Mantibo, Sibuco, Zamboanga del Norte that reportedly brought to the hospital early wealth from the marine toxin poisoning.


      In the interview to Sibuco Municipal Health Officer, that Dr. Derileen edding, he said that aside from the 1 you just victim remains in hospital should be made wealth from other examinations, which escaped from the Zamboanga City Medical Center 15 victims in the hospital that first brought wealth from the alleged marine toxin poisoning.


      The 15 residents Mantibo, today kasamtangan nanimuyo the house of captain Mantibo in Labuan, Zamboanga City while still expected results was made a laboratory test water samples from Mantibo and sample the fish sent to kaulohang-Manila.


      National and yet Dr.. Edding, yet they are waiting on laboratory test results to masuta mitakboy that the cause of sickness to the victims.


      Love it, knowing that 4 You are resident in the village Mantibo died last month from May wealth from non-sensible sickness.


      Gireklamo the victims pagpanguhubag their feet, loss of appetite and vomiting, food and vomit.


      Following this, gimando of Zamboanga del Norte Provincial Health Officer, Dr. Eduardo Luayon delivering and medical teams in the area to probe the status of residents in nasangpit barangays.


      The village Mantibo was a coastal village in the city Sibuco in the third district of the province that reach only by pumpboat within an hour if not maot timing. (JPA/ATR/PIA9-Zambo Norte)

      Comment


      • #18
        Re: Zamboanga, Philippines: Four die, 16 others ill with unknown illness - marine toxin suspected

        Two new clues here. First, although the onset dates seem to be scattered over the past three months (at least according to some reports), all the hospitalizations occurred at the same time. Secondly, all surviving cases have been discharged.



        Victims of mystery illness remain in city awaiting test results
        Wednesday, 13 July 2011 12:22

        The Zamboanga City Medical Center (ZCMC) already discharged on Wednesday the 16 patients afflicted with a mysterious illness from Sibuco, Zamboanga del Norte.

        ZCMC Information Officer, Dra. Maribel Felisario confirmed that the 16 patients, composed of four females and 12 males, were discharged from the hospital already in good condition.

        Some of the patients according to Felisario are staying in Barangay Labuan awaiting for their test results.

        Four of the patients were admitted at ZCMC last June 28 while the other 12 were admitted last June 29.

        The patients complained of weakness, numbness and tingling sensation in the feet and difficulty in standing and walking.

        Felisario assured that they will reveal the result of the tests, as well as the official diagnoses, once all the test results and the investigation results come out.

        Some of the tests were done at the Department of Health (DOH) Research Institute for Tropical Medicine (RITM), UP Marine Science Laboratory and Chempro Laboratory.

        According to Felisario, the DOH National Epidemiology Center already sent a team of doctors to Zamboanga del Norte to look into the matter.

        As of now, the type of illness that hit the 16 patients remains to be a mystery.

        Comment


        • #19
          Re: Zamboanga, Philippines: Four die, 16 others ill with unknown illness - marine toxin suspected

          ?Mystery? disease in Zamboanga del Norte identified as leptospirosis
          By Jocelyn R. Uy
          Philippine Daily Inquirer
          6:45 pm | Friday, July 15th, 2011 0shareNew 0MANILA, Philippines?Health officials have finally identified what was earlier thought to be a mysterious disease that killed at least four people in a fishing village in Sibuco, Zamboanga del Norte over the last few months.

          In a press conference Friday, Health Secretary Enrique Ona announced that it was a ?variant of leptospirosis,? which had symptoms different from those normally associated with the disease.

          Most of the patients stricken ill by the supposed ?mysterious disease? showed symptoms of coughing, fever, blurring of vision, headache, stomach pains and mild paralysis of the lower extremities.

          The usual symptoms of leptospirosis, commonly transmitted to humans from water contaminated by animal urine, include fever, chills and intense headache.

          In extreme cases, complications like meningitis, renal failure and respiratory distress may arise and lead to death, according to the Department of Health.

          The Research Institute for Topical Medicine on Friday confirmed that at least 10 blood samples taken from the patients afflicted by the so-called mystery disease were positive for leptospirosis, said Assistant Health Secretary Dr. Eric Tayag, also head of the National Epidemiology Center.

          ?So it?s not a mystery anymore,? Tayag told reporters after receiving a call from the RITM on Friday.

          Preliminary reports reaching the DOH showed that the fishing village had experienced regular rains over the past few months, which could have possibly caused the spread of leptospirosis in the area, said Tayag.

          ?There are also many animals, including rats, in the area, which explains why there were residents infected by leptospirosis,? added the health official.

          Health officials have finally identified what was earlier thought to be a mysterious disease that killed at least four people in a fishing village in Sibuco, Zamboanga del Norte over the last few months.
          Twitter: @RonanKelly13
          The views expressed are mine alone and do not represent the views of my employer or any other person or organization.

          Comment


          • #20
            Re: Zamboanga, Philippines: Four die, 16 others ill with unknown illness - leptospirosis identified



            New cases of Lepto confirmed By JENNY F. MANONGDOJuly 15, 2011, 6:50pmMANILA, Philippines ? Health authorities Friday confirmed that Leptospirosis caused the deaths of four people and hospitalization of 16 others in Barangay Mantibo in Sibuco, Zamboanga City.

            Based on laboratory results from the Research Institute for Tropical Medicine (RITM), 10 out of the 20 patients were inflicted with Leptospirosis, a disease transmitted through water contaminated by animal urine, usually from rats. It can be ingested through contaminated food and water or through floodwater.

            Earlier, authorities were puzzled about the cause of disease that started affecting the residents since May. Chemical and marine products poisoning were earlier thought to have caused the sickness and deaths of the affected residents. Specimens were gathered from the residents and were sent to RITM for laboratory testing.

            ?Laboratory tests showed they are negative for arsenic, lead and mercury? There were three people who were positive for mercury but they are on safe levels, so it is not mercury poisoning,? DoH Assistant Secretary Dr. Eric Tayag said.

            Doctors also noted that the patients manifested symptoms that were unusual from the common symptoms seen among Leptospirosis such as fever, chills and intense headache.

            ?The presentation of patients was mostly neurological, they became paralyzed and their lower extremities became numb and they also suffered from stomach pain,? DoH Secretary Enrique T. Ona said.

            The patients were also suspected to have suffered from vitamin B1 deficiency or Beri Beri due to their diet which is mostly seafood.

            According to Tayag, local authorities reported heavy rains in Simbuco recently. ?There are many animals in the area including rats.?

            According to experts, the Leptospira bacteria can enter a person?s body through the eyes and nose and through breaks in the skin.

            .

            Comment


            • #21
              Re: Zamboanga, Philippines: Four die, 16 others ill with unknown illness - leptospirosis identified

              I have to admit, I would have never guessed this one....



              DOH: Killer 'mystery disease' in Zambo was leptospirosisCANDICE MONTENEGRO, GMA News
              07/15/2011 | 02:24 PM


              The Department of Health (DOH) confirmed on Friday that leptospirosis was the "mystery disease" that downed at least 20 people and killed four others in Sibuco town, Zamboanga del Norte last week.

              In a press briefing, DOH Assistant Secretary Dr. Eric Tayag said a team from the the Research Institute for Tropical Medicine (RITM) traveled to Sibuco town to determine the cause of the illness.

              Last week, health officials from Western Mindanao could not figure out the cause of the illness that plagued the fishing town of Sibuco.

              Tayag said residents of Sibuco reportedly experienced bloating and numbness, which health officials initially thought was caused by either chemical poisoning or vitamin deficiency.

              After examinations by RITM, the DOH confirmed that the "mystery disease" was leptospirosis.

              Tayag noted that the DOH found out that it has been raining in Sibuco the past weeks and that there are animals living in the area.

              Not the usual symptoms

              Tayag said the health department did not initially diagnose it a leptospirosis because the patients' initial symptoms were not the usual characteristics of leptospirosis.

              The usual symptoms of leptospirosis are high-grade fever, muscle pain and nausea.

              Leptospirosis is a bacterial infection usually found in water, vegetation or moist soil contaminated with animal urine, especially rat urine.

              Treatable disease

              Tayag said leptospirosis is treatable when detected early, but it can lead to organ failure and even death if one does not seek medical help immediately.

              "'Pag kayo ay nagtampisaw sa basang bahagi ng lupa, tubig-baha at may sugat (kayo) sa binti, tapos may karamdaman na may kinalaman sa pananakit ng kasukasuhan at lagnat ay mag-suspetya na kayo na baka leptospirosis 'yan," he said.

              However, Tayag also said that symptoms of leptospirosis can manifest in other ways, as in the case of the patients in Sibuco, Zamboanga del Norte.

              He said the safest thing to do is to seek medical attention if a person is not feeling well after being exposed to flood water.

              DOH data show that 521 cases of leptospirosis were reported nationwide between January and May 2011, and the health department expects the number of cases to rise during the rainy season.

              People are advised not to swim or wade in flood water, or to use proper protection like boots and gloves when required to wade in flood water.

              The DOH also advised the public to rain flood water, and control rats in the household by maintaining cleanliness in the house and by using traps. - VVP, GMA News

              Comment


              • #22
                Re: Zamboanga, Philippines: Four die, 16 others ill with unknown illness - leptospirosis identified

                And one more from a government source.



                PIA Press Release
                Monday, July 18, 2011


                DOH: Zambo 'mystery disease' was leptospirosis

                MANILA, July 18 (PIA) -- The Department of Health (DOH) confirmed over the weekend that leptospirosis was the "mystery disease" that downed at least 20 people and killed four others in Sibuco town, Zamboanga del Norte last week.


                According to DOH Assistant Secretary Dr. Eric Tayag, a team from the Research Institute for Tropical Medicine (RITM), who traveled to Sibuco town to determine the cause of the illness, conducted some tests in the area and found out that the "mystery disease" was leptospirosis.


                Tayag said residents of Sibuco reportedly experienced bloating and numbness, which health officials initially thought was caused by either vitamin deficiency or chemical poisoning.


                Tayag said the DOH discovered that it has been raining in Sibuco earlier, and that there were rats found in the area. (DOH/RJB/JCP-PIA NCR)

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