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

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

    Given the mention of fishing, tetrodotoxin might be likely...

    http://www.abs-cbnnews.com/nation/re...s-16-others-ph

    Mystery illness kills 4, downs 16 others in PH
    by Queenie Casimiro, ABS CBN News Zamboanga
    Posted at 07/01/2011 8:10 PM | Updated as of 07/01/2011 8:10 PM


    ZAMBOANGA DEL NORTE, Philippines - Four people died while 16 others were hospitalized in Zamboanga del Norte because of a mysterious illness, health officials said Friday.

    The victims, who all live in Barangay Mantebo, Sibuco town in Zamboanga del Norte, complained of pain and numbness in their lower extremities.

    Pantera Nadjal, one of the patients said she started feeling numbness and a tingling sensation in her feet and legs starting last May.

    "Parang hangin dito sa paa nagsimula tapos umakyat hanggang sa tyan," Nadjal said.

    Fifteen other villagers who experienced the same sysmptoms have been admitted at the Zamboanga City Medical Center (ZCMC).

    Dr. Saibzur Edding, Sibuco hospital chief, said other residents of Mantebo were admitted to the hospital.

    Four have died due to the unidentified infection.

    Edding said there is no mining activity in or near Mantebo. Fishermen also do not use either dynamite or cyanide when fishing.

    Dr. Maribel Felisario, ZCMC information officer, said they sent samples of the patients' urine and blood to the Department of Health in Manila for testing.

    They have also gathered samples from the village including water, fish, and seaweeds that are reportedly part of the patients' diet.

    Felisario said they have encountered similar cases before but "this one is different since the patients come from one area."

  • #2
    Re: Zamboanga, Philippines: Four die, 16 others ill with unknown illness

    Probably not true but numbness starting in the lower extremities does remind me of the forced suicide of Socrates. He took a potion that contained Conium maculatum or poison hemlock.

    Plato describes it as:
    The man...laid his hands on him and after a while examined his feet and legs, then pinched his foot hard and asked if he felt it. He said "No"; then after that, his thighs; and passing upwards in this way he showed us that he was growing cold and rigid. And then again he touched him and said that when it reached his heart, he would be gone. The chill had now reached the region about the groin...

    Does it grow in The Philippines?
    Conium maculatum is native in temperate regions of Europe, West Asia, as well as North Africa. It has been introduced and naturalised in many other areas, including Asia, North America, Australia, and New Zealand.

    Comment


    • #3
      Re: Zamboanga, Philippines: Four die, 16 others ill with unknown illness

      I believe that particular symptom is the result of the destruction of the myelin in the nervous system. There are a wide variety of things that could produce such damage, from infections (such as polio, typhus, and WNV), to auto-immune conditions (such as Guillain-Barre and ODS) to toxins (such as the one you mention).

      The rest of the symptomatic description is too crude to guess which one is in play here, but the lack of fever as a reported symptom tends to suggest something toxic.

      Comment


      • #4
        Re: Zamboanga, Philippines: Four die, 16 others ill with unknown illness

        This is a markedly different description than the original post, indicating swelling, pain, and vomiting, among other symptoms. The above explanations are likely thus incorrect.

        http://www.sunstar.com.ph/zamboanga/...o-norte-164626

        Illness kills 4, downs 19 in Zambo Norte

        By Bong Garcia

        Saturday, July 2, 2011

        ZAMBOANGA CITY -- Health authorities are baffled by an unknown sickness that hit a coastal village in Zamboanga del Norte province that has already killed four people and hospitalized 19 others.


        The 19 people are all residents of Mantibo village in Sibuco town and are admitted at the Zamboanga City Medical Center.

        The 19 patients suffered swollen lower limbs but doctors could not give any diagnoses yet as of this posting.


        The patients complained of pain and numbness in their lower extremities, cramps, loss of appetite and vomiting
        .


        Sibuco town Mayor Bong Edding has recommended the conduct of laboratory test to determine what disease struck the village.


        Hospital authorities could not exactly diagnose the kind of ailment the villagers are suffering pending the conduct of laboratory analysis.


        Health officials said there had been similar cases in the past but patients came from different places, not like the case of Sibuco town where all the patients are from Mantibo village.


        Edding ordered the municipal health officer to check if there are still residents in Mantibo who are suffering the same kind of ailment but were not brought to the hospital.


        Edding described Mantibo, which is a coastal village, as a typical normal village where there are not many activities like mining and other that may cause the sickness.


        The village of Mantibo has close to a thousand residents, Edding said.(Sunnex)

        Comment


        • #5
          Re: Zamboanga, Philippines: Four die, 19 others ill with unknown illness

          http://www.mb.com.ph/articles/325244...anga-del-norte

          Mystery ailment kills 4, downs 19 in Zamboanga del NorteJuly 3, 2011, 7:47pmZAMBOANGA CITY, Philippines (PNA) – Health authorities are baffled by a mysterious disease that has so far killed four people and hospitalized 19 others who are all residents of a coastal barangay in Zamboanga del Norte.

          The 19 people, all residents of Barangay Mantibo, Sibuco municipality, have been affected by the unknown disease and are now confined at the government-run Zamboanga City Medical Center (ZCMC).

          The lower limbs of the 19 patients are swollen but physicians could not exactly diagnose the kind of ailment that struck them.

          The patients complained of cramps, loss of appetite, and vomiting.

          Sibuco Mayor Bong Edding recommended the conduct of laboratory tests to determine the disease.

          Officials at the ZCMC have not issued any statement yet since they have to conduct laboratory analysis first
          .

          Edding said he ordered his municipal health officer to check if there are still residents in Mantibo who are afflicted with the same ailment but were not brought to the hospital.

          Edding described Mantibo as a coastal barangay, a typical village where there is not much activity that may bring any diseases.

          The barangay of Manbito has close to a thousand residents, Edding said.

          Comment


          • #6
            Re: Zamboanga, Philippines: Four die, 19 others ill with unknown illness

            In response to the moderator's questions below, other articles seem to indicate that swelling is present, as is pain.

            http://www.promedmail.org/pls/apex/f..._ID:1000,89184

            Archive Number 20110703.2021
            Published Date 03-JUL-2011
            Subject PRO/EDR> Undiagnosed disease, fatal - Philippines: (ZN)

            UNDIAGNOSED DISEASE, FATAL - PHILIPPINES: (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: 1 Jul 2011
            Source: ABS CBN News Zamboanga [edited]
            <http://www.abs-cbnnews.com/nation/regions/07/01/11/mystery-illness-kills-4-downs-16-others-ph>


            4 people died, while 16 others were hospitalized in Zamboanga del
            Norte because of a mysterious illness, health officials said Friday [1
            Jul 2011].

            The victims, who all live in Barangay Mantebo, Sibuco town in
            Zamboanga del Norte, complained of pain and numbness in their lower
            extremities. One of the patients said she started feeling numbness and
            a tingling sensation in her feet and legs starting last May [2011]; 15
            other villagers who experienced the same symptoms have been admitted
            at the Zamboanga City Medical Center (ZCMC).

            Dr. Saibzur Edding, Sibuco hospital chief, said other residents of
            Mantebo were admitted to the hospital; 4 have died due to the
            unidentified infection. Edding said there is no mining activity in or
            near Mantebo. Fishermen also do not use either dynamite or cyanide
            when fishing [thus excluding toxic chemicals used in those activities
            - Mod.JW].

            Dr. Maribel Felisario, ZCMC information officer, said they sent
            samples of the patients' urine and blood to the Department of Health
            in Manila for testing. They have also gathered samples from the
            village, including water, fish and seaweeds that are reportedly part
            of the patients' diet. Felisario said they have encountered similar
            cases before, but "this one is different, since the patients come from
            one area."

            [Byline: Queenie Casimiro]

            --
            Communicated by:
            ProMED-mail <promed@promedmail.org>

            [If this is a toxin, more information regarding what these people are
            eating would be nice to have. It sounds a little bit like cassava root
            poisoning. However, there are other things that may cause neurological
            complications and produce tingling. I don't know whether this is just
            a sensory tingling, as when the blood supply is compromised, or
            whether this is painful in some way. - Mod.TG]

            [I agree, it sounds toxic. - Mod.LM]

            [The HealthMap/ProMED interactive map showing Sibuco town is at:
            <http://healthmap.org/r/0*XI>
            - Mod.JW]

            Comment


            • #7
              Re: Zamboanga, Philippines: Four die, 19 others ill with unknown illness

              http://e-dyario.com/actualidad/2011/...-20-afectados/

              Spanish to English translation

              Zamboanga health authorities investigate mysterious disease with 5 deaths and 20 affected
              Published on July 4, 2011 by Newel Carlet
              Share. Health officials are investigating the cause of death of five people because of an unknown disease that has affected 20 other people in the town of Sibuco in Zamboanga del Norte province and about 820 kilometers south of Manila.


              Sibuco Township, in southwestern Mindanao
              The affected residents in the neighborhood of Mantibo and were admitted to the Zamboanga Medical Center with inflammation in the lower limbs, and suffer from leg cramps, loss of appetite and vomiting.

              Sibuco Mayor, Bong Edding, ordered the investigation to the many people affected appeared since earlier this month it will increase surveillance if more patients in the neighborhood, which has about a thousand residents, mostly Muslims involved in mining and other agricultural activities.

              Edding said that so far has not been informed of contamination in the food chain in the affected village, where in addition to agriculture fishing is also exercised.

              Comment


              • #8
                Re: Zamboanga, Philippines: Four die, 19 others ill with unknown illness

                http://www.philstar.com/nation/artic...ticleId=702371

                Mysterious disease kills 5, downs 20 in Zambo
                By J. Antonio Rimando The Philippine Star Updated July 04, 2011 12:00 AM 0 comment to this post


                Zoom
                DIPOLOG CITY, Zamboanga del Norte, Philippines – At least five persons have succumbed to an unknown disease which also hit 20 others for the past three days in a mountain village of Sibuco town in this province.

                Reports from Sibuco town mayor Erbie “Bong” Edding said some of the afflicted victims were taken to the Zamboanga del Norte Medical Center, Siocon District Hospital and several other hospitals in Zamboanga City.

                The patients were said to have suffered from swollen lower limbs and complained of severe leg cramps followed by loss of appetite and vomiting.

                Edding was quoted as saying that the community which has 1,000 residents and mostly Muslims, was a typical village and some of the villagers engaged in mining activities in the upper portion of the barangay. He said a portion of the mountain town is rich in mineral deposits which are being excavated by a Canadian-based mining company.

                But he assured that that there so far has been no reported food contamination in the community as most of the villagers engage in farming, gardening and fishing.

                Edding also recommended laboratory examination for the affected patients to pinpoint the actual cause of their mysterious ailment which, he feared, could affect later other residents.

                Comment


                • #9
                  Re: Zamboanga, Philippines: Five die, 20 others ill with unknown illness

                  http://www.zamboangatoday.ph/index.p...a-mystery.html

                  Disease of patients at ZCMC remains a mystery
                  Tuesday, 05 July 2011 11:21

                  Doctors at the Zamboanga City Medical Center remain uncertain as to the true cause of the disease that has afflicted sixteen residents from barangay Mantibu, Sibuco Zamboanga del Norte who are now confined in this medical facility.

                  Hospital PIO Dr. Maribel O. Felisario disclosed there are four females and 12 males, 19 years old is the youngest and 49 is the oldest who have been confined in the said hospital since last week.

                  Felisario said the primary consideration is that the victims could have been exposed to something such as toxins from marine food, sea weeds, water, heavy metal poisoning. But they cannot give the exact findings until the laboratory test results from Manila will arrive.

                  The common complaints of the victims are numbness in the lower extremities like the legs, swollen of the feet, sensory deficit in the feet, weakness to stand on two feet and other symptoms, all in the lower extremities.

                  Toxicologist Dr. Aeesha Pingli said she really has to rely on the results of laboratory tests from the blood, urine, feces samples including the food taken by the victims to be able to identify the cause of the disease.

                  “So far many of them are recuperating from the medicines we have administered,” Pingli said.

                  Meanwhile, Sibuco Municipal Mayor Norbi Edding Jr. confirmed four residents in the said barrio have already died.

                  “Two females, one male and a minor have already died, but I do not know if the cause of their death is related to this incident,” Edding said.

                  He said it was through his Municipal Health Office that he knew about the incident and immediately rushed the victims to Zamboanga City for treatment.
                  According to Edding, medical expenses incurred by the victims will be shouldered by the local government.

                  He has coordinated with the Department of Health for the conduct of medical mission in the said community within the week.

                  One of the patients, Pantera Najal, 42, confirmed a certain Hajiban Abdurahman, her neighbor, died due to the disease.

                  Comment


                  • #10
                    Re: Zamboanga, Philippines: Five die, 20 others ill with unknown illness

                    This is not good at all. This sounds almost nothing like the other articles in this thread.

                    http://newsinfo.inquirer.net/21500/m...-norte-village

                    Mystery disease afflicts Zamboanga del Norte village
                    By Julie S. Alipala
                    Inquirer Mindanao
                    8:33 pm | Tuesday, July 5th, 2011 0share21 21ZAMBOANGA CITY, Philippines—Health officials in Western Mindanao are in a quandary as to what has killed at least four people and downed more than two dozen other people in a fishing village in Sibuco, Zamboanga del Norte, since late April.

                    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, said they were expecting the results from Manila to come in next week.

                    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 Hadjiban Abdurahman, 23, who died 18 hours after being hospitalized on June 11.

                    “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 July 7 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.

                    Comment


                    • #11
                      Re: Zamboanga, Philippines: Five die, 20 others ill with unknown illness

                      Guillain-Barre would not cause swelling of the legs, so if the reports of swelling are correct, GBS should be excluded.

                      http://zamboangatimes.ph/top-news/17...hospital-.html

                      10 victims of mysterious disease discharged from Zambo hospital
                      Tuesday, 05 July 2011 16:47
                      Government physicians has discharged from the hospital 10 patients from Sibuco, Zamboanga del Norte who were struck by a mysterious disease that has killed four people and hospitalized 16 others on Sunday

                      Sibuco Mayor Bong Edding said doctors at the Zamboanga City Medical Center has discharged 10 of their patients suffering from an unknown disease. Six others were placed under further observation.

                      Edding said medical and laboratory tests conducted on the 20 patients were also sent to Manila for further analysis to determine the kind of disease that have struck the coastal Barangay of Montebo in Sibuco last week.

                      Medical experts at the government hospital suspect the victims may have suffered from the “Guillain Barre Syndrome,” since the patients’ lower limbs are swollen and they complained of cramps, loss of appetite and vomiting, Edding said.

                      Edding who personally attended to the needs of the patients said his administration will shoulder the medical expenses of the victims.
                      He said that food and medicines and financial assistance were also extended by him to the relatives of the victims who are in this city taking care of the patients.

                      On Sunday, physicians in this city were baffled by a mysterious disease that has struck 20 people from Sibuco.
                      Four of the patients affected by the unknown disease died at the hospital while 16 others were placed under medication.
                      Hospital officials said there had been similar cases in the past in which the patients came from different places. But this time, they are puzzled because all the 19 patients come from one place — Sibuco. — Nonoy E. Lacson

                      Comment


                      • #12
                        Re: Zamboanga, Philippines: Five die, 20 others ill with unknown illness

                        http://www.zambotimes.com/archives/3...-hospital.html

                        Wednesday, July 6. 2011
                        10 of 16 patients with mysterious disease discharged from Zambo hospital
                        by Teofilo P. Garcia


                        ZAMBOANGA CITY — The government physicians have discharged 10 of the 16 (not 19 as earlier reported) patients who have recuperated after suffering from a still unknown disease, officials said.

                        The patients, all residents of the coastal Barangay Mantibo in the town of Sibuco, Zamboanga del Norte, were rushed last week to the government-run Zamboanga City Medical Center here after they fell ill from the mysterious disease.

                        The patients, whose lower limbs were swollen, complained of cramps, loss of appetite and vomiting.

                        Sibuco Mayor Bong Edding said the remaining six patients were placed under further observation as the attending physicians have yet to wait for the results of the laboratory analysis to determine what disease they are suffering from.

                        Edding said some health officials suspects the victims may have suffered from the Guillain Barre Syndrome since the patients' lower limbs are swollen and complained of cramps, appetite loss and vomiting.

                        Guillain-Barre Syndrome, as stated at Yahoo Health, is a serious disorder that occurs when the body's defense (immune) system mistakenly attacks part of the nervous system that leads to nerve inflammation that causes muscle weakness.

                        The YahooHealth said the symptoms of Guillain-Barre can get worse very quickly since it may take only a few hours to reach the most severe symptoms, but weakness increasing over several days is also common.

                        "Muscle weakness or the loss of muscle function (paralysis) affects both sides of the body. In most cases, the muscle weakness starts from the legs and then spreads to the arms. This is called ascending paralysis," Yahoo Health stated.

                        "Patients may notice tingling, foot or hand pain, and clumsiness. If the inflammation affects the nerves to the diaphragm, and there is weakness in those muscles, the person may need breathing assistance," Yahoo Health added.

                        However, ZCMC Toxicologist Dr. Aeesha Pingli said she really has to rely on the results of the laboratory tests to determine what disease struck the patients.

                        Samples of blood, urine and feces were taken and sent to Manila for laboratory analysis.

                        Of the 16 patients taken to the ZCMC, 12 are males and four are females aged between 19 to 49 years old.

                        Edding confirmed that, so far, four residents of Barangay Mantibo have already died after they fell ill from the mysterious disease.

                        Edding said he coordinated with the Department of Health (DOH) regional office for the conduct of medical mission in Mantibo the soonest possible time.

                        Edding described Mantibo, which is a coastal barangay, as a typical normal village where there is not much activities like mining and others that may bring disease.

                        The barangay has close to a thousand residents, Edding said. (PNA)

                        Comment


                        • #13
                          Re: Zamboanga, Philippines: Five die, 20 others ill with unknown illness

                          The reporting is all over the place here. Some of the reports indicate a paralytic illness with perhaps a gastrointestinal component. Others seem to indicate primarily swelling and pain, and not paralysis, sounding perhaps like an ingested parasite. And one article above describes the illness as almost flu-like, with symptoms of cough and fever. The attack rate in the village seems to be about 3-5&#37; which would be an incredible rate for GBS (and probably too many paralytic cases to consider polio). The number of cases ranges from 20 in some reports to more than 40 in the flu-like report. And curiously, few if any of the cases appear to be children.

                          The counts are equally all over the place, as it the time period, but it seems this outbreak has been going on for at least two months. There are conflicting reports as to whether mining is ongoing in the village.

                          And contagion appears unlikely, as some of the cases were in the hospital (which is not in the village) as early as May, and there is no evidence of spread in the hospital, and no evidence of family clustering of cases.

                          Comment


                          • #14
                            Re: Zamboanga, Philippines: Five die, 20 others ill with unknown illness

                            http://www.sunstar.com.ph/zamboanga/...lnesses-165291

                            Hospital discharges 10 patients with mysterious illnesses
                            By Bong Garcia

                            Wednesday, July 6, 2011

                            A GOVERNMENT-RUN hospital in Zamboanga City discharged 10 people who suffered from an unknown disease after they showed signs of recovery from the illness.

                            Six others suffering from same illness are still in the hospital. Four people in same village have reportedly died of the disease in the village of Mantibo, said Sibuco town Mayor Bong Edding.

                            The patients, all from the coastal village of Mantibo in the town of Sibuco, Zamboanga del Norte, were brought to Zamboanga City Medical Center after they have fallen ill from the mysterious disease.


                            They all suffered from swollen lower limbs, cramps, loss of appetite, and vomiting.


                            Mayor Edding said the six remaining patients have been were placed under further observation as doctors are still waiting for results of their laboratory analysis to determine what type of disease they suffer from.


                            Edding said some health officials in the city suspect the victims may have suffered from the Guillain Barre Syndrome.


                            Guillain Barre Syndrome is a rare and severe disease, which affects the peripheral nervous system.


                            However, ZCMC Toxicologist Dr. Aeesha Pingli said she has to rely on the results of the laboratory tests to determine what disease struck the patients.


                            Samples of blood, urine and feces were taken from the patients and sent to Manila for laboratory analysis.


                            Of the 16 patients taken to the ZCMC, 12 are males and four are females. The youngest in the group is 19 years old and the oldest is 49 years old.


                            Edding said he has coordinated with the Department of Health in the region for the conduct of medical mission in Mantibo village.

                            Comment


                            • #15
                              Re: Zamboanga, Philippines: Five die, 20 others ill with unknown illness

                              http://news.xinhuanet.com/english201...c_13969470.htm

                              Mysterious disease kills 4, hospitalizes 19 in S Philippines

                              English.news.cn 2011-07-06 19:04:27 FeedbackPrintRSS

                              ZAMBOANGA CITY, the Philippines, July 6 (Xinhua) -- A mysterious disease has claimed at least four lives and sent 19 villagers from a coastal town in southern Philippines, health officials said Wednesday.

                              The patients, aged 19 to 49 years old, all native of Mantebo, a coastal village of Sibuco town, Zamboanga del Norte province, were brought to Zamboanga City Medical Center last week after the local town officials were alarmed of the disease that have stricken the village.

                              Dr. Maribel Felisario, public information officer of the medical center, said the patients complained of cramps, swollen lower limps, and experienced loss of appetite and vomiting.

                              At least four people have died but Sibuco Mayor Norbie Bong Edding said they were investigating if the death of the victims were related to the disease that have stricken the village.

                              Although the hospital initially believed the victims might have been exposed to toxin of marine products, doctors have to rely on the laboratory test to determine the cause of the disease, said Felisario.

                              "Until now we are still waiting for the result of the laboratory testing that was conducted in Manila to really determine the cause," Felisario said.

                              Edding said exposure to mining was unlikely, noting that there is no tributary that connects to his town from the mining site that is based in the hinterland of Siocon town, which is a town away from his place.

                              The Department of Health has sent its experts to investigate, and examination will be processed in Manila, according to Edding.

                              Comment

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