Announcement

**alert** · September 29, 2011, 08:53 AM

Re: Namibia: Mysterious disease (causing hemorrhaging) kills 4

Both Crimean-Congo Hemorrhagic Fever (CCHF) and Rift Valley Fever (RVF) have previously been reported from Namibia:

http://promedmail.org/pls/apex/f?p=2400:1202:1001446974831246::NO::F2400_P1202_CHECK_DISPLAY,F2400_P1202_PUB_MAIL_ID:X,84092

The apparent sporadic nature of the cases (no indication of transmission within a family or to HCW) might also argue in favor of one of those vector-borne illnesses. It is also possible that this could be toxic, as one person in the above article suspects, especially as fever itself is not yet mentioned as a symptom.

Ebola and Marburg are unlikely here both due to the location, the apparent epidemiology, as well as the short time span of the outbreak, as both those viruses have a much longer incubation period.

Please send this to ProMED either way.

**alert** · September 29, 2011, 07:46 PM

Re: Namibia: Mysterious disease (causing hemorrhaging) kills 4

This report only mentions two deaths, not four, and has no mention of hemorrhage (or of fever), but is far less clear as to what this could be.

This is a different source than post #1; I have no way of knowing which report is more accurate.

Page not found | nbc

http://www.nbc.na/article.php?id=5870

Unknown disease

Published: September 29th, 2011
An unknown disease has claimed lives of two residents of the Hakahana informal settlement of Windhoek's Moses //Garoeb constituency at the weekend.

Two other residents from the settlement have also been admitted to the Katutura State Hospital.

One of the deceased's elder sister, Ndateelela Gideon, told NBC News that her brother approached her last Thursday complaining of headache and she advised him to visit the nearest health centre.

Gideon said her brother started to develop a rash, which spread all over his body, while his eyes became abnormally red, prompting the family to take him to the Katutura State Hospital for treatment.

But his condition worsened and he died early Sunday morning.

Health authorities have taken blood samples from two other people who displayed similar symptoms.

The Health Ministry's Permanent Secretary, Kahijoro Kahuure told NBC News that the Ministry was aware of the cases.

He noted that officials from the Primary Health Care Directorate had confirmed the deaths to his office.

The Ministry is investigating the cause of death and Kahuure said it would make an announcement as soon as the results were back from the laboratory.

**alert** · September 30, 2011, 07:46 AM

Re: Namibia: Mysterious disease (causing hemorrhaging?) kills 4

And a third source with a third perspective; three deaths, hemorrhagic symptoms, but no fever reported, and suspicion of poisoning. Also no mention of other currently ill patients. It is unclear on what basis hemorrhagic fever is being excluded.

Windhoek mental health facility security risks exposed

http://www.namibian.com.na/news-articles/national/full-story/archive/2011/september/article/congo-fever-not-cause-of-mysterious-deaths/

%%title%% %%sep%% %%primary_category%% %%sep%% %%sitename%% %%sep%% The Ministry of Health and Social Services has admitted to systemic failures at the Windhoek Central Mental Health Centre, following a patient escaping and a fatal police shooting.

30.09.2011
Congo Fever not cause of ‘mysterious’ deaths
By: DENVER KISTING

THE three Katutura residents who died in the past week did not suffer from a haemorrhagic fever such as the dreaded Ebola, Congo Fever or Rift Valley Fever.
Dr Jack Vries, the chairperson of the National Health Emergency Management Committee in the Ministry of Health and Social Services, yesterday confirmed that the deaths were being investigated.
He said an emergency meeting was held yesterday morning, attended by senior ministerial officials as well as the medical superintendents of the Katutura State Hospital and the Windhoek Central Hospital.
The three patients died in these two hospitals after presenting with excessive bleeding and vomiting.
Ailli Shakungwa died in the Katutura State Hospital on Saturday. The second patient, Frans Shekutamba, died in the Windhoek Central Hospital on Monday.
Another patient also died in the Katutura State Hospital.
All of them were residents of the Hakahana area in Katutura.
They were admitted to hospital vomiting and bleeding from their noses and eyes, their families claim.
Shakungwa apparently also complained of headache and a stiff neck.
The families are now demanding answers from the authorities.
Answers about the cause of death in these cases are expected today.
It is suspected that the deceased may have suffered some kind of poisoning.

--------------------------------------------------------------------------------

**alert** · September 30, 2011, 07:49 AM

Re: Namibia: Mysterious disease (causing hemorrhaging?) kills 4

Presumably, these samples are being sent to the reference labs in South Africa, so we can fairly conclusively rule out the above hemorrhagic fevers.

Page not found | nbc

http://www.nbc.na/article.php?id=5873

Health officials to identify killer disease

Published: September 30th, 2011

Health and Social Services Minister Richard Kamwi says health authorities are hard at work to identify a disease, which claimed the lives of three people in the Hakahana informal area in Windhoek's Moses //Garoeb constituency.

But, Dr Kamwi points out that there is no need for panic as the outcome of labarotory tests has revealed no links to any Viral Hemorrhagic Fevers such as Ebola.

He has confirmed that Windhoek's Chief Medical Superintendent for Emergency Cases, Dr Jack Vries, and his team are working around the clock to determine the cause of the deaths.

Dr Kamwi says it is suspected that the deaths could be related to food poisoning, but points out the investigation will provide conclusive proof.

He has called on the public to remain calm

**alert** · September 30, 2011, 12:55 PM

Re: Namibia: Mysterious disease (causing hemorrhaging?) kills 4

http://promedmail.org/pls/apex/f?p=2400:1001:1375410004904601::NO::F2400_P1001_BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,90478

Archive Number 20110930.2951
Published Date 30-SEP-2011
Subject PRO/EDR> Undiagnosed hemorrhagic disease - Namibia: (Windhoek) RFI

UNDIAGNOSED HEMORRHAGIC DISEASE - NAMIBIA: (WINDHOEK) 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: Thu 29 Sep 2011
Source: New Era [edited]
<http://www.newera.com.na/article.php?articleid=40894>

Mysterious disease kills 4
--------------------------
Four Hakahana residents died from a mysterious illness that caused a
strange rash and caused hemorrhaging through the nose, eyes, and other
body openings. 3 died over the past 3 days while 2 shack dwellers are
fighting for their lives in a city hospital and several others have
been discharged from hospital. One died last week [week of 19 Sep
2011].

The strange disease that causes its victims to bleed and pass
excessive blood in their urine and fecal matter has left doctors at
Katutura State Hospital baffled. Medical authorities are also trying
to find the source of the swiftly-killing disease that has struck
terror at Hakahana.

Among those who died in the last 3 days are one man, one woman, and a
child. When New Era visited the bereaved families yesterday [28 Sep
2011] together with the Moses Garoeb Constituency councillor, Martin
David, the families of the deceased were still in shock at the sudden
death of their beloved ones.

[A man] said his shebeen [bar] attendant went to see him before her
demise complaining of a splitting headache and he told her to go to
hospital. "After she went to the hospital she started to develop red
pimples on the whole body, the same afternoon she started vomiting
blood, bleeding through the anus," he said. She started complaining
last Thursday evening [22 Sep 2011] and went to Katutura hospital on
Friday but was sent back home as nurses said she was in a stable
condition. But on Sunday [25 Sep 2011] at around 11 pm her relatives
called him saying she was critical and she died upon arrival at
Katutura State Hospital where she had been admitted. According to a
family member of the deceased, the woman died on Monday [26 Sep 2011],
and they are still shocked by the death because they had not
experienced a disease with such symptoms before.

New Era has learnt that another of the victims also died yesterday
[Wed 28 Sep 2011] after displaying similar symptoms. The victim was
also a resident of Hakahana. The residents said they now live in fear
because they do not know what exactly is causing the sudden deaths.

Councillor David has his own theories about the deaths saying it could
be that the victims ate poisoned food scavenged from one of the
dumpsites. A mourner at one of the funerals said: "We are still
waiting from the doctors to identify the cause of the deaths but for
now we are very scared." Residents appealed to the Ministry of Health
and Social Services to urgently investigate the disease and inform the
public on how to prevent it so that they could take precautionary
measures. "The ministry must investigate so that they can introduce
campaigns of injecting or whatever they can do for us to prevent this
serious outbreak. People are dying in a short period," said one
resident.

Another child died last week [week of 19 Sep 2011] in the same
neighbourhood when he started passing blood-tainted urine and his
mother took him to hospital, bringing to 4 the number of victims. 2
people who are hospitalised are also bleeding from the eyes and
urinating blood and have symptoms similar to those who died.

Approached for comment, the permanent secretary in the Ministry of
Health and Social Services, Kahijoro Kahuure, said he had not been
informed about the illness.

[Byline: Loide Jason, Fifi Rhodes]

--
Communicated by:
Ronan Kelly
for FluTrackers.com
<ronankelly@comcast.net>

[Hakahana is a suburb of Windhoek, the capital of Namibia. The
township is situated in the north of the town. The
HealthMap/ProMED-mail interactive map of Namibia, showing the location
of Windhoek, can be accessed at <http://healthmap.org/r/1i9l>.

The undiagnosed fatal hemorrhagic disease, which has caused the death
of 4 people in a suburb of Windhoek, has some features characteristic
of a viral hemorrhagic fever (VHF, such as for example Lassa fever).

Viruses causing hemorrhagic fever are initially transmitted to humans
when the activities of infected reservoir hosts or vectors and humans
overlap. The viruses carried in rodent reservoirs are transmitted when
humans have contact with urine, fecal matter, saliva, or other body
excretions from infected rodents. The viruses associated with
arthropod vectors are spread most often when the vector mosquito or
tick bites a human, or when a human crushes a tick. However, some of
these vectors may spread virus to animals, livestock, for example.
Humans then become infected when they care for or slaughter the
animals.

Specific signs and symptoms vary by the type of VHF, but initial signs
and symptoms often include marked fever, fatigue, dizziness, muscle
aches, loss of strength, and exhaustion. Patients with severe cases of
VHF often show signs of bleeding under the skin, in internal organs,
or from body orifices like the mouth, eyes, or ears. However, although
they may bleed from many sites around the body, patients rarely die
because of blood loss. Severely ill patient cases may also show shock,
nervous system malfunction, coma, delirium, and seizures. Some types
of viral hemorrhagic fever are associated with renal failure.

Although Rift Valley Fever and Crimean-Congo hemorrhagic fever have
been reported in Namibia in recent times, the cases described above
appear to be sporadic rather than clustered. Furthermore there is no
indication of nosocomial transmission of the condition. It is possible
that the victims may have been exposed to some environmental toxin,
which seems to be the local opinion. Further information would be
welcomed. - Mod.CP]

**alert** · October 3, 2011, 10:54 AM

Re: Namibia: Mysterious disease (causing hemorrhaging?) kills 4 - Tests negative for Ebola, CCHF, RVF

It is increasingly looking like the first post in this thread might be a false report, especially since it exaggerated both the number of deaths and symptoms...

Windhoek mental health facility security risks exposed

http://www.namibian.com.na/news-articles/national/full-story/archive/2011/october/article/mysterious-deaths-also-not-poisoning/

%%title%% %%sep%% %%primary_category%% %%sep%% %%sitename%% %%sep%% The Ministry of Health and Social Services has admitted to systemic failures at the Windhoek Central Mental Health Centre, following a patient escaping and a fatal police shooting.

03.10.2011
‘Mysterious deaths’ also not poisoning
By: DENVER KISTING

THE two Katutura residents who died last week – allegedly due to a mysterious bleeding disease – died not of poisoning.
On Friday, Dr Jack Vries of the Ministry of Health and Social Services said one patient probably died of liver failure while the other is suspected to have died of heart failure.
The conclusive post-mortem results will be announced today, he said.
On Thursday, he ruled out haemorrhagic fever as the cause of the deaths.
Residents of the Hakahana area in Katutura last week claimed that a number of people were bleeding to death.
Vries said rumours that a third person had also died last week were found to be untrue.
According to him, the one patient died in the Katutura State Hospital while the other one died in the Roman Catholic Hospital.
The Health Ministry launched an investigation into the deaths following panic in Hakahana about what disease claimed the two lives.
An emergency meeting was held on Wednesday morning attended by senior Ministerial officials as well as the medical superintendents of the Katutura State Hospital and the Windhoek Central Hospital.
The patients who were admitted to hospital allegedly were vomiting and bleeding from their noses and eyes, their families claimed.

--------------------------------------------------------------------------------

**alert** · October 3, 2011, 05:49 PM

Re: Namibia: Mysterious disease (causing hemorrhaging?) kills 4 - False report?

Perhaps we should send the above post to ProMED to avoid more speculation such as below.

It is certainly possible that one of the cases could have had something similiar to this (or even something in the differential diagnosis), but this doesn't look like a cluster of these cases.

http://promedmail.org/pls/apex/f?p=2400:1001:2824821846699228::NO::F2400_P1001_BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,90528

Archive Number 20111003.2981
Published Date 03-OCT-2011
Subject PRO/EDR> Undiagnosed hemorrhagic disease - Namibia (02): Windhoek, comment

UNDIAGNOSED HEMORRHAGIC DISEASE - NAMIBIA (02): WINDHOEK, COMMENT
************************************************** ***************
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 3 Oct 2011
From: Michel Van Herp <michel.van.herp@brussels.msf.org> [edited]

In this context (Namibia), we need to consider in the differential
diagnosis a mycotoxin present in food, resulting in the Onyalai
disease. In the past, we have been confronted by this disease in
Kuito, Angola.

--
Dr Michel Van Herp
Epidemiologist
Medical Departement
Medecins Sans Frontieres
Brussels
<michel.van.herp@brussels.msf.org>

[ProMED-mail thanks Dr Van Herp for drawing attention to this
possibility.

The following description of Onyalai disease is reproduced from the
web-site of the Institute of Tropical Medicine Antwerp
<http://www.itg.be/itg/DistanceLearning/LectureNotesVandenEndenE/45_Haematologyp6.htm>:

"General: Onyalai (syn. akembe and afindo) is a rather mysterious
disease which only seems to occur in central southern Africa (southern
Angola and northern Namibia; Kavango and Ovambo territories). Onyalai
means "blood blister" in the language of the Kimbundu, an Angolan
tribe. Onyalai is a disease of unknown etiology. Defective nutrition
may be the cause. One hypothesis is that a toxin, possibly acting as a
hapten, is responsible for this form of thrombocytopenia. The possible
aetiological role of mycotoxins from contaminated millet, sorghum
and/or maize requires further investigation.

Clinical aspects: The disease differs clinically, epidemiologically
and immunologically from idiopathic thrombocytopenic purpura (ITP).
The age of onset varies from 6 months to 70 years with a peak
incidence between 11 and 20 years. It is an acute disease,
characterised by the formation of haemorrhagic vesicles and blisters
on the palatal and buccal mucous membranes, together with severe
thrombocytopenia. Sometimes, haemorrhagic blebs do appear on the skin,
including on the soles of the feet. The general condition tends to be
good, and there are no signs of a constitutional disorder. This
acquired form of thrombocytopenic purpura can lead to haematuria and
melena. Epistaxis, petechiae and ecchymoses are common, as are
subconjunctival bleeding and menorrhagia. The median duration of
bleeding is about 8 days, but recurrent bleeding episodes are common.
About 80 percent of cases will have chronic thrombocytopenia with a
risk of intermittent attacks of acute haemorrhage. Haemorrhage from
ruptured bullae, epistaxis or gastrointestinal bleeding can be severe
and may cause shock and even death.

Diagnosis: The diagnosis is a clinical one, supported by lab tests.
There will be thrombocytopenia and anaemia. The platelets are
morphologically normal. The bone marrow shows changes which are to be
expected: hyperplasia of the red cell precursors and megakaryocytes.
Many patients have IgG and IgM platelet antibodies and glycoprotein
IIb/IIIa autoantibodies in their serum. Complement levels are normal.
Infants of mothers with onyalai, unlike infants of mothers with
idiopathic thrombocytopenic purpura, are not at risk of
thrombocytopenia and haemorrhage. Their mothers however, have a risk
of post-partum haemorrhage.

Differential diagnosis: Differential diagnosis includes other
conditions which are characterized by severe thrombocytopenia, such as
ITP, HIV-associated thrombocytopenia, immune thrombocytopenia
secondary to SLE or lymphoproliferative disease, drug-related
thrombocytopenia (e.g. quinine, heparin), TTP-HUS, hypersplenism and
diffuse intravascular coagulation (DIC). Several infections are
accompanied by low platelet counts (e.g. malaria, leptospirosis,
septicaemias, trypanosomiasis, Marburg virus and arboviral infections
such as Crimean-Congo haemorrhagic fever and dengue). DIC is common in
certain obstetric disorders (eclampsia, abruptio placentae, amniotic
fluid embolus, septic abortion, hydatidiform mole), envenomation
(several snakes), heat stroke and traumata. Suicide attempts with
coumarines is common and leads to bleeding tendency, but is not
accompanied by low platelet counts or haemorrhagic bullae on the
mucosa.

Treatment: Treatment is directed at the prevention of haemorrhagic
shock, and management consists of the correction of blood loss.
Transfusion of blood and of platelets can be life saving. Oral hygiene
is important. The use of aspirin is of course prohibited.
Corticosteroids do not increase the platelet count, although high-dose
methylprednisolone reduced the morbidity of onyalai in children. High
dose intravenous gammaglobulin (Sandoglobulin) may be followed by a
rise in the platelet count and cessation of haemorrhage, but in
general, this treatment is disappointing (and expensive). Vincristine
sulphate (1.5 mg/m2) can be used, as it benefits some patients.
Splenectomy can be considered for patients with severe uncontrollable
bleeding, although splenectomy does not always control the disease.
Splenectomy is followed by a rise in platelet count. If possible,
vaccination against pneumococci should be performed before
splenectomy."

Further information from Namibia is awaited. The HealthMap/ProMED-mail
interactive map of Namibia can be accessed at:
<http://healthmap.org/r/1i9l>, and that of Angola at:
<http://healthmap.org/r/1iGj. - Mod.CP]

**alert** · October 4, 2011, 10:52 AM

Re: Namibia: Mysterious disease (causing hemorrhaging?) kills 4 - False report?

This is a common way to produce a VHF false alarm; one person dies of liver disease, someone has a heart attack or pulmonary embolism (see below), maybe a couple more have mild febrile illnesses, and we get a report like post #1 in this thread.

Windhoek mental health facility security risks exposed

http://www.namibian.com.na/news-articles/national/full-story/archive/2011/october/article/mysterious-deaths-put-to-rest/

%%title%% %%sep%% %%primary_category%% %%sep%% %%sitename%% %%sep%% The Ministry of Health and Social Services has admitted to systemic failures at the Windhoek Central Mental Health Centre, following a patient escaping and a fatal police shooting.

04.10.2011
‘Mysterious’ deaths put to rest
By: DENVER KISTING

THE 27-year-old woman who died in the Katutura State Hospital on September 24 had liver failure and not a communicable disease.
Similarly, the man (41), who died in the Roman Catholic Hospital on September 27 had no contagious disease and died of heart failure.This was confirmed at a meeting at the Ministry of Health and Social Services head office in Windhoek yesterday.
The ministry, the World Health Organisation (WHO) and the Centre for Disease Control and Prevention launched an investigation last week after it was reported that people were allegedly dying of a mysterious bleeding disease in the Hakahana area of Katutura.
Yesterday, it was also revealed that only two patients died and not four as had been reported earlier.
It was further established that the two deaths were unrelated.
When the female patient was admitted to hospital, she complained of headache and a body rash. She was also found to be bleeding.
After admission, her condition deteriorated and she later died.
The second patient collapsed on arrival at hospital and later died.
According to his death certificate, he died because of heart failure.
Dr Jack Vries of the health ministry said the probe showed that there is no public health concern.
On Friday already, Vries said the patients did not die of poisoning.
This came after he ruled out haemorrhagic fever – like Congo, Ebola or Rift Valley fever – as the cause of the deaths on Thursday.

--------------------------------------------------------------------------------

**alert** · October 4, 2011, 10:59 AM

Re: Namibia: Mysterious disease (causing hemorrhaging?) kills 4 - False report?

http://mobi.namibiansun.com/content/global-news/nothing-mysterious-about-%E2%80%98killer-disease%E2%80%99

Nothing mysterious about ‘killer disease’
Posted on Tue, 04 Oct, 2011 Global NewsAuthor: Ellanie Smit
REPORTS of a “mysterious disease” causing the deaths of several people in Windhoek’s Hakahana residential area were yesterday nipped in the bud.

A local daily last week reported that 4 people died from a mysterious illness that caused a strange rash and haemorrhaging through the nose, eyes and other openings of their bodies.

“There is no reason for any panic,” announced Dr Jack Vries, the Chairperson of the National Health Emergency Management Committee, after investigations showed that there were only two cases, instead of the reported four, and that the causes of deaths were completely natural.

The Ministry of Health and Social Services, along with the World Health Organisation and the Centre of Disease Control and Prevention, launched the investigation.

Aily Shakungu (27) died of liver failure, and Frans Shekutammba (41) died of heart failure.

Vries labeled the media reports as very irresponsible “and this is also coming from the Minister’s mouth”.

Neither the reporting journalist nor the family of the alleged victims could indicate who the other two people were, or the hospital or mortuary where the other two cases came from.

“How can you write a front page story stating ‘mysterious disease kills 4 people’, causing panic and scaring people in that way? This is sensationalism and poor reporting.”

In both cases the investigation revealed that the causes of death were not likely due to communicable disease of public health concern. The deceased did not even have contact with or links to each other.

“These cases do not represent a presentation of a contagious disease as speculated in the media,” said Vries.

He also stressed that in both cases the family members are also fine and there are no complaints of anyone being ill. “It is nothing infectious and is not spreading.”

According to the investigation team rumors will not always be accurate and therefore should be investigated to determine if it is of public health concern.

Shakungu was admitted to the Katatura Hospital on 24 September after she was found unresponsive by her family.

Earlier that day she also visited the hospital complaining about headache and a body rash. After the clinic visit she stayed home from work until her family found her and brought her to the hospital.

She was bleeding from the nose and mouth, while her health quickly deteriorated.

The investigation revealed that the cause of death was liver failure.

Shekutammba died of heart failure. He was admitted to the Roman Catholic Hospital on 27 September after complaining that he was suffocating.

The family indicated that they saw mucous secretions from his mouth but no sign of red blood in secretions or eyes. There were also no reports of fever as is the case with viral infections.

The patient died of cardiac arrest while a further review by the investigation team indicates possible acute respiratory event such as pulmonary embolism leading to cardiac arrest.

**alert** · October 5, 2011, 05:25 PM

Re: Namibia: Mysterious disease (causing hemorrhaging?) kills 4 - False report

http://promedmail.org/pls/apex/f?p=2400:1001:638298439232178::NO::F2400_P1001_BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,90557

Archive Number 20111005.2997
Published Date 05-OCT-2011
Subject PRO/EDR> Undiagnosed hemorrhagic fever - Namibia (03): (Windhoek) NOT

UNDIAGNOSED HEMORRHAGIC FEVER - NAMIBIA (03): (WINDHOEK) NOT
************************************************** **********
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

[1]
Date: Tue 4 Oct 2011
Source: The Namibian [edited]
<http://www.namibian.com.na/news-articles/national/full-story/archive/2011/october/article/mysterious-deaths-put-to-rest/>

The 27-year-old woman who died in the Katutura State Hospital on 24
Sep 2011 had liver failure and not a communicable disease. Similarly,
the 41-year-old man who died in the Roman Catholic Hospital on 27 Sep
2011 had no contagious disease and died of heart failure.

This was confirmed at a meeting at the Ministry of Health and Social
Services head office in Windhoek yesterday [3 Oct 2011]. The ministry,
the World Health Organisation (WHO) and the Centers for Disease
Control and Prevention launched an investigation last week [week of 26
Sep 2011] after it was reported that people were allegedly dying of a
mysterious bleeding disease in the Hakahana area of Katutura.

Yesterday [3 Oct 2011], it was also revealed that only 2 patients died
and not 4 as had been reported earlier. It was further established
that the 2 deaths were unrelated. When the female patient was admitted
to hospital, she complained of headache and a body rash. She was also
found to be bleeding. After admission, her condition deteriorated and
she later died.

The 2nd patient collapsed on arrival at hospital and later died.
According to his death certificate, he died because of heart failure.

Dr Jack Vries of the health ministry said the probe showed that there
is no public health concern. On Friday [30 Sep 2011] already, Vries
had said the patients did not die of poisoning. This came after he
ruled out haemorrhagic fever -- like Crimean-Congo haemorrhagic fever,
Ebola fever, or Rift Valley fever -- as the cause of the deaths on
Thursday [29 Sep 2011].

[Byline: Denver Kisting]

--
Communicated by:
Ronan Kelly
for FluTrackers.com
<ronankelly@comcast.net>

******
[2]
Date: Tue 4 Oct 2011
Source: The Namibian Sun [edited]
<http://mobi.namibiansun.com/content/global-news/nothing-mysterious-about-%E2%80%98killer-disease%E2%80%99>

Reports of a 'mysterious disease' causing the deaths of several people
in Windhoek's Hakahana residential area were yesterday [3 Oct 2011]
nipped in the bud. A local daily last week [week of 26 Sep 2011]
reported that 4 people died from a mysterious illness that caused a
strange rash and haemorrhaging through the nose, eyes, and other
openings of their bodies.

"There is no reason for any panic," announced Dr Jack Vries, the
chairperson of the National Health Emergency Management Committee,
after investigations showed that there were only 2 cases, instead of
the reported 4, and that the causes of deaths were completely
natural.

The Ministry of Health and Social Services, along with the World
Health Organisation and the Centers for Disease Control and
Prevention, launched an investigation. A 27-year-old woman died of
liver failure, and a 41-year-old man died of heart failure. Vries
labeled the media reports as very irresponsible "and this is also
coming from the minister's mouth".

Neither the reporting journalist nor the family of the alleged victims
could indicate who the other 2 people were, or the hospital or
mortuary where the other 2 cases came from. "How can you write a front
page story stating 'mysterious disease kills 4 people', causing panic
and scaring people in that way? This is sensationalism and poor
reporting."

In both cases the investigation revealed that the causes of death were
not likely due to communicable disease of public health concern. The
deceased did not even have contact with or links to each other. "These
cases do not represent a presentation of a contagious disease as
speculated in the media," said Vries. He also stressed that in both
cases the family members are also fine and there are no complaints of
anyone being ill. "It is nothing infectious and is not spreading."

According to the investigation team rumors will not always be accurate
and therefore should be investigated to determine if it is of public
health concern. The woman was admitted to the Katatura Hospital on 24
Sep 2011 after she was found unresponsive by her family. Earlier that
day she also visited the hospital complaining about headache and a
body rash. After the clinic visit she stayed home from work until her
family found her and brought her to the hospital. She was bleeding
from the nose and mouth, while her health quickly deteriorated. The
investigation revealed that the cause of death was liver failure.

The man died of heart failure. He was admitted to the Roman Catholic
Hospital on 27 Sep 2011 after complaining that he was suffocating. The
family indicated that they saw mucous secretions from his mouth but no
sign of red blood in secretions or eyes. There were also no reports of
fever as is the case with viral infections. The patient died of
cardiac arrest while a further review by the investigation team
indicates a possible acute respiratory event such as pulmonary
embolism leading to cardiac arrest.

[Byline: Ellanie Smit]

--
Communicated by:
Ronan Kelly
for FluTrackers.com
<ronankelly@comcast.net>

[ProMED-mail thanks Ronan Kelly for forwarding these 2 reports which
clarify the situation in Namibia. Clearly there has been no outbreak
of a transmissible haemorrhagic fever in Namibia, nor any other
communicable disease in Windhoek associated with these 2 cases.

The HealthMap/ProMED-mail interactive map of Namibia can be accessed
at <http://healthmap.org/r/1i9l>. - Mod.CP]

Announcement

Namibia: Mysterious disease (causing hemorrhaging?) kills 4 - False report

Namibia: Mysterious disease (causing hemorrhaging?) kills 4 - False report

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