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Woman dies of mystery hemorrhagic illness in Nairobi - Tests negative for Ebola and other hemorrhagic fever viruses - gastrointestinal hemorrhage suspected

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  • #16
    Re: Woman dies of mystery hemorrhagic illness in Nairobi - Ebola suspected

    Ministry allays fears of Ebola outbreak



    Ministry allays fears of Ebola outbreak
    Director of Public Health and Sanitation Dr Shanaz Shariff addresses a news conference at Afya House December 23, 2011. He allayed fears of an Ebola outbreak following the death of a woman at Kenyatta National Hospital.
    JENNIFER MUIRURI
    By AGGREY MUTAMBO amutambo@ke.nationmedia.com
    Posted Friday, December 23 2011 at 11:46

    The Ministry of Health has allayed fears of an Ebola outbreak following the death of a woman at Kenyatta National Hospital.The Ministry of Health has allayed fears of an Ebola outbreak following the death of a woman at Kenyatta National Hospital.
    At the same time, KNH Friday discharged three people who had been quarantined for being in contact with Ms Gladys Muthoni who died from excessive bleeding.

    <!--Ads and Related Buttons--><!-- Ads minus related Buttons -->Findings by scientists from the Kenya Medical Research Institute (KEMRI) and the Centre for Disease Control (CDC) showed that there were no traces of Ebola or any other related infectious disease in the blood samples taken from the body of the woman.

    <!--Ads and Related Buttons--><!-- Ads minus related Buttons -->?Blood specimen obtained was analysed in both KEMRI and CDC laboratories and is negative for all viral hemorrhagic fever (VHF) including Ebola,? said Director of Public Health Sharif Shanaaz.

    <!--Ads and Related Buttons--><!-- Ads minus related Buttons -->VHF is characterised by fever and bleeding which can lead to shock and death in most cases. They include Ebola, Yellow Fever, Marburg Fever and Rift Valley Fever among others.
    For Ebola, normally, early signs of this infection start with tiredness, headache, sore throat then high fever before bleeding sets in from any body opening like the mouth, nose, vaginal opening or the anus.

    <!--Ads and Related Buttons--><!-- Ads minus related Buttons -->Dr Shanaaz, told reporters in Nairobi that the 29-year-old woman, who was a restaurant attendant, might have died from bleeding possibly caused by stomach ulcer or a related ailment.

    <!--Ads and Related Buttons--><!-- Ads minus related Buttons -->?Tests showed that the lady was not suffering from any infectious disease, but she was vomiting blood and indication that she might have had an ulcer.?
    On Thursday, medics at the KNH Casualty department received Ms Muthoni in a state of heavy bleeding. Earlier suspicions were that the woman who died immediately on arrival was a victim of Ebola. According to Dr Shanaaz, the clinician who first examined the body at the country?s largest referral hospital suspected the disease ?since her clothes were soaked with blood".

    <!--Ads and Related Buttons--><!-- Ads minus related Buttons -->Three other people who had taken her there; her father, taxi driver and another relative were isolated in a special ward as the tests on the body were conducted.



    <!--Ads and Related Buttons--><!-- Ads minus related Buttons -->According to a 2000 report by The American Society of Tropical Medicine and Hygiene, most VHFs are rare and unpredictable epidemics. Rodents like rats and mice and arthropods such as certain insects are the main reservoirs for this type of viruses.
    Dr Shanaaz said medics are yet to find a cure for the diseases because their unpredictable nature makes it difficult to conduct experimental studies.

    <!--Ads and Related Buttons--><!-- Ads minus related Buttons -->The Ministry?s Head of the Division of Disease Surveillance and Response Daniel Langat said that despite the results showing no traces of the dreaded Ebola, the government would continue to monitor the situation.

    <!--Ads and Related Buttons--><!-- Ads minus related Buttons -->?Quarantine facilities will continue to be there to keep track of future incidences. But we would like to assure Kenyans and the entire public that we are all safe.?

    <!--Ads and Related Buttons--><!-- Ads minus related Buttons -->In Africa, Ebola virus was first associated with an outbreak of 318 cases of a haemorrhagic disease the Democratic Republic of Congo in 1976. Similar incidences have since been reported in Northern Uganda, DRC and even South Sudan http://www.nation.co.ke/News/Ministry+allays+fears+of+Ebola+outbreak+/-/1056/1294366/-/
    CSI:WORLD http://swineflumagazine.blogspot.com/

    treyfish2004@yahoo.com

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    • #17
      Re: Woman dies of mystery hemorrhagic illness in Nairobi - Tests negative for Ebola



      Doctors rule out Ebola cases after tests

      Doctors are still trying to establish what killed the 29-year-old lady who bled to death on her way to Kenyatta National Hospital in Nairobi although tests have ruled out the highly contagious Ebola virus or any other viral haemorrhagic fever.

      A sigh of relief greeted news that laboratory tests done by KEMRI CDC on blood samples of Gladys Muthoni were negative to the dreaded ebola, which would have created a health scare among Kenyans as they embark on the holiday season.

      Initial reports that the deceased woman was bleeding from all her body openings proved inaccurate with the Ministry of Public Health officials confirming that Gladys was expelling fresh blood from the mouth only.

      "We wish to assure Kenyans that the cause of death was not Ebola or any other haemorrhagic fever virus infection," said Dr Shahnaz Sharrif, the Director of Public Health and Sanitation in a press conference to calm national fears.

      The three individuals who came into close contact with the deceased, including her father and a taxi driver were on Friday released from quarantine that had earlier been imposed on them.

      "I’m mourning. My daughter left me suddenly. But I was not worried about the possibility of having Ebola. I had faith in God that it would not turn out to be Ebola or any other infectious disease," Gibson Kagai, the father of the deceased said on Friday upon being released.

      Sharriff explained that since the clothes worn by the deceased were soaked with blood, the clinician who first examined the body suspected it to be Ebola or other viral haemorrhagic fevers like Marburg virus.

      Dr Daniel Langat, an epidemiologist at the Ministry of Public Health said doctors are yet to work out exactly what killed the deceased woman, with initial theories being a severe ulcer in the stomach or other conditions that cause bleeding from the gastrointestinal tract.

      But family members revealed that the deceased had no history of ulcers or intestinal bleeding. But her father confirmed that she had a pneumonia attack three weeks ago and that may have contributed to her tragic death.

      Sharriff said that the government had already informed the matter to the World Health Organisation (WHO), which was closely following the case that was initially suspected to be Ebola.

      There was wide interest on the story from the international media and had the case been confirmed to be Ebola, it could have seriously affected the tourism industry at its high season.

      Meanwhile the hotel in Nairobi where Gladys used to work is expected to return to normal work after the fears of Ebola were dispelled by laboratory tests.

      Comment


      • #18
        Re: Woman dies of mystery hemorrhagic illness in Nairobi - Tests negative for Ebola

        NAIROBI, Kenya, Dec 23–Laboratory tests to establish the cause of death of a 29 year old lady who on Thursday bled to death have ruled out Ebola. The investigations done by the Kenya Medical Research Institute and Centres for Disease Control also came out negative for all other viral hemorrhagic fever viruses like Rift Valley […]


        [snip]

        Director of Public Health Dr Shahnaaz Sharif said on Friday that the tests also confirmed that the patient, Gladys Muthoni was not bleeding from eyes, nose and mouth as had earlier been indicated.

        ?What she was having was vomiting blood, what is known as hematemesis so when the doctor saw her first, he thought she was bleeding from the skin but she was actually bleeding from the stomach,? Dr Sharif explained.

        ?It may have been an ulcer or the other thing we are suspecting she may have had esophageal varices,? he went on to say.

        Comment


        • #19
          Re: Woman dies of mystery hemorrhagic illness in Nairobi - Tests negative for Ebola and other hemorrhagic fever viruses - gastrointestinal hemorrhage suspected

          As above, I had suspected that the actual symptoms might be a slight exaggeration as the patient died before receiving any treatment in the hospital.

          So what caused her death? Obviously, some kind of sudden hemorrhage. There has been speculation above about a bleeding ulcer or esophageal varices. Two other articles have mentioned previous tuberculosis and pneumonia (H1N1?) infections which could produce a respiratory hemorrhage. It is unclear based on what evidence there is the presumption that the blood coming out of her mouth came from the GI tract as opposed to the lungs (the old issue that it is difficult to tell if one is coughing up blood or vomitting it, for example http://www.flutrackers.com/forum/sho...=114685&page=2). One article has also suspected she took some kind of medicine immediately before taking ill, which raises the possibility of an accidental poisoning or overdose. It would be useful to know what the medication was supposed to be; an antacid perhaps? It is possible that several of the above factors may have combined in this unfortunate case.

          Comment


          • #20
            Re: Woman dies of mystery hemorrhagic illness in Nairobi - Tests negative for Ebola and other hemorrhagic fever viruses - gastrointestinal hemorrhage suspected

            ProMED is the largest publicly-available surveillance system conducting global reporting of infectious diseases outbreaks. Subscribe today.


            Published Date: 2011-12-23 16:45:58
            Subject: PRO/EDR> Undiagnosed illness - Kenya: (Nairobi) Ebola NOT
            Archive Number: 20111223.3663

            UNDIAGNOSED ILLNESS - KENYA: (NAIROBI) EBOLA NOT
            ************************************************

            A ProMED-mail post
            ProMED is the largest publicly-available surveillance system conducting global reporting of infectious diseases outbreaks. Subscribe today.

            ProMED-mail is a program of the
            International Society for Infectious Diseases
            The International Society for Infectious Diseases (ISID) brings together a network of individuals from around the world.


            [1]Date: Fri 23 Dec 2011Source: Daily Nation [edited]http://www.nation.co.ke/News/Ministry+allays+fears+of+Ebola+outbreak+/-/1056/1294366/-/78bu67z/-/index.html


            The Ministry of Health has allayed fears of an Ebola [haemorrhagic
            fever] outbreak following the death of a woman at Kenyatta National
            Hospital (KNH). At the same time, KNH Friday [23 Dec 2011] discharged
            3 people who had been quarantined for being in contact with the
            patient who died from excessive bleeding.

            Findings by scientists from the Kenya Medical Research Institute
            (KEMRI) and the Centres for Disease Control and Prevention (CDC)
            showed that there were no traces of ebola[virus] or any other related
            infectious [agent] in the blood samples taken from the body of the
            woman. Blood from the patient was analysed in both KEMRI and CDC
            laboratories and is negative for all viral hemorrhagic fever viruses
            tested, including [ebolavirus] said the Director of Public Health
            Sharif Shanaaz.

            Viral haemorrhaic fever is characterised by fever and bleeding, which
            can lead to shock and death in most cases. The viral haemorrhagic
            fevers include Ebola, yellow fever, Marburg fever, and Rift Valley
            fever among others. In the case of ebolavirus fever normally the early
            signs of this infection start with tiredness, headache, sore throat,
            then high fever before bleeding sets in from any body opening like the
            mouth, nose, vaginal opening, or the anus.

            Dr Shanaaz told reporters in Nairobi that the 29-year-old woman, who
            was a restaurant attendant, might have died from bleeding possibly
            caused by stomach ulcer or a related ailment. Tests showed that the
            woman was not suffering from any infectious disease, but she was
            vomiting blood, an indication that she might have had an ulcer.

            On Thursday [22 Dec 2011], medics at the KNH Casualty department
            received the patient in a state of heavy bleeding. Early suspicions
            were that the woman who died immediately on arrival [might have been a
            victim of Ebola haemorrhagic fever since her clothes were soaked with
            blood. The 3 other people who had taken the woman to the hospital --
            her father, another relative, and the taxi driver, were isolated in a
            special ward until the tests on the deceased patient had been
            conducted.]

            According to a report in 2000 by the American Society of Tropical
            Medicine and Hygiene, most viral haemorrhagic fevers are rare and
            unpredictable epidemics. Rodents like rats and mice, and arthropods
            such as certain insects are the main reservoirs for this type of
            virus. [Bats are also likely vectors]. Dr Shanaaz said medics have yet
            to find a cure for these diseases because of their unpredictable
            nature, which makes it difficult to conduct experimental studies.

            The Ministry's Head of the Division of Disease Surveillance and
            Response Daniel Langat said that despite the results showing no traces
            of the dreaded Ebola haemorrhagic fever, the government would continue
            to monitor the situation. "Quarantine facilities will be retained, but
            we would like to assure Kenyans and the entire public that we are all
            safe."

            In Africa, Ebolavirus was first associated with an outbreak of 318
            cases of a haemorrhagic disease the Democratic Republic of Congo in
            1976. Similar outbreaks have since been reported in Northern Uganda,
            Democratic Republic of Congo and even South Sudan. In Kenya, there is
            yet to be any officially confirmed case.

            [Byline: Aggrey Mutambo]

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

            ******
            [2]
            Date: Fri 23 Dec 2011
            From: SK Sharif [edited]


            A 29-year-old female was brought to Kenyatta National Hospital on 22
            Dec 2011. She was pronounced dead on arrival at the casualty. She had
            been alright until 9 in the morning when she started vomiting blood.
            There was no bleeding from other body orifices. There was no history
            of travel outside Nairobi in the last 3 weeks. The hospital doctors
            suspected viral hemorrhagic fever and wanted to rule out
            [ebolavirus].

            Blood samples were taken by CDC and KEMRI staff for testing. The tests
            were negative for Ebola, Marburg, CCHF, yellow fever, and dengue by
            RT-PCR. The tests were negative for Ebola and Marburg by antigen
            capture ELISA tests. The samples were also negative for IgM antibody
            ELISA for Ebola, Marburg, Lassa, yellow fever, dengue, chikungunya,
            CCHF, and Rift Valley fever
            .

            The diagnosis of Ebola [hemorrhagic fever] was most unlikely in this
            case because of a very short history of illness and no history of
            travel outside Nairobi
            in the preceding weeks. The profuse hematemesis
            covered the patient and her clothes with blood and lead the clinicians
            to believe that she was bleeding from the nose, ears, and skin. It
            shows how important it is to get a proper history and examination
            before making a diagnosis of a viral hemorrhagic fever.
            --
            Dr SK Sharif MBS, MMed, MSc
            Director of Public Health and Sanitation
            Ministry of Public Health and Sanitation
            PO Box 30016-00100
            Nairobi Kenya

            via
            ProMED-EAFR
            <promed-eafr@promedmail.org>

            [ProMED-EAFR would like to thank Dr Sharif for his rapid sharing of
            the detailed information above on the official results of the rapid
            investigation and laboratory findings on the case/patient. The
            observation of the importance of a thorough history and physical
            examination at the entry point is notable. - Mod.MPP]

            [It is likely that infectious disease was not responsible for the
            death of the patient. It remains true that up to the present there
            have been no confirmed cases of Ebola haemorrhagic fever in Kenya
            .

            The HealthMap/ProMED-mail interactive map of Kenya, showing the
            location of Nairobi, can be accessed at http://healthmap.org/r/1zkN.
            - Mod.CP]

            Comment


            • #21
              Re: Woman dies of mystery hemorrhagic illness in Nairobi - Tests negative for Ebola and other hemorrhagic fever viruses - gastrointestinal hemorrhage suspected

              Here's a new twist. But if it was E. coli, wouldn't there be a history of fever, diarrhea, etc. that seems to be absent in this case?

              We do have at least one previous incident of a fatality in Kenya suspected as Ebola that was later confirmed as HUS (http://www.flutrackers.com/forum/sho...d.php?t=171686), but that seems to be a drastically different presentation.

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              [snip]

              Dr. Sam Mwaniki, an Infectious Diseases Researcher, also said on Thursday night the symptoms showed either a genetic disorder or an ecoli virus attack was likely.

              "There are various causes of such bleeding, including genetic disorders or internal hemorrhage.

              "You can also have infectious diseases such as ecoli," Mwaniki said.

              Comment

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