Cholera Outbreak in Papua New Guinea?s Morobe Province

[sharon sanders]

Re: 41 dead, hundreds affected by mystery illness in Papua New Guinea?s Morobe Province

Sent to ProMed.

[alert]

Re: 41 dead, hundreds affected by mystery illness in Papua New Guinea?s Morobe Province

Sent to ProMed.

Good move. Thanks.

[alert]

Re: 41 dead, hundreds affected by mystery illness in Papua New Guinea?s Morobe Province

ProMed has actually seen similar outbreaks in the same area before. Here is one from 2004. The possible dianoses mentioned at the end of this article seem to apply to the current outbreak as well.

http://www.promedmail.org/pls/otn/f?p=2400:1001:1288464687879163::::F2400_P1001_BACK_PAGE,F2400_P1001_ARCHIVE_NUMBER,F2400_P1001_USE_ARCHIVE:1001,20040728.2062,Y

UNDIAGNOSED DEATHS - PAPUA NEW GUINEA (SOUTHERN HIGHLANDS) (02):
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: 28 Jul 2004
From: ProMED-mail <promed@promedmail.org>
Source: The National [edited]
<http://www.thenational.com.pg/0728/nation2.htm>


Mystery disease killing 2 a day
-------------------------------
An average of 2 persons are dying each day from the mystery disease
that has hit the Kagua Erave district in Southern Highlands,
according to the son of a medical assistant.

[One individual interviewed], whose father works at the Usa village
aid post, said that this month [July 2004] alone, 25 people from
Apopa village had died. "It is a major epidemic," he told The
National on arrival in Lae yesterday [27 Jul 2004], and warned that
the aid post was running out of medical supplies.

Villagers from surrounding areas have also succumbed to the disease,
which is believed to be malaria. Since April 2004, the disease is
reported to have claimed more than 100 lives. A medical team has been
dispatched to the villages, but the provincial health authorities
have yet to hear from it.

[The individual interviewed] said he spent 3 weeks with his father in
Usa. He said that 2 aid posts in the Sumi and Wabi areas had been
closed due to election-related problems, and sick people had to go to
Usa for treatment. "The sick are coming from the villages of Lakira,
Kandopa, Imane, Marunda, Ralomanda, Rakere, Sugu, Rakuare, Sare in
the Usa, Wabi, and Sumi areas. They have symptoms of malaria, and the
aid post can only give them anti-malaria tablets, which does not seem
to do much good. The villagers are finding it hard to arrange proper
funerals, as the deaths are continuous, with many belonging to the
same family. This is a major disaster that has hit the entire Kagua
Erave area," he said, adding that he had witnessed some of the
deaths. [He] said his father's aid post was ill-equipped to look
after the 20 000 people in the Usa, Wabi and Sumi areas. "This is a
crisis, and I urge the medical team that is investigating the cause
of the mystery disease to quickly find out the cause," he said. He
said the problem was compounded by the fact that the people want to
move around freely.

[Byline: Peter Miva]

--
ProMED-mail
<promed@promedmail.org>

[In the prior ProMED-mail posting (Undiagnosed deaths - Papua New
Guinea (Southern Highlands): RFI 20040721.1978), the symptom complex
of a severe, fatal illness, associated with fever, headache, nausea,
vomiting, and jaundice, was given in the news wire article. The
earlier article mentioned that, although malaria was suspected, of
the 5 individuals on whom blood testing was performed, all 5 were
negative for malaria. It appears as though the above outbreak is
still being considered as due to malaria, in which case, drug
resistance (treatment failure) would be the explanation for the high
mortality being reported (albeit a true case fatality rate is not
calculable, as the number of non-fatal cases is not given). In the
absence of more definitive information from authoritative sources,
one is hard pressed to conclude that this outbreak is due to drug
resistant malaria, or, to other possible etiologies of illness that
present with fever, headache, nausea, vomiting, and jaundice such as
the hepatitis viruses, leptospirosis, malaria, or old world
hantaviruses. Again, we are requesting more information from
knowledgeable sources. - Mod.MPP]

[see also:
Undiagnosed deaths - Papua New Guinea (Southern Highlands): RFI 20040721.1978]
.........................mpp/msp/lm

[alert]

Re: 41 dead, hundreds affected by mystery illness in Papua New Guinea?s Morobe Province

And another one from 2004, this one with over 100 deaths. This one also mentions children being affected the hardest. Apparently reports of undiagnosed outbreaks with large numbers of deaths aren't that uncommon in that area.

http://www.promedmail.org/pls/otn/f?p=2400:1001:1288464687879163::::F2400_P1001_BACK_PAGE,F2400_P1001_ARCHIVE_NUMBER,F2400_P1001_USE_ARCHIVE:1202,20040419.1083,Y

UNDIAGNOSED DEATHS - PAPUA NEW GUINEA: 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: 16 Apr 2004
From: ProMED-mail <promed@promedmail.org>
Source: Post Courier [edited]
<http://www.postcourier.com.pg/>


Mystery disease breaks out near Yonki
---------------------
More than 100 people have reportedly died in a month following the outbreak
of a mystery disease in several villages near Yonki, Eastern Highlands
Province.

Kollen Upa, a community leader and chairman of the Eastern Highlands
Blockholder coffee growers' association, who hails from Omaura, one of the
villages affected, raised the alarm yesterday. In his village alone, 3
people had died "strangely" in just one day.

Villages affected by what they claimed to be malaria and typhoid were
Omaura, Onanika, Sasaura, Ikana and hamlets surrounding the Yonki dam, in
the Obura-Wonenara electorate. These villages -- from the last census --
have a total population of more than 5000 people.

Mr Upa said men, women and children in the area have been falling sick and
dying since mid-March 2004. Children mainly have been worst hit by the
outbreak.

"People are dying one after the other in the villages. It is an outbreak
situation at the moment, and we desperately need an urgent medical
assistance," Mr Upa said.

Health authorities in Kainantu confirmed receiving verbal reports of the
diseases and deaths in the area. However, the chief executive officer of
the Kainantu hospital, Thomas Koimbu said so far reports have been sketchy,
as the villages were remote.

"We will investigate, however, at this stage we are only getting verbal
reports coming from the area," Mr Koimbu said. "At this stage we have yet
to establish a firm diagnostic on whether the reported cases are of malaria
or typhoid."

Mr Koimbu said malaria was endemic in the area due to the rising water
levels of the Yonki dam.

The Eastern Highlands provincial health adviser, when contacted, said it
was news to him and was skeptical about giving further information.

Mr Upa said deaths had occurred in the area and villagers were living with
fear and anxiety. He named the 3 deaths in his village as [an adult male]
in his mid 40s, [an adult female aged] 26 and a 9-year-old boy.

--
ProMED-mail
<promed@promedmail.org>

[The above newswire is too sketchy to attempt to draw any conclusions on
the etiology of the reported deaths. More information from knowledgeable
sources would be appreciated. - Mod.MPP]
...........................mpp/pg/dk

[Blue]

Re: 41 dead, hundreds affected by mystery illness in Papua New Guinea?s Morobe Province

I think we're close to 100 deaths. This is a VERY bad sign. And with red eyes as a symptom, this probably isn't any kind of flu.

Conjunctivitis is associated with flu. One country in Africa was reporting this with swine flu cases.

I also know of two cases locally that were probably flu (not tested).

[sharon sanders]

Re: 41 dead, hundreds affected by mystery illness in Papua New Guinea?s Morobe Province

Updated Fri Aug 28, 2009 5:00pm AEST


Authorities in Papua New Guinea are investigating a mysterious disease that reportedly claimed the lives of more than 40 people in a remote District of Morobe province last week. Ten villages with no health facilities and poor road and communication links are reported to have been affected by the disease.

Presenter: Firmin Nanol
Speaker: Morobe Province Health Advisor, Dr Theo Likei

• Listen:
• Windows Media

While local media reports say 70 people have died from the mysterious disease, the Morobe Provincial Health Office has denied that. The Health Advisor Dr Theo Likei says that 20 people died of dysentery in the remote Menyamya District last week, and 21 died of a mysterious influenza-like disease. He says more than 800 people have been affected from nearly 10 villages. He says the worst affected are children and pregnant women.

The Morobe Provincial Health authorities say they have responded as soon as the reports of the deaths reached them. However Doctor Theo Likei says medicines could not be delivered on time as the area is so remote and there are no road links.

Officials from both the World Health Organisation and PNG's Health Department have visited the affected villages and will test samples collected, to determine the cause of the deaths.

http://www.radioaustralia.net.au/pacbeat/stories/200908/s2670180.htm

[Rwilmer]

Re: 70 dead, 800+ hundred affected by mystery illness in Papua New Guinea?s Morobe Province

UNDIAGNOSED DISEASE - PAPUA NEW GUINEA (MOROBE), 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>

******
[1]
Date: Fri 28 Aug 2009
Source: ABC, Radio Australia [edited]
<http://www.radioaustralia.net.au/pacbeat/stories/200908/s2670180.htm>


Morobe people dying of mysterious disease
-----------------------------------------
Authorities in Papua New Guinea [PNG] are investigating a mysterious
disease that reportedly claimed the lives of more than 40 people in a
remote District of Morobe province last week. A total of 10 villages with
no health facilities and poor road and communication links are reported to
have been affected by the disease.

While local media reports say 70 people have died from the mysterious
disease, the Morobe Provincial Health Office has denied that. The health
advisor Dr Theo Likei says that 20 people died of dysentery in the remote
Menyamya District last week, and 21 died of a mysterious influenza-like
disease. He says more than 800 people have been affected from nearly 10
villages. He says the worst affected are children and pregnant women.

The Morobe Provincial Health authorities say they have responded as soon as
the reports of the deaths reached them. But Dr Theo Likei says medicines
could not be delivered on time as the area is so remote and there are no
road links.

Officials from both WHO and PNG's Health Department have visited the
affected villages and will test samples collected, to determine the cause
of the deaths.

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

******
[2]
Date: Fri 28 Aug 2009
Source: Radio New Zealand International [edited]
<http://www.rnzi.com/pages/news.php?op=read&id=48764>


41 dead, hundreds affected by mystery illness in Papua New Guinea's Morobe
Province
-----------------------------------------------------------------------------------

Outbreaks of dysentry and influenza in the Menyamya district of Papua New
Guinea's Morobe Province have claimed the lives of 41 people in the past 3
weeks. The provincial health advisor for Morobe, Dr Theo Likei, confirmed
more than 800 people have become unwell and 21 have died from influenza and
a further 20 are dead due to dysentry. He says the cause is not yet known
and more villagers may die.

"The centre of the outbreak is in one village in Menyamya district but
people in 9 other villages have also become unwell. The location of the
problem seems to be centred around one particular village, that's Akwanda
village. There are 9 other villages being involved, but with fewer numbers
than Akwanda. Akwanda definitely had about 99 per cent of the total. Out of
830 700 plus are from Akwanda. Out of 41 deaths, 40 deaths are from Akwanda
alone."

A total of 27 people have been transported out of Akwanda village for
further treatment. A medical team from Port Moresby, including staff from
WHO, and supplies have been dispatched. The situation is being continuously
monitored but communication with the villages is difficult due to their
remote locations.

Dr Likei says medical staff are working around the clock to contain the
illness outbreak and, if there is any further spread, more help from
outside the district will be needed.

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

[These 2 reports are conflicting. The 1st suggests a specific outbreak of
influenza-like illness (possibly influenza pandemic H1N1 2009 influenza
virus) on account of the vulnerability of children and pregnant women. The
2nd suggests a more extensive multifaceted outbreak. Further information is
awaited.

The province of Morobe can be located using the HealthMap/ProMED-mail
interactive map of Papua New Guinea at <http://healthmap.org/r/00JW>. - Mod.CP]

[see also:
2007
---
Undiagnosed deaths, human, swine - Papua New Guinea (02) 20070305.0781
Undiagnosed deaths, human, swine - Papua New Guinea: RFI 20070221.0641
2004
---
Undiagnosed deaths - Papua New Guinea (Southern Highlands) (03): RFI
20040801.2101
Undiagnosed deaths - Papua New Guinea (Southern Highlands) (02): RFI
20040728.2062
Undiagnosed deaths - Papua New Guinea (Southern Highlands): RFI 20040721.1978
Undiagnosed deaths - Papua New Guinea: RFI 20040419.1083]

...................mpp/cp/ejp/sh

http://www.promedmail.com/pls/otn/f?..._ID:1000,78985

[sharon sanders]

Re: 70 dead, 800+ hundred affected by mystery illness in Papua New Guinea?s Morobe Province

Thanks ProMED.

[Rwilmer]

Re: 70 dead, 800+ hundred affected by mystery illness in Papua New Guinea?s Morobe Province

Thank you, Sharon for sending in the articles.

[Treyfish]

Re: 70 dead, 800+ hundred affected by mystery illness in Papua New Guinea?s Morobe Province

Mysterious killer illness strikes PNG province

<!--headlinesBar--><!--headlinesRelated-->
PHOTO

Villagers help unload supplies in Papua New Guinea. [Australian Defence Force]







<!--headlinesRelated--><!--headlinesCopy-->Firmin Nanol, Port Moresby
Last Updated: Fri, 28 Aug 2009 08:12:00 +1000
Authorities in Papua New Guinea are investigating diseases that claimed the lives of more than 40 people in a remote district of Morobe province last week.

Health adviser for Morobe province, Dr Theo Likei, says 20 people died of dysentery in the remote Menyamya district, and 21 died of a mysterious influenza-like disease.

He says more than 800 people have been affected and fears children and pregnant women are at risk.

''The most important people are, of course, our children, under-fives," he says.

"Then the second will be followed by our women, particularly those who are pregnant, we want to make sure they are safe.''

He says officials from the World Health Organisation and PNG's health department are in the area to determine the cause of the deaths.

Ten villages with no health facilities and poor road and communication links are reported to have been affected by the disease.http://australianetworknews.com/stor...38.htm?desktop

[Laidback Al]

Re: 70 dead, 800+ hundred affected by mystery illness in Papua New Guinea?s Morobe Province

Location of Morobe Province in Papua New Guinea.

[Sally Furniss]

Re: 70 dead, 800+ hundred affected by mystery illness in Papua New Guinea?s Morobe Province

communities affected included those in the Karanas and Kundi catchment areas, Wailala and Wawoka catchment in Wapi LLG. (Local Level Government (LLG) areas.)

Kome local level government manager Desmond Timiyaso feared that the death toll would increase further

Morobe Province
-Menyamya District
--Kapao Rural
--Nanima Kariba
--Kome Rural
--Wapi Rural

District Capital is Menyamya


Subdivisions of Papua New Guinea in local languages (capitals in brackets)
eng: Morobe Province
tpi: Morobe Provins
eng: 9 districts | tpi: 9 distrik: Bulolo; Finschhafen (Gagidu); Huon (Salamaua); Kabwum; Lae; Markham (Kaiapit); Menyamya; Nawae (Boana); Tewae-Siassi (Wasu)

http://www.geonames.de/coupg-sub.html

http://www.christianvisionpng.info/page30.htm

[hawkeye]

Re: 70 dead, 800+ hundred affected by mystery illness in Papua New Guinea?s Morobe Province

Listening to the audio a CFR of 9.4&#37; has occurred in 3 villages

212 dysentery with 20 deaths = 9.4%

audio link:

http://www.abc.net.au/ra/pacbeat/stories/m1782607.asx

[Shannon Bennett]

Re: 70 dead, 800+ hundred affected by mystery illness in Papua New Guinea?s Morobe Province

I cannot help but wonder if any of the locals are in panic mode? That is a very ugly CFR.

[alert]

Re: 70 dead, 800+ hundred affected by mystery illness in Papua New Guinea?s Morobe Province

Untreated cholera or dysentery in Africa has been reported to have CFR as high as 40-60%. That is only ugly if this is flu.