Uruguay - Unknown illness on ship - 2 deaths 1 sick - tests negative for influenza, dengue

[alert]

Re: Uruguay - Unknown illness on ship - 2 deaths 1 sick - tests negative for influenza, dengue

Published Date: 2013-06-12 13:12:29
Subject: PRO/EDR> Undiagnosed deaths - Uruguay: (Montevideo) ex Chinese ships, RFI
Archive Number: 20130612.1768816

UNDIAGNOSED DEATHS - URUGUAY: (MONTEVIDEO) ex CHINESE SHIPS, 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: Wed 5 Jun 2013
Source: Portal 180 (Uruguay) [in Spanish, machine trans., edited]
http://www.180.com.uy/articulo/33691...-en-cuarentena


On [Tue 4 Jun 2013] the [Uruguayan] government placed under quarantine a 2nd Chinese-flagged vessel near the coast, after one of its crew presented with symptoms similar to those of 2 sailors from another ship of the same origin who died recently.

The Ministry of Health (MOH) said the new crew member is hospitalized in Montevideo in serious condition, but the illness that affects him is not known.

The 1st ship, with 40 people on board, entered Montevideo last week [week of 27 May 2013] with one crew member dead and another one sick, who after being treated at a local health center also died. Another sailor from that ship remains in hospital.

"Infectious diseases such as influenza, dengue, leptospirosis, and hantavirus infection have been ruled out," the national director of health, Marlene Sica, said in a press conference.

Those affected had similar symptoms with lower limb edema, respiratory problems, and heart failure.

Authorities ordered the autopsy of the 2 bodies, while tests are being carried out on the other 2 hospitalized patients. "We are now waiting for toxicology results," said Sica.

However, "one of the boats left Beijing more than a year ago," making it more difficult to determine what the crew have eaten or what they have been exposed to in order to identify the cause of illness, she said.

Uruguay has reported the cases to the World Health Organization (WHO) and the Pan American Health Organization.

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

[The news report above first appeared in ProMED/ESP "Enfermedad desconocida - Uruguay (MON): muertes, cuarentena de barcos" archive no 20130606.326495. This post reports a shipboard outbreak that involved 3 members of the crew (2 of whom died) of one Chinese-flagged ship and a 4th member of the crew of another Chinese-flagged ship both quarantined in the port of Montevideo, Uruguay. All 4 developed a similar illness with lower limb edema, respiratory problems, and heart failure. No further details are given, except one of the 2 ships left Beijing over a year ago. We are not told what the ships' prior ports of call were or if the ships traveled together and had similar ports of call.

We are told that infectious diseases such as influenza, dengue, leptospirosis, and hantavirus infection have been ruled out, but we are not told how this was done. Since infectious diseases were investigated first, presumably the patients were febrile and developed acute congestive heart failure. Diagnostic possibilities include orally transmitted Chagas disease, which causes acute myocarditis (due to massive parasite transmission) after an incubation period of 5 days (http://www.scielo.br/scielo.php?scri...=iso&tlng=en); and enterovirus, such as EV71, or a coxsackie virus infections, which have been linked in the literature to clusters of cases of acute myocarditis that were preceded by a non-specific febrile prodrome that suggested the outbreak was viral in origin (http://wwwnc.cdc.gov/eid/article/11/...52_article.htm). Dengue (http://www.biomedcentral.com/content...0500-4-268.pdf) or influenza (http://bit.ly/11vxdAA) can also cause a non-specific febrile illness with acute myocarditis.

The possibility that this is not due to an infection but rather is due to a toxic exposure also exists. Acute cocaine intoxication may also cause acute congestive heart failure and pulmonary edema (http://emedicine.medscape.com/articl...view#aw2aab6b6).

ProMED-mail would greatly appreciate more information from knowledgeable sources on this cluster including laboratory testing thus far, clinical and epidemiologic details of the cases -- age, sex, a detailed history of travel, food history, history of contact with other cases or animals.

[alert]

Re: Uruguay - Unknown illness on ship - 2 deaths 1 sick

Here's one from Peru ex China in 2008 that was due to adenovirus and possibly an unidentifed toxin:

http://www.flutrackers.com/forum/showthread.php?t=65398

And here's one from France ex Russia in 2010 that was due to methanol poisoning:

http://www.flutrackers.com/forum/sho...d.php?t=142776

[alert]

Re: Uruguay - Unknown illness on ship - 2 deaths 1 sick

Two points. First, infleunza, dengue, leptospirosis, and hantavirus are excluded. Secondly, if they left China a year ago, this illness could not have been contracted in China.

I can't find the thread, but I remember reading a couple years ago about a similar boat somewhere in South America that left China a long time earlier and was quarantined for undiganosed fatalities. That outbreak was the result of an accidental poisoning.

Published Date: 06/06/2013 00:42:10
Subject: PRO / AH> Unknown Disease - Uruguay (MON): Kill, boat curentena
Archive Number: 20130606.326495

DISEASE UNKNOWN - URUGUAY (MON): DEATHS, BOATS CURENTENA
************************************************** ****
A ProMED-mail
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org

Date: June 5, 2013
Source: 180.com, Uruguay
http://www.180.com.uy/articulo/33691...-en-cuarentena
[Edited by Jaime Torres]


The government put in quarantine Tuesday near the coast to a
second Chinese flag ship, after one of its crew
showing symptoms similar to those of another two marine vessel
the same origin who died in recent days.

The Ministry of Health (MOH) said the new crew
concerned is hospitalized in serious condition in Montevideo, although
not know the disease that afflicts.

The first ship with 40 people on board, entered Montevideo
last week with a crew died and another patient, who after being
treated at a local health center also died. Other marine of that
boat remains hospitalized.

"The diseases that were first infections were discarded as
influenza, dengue, leptosirosis, or hantavirus, "he told conference
press the national director of Health, Marlene Sica.

All affected had similar symptoms, with edema in the
lower limbs, respiratory problems and heart failure.

Authorities ordered the autopsy of the two bodies,
while they are performing analysis to the other two patients
hospitalized.

"We are now waiting for toxicology results," said
Sica, indicating that while performing a survey of the
causes that may be behind the diseases.

However, "one of the boats over a year ago that left
Peking ", making it perform more complex than counting the
crew have eaten or what they have been exposed and determine the
condition of the crew, he said.

Uruguay and reported the cases to the World Health Organization
(WHO) and the Pan American Health Organization.


Communicated by: Jaime R. Torres <torresjaime@cantv.net>


- ProMED-ESP

[tetano]

Re: Uruguay - Unknown illness on ship - 2 deaths 1 sick

The cause of the death of two crew members is unknown. The MSP research in its laboratories. The authorities did not permit the entry of the ship to Montevideo.



The country's health authorities try to determine the cause of the death of two crew members of a Chinese fishing boat which is anchored near the entrance to the port of Montevideo (pictured).

The alarm went on last Tuesday when the first of the crew died. On Thursday he died the second in a mutual society of Montevideo. About 30 people make up the crew.

On Friday were the first signs of this patient died at the public health laboratory to determine what died, but until this Saturday is no answer.

Before the unknown who revealed the case, health authorities decided to keep out of the port to the ship, which is dedicated to fishing for squid. At the moment there are two dead and a third person is sick, but apparently out of danger. No one knows what has yet.

The situation was confirmed to underline by Raquel rose, Director of epidemiology of the Health Ministry public.

As did underscore, the National Naval Prefecture and the national ports administration expected the MSP instructions. There is fear the ignorance of the cause of death.

Public health sources said to underscore that is not yet known if it is a virus or what. The patients who died suffered swelling of the abdomen and a general malaise.

Other sources consulted by underline, with access to the port of Montevideo, said that the fear is such that few dare to go to the ship anchored in quarantine.

http://www.subrayado.com.uy/Site/not...to-dos-muertos

[FrenchieGirl]

The Uruguay Health Minister has quarantined a fishing vessel owing to the death of two crew and the illness of a third, from unknown causes. These members of the crew suffered oedema from the lower body extremities, cardiac insufficiency, fatigue and breathing difficulties. No cause could be ascertained before and after autopsy. The authorities have quarantined the vessel. It had sailed from China and had stopped for refuelling in Hong Kong and Singapore. Uruguay notified both WHO and PAHO.

Sources (in Spanish):

MSP investigate ship crew cause of death

Uruguay - Chinese Fishing quarantined outside the port, two dead