Maharashtra: 16 people dead in 90 days; Cause of death: unknown

[Ronan Kelly]

16 people dead in 90 days; Cause of death: unknown
By: Priyanka Vora Date: 2011-10-03 Place: Mumbai

Officials and experts from five medical bodies of the state are hard at work in Sindhudurg district, where a mystery organism has claimed 16 lives; preliminary investigations have ruled out Leptospirosis as a probable cause

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Giving officials of the Health Ministry additional cause for concern is the fact that this is the second consecutive deadly outbreak in the district, within the span of a year. Last year, 18 deaths were reported in the district, all caused by leptospirosis. In the Konkan belt, 12,000 confirmed cases of the disease were recorded, with 44 of the afflicted patients succumbing to it.

According to reports, 17 patients complaining of symptoms like cold and respiratory distress died in the past three months. Doctors at Sindhudurg immediately suspected a return of the Leptospirosis bug, and the district had experienced an outbreak of the disease last year. Moreover, the symptoms common among all the victims were fever and respiratory distress, both of which are tell-tale signs of leptospirosis. However, pathological reports managed to confirm Leptospirosis as the cause for only one death of the 17. Six of the deaths occurred in the Kankavli block of the district.

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http://www.mid-day.com/news/2011/oct/031011-16-people-dead-in-90-days-Cause-of-death-unknown.htm

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Re: Maharashtra: 16 people dead in 90 days; Cause of death: unknown

The article also contains:

Expertspeak
Senior physician Dr Pratit Samdani of the Jaslok hospital said, "It's a good move that the state health department is studying the patterns. The fact that a majority of the cases have not tested positive for leptospirosis is a cause for worry. The deaths may have been caused by the Hanata virus [hantavirus -alert], which presents symptoms similar to that of Leptospirosis."


[Presumably they have ruled out H1N1 as well? - alert]

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Re: Maharashtra: 16 people dead in 90 days; Cause of death: unknown

http://www.mid-day.com/news/2011/oct/041011-Experts-try-to-crack-mysterious-illness.htm

Experts try to crack mysterious illness
By: Priyanka Vora Date: 2011-10-04 Place: Mumbai


Medical experts who visited Sindhudurg district have collected serum samples; will submit detailed report to the public health dept

Sixteen deaths in Sindhudurg district in the last three months have kept medical experts on their toes, who are now analysing the serum samples of other patients exhibiting similar symptoms of fever and breathlessness.

MiD DAY had reported yesterday, 'Mystery illness kills 16', how officials and experts from five medical bodies of the state, visited Sindhudurg district to infer the cause of death of 16 residents who succumbed to an unknown malady.

In their two-day visit to the affected villages of Sindhudurg district, the team of experts from B J Medical College and National Institute of Virology (NIV) in Pune have collected serum samples of the affected individuals along with samples from relatives who shared common space with the deceased. To regularly monitor the situation, the state public health department has also asked the doctors to send serum samples of each critical patient to the NIV. Directorate Health Services director, Dr D S Dakhure, said, "The teams have collected the serum samples and studied the demographics of the district. Only after these samples are examined in the laboratory we can determine the actual cause of death."

Common threads
Highlighting similarities among the deceased, Dr C J Shinde from the public health department, said, "When we checked the medical history of the 16 deceased patients, we found that all of them exhibited symptoms of fever and breathlessness while nobody tested positive for leptospirosis, dengue or malaria (diseases where patients usually exhibit such symptoms). This has raised our suspicion that some other pathogen or virus may be responsible, which only the laboratory reports can testify."

The health machinery in Sindhudurg was unable to trace the samples from the deceased therefore the microbiology teams are relying on the serum samples of those associated to the deceased. "Samples that were collected from the deceased were used up to diagnose other ailments but now the NIV has collected serum samples from critical patients to zero down on a common virus," Shinde added. When MiD DAY contacted Dr Mangesh Nanavre, assistant professor, Preventive Social Medicine of BJ Medical College Pune, who was part
of the medical team, he asserted, "While studying the medical background of the deceased patients, three among them had a history of liver cirrhosis which might have triggered the death in their cases. Another common observation is that all the patients died within five days of the fever."
Both NIV and B J Medical College officials have collected samples and will submit a detailed report to the public health department, after which the state will decide if they need to alter the treatment.

[Ronan Kelly]

Re: Maharashtra: 16 people dead in 90 days; Cause of death: unknown

Mice may reveal what killed 16 in Sindhudurg
By: Priyanka Vora Date: 2011-10-12 Place: Mumbai


A team of experts from the National Institute of Virology is now using the animal model testing procedure to figure out 'mystery disease'

Even after five bodies of experts failed to detect the identity of the mystery bug that has caused 16 deaths in Sindhudurg in the past three months, the bewildered state health department has asked the team from the National Institute of Virology (NIV) to expedite the search process, and provide it with some much-needed answers. The body of experts from the nation's apex body in virus research is now injecting serum samples in mice, so as to examine their pathological response to its presence in their bloodstream, and deduce the identity of the pathogen that could have cause the mysterious deaths.

MiD DAY had reported in its October 3 ('Mystery illness kills 16'), about the John Doe bug to which 16 residents of Sindhudurg succumbed in the past three months, all exhibiting the common symptom of respiratory failure.
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"We observed that all the houses in which the disease struck were situated in close proximity of the cattle sheds, a situation favorable for the spread of Leptospirosis," said Dr Mangesh Nanavre, assistant professor, Preventive Social Medicine of BJ Medical College, Pune.

He added that most of the deaths had occurred within five days of the visible onset of symptoms.
Meanwhile, Dr RD Mane, civil surgeon, Sindhudurg Civil hospital, said, "At present, we are treating all patients -- who are exhibiting symptoms like fever, weakness and cough -- as possible carriers of the mystery bug. If they test negative for leptospirosis, malaria, and dengue, we administer medication for symptomatic relief."
At present the hospital has 24 patients suffering from leptospirosis, two of whom are admitted in the ICU.
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Dr Pradeep Awate, in-charge of the state's integrated disease surveillance programme, said, "At present, we have reported a total of 58 cases of leptospirosis since April. The doctors have been strictly instructed to treat every case of fever as a suspected case of leptospirosis."

http://www.mid-day.com/news/2011/oct/121011-National-Institute-of-Virology-Sindhudurg.htm

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Re: Maharashtra: 16 people dead in 90 days; Cause of death: unknown

Buried later in the article is the following very revealing text. This might be leptospirosis after all:

http://www.mid-day.com/news/2011/oct/121011-National-Institute-of-Virology-Sindhudurg.htm

Meanwhile, a team from the Microbiology and Preventive Social medicine department of Pune's BJ medical College has examined samples from seven close associates of the victims, who also reported similar symptoms. Of these, six have tested positive for Leptospirosis.

[snip]

"We observed that all the houses in which the disease struck were situated in close proximity of the cattle sheds, a situation favorable for the spread of Leptospirosis," said Dr Mangesh Nanavre, assistant professor, Preventive Social Medicine of BJ Medical College, Pune.