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Indonesia - ​Mysterious outbreak kills four in South Sulawesi village - negative for malaria, dengue, H5N1

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  • Indonesia - ​Mysterious outbreak kills four in South Sulawesi village - negative for malaria, dengue, H5N1

    Mysterious outbreak kills four in South Sulawesi village

    Gemma Holliani Cahya and Andi Hajramurni
    The Jakarta Post
    Jakarta / Sat, May 11, 2019 / 10:37 am

    No one really knows what is spreading in the small village of Garonggong in Jeneponto regency, South Sulawesi. However, for the last couple of months, nearly all people living there have been experiencing mysterious symptoms, which started with a fever and pain all over the body, especially in their joints. The unknown disease killed four people from a total of 72 people that had experienced similar symptoms.
    ...
    https://www.thejakartapost.com/news/...i-village.html
    "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
    -Nelson Mandela

  • #2
    Published Date: 2019-05-13 22:05:42
    Subject: PRO/AH/EDR> Unidentified febrile disease - Indonesia: (SE)
    Archive Number: 20190513.6467696
    UNIDENTIFIED FEBRILE DISEASE - INDONESIA: (SULAWESI SELATAN)
    ************************************************** **********
    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: Sat 11 May 2019
    Source: The Jakarta Post [edited]
    https://www.thejakartapost.com/news/...i-village.html

    No one really knows what is spreading in the small village of Garonggong in Jeneponto regency, South Sulawesi. However, for the last couple of months, nearly all people living there have been experiencing mysterious symptoms, which started with a fever and pain all over the body, especially in their joints.

    The unknown disease killed 4 people from a total of 72 people that had experienced similar symptoms.

    The village administration has declared a health emergency. Several villagers have moved to avoid contagion.

    "It has been going on for 2 months. They have experienced the same symptoms, and 4 people have died because of it, including my child, a local, said on Thursday [9 May 2019] as quoted by kompas.com.

    The acting head of Jeneponto Health Agency, Syafruddin Nurdin, said it all began in April [2019] when a couple of villagers were infected. By 24 Apr [2019], 17 residents had been admitted to hospitals and community health centers for the same symptoms.

    Syafruddin said most of them had experienced similar symptoms, such as a fever, headache, nausea and joint pain.

    "All of them came from the same village, Garonggong village," Syafruddin told The Jakarta Post on Friday [10 May 2019].

    However, the health workers and agency have not been able to identify the disease or the cause of it, or why it had struck many people at the same time.

    "The patients gradually lost consciousness. [...] When their blood was tested, all of the suspected diseases such as malaria, dengue fever, Zika, leptospirosis, anthrax, H5N1, were all ruled out. The tests came back negative for all of them," Syafruddin said.

    The Health Ministry has yet to provide an explanation on this matter, but the ministry's disease control and prevention director general, Anung Sugihantono, said his side was investigating the outbreak.

    A special team consisting of academics, health and environment experts, as well as veterinarians have been deployed to the village to carry out disease surveillance and epidemiology research.

    Also, 3 patients have been moved to Makassar, the provincial capital, for further examination and treatment.

    "Initial laboratory research had shown indication of typhoid, but further studies are needed," he added.

    South Sulawesi Health Agency acting head Bachtiar Baso said one of the deceased patients was pregnant. Doctors have been treating the patients using different approaches.

    "Most doctors treated those admitted to the hospitals for typhoid. Some of them saw their health improve, and some of them did not," he said.

    Bachtiar said the investigative team had collected blood samples from the infected patients and animals in the area and had collected soil samples.

    The team suspects those affected may have had either leptospirosis, meningitis or the hantavirus, Bachtiar said.

    "I hope the research results will be revealed soon and the team can gain a better understanding of the disease that has been spreading across Garonggong so we can prepare the necessary medicine and preventative measures," he added.

    --
    Communicated by:
    ProMED-mail Rapporteur Kunihiko Iizuka

    [A comprehensive laboratory workup is necessary to establish a diagnosis. There is no indication that autopsies were carried out that might provide addition clues about the etiology. Mention was made of hantaviruses, but no mention was made of supporting laboratory results that might point to Seoul hantavirus infections, but the large number of cases occurring in a single village in a short period of time would be unusual for hantavirus infections or for scrub typhus. There was an outbreak of Japanese encephalitis (JE) in North Sulawesi last year (2018). Although there is no specific mention of encephalitis in these patients, JE should be ruled out.

    ProMED-mail would be interested in receiving further information about confirmation of typhus, any new cases, or laboratory results as they become available. - Mod.TY

    Comment


    • #3
      I assume they also tested for Chick - although it is not mentioned in the list. Alert have you seen this mentioned?

      Comment


      • #4
        Four deaths in 72 cases is a lot for chikungunya, but I haven't seen any articles that mention testing for it.

        It's also odd that they mention excluding H5N1, but not testing for more common forms of influenza. A good PCR test would rule out not only H5N1 but all influenza.

        The end of the article cited by ProMED seems to suggest that patients who receive treatment are responding better than those that don't. That is more consistent with something bacterial like meningitis, leptospirosis, or typhoid.

        Just waiting for the results of further tests at this point. From my understanding, leptospirosis and typhoid are both fairly difficult to detect, especially after treatment has begun.

        Comment


        • #5
          Translation Google

          3 Residents Died, South Sulawesi Provincial Government Involves Researchers in Disease in Jeneponto

          South Sulawesi
          May 13, 2019 0 20

          Diagnosis of Types of Laboratory Result Waiting Diseases

          Makassar, birohumas.sulselprov.go.id
          - A total of 70 residents of Garongkong Hamlet, Tuju Village, Bangkala Barat Subdistrict, Jeneponto Regency, South Sulawesi, were diagnosed with a disease that is still being sought for its causes and types. Three local residents died. Some residents who have this disease have symptoms of fever and pain in the body, elbow and spine. The Rapid Motion Team has been handed down by the Provincial Government, involving the South Sulawesi Health Office and the South Sulawesi Animal Husbandry and Animal Health Service and related elements.

          Head of South Sulawesi DPKH Animal Health and Veterinary Public Health, Syamsul Bahri, explained on Saturday (11/5) after seeing the phenomenon and reporting in Jeneponto Regency and coordinating with the Jeneponto District Animal Husbandry Office, South Sulawesi Provincial Health Office and Jeneponto Health Service team, after a few days there was no type of disease found. Although it has been tested, for example, some diseases of leptospirosis (a disease caused by the Leptospira interrogans bacteria that is spread through urine or blood of animals).

          The team together came down to make sure there were no soloses (diseases) from animals or livestock. It is feared that the cause is solosis from livestock, such as anthrax.

          "Apparently it was seen and asked by the people there in the village that all the answers were healthy livestock and there were no deaths," Syamsul Bahri said.


          According to Syamsul Bahri, this area is also not a flood area a few months ago that occurred in the Jeneponto region and its surroundings.

          "We try to take the blood of buffaloes and cows and then chickens, we are afraid not to get solos, so we are still waiting for the results of the Bevet (Center for Veterinary Medicine) Maros. We have anticipated, there is already an integrated team down, the Health Office also, "he explained.

          To anticipate, once there are symptoms the disease is found directly dealt with the national animal health reporting system
          "So once there are symptoms, there is a death of livestock, for example suspected, direct livestock was reported to the province and center that day," he added.

          Another step is to educate educators on farmers. Education and information continues to be carried out and vaccines livestock and spraying with disinfectants.

          This case is admitted to have just happened in South Sulawesi. To conclude the disease is still waiting for laboratory results.

          Previously (7/5), Acting Head of South Sulawesi Health Office, said the meeting was held to gather experts, including from Hasanuddin University, Wahidin Hospital, from several expertise and also the Ministry of Health.

          "So, in the case of watching, we have a special meeting, inviting experts and specialists who are experts in their fields to ascertain what the underlying diagnosis is in Jeneponto," Bachtiar said.

          According to Bachtiar, of 70 people who had fever, three patients died, one of whom was pregnant. Some residents were also treated in Takalar District, while the rest were allowed to go home because their condition was assessed to begin to improve.

          "Handling done by doctor's friends there is handling typhus. We are again suspecting whether it is purely typoid or there is a name for typhoid meningitis, this time, that's our analysis, "he said.

          Another possibility besides typhoid meningitis, namely japanesa encephalitis (Japanese encephalitis) as it developed in Bali today.

          From the results of the sample tests for cikungunya, zika, dengue, malaria and rat urine all were negative. Symptoms experienced by residents, typical of fever, pain in the elbow and spine.
          The patient who was there by Bachtiar asked to be transferred to Wahidin Hospital, so that the expert doctor in the field of this disease could confirm the diagnosis.

          "Handling carried out in Takalar handled typhus, but recovered home. But there is no cure so it varies. Apparently the handling is suitable, but the others are not suitable, "he explained.

          Earlier, the Head of the Jeneponto Health Office, Syafruddin Nurdin, said, on April 24, he received community complaints such as nausea and headaches. Those affected are treated in hospitals and health centers. (*)

          https://birohumas.sulselprov.go.id/i...-di-jeneponto/
          "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
          -Nelson Mandela

          Comment


          • #6
            Translation Google

            Blood samples from Jeneponto residents are still being tested by the laboratory

            Author: Indriyani Astuti
            On: Thursday, May 16 2019, 15:35 WIB HUMANITIES

            TEST blood samples to the people in Garonggong Village, Jeneponto Regency, South Sulawesi (South Sulawesi) continue.

            The Director General of Disease Control and Prevention of the Ministry of Health, Anung Sugihantono, explained that the phase I sample test had been completed on Monday (13/5). However, the results cannot yet be known.

            "Test phase II is likely to be completed next Monday," Anung said when contacted in Jakarta, Thursday (5/16).

            Also read: KLB Disease in Jeneponto Still Investigated

            Examination of blood sample tests on humans and the environment and animals around Jeneponto Regency is being carried out. This investigation still requires a laboratory examination.

            As has been reported, dozens of people in Garonggong Village, Jeneponto, have had a disease that has no known cause. The cases are grouped in extraordinary events (KLB).

            The disease caused three people to die. The symptoms reported are fever, joint pain, and abdominal pain. However, the results of the examination of suspected dengue hemorrhagic fever (DHF), leptospirosis, chikungunya, and Japanese encephalitis showed negative results. (OL-6)

            https://mediaindonesia.com/read/deta...i-laboratorium
            "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
            -Nelson Mandela

            Comment


            • #7
              Translation Google

              Monday, May 20 2019 14:51 WIB

              Mysterious Disease Revealed, South Sulawesi Health Office Still Suspects Other Causes
              Muhammad Taufiqqurahman - detikHealth

              Makassar - The Ministry of Health (Kemenkes) managed to identify a mysterious disease that caused 3 people to die in Jeneponto, South Sulawesi. The South Sulawesi Provincial Health Office confirmed this, but still suspected other causes in this case.

              "Already (revealed), but not yet real because all the lab results we have not received. 200 of all our residents check their blood. This takes a week," said Head of South Sulawesi Health Office, Bahctiar Baso when confirmed on Monday (05/20/2019) )

              He said, the initial examination led to typhoid disease which caused dozens of Jeneponto residents to fall ill. This disease is caused by Salmonella infection, a bacterium that attacks the intestine.

              "Although it has been directed to typhoid. It has been directed, mostly," he said.

              Even so, his party still suspects about other causes that caused 3 people to die. Therefore, the blood sample is expected to show definite results regarding this mysterious disease.

              "But we want to see those who died during typhoid tok. That means there is something. So we check it," said Bachtiar.

              Previously, Director General of Disease Prevention and Control of the Indonesian Ministry of Health, Anung Sugihantono said the Ministry of Health team together with the South Sulawesi Provincial Health Office, Unhas R & D and Jeneponto Kadinkes had examined data from laboratory tests on mysterious diseases that occurred in Jeneponto.

              "The results of the lab tests that we did included 3 people who died, 1 was diagnosed with dengue shock syndrome, 1 was diagnosed with typhoid fever and 1 was diagnosed with suspect leptospirosis ," he told detikHealth recently.

              Meanwhile, the results of examinations on people who are sick are found to be increasing indicators for typhoid and suspected leptospirosis. Dengue fever was not found, which was previously called one of the causes of disease.

              https://health.detik.com/berita-deti...gai-sebab-lain
              "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
              -Nelson Mandela

              Comment

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