Antigua - Further testing to determine cause of 2 boys mysterious deaths / Update- Meningitis Caused Deaths

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<LABEL class=article-particulars>Further testing to determine cause of boys? mysterious deaths </LABEL>
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<LABEL class=article-particulars>By Amar Spencer - Saturday, April 10th, 2010</LABEL>
<!-- content --> Photo: From left, Nurse Epidemiologist Sybil Smith; Acting Permanent Secretary in the Ministry of Health Edson Joseph; Chief Medical Officer Dr Rhonda Sealey-Thomas; Medical Officer of Health Dr Oritta Zachariah; Public Relations Officer for the Ministry of Health Colin O?Neal in a press conference at the Ministry of Health yesterday


An autopsy was conducted on Thursday on the two boys who died suddenly in Liberta and English Harbour. However, specimen had to be sent to the Caribbean Epidemiology Centre (CAREC) in Trinidad & Tobago yesterday for further testing so that the exact cause of death can be determined.

Health officials made the announcement in a press briefing at the Ministry of Health.

Chief Medical Officer Dr Rhonda Sealey-Thomas said that the medical officials at CAREC have been asked to expedite the investigation so that the results can be sent back to Antigua & Barbuda as soon as possible.

In the meantime, the Ministry of Health has been keeping tabs on any cases of persons with symptoms of diarrhoea, fever and vomiting, she said. Dr Sealey-Thomas therefore cautioned residents to be on the lookout for any such occurrences.

According to Medical Officer of Health Dr Oritta Zachariah, based on the symptoms the two boys exhibited, it can be construed that the disease is infectious and could possibly be from a point source.

?We can reasonably assume it was infectious because the pathogenesis suggests some sort of viral illness,? she said. ?We have done our investigations ? and we have had questions asked of all the communities in which these two children resided.?

Asked if there have been any other incidences of the illness, Dr Zachariah confirmed there have only been the two cases and reiterated the importance for parents and the public at large to be vigilant of any such symptoms.

But she noted that there has been an increase in vomiting, diarrhoea and fever over the past three weeks because of the dry conditions and water rationing.

When Dr Zachariah was questioned on whether there is a possibility that the disease could have been from a foreign source, given the proximity of Liberta and English Harbour to a port, she said it could be foreign or it could be endemic.

Dr Zachariah further noted that they have also not ruled out the possibility that the deaths could have been caused by the Influenza A H1N1, as a swab was taken from one of the deceased to be sent to CAREC to test for the virus.

Meanwhile, assuring the public that the Ministry of Health is committed to ensuring the well-being of the populace, Acting Permanent Secretary in the Ministry of Health Edson Joseph said: ?The Ministry of Health is taking this matter as a very serious one and everything will be done to ensure the safety of our citizens and to maintain the wellness that they presently experience and enjoy.

?As soon as the information is disseminated pertaining to the cause of death, that if it is infectious, that every precaution will be taken to isolate or quarantine those who have been in contact with those who have passed and every effort would be made to ensure that they are properly treated so that they can be in a state of wellness once again,? he added.

The health officials renewed their calls for residents to practise proper hygiene and to ensure that children are hydrated at all times. The two boys, victims of what has become a mysterious illness, died just two days apart.

The first victim was six-year-old Alfred Norwood Perkins who lived in English Harbour and died on Monday a few hours after waking with a fever.

By Wednesday, nine-year-old Ishmael Bailey of Liberta died shortly after exhibiting symptoms of fever, diarrhoea and vomiting.

http://antiguaobserver.com/?p=29227

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Re: Antigua - Further testing to determine cause of 2 boys mysterious deaths

H1N1 Not Ruled Out

Saturday, 10 April 2010 06:55 Kam Wright Antigua Health - Health News


Given the global health pandemic last year concerning H1N1 - a subtype of the Influenza A - authorities are not ruling out a recurrence of the virus.

Medical Officer of Health Dr Oritta Zachariah told the press on Friday that a sample is being tested for the virus to determine if it could be the mysterious flu-like illness which resulted in two children's deaths.

?We have done the nasopharyngeal swab that is required for H1N1 in one of the siblings of the children who died, and we are sending if off to the CAREC as we speak, for investigation,? Zachariah said.

In the meantime, authorities are still stumped as to cause of the boys' deaths, but Zachariah said so far they ?can reasonably assume that it was infectious because the pathogenesis suggests some sort viral illness".

She added, ?It?s obviously an infection by method of presentation. Both children had an intense course of diarrhoea in an hour of dying, and by extension we can deduce that to a diagnosis of some sort of bacterial or viral infection. But at the same time it could also be something that they contracted from a point source."

A well-placed medical source has told Caribarena.com that if the virus turns out to be H1N1, the Ministry of Health has enough vaccine on hand.

At the press conference, Chief Medical Officer Dr Rhonda Sealey-Thomas said her office is awaiting confirmation from preliminary tests done in Antigua.

?Samples were done on both causes at the lab in Antigua and it is currently conducting investigations," she said. "They will be sent to CAREC today [Friday] for further testing. We haven?t had any confirmatory results from the pathologist so I won?t be able to comment on anything regarding test results,? Dr Sealey-Thomas said.

She said she has been advised by Caribbean Epidemiological Centre (CAREC) that once they receive the samples, they would be working expeditiously over the weekend. The Antigua medical team has been discussing the situation with CAREC since the boys' sudden deaths.

http://antigua.caribarena.com/health/health-news/8882-h1n1-not-ruled-out.html

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Re: Antigua - Further testing to determine cause of 2 boys mysterious deaths

<TABLE class=contentpaneopen><TBODY><TR><TD class=contentheading width="100%">Cause of death of two children to be revealed </TD><TD class=buttonheading align=right width="100%"></TD></TR></TBODY></TABLE><TABLE class=contentpaneopen><TBODY><TR><TD></TD></TR><TR><TD vAlign=top>Written by Reporter </TD></TR><TR><TD class=createdate vAlign=top>
Monday, 12 April 2010 03:00

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Ministry of health Officials are optimistic that they will, at some point today, have pertinent information that will reveal what might have caused the deaths of two young people from the St. Paul?s community last week.

"Basically, we are trying to find out why two otherwise healthy children died within the last 36 hours. They had a viral type illness, started vomiting and having diarrhea then met their demise within an hour," Medical Officer of Health Oritta Zachariah told the AntiguaSun one day after the cases came to light.

"We are looking to see what this might be. We are collaborating with (CAREC) the Caribbean Epidemiology Centre to see what they come up with before we put out any definitive results. In the meantime we are not waiting around but are depending on our local labs to work on giving us some preliminary answers at least," Dr. Zachariah said.

During meetings at the Cobbs Cross and Liberta Primary Schools last week, Zachariah and chief health inspector had no positive information for community members save to offer them useful hints at maintaining an hygienic environment, an important aspect in stopping the spreading of any possible contagious illnesses.

The AntiguaSun has learned, however, that autopsy results are now available to officials and that is more than likely that test results from the Caribbean Epidemiology Centre (CAREC) would also become available to officials so that the nation will know whether or not it has a potential epidemic on hand or if the two cases may be considered isolated incidents.

http://www.antiguasunonline.com/news/local/256308-cause-of-death-of-two-children-to-be-revealed.html

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Re: Antigua - Further testing to determine cause of 2 boys mysterious deaths

http://www.prensa-latina.cu/index.php?option=com_content&task=view&id=178229&Itemid=1

Entity analyze child death Caribbean Antigua and Barbuda
s?bado, 10 de abril de 2010 Saturday, April 10, 2010

10 de abril de 2010, 10:49 Saint John´s, 10 abr (PL) El Centro Epidemiol?gico del Caribe (CAREC) realiza hoy las autopsias de dos ni?os de Antigua y Barbuda que murieron repentinamente a inicios de semana pocas horas despu?s de presentar fiebre alta, v?mito y diarrea. April 10, 2010, 10:49 Saint John's, Apr 10 (Prensa Latina) The Caribbean Epidemiology Centre (CAREC) today made the autopsies of two children of Antigua and Barbuda who died suddenly earlier this week just hours after presenting high fever, vomiting and diarrhea.

Seg?n una nota de prensa del ministerio de Salud de las islas, esa instituci?n regional profundizar? en las investigaciones forenses iniciadas en el pa?s para determinar las causas del fallecimiento de Alfred Norwood, de seis de edad, e Ishmael Bailey, nueve. According to a press release from the Ministry of Health of the islands, that institution will deepen regional forensic investigations initiated in the country to determine the cause of the death of Alfred Norwood, age six, and Ishmael Bailey, nine.

Los casos -precis? el documento- son la actual prioridad de CAREC y los resultados de los estudios cl?nicos ser?n difundidos de manera inmediata a la poblaci?n en cuanto est?n disponibles. The cases, said the document, are the current priority of CAREC and the results of clinical studies will be reported immediately to the public as they become available.

El gobierno acudi? a los servicios del centro establecido en Trinidad y Tobago por sospechas de una enfermedad contagiosa, que hasta la fecha s?lo ha cobrado las vidas de Norwood y Bailey. The government went to the center's services established in Trinidad and Tobago on suspicion of a contagious disease, which so far has only taken the lives of Norwood and Bailey.

Sin embargo, el ministerio de Salud inform? sobre un repunte en las casos con fiebre alta, v?mito y diarrea en las ?ltimas tres semanas, asociado con la reducci?n en el abastecimiento del agua frente a la sequ?a que azota el territorio y otras naciones vecinas desde octubre. But the Health Ministry reported a spike in cases with high fever, vomiting and diarrhea in the last three weeks, associated with the reduction in water supply to drought plaguing the region and other neighboring countries since October .

Ante esa situaci?n, las autoridades reiteraron a los habitantes del Antigua y Barbuda a almacenar y manipular productos comestibles de manera apropiada, adem?s de practicar medidas higi?nico-sanitarias como el lavado de las manos despu?s de usar el ba?o y antes de comer. In response, the authorities reiterated to the people of Antigua and Barbuda to storing and handling food properly, besides practicing sanitary measures like washing hands after using the toilet and before eating.

Solicitaron, en especial, extremar esas precauciones con los ni?os tanto en los hogares como en los centros educativos. Requested, in particular, extreme caution with these children in homes and in schools.

Asimismo, aconsejaron al p?blico hervir o clorificar el agua de cisternas y tanques ante el posible riesgo de contaminaci?n. Also advised the public to boil or clorificar water tanks and tanks at the possible risk of contamination

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Re: Antigua - Further testing to determine cause of 2 boys mysterious deaths/ Update- Meningitis Caused Deaths

Meningitis Caused Deaths

Monday, 12 April 2010 12:33 caribarena news Antigua Health - Health


The two young students who died last week had meningitis. Health officials at a press conference now underway said the nine-year-old victim died from meningitis due to streptococos pneumonia, while the other child, a six year old, also had meningitis.

Further updates will be provided.

http://www.caribarena.com/antigua/antigua-health/health-news/meningitis-caused-deaths-201004128901.html

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Re: Antigua - Further testing to determine cause of 2 boys mysterious deaths / Update- Meningitis Caused Deaths

http://www.prensa-latina.cu/index.php?option=com_content&task=view&id=178731&Itemid=1

Discover causes of death for children in Antigua and Barbuda
lunes, 12 de abril de 2010 Monday, April 12, 2010

12 de abril de 2010, 15:15 Saint John´s, 12 abr (PL) El ministerio de Salud de Antigua y Barbuda inform? hoy que la meningitis caus? la muerte repentina de dos ni?os la semana anterior pocas horas despu?s de presentar fiebre alta, v?mito y diarrea. April 12, 2010, 15:15 Saint John's, April 12 (PL) Ministry of Health of Antigua and Barbuda reported today that the meningitis caused the sudden death of two children last week just hours after a high fever, vomiting and diarrhea.

En una conferencia de prensa, a?n en marcha, la entidad difundi? los resultados de la investigaci?n forense del Centro Epidemiol?gico del Caribe (CAREC) para determinar las causas del fallecimiento de Alfred Norwood, de seis a?os de edad, e Ishmael Bailey, nueve. In a press conference, still running, the organization released the results of the forensic investigation of the Caribbean Epidemiology Centre (CAREC) to determine the causes of death of Alfred Norwood, six years of age, and Ishmael Bailey, nine.

La instituci?n regional, establecido en Trinidad y Tobago, concluy? que los menores contrajeron la bacteria Streptococcus pneumoniae ? el neumococo, como com?nmente se conoce, el cual produjo la meningitis. The regional institution, established in Trinidad and Tobago, concluded that the children contracted the bacterium Streptococcus pneumoniae, or pneumococcus, as commonly known, which produced the meningitis.

Esa enfermedad progresa con mucha rapidez y afecta las membranas (meninges) que envuelven el cerebro y la m?dula espinal, lo cual provoca rigidez de la nuca y fiebre superior a los 39 grados, entre otros s?ntomas. The disease progresses rapidly and affects the membranes (meninges) that surrounds the brain and spinal cord, causing stiff neck and fever over 39 degrees, among other symptoms.

El Streptococcus pneumoniae se transmite por el aire y el contacto (tos, estornudos, besos, entre otros). Streptococcus pneumoniae is spread through the air and contact (coughing, sneezing, kissing, etc.). Adem?s, habita normalmente en la garganta y la nariz de muchas personas, y s?lo en algunas penetra en el cuerpo y produce la enfermedad. In addition, normally live in the throat and nose of many people, and only in some enters the body and causes disease.

El viernes anterior, el gobierno de las islas acudi? a los servicios del centro regional por sospechas de una enfermedad contagiosa, que hasta la fecha s?lo ha cobrado las vidas de Norwood y Bailey. The previous Friday, the government of the islands went to regional center services on suspicion of a contagious disease, which so far has only taken the lives of Norwood and Bailey.

CAREC prioriz? los estudios cl?nicos de ambos casos y entreg? este lunes los resultados a las autoridades sanitarias de Antigua y Barbuda. CAREC prioritized clinical studies of both cases and delivered on Monday the results to the health authorities of Antigua and Barbuda.

Anteriormente, el ministerio de Salud inform? sobre un repunte en los personas con fiebre alta, v?mito y diarrea en las ?ltimas tres semanas, asociado con el d?ficit del agua como consecuencia de la sequ?a que azota el territorio y otras naciones vecinas desde octubre. Previously, the Health Ministry reported a surge in people with high fever, vomiting and diarrhea in the last three weeks, associated with water deficit as a result of drought in the area and other neighboring countries since October.

Ante esa situaci?n, las autoridades reiteraron a los habitantes del pa?s a almacenar y manipular productos comestibles de manera apropiada, adem?s de practicar medidas higi?nico-sanitarias como el lavado de las manos despu?s de usar el ba?o y antes de comer. In response, the authorities reiterated the country's inhabitants to storing and handling food properly, besides practicing sanitary measures like washing hands after using the toilet and before eating.

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Re: Antigua - Further testing to determine cause of 2 boys mysterious deaths / Update- Meningitis Caused Deaths

Note the red text. We'll likely never know, but H1N1 could have been involved in one or both deaths.

http://antigua.caribarena.com/health/health-news/8903-meningitis-cases-unrelated-.html

Meningitis Cases Unrelated
Monday, 12 April 2010 18:37 Kam Wright Antigua Health - Health News .Meningitis Cases Unrelated
The results from tests on two boys who died mysteriously last week are in. The findings, released at a press conference at the Ministry of Health on Monday, confirmed a case of streptococcus pneumonia meningitis in nine-year-old Ishmael Bailey, and a diagnosis of meningitis, possibly due to a viral infection or chemical reaction, in six-year-old Alfred Perkins.

However, medical officers stressed that the cases are unrelated, as there are no confirmed links. They also stressed there is absolutely no cause for alarm, as the cases are not endemic.

Chief Medical Officer Dr Rhonda Sealey-Thomas said samples of cerebrospinal fluid (CSF), blood, and stool were taken in Antigua, tested, and sent to the Caribbean Epidemiological Centre for further testing and confirmation.

Dr Sealey-Thomas said in Bailey's case, the CSF showed a growth of bacterial streptococcus pneumonia which led to meningitis. Well-known pathologist Dr Lester Simon said the bacteria may have spread to the blood and onwards into cerebrospinal fluid due to a weakened immune system.

Dr Simon cautioned that “roughly 5- 50&#37; of healthy people harbour this bacterium in the back of their nose and mouths and it raises the question as to why someone would get ill with something that is normally there.”






As a result, he said the effects of the bacteria could have been compounded by a respiratory infection (flu) which suppressed Bailey’s immune system. Dr Simon said they are also investigating the possibility that Bailey could have been suffering with sickle cell disease.

As far as six-year-old Alfred Perkins, the results from the cultured CFS showed the presence of 90 percent of lymphocytes (white blood cells) in his CSF.

According to the medical professionals, normally the CSF is a sterile environment that should not contain any organisms, white blood cells, bacteria, or viruses. This abnormally high level of white blood cells indicates that there was some sort of inflammatory process.

Nonetheless, on analysis, no bacteria were found. However, due to the type of white blood cells that were found, Dr Sealey-Thomas said they were led to a diagnosis of meningitis.