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Guerrero: 7 men contract unidentified disease after cleaning out a warehouse

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  • Guerrero: 7 men contract unidentified disease after cleaning out a warehouse

    I'm not sure why a toxic exposure is not suspected as opposed to a viral one.

    I am using the term "warehouse" as that is the translation used by ProMED, but "supermarket" can also be a translation of "bodega" in Spanish and would better explain the reference to food in the storeroom.

    http://www.promedmail.org/pls/apex/f..._ID:1000,88538

    Archive Number 20110521.1551
    Published Date 21-MAY-2011
    Subject PRO/AH/EDR> Undiagnosed disease - Mexico: (GR) RFI

    UNDIAGNOSED DISEASE - MEXICO: (GUERRERO) 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: Tue 17 May 2011
    Source: La Jornada [in Spanish, trans. Corr.SB, edited]
    <http://www.lajornadaguerrero.com.mx/2011/05/18/index.php?section=politica&article=005n3pol>


    A man is bedridden, unable to move his legs, due to a strange virus
    he believed to have contacted while cleaning a warehouse owned by the
    state DIF [Desarrollo Integral de La Familia; Integrated Family
    Development agency] system in this city [Tecpan]. According to this
    DIF worker, 6 of his colleagues who cleaned the room with him have the
    same symptoms and he fears an epidemic that could contaminate the food
    inside the storeroom.

    In an interview, the man of about 65 years said his health problems
    started 3 months ago after cleaning a DIF warehouse storage [building]
    located next to the prison in Tecpan. "I was the first to open the
    doors of the small warehouse that had not been cleaned for more than 3
    years, as well as [opening] the door of the bathroom inside, which had
    a lot of bat droppings and other waste from rats and insects, which I
    removed without any protection."

    He continued: "The next day I started to feel sick. I got a very high
    fever and my bones ached, so I went to Acapulco to be treated at the
    Social Security [clinic] and where I was admitted for a month. But
    when I was discharged and returned to my home in Santa Maria, I could
    no longer feel my legs and from that day I am restricted to bed
    without being able to move."

    He explained further that the other 6 warehouse workers had the same
    symptoms but to a lesser [degree], "Perhaps because I was the first to
    inhale gases produced by animal manure I was more ill," he said.

    He said he was also concerned that the food stored there, most of
    which is for consumption by children in the municipality, might be
    contaminated.

    [Byline: Rodolfo Valadez Aladez Luviano]

    --
    Communicated by:
    HealthMap Alerts via ProMED-mail
    <promed@promedmail.org>

    [The fact that there were 7 cases (the most affected individual above
    and 6 other co-workers) suggests a point source of the etiological
    agent involved. The accumulation of bat and other excrement in this
    closed space makes one wonder if these might be cases of disseminated
    Valley Fever (coccidioidomycosis -- an infection from inhalation of
    the spores of the fungus _Coccidioides immitis_) that occurs in arid
    regions of the southwestern USA, Central, and South America. Further
    information about these cases and any laboratory results or additional
    clinical findings would be of interest.

    A HealthMap/ProMED-mail interactive map of Mexico showing the
    location of Tecpan in Guerrero state can be accessed at
    <http://healthmap.org/r/0RhS>. - Mod.TY]

    [Coccidioidomycosis is a great thought. There isn't a lot of
    clinical detail provided other than fever and muscle aches, prolonged
    illness that might or might not be related to cleaning a building.
    Legionellosis (Pontiac fever)? Typhus? Hypersensitivity pneumonitis?
    - Mod.LM]

    [Coccidioidomycosis sounds good, but the inability to move the legs
    is difficult to explain unless he has a spinal abscess. The
    information is inadequate to postulate further. - Mod.DK]

    [There are so few details that it is impossible to know what it is.
    We need at least data on a spinal tap and a scanning like an MRI. -
    Mod.EP]

    [Both histoplasmosis and coccidioidomycosis can be considered, but
    the incubation period is way too short (1 day) for either. - Mod.LL]

  • #2
    Re: Guerrero: 7 men contract unidentified disease after cleaning out a warehouse

    The comment on the Portuguese ProMED article. Plague is unlikely; the cases would not still be ill and alive three months later.

    http://www.promedmail.org/pls/apex/f..._ID:1050,88545

    Comment:
    [Infections acquired stores are clean hantavirus, histoplasmosis and
    murine typhus. Eventually plague, but this seems to be rare.

    With three months of history, the only possible infection would histoplasmosis,
    However, history suggests a more intoxication
    . Let's see? ljs]

    Comment


    • #3
      Re: Guerrero: 7 men contract unidentified disease after cleaning out a warehouse

      Incidentally, during the first US pandemic H1N1 2009 flu wave - a cluster of cases happened in a group of youngsters involved in cleansing operations in a barn. I have not a direct link toward the FT thread but I suspect that with a bit of patience it could be retrieved.

      One of the boy died and initially was suspected to have contracted a tick-borne pathogen. Subsequently, H1N1 2009 was declared as causal agent of his infection.

      Comment


      • #4
        Re: Guerrero: 7 men contract unidentified disease after cleaning out a warehouse

        The incident referred to by IOH is here:

        http://www.flutrackers.com/forum/sho...d.php?p=269187

        I think influenza is unlikely here due for the same reason plague was: the victims have been ill for too long; they would have either recovered or died by now. There is also no indication here of spread to anyone not involved in the cleaning. I believe Matt and Mindy McIntosh (above) infected both parents, Matt's girlfriend, the girfriend's sister....

        There is some mention in the article of paralytic symptoms in at least one case. Perhaps it could have been a GBS case secondary to influenza infection, though. If the illness really is paralytic, any connection to the still unresolved situation 200 miles away in Orizaba (http://www.flutrackers.com/forum/sho...d.php?t=156348), in which a novel enterovirus is becoming suspect, should also be investigated.

        Comment

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