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UNDIAGNOSED DEATHS, HUMAN, SWINE - PAPUA NEW GUINEA - PROMED

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  • UNDIAGNOSED DEATHS, HUMAN, SWINE - PAPUA NEW GUINEA - PROMED



    Subject: Pig deaths in Papua New Guinea
    Source: The National [edited]
    <http://www.thenational.com.pg/021907/nation1.htm>


    Three women in remote Mt. Bosavi and Walagu, in the Southern
    Highlands province [of Papua New Guinea (PNG)], have died after
    eating contaminated pork, while an estimated 1000 pigs are known to
    have died from an outbreak of an as yet unidentified disease.


    The pigs developed a swollen neck, flu and fever, and parts of their
    bodies were decaying causing them to die within days.


    Other animal species were reported to have died after developing similar symptoms and authorities fear the rivers and creeks are contaminated by dead animals. Mt. Bosavi and Walagu are located close to the border of the
    Western and Gulf provinces and are only accessible by air transportation.

    Over 16 000 people live in this remote area, which is 3 walking days
    from Moro, in Kutubu.

    Norman Kambo, Deputy controller of the State of Emergency, and
    Southern Highlands' provincial livestock expert, John Kunjip, were
    flown by a chartered Oil Search helicopter into Bosavi and Walagu to
    investigate the epidemic last Wednesday [14 Feb 2007]. Although no
    official diagnosis had been made at this stage, Mr. Kambo is fearful
    the disease could be the dreaded 'weapon anthrax' said to be caused
    by gunpowder poisoning. Mr. Kambo believes the disease may have been
    brought in by migratory animals from the Indonesian province of
    Papua, where poachers are known to be using guns to hunt animals.

    Similar cases have been reported in Western and Gulf provinces, where
    hunters have come across live animals with decaying limbs. In Walagu,
    the decaying intestines of a live pig were exposed and the stench was
    awfully unbearable, resembling the description related by sources
    familiar with weapons anthrax.

    Mr. Kambo said arrangements were being made with the acting
    provincial administrator, William Powi, to fly in livestock and
    health experts to collect human and animal blood samples for testing.
    The provincial administration would also assist by dispatching
    agriculture experts to collect water and crop samples for testing.

    According to Jackson Honia, the local medical officer in Walagu, up
    to 200 people have complained of fever and were being treated with
    antibiotics, prompting fears the disease could be transmitted from
    animals to humans. The medical drugs at Walagu aid post have run out
    and Mr. Honia has made an urgent plea to the security forces and the
    Southern Highlands administration to bring in more medicine and food
    supplies for the people affected. He said the people cannot prepare
    sago [Sago is a powdery starch made from the processed pith found
    inside the trunks of the Sago palm Metroxylon sagu. Sago forms a
    major staple food for the lowland peoples of New Guinea and the
    Moluccas. - CopyEd.MJ] or go fishing and hunting because their food
    sources are contaminated. "We have a very serious problem and we need
    medicine and food supplies," he said.

    Mr. Kambo said he would consult the provincial administration, other
    relevant Government authorities, and the national disaster and
    emergency services to source out ways and means of assisting the
    people affected. He has also urged the villagers to bury dead animals
    in deep graves to prevent them from being exhumed by other scavenging
    animals. But the villagers in Mt. Bosavi and Walagu say there are too
    many pigs dying and the stench is just too much to bear.

    If the disease is preventable, the Department of Livestock in
    Southern Highlands province may attempt to carry out a vaccination
    programme in the area, buy they would need logistics [coordination]
    and manpower to effectively carry out the programme.

    [The Southern Highlands province can be located on a map of Papua New
    Guinea available at:
    <http://www.lib.utexas.edu/maps/australia/papua_newguinea_pol89.jpg>.
    - CopyEd.MJ]

    [Apropos, a news item titled "PNG pig death mystery", by Adrienne
    Francis, was published by the "abc.net.au" on 9 Nov 2004,
    (<http://www.abc.net.au/rural/wa/stories/s1239525.htm>), which
    relates an outbreak of classical swine fever in Papua New Guinea; see
    below. - Mod.MHJ]

    ******
    [2]
    [Various people were polled as to their opinions on this event. Mike
    Nunn's reply follows. - Mod.MHJ]

    Date: Tue 20 February 2007
    From: Mike Nunn


    I'm overseas at present (as is Peter Beers: at a workshop in
    Vancouver on zoning that is using avian influenza as a case study) so
    have not spoken with the Papua New Guinea [PNG] CVO (chief veterinary
    officer) on this report. However, having worked in PNG for 13 years,
    I feel I can offer some reasonable comments on the likely explanation.

    My 1st point is that the report needs to be checked: numbers tend to
    be fairly fluid, as many groups don't have rigid counting systems.
    Incidents that occur at or around the same time are often linked
    there based on coincidence rather than cause (e.g. human deaths and
    deaths in animals).

    Notwithstanding these provisos, if we assume that a large number of
    pigs died and the main signs were 'swollen necks, fever', death, and
    rapid decay, the most likely diagnosis by far is anthrax, which is
    endemic in pigs in the highlands provinces of PNG. The local name for
    the disease is (in Pidgin) 'sot win' (= short wind) as the massive
    oedema in the neck region blocks the trachea and causes severe
    respiratory distress. The strain of anthrax in PNG (and indeed in the
    Indonesian provinces on the western half of the island of New Guinea)
    affects only pigs (and not ruminants or indigenous people: similar to
    the situation in parts of southern Africa). Local people regularly
    eat pigs that have or have died form anthrax there, butchering them
    in villages and consuming the meat only partly cooked, at best,
    without any untoward effects. The only known human cases in PNG have
    occurred as cutaneous anthrax in (from memory) only 3 Europeans
    (Caucasians/expatriates): all laboratory workers! [No] others,
    [occurred] despite massive exposure of tens of thousands of
    indigenous people over many years.

    Thus the reported deaths of 3 indigenous women is most unlikely to be
    due to anthrax and likely to be due either to an unrelated disease or
    diseases or to 'pig bel', a clostridial enterotoxaemia associated
    with the ingestion of large amounts of pork together with sweet
    potato, which contains a trypsin inhibitor that delays digestion long
    enough for clostridial numbers and toxin to build up to cause
    disease. Outbreaks of 'pig bel' occur in association with events in
    which large amounts of pork are consumed: typically in large
    celebrations ('sing sings') or in outbreaks of disease (to salvage
    valuable meat of ill or dead pigs rather than see it wasted).

    This disease ecology has been operating for anthrax in the highlands
    of New Guinea for many years (possibly hundreds or thousands of
    years) and is well and truly established ('endemic' there: there is
    no scientific reason to postulate any incursion or 'exotic' origin,
    including so-called 'weapons' or 'gunshot anthrax') if (as is highly
    likely based on the information in the report) anthrax is the cause
    of the disease in the pigs and 'pig bel' or a disease unrelated to
    pigs or the consumption of pig meat is the cause of the 3 human
    deaths reported. The reported comments regarding wild birds (if
    accurate) almost certainly reflect confusion between anthrax and
    avian influenza by people with no veterinary, medical or related expertise.

    Both anthrax in pigs and clostridial enterotoxaemia in people are
    readily and cheaply preventable by vaccination, which, sadly has
    declined dramatically in the past decade due to (i) a decline in
    government resources in both the animal and human health areas in
    PNG, and (ii) reallocation of human health resources from preventive
    (e.g. vaccination) to emergency/critical medicine (e.g. intensive
    care for diseases of affluence: road accidents, cardiac disease,
    diabetes...) in towns/cities.

    --
    Mike Nunn
    Principal Scientist (Animal Biosecurity)
    Biosecurity Australia

    [Obviously we must await laboratory confirmations on the human and
    pig deaths. It could be porcine anthrax but others come to mind,
    including a hodge-podge of separate pig and human diseases being
    lumped together in worried gossip. If anyone has hard information, it
    would be appreciated if it could be shared. Thanks to Mike for his
    insightful comments. - Mod MHJ]

    [see also:
    2004
    ----
    Swine fever, classical - Papua New Guinea 20041113.3072
    Malaria - Papua New Guinea (Southern Highlands) 20040821.2324
    Undiagnosed deaths - Papua New Guinea (Southern Highlands) (03): RFI
    20040801.2101
    Undiagnosed deaths - Papua New Guinea (Southern Highlands) (02): RFI
    20040728.2062
    Undiagnosed deaths - Papua New Guinea (Southern Highlands): RFI 20040721.1978
    Undiagnosed deaths - Papua New Guinea: RFI 20040419.1083
    1998
    ----
    Mortality, human, cause unknown - Papua New Guinea (04) 19980114.0105
    1997
    ----
    Mortality, human, cause unknown - Papua New Guinea (03) 19971225.2551
    Mortality, human, cause unknown - Papua New Guinea (02) 19971221.2527
    Mortality, human, cause unknown - Papua New Guinea 19971219.2507
    1996
    ----
    Malaria in Highlands of Papua New Guinea 19960402.0618]
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