Two ProMED Portuguese posts - machine translations:
UNIDENTIFIED DISEASE - BRAZIL (03) (BAHIA), MYOPATHY, OUTBREAK
************************************************** **************
A message / A message / from ProMED-PORT
ProMED-mail and a program from / is a program of the
International Society for Infectious Diseases
Date: Friday, December 16, 2016
[1]
Source: G1 [15/12/2016] [edited]
Mysterious virus in Salvador causes muscle pain and leaves black urine
-------------------------------------------------- --------------------------------------
Extreme muscle pain and black urine. These are the main symptoms of a disease that has already taken at least 9 people to the hospitals of Salvador in the last days and that, in more serious cases, can lead to renal failure. Dr. Gubbio Soares, a researcher at the virology laboratory at the Federal University of Bahia (UFBA) and a doctor of virology, says that the disease is caused by a virus that has not yet been identified.
"We already know that it is a virus that causes the disease, but we have not yet determined which type" [is it already known that the etiology is viral? What evidence has already been identified? - Mod RNA], says Dr. Gubbio, who adds already have collected samples of patients, to try to identify the virus. "We need about 10 to 15 days to get this ID."
The specialist believes that the transmission is via oral, through the respiratory apparatus [confused ... - Mod RNA]. He points out that another symptom of the disease is the increase in the body's enzyme CPK, which acts on regulating the metabolism of contractile tissues, such as the skeletal and cardiac muscles. "He had a patient with a CPK index of 100,000 units per liter of blood, while the normal one was 200 units per liter," Dr. Gubbio said. "Because of the risk of kidney failure, patients should be hospitalized until their urine returns to normal," he says.
The G.C. student, 24, was one of the people who had the disease in Salvador. She says her boyfriend, T.P. The same symptoms, in the same period as her. "Last Friday (9) [December / 2016], I felt a very strong pain in the whole body." It started at the neck, radiating, and took the whole body.I took a muscle relaxant and it did not work, then I took a second tablet And I felt a slight improvement.When I woke up on Saturday morning (10) [December / 2016], I was still in pain and went to the hospital, "says G., who reports that the pain was unbearable. "When you think about moving, it hurts every muscle you use to make the move you want. It's a pain I do not want for my worst enemy," says the student.
According to G., she was admitted to the hospital on Saturday until last Wednesday (December 14, 2016) when she was discharged. The infectious doctor Ant?nio Bandeira says that the treatment is done with hydration and analgesic. "The patient should not under any circumstances take anti-inflammatory, because it can worsen renal function," he warns. The improvement time, on average, lasts three days.
The doctor says that the capital of Bahia lives an outbreak of the disease. "This is an outbreak," said Dr. Ant?nio Bandeira. "It is an outbreak.
According to him, of the 9 confirmed patients, three had black urine and, of these, one patient had progressed to renal failure. "Despite the condition, the insufficiency was temporary and it improved," says the doctor.
Through a note, the Directorate of Epidemiological Surveillance (Divep) of the State Department of Health (Sesab) reported that it has already been notified about the disease [which disease? It has been notified about outbreak - Mod. RNA] and that it is investigating the cases.
-
Communicated by: ProMED-PORT http://www.promedmail.org
[2]
Source: Correio da Bahia [16/12/2016] [edited]
Sesab issues alert to health units after outbreak of mysterious disease in Bahia
-------------------------------------------------- -------------------------------------------------- ------
The State Health Department (Sesab) has issued an alert for health units in Bahia, on Friday (December 16, 2016), due to a mysterious illness that affected at least 11 people, some of them after visiting North Coast. The document was protocolated by the strategic information centers in health surveillance in Bahia and Salvador (CIEVS-BA and CIEVS Salvador). Sesab's communications adviser informed CORREIO that the alert is not directed at the population.
According to the publication, the cases are suspected of a possible variant of epidemic myalgia. On December 14 [2016] 9 suspected cases were reported by a hospital unit in Salvador to people from 3 different families.
The patients were treated and admitted to a health unit in the capital on December 2 and 10 [2016], presenting a clinical picture characterized by sudden onset of severe pain in the cervical region, trapezius, followed by intense muscular pains in the arms, back, Thighs and calves.
According to Sesab, the disease showed a rapid spread among the relatives, which suggests that transmission occurs through contact or droplets [or exposure to a toxic agent, for example, occurred simultaneously - RNA Mod.]. The clinical picture presented is compatible with a variant of Epidemic Myalgia Syndrome - usually caused by an Echovirus.
Epidemic myalgia is also known as Bornholm's disease. Muscle pain is caused by a viral infection and affects the upper abdomen and lower thorax. The pain is characterized as spasmodic and develops suddenly, worsening with each movement and deep breathing, causing shortness of breath for the affected individual (in the outbreak in question, the cases did not present respiratory compromise). In many cases, the disease also causes abdominal pain, fever, headache, sore throat and muscle. Transmission occurs through fecal-oral or, less commonly, person-to-person, through droplets or contaminated objects.
Experts investigate whether the consumption of the bull's eye fish, also known as Arabaiana, is related to the disease. According to the infectious physician Antonio Bandeira, the 11 patients who are receiving medical follow-up reported that they consumed fish meat before or during the onset of symptoms. The fish was bought fresh and prepared at home [this makes the hypothesis of intoxication more likely - mod. RNA].
"A family of four, which consumes a lot of fish, said that in the days before the onset of symptoms, they did not eat. But we have at least five people who fed on fish in Guarajuba, which is a couple of boyfriends, the aunt , A woman who bought the food and also her maid, "said the doctor.
According to him, the couple's aunt even confused the symptoms with a virus. "These five people who had the symptoms ate bull's eye, also known as the Arabavian, and so this is a hypothesis, the other is that we are looking for a virus that may be causing this," he said.
There is still no certainty as to the causes of the disease, but the advice is that when patients are aware of symptoms, they hydrate enough, avoid taking anti-inflammatories and seek a doctor. "The risk is that the person has dark urine, does not hydrate properly and end up having kidney failure, and that can happen," the doctor said.
The identification of the toxin or virus that is causing the mysterious disease will depend on the clinical analysis of the patients already registered. "Of course, if we remove the viral causes, and if more cases appear, they can lead to believing that there is such a situation," the doctor said about the relationship with the fish.
According to Bandeira, the analysis in fish is more difficult, since it can be a toxin or chemical, which is more difficult to discover than a bacterium or virus, for example. "So it's important that the Sanitary Surveillance and government agencies seek to investigate, because we can not do this," he concluded.
-
Communicated by: ProMED-PORT http://www.promedmail.org
[As we have always pointed out: information about person-time-place is essential for investigating any outbreak and formulating hypotheses.
What is the age group of the patients? Is there a link between the 3 families?
Information on the clinical picture suggests that the only two manifestations are myalgia (with rhabdomyolysis) and darkened urine (possibly myoglobinuria). There was, in fact, no fever, headache, rash, respiratory symptoms,
------------------------------------------------------------------------------------
Published Date: 2016-12-17 05:44:53
Subject: PRO / PORT> Unidentified disease - Brazil (04) (BA), outbreak, myopathy, update, epidemiological report
Archive Number: 20161217.4704477
DISEASE NON-IDENTIFIED - BRAZIL (04) (BAHIA), SURGERY, MYOPATHY, UPDATE, EPIDEMIOLOGICAL REPORT
************************************************** ************************************************** (I.e.
A message / A message / from ProMED-PORT
ProMED-mail and a program from / is a program of the
International Society for Infectious Diseases
Date: Saturday, December 17, 2016
Source: Directorate of Epidemiological Surveillance, Health Secretariat of the State of Bahia [16/12/2016] [edited]
Epidemiological Alert
----------------------------
The Centers for Strategic Information in Health Surveillance in Bahia and Salvador (CIEVS-BA and CIEVS Salvador) warn health units in Salvador about the occurrence of suspected cases of a possible variant of epidemic myalgia.
On December 14 [2016], 9 suspected cases of epidemic myalgia in people from 3 different families were reported by a hospital unit in Salvador: family 1 (N = 4); Family 2 (N = 3) and family 3 (N = 2). The cases were attended to and hospitalized at a health unit located in Salvador, on December 2 and 10 [2016], presenting a clinical picture characterized by sudden onset of severe pain in the cervical region, trapezius region, followed by intense muscle pain in the Arms, back, thighs and calves. All the patients presented significant elevations of the muscular enzymes, without fever, arthralgia or headache.
The disease had a rapid spread [hours, days? - Mod. RNA] among the relatives, which suggests that the transmission occurs through contact or droplets [or exposure to the same inoculum, toxin - Mod. RNA]. Since the clinical picture presented is compatible with a variant of Epidemic Myalgia Syndrome - usually caused by an Echovirus, the CIEVS-BA and the CIEVS / Salvador issue the present epidemiological alert with recommendations for conducts and guidelines for hospital and emergency health teams Of the capital, in order to elucidate the event, verify the occurrence of other cases, investigate in a timely manner and adopt appropriate measures.
1. About the disease: Epidemic myalgia is also known as Bornholm's disease. Muscle pain is caused by a viral infection and affects the upper abdomen and lower thorax. The pain is characterized as spasmodic and develops suddenly, worsening with each movement and deep breathing, causing shortness of breath for the affected individual (in the outbreak in question the cases did not present respiratory compromise). It sometimes causes abdominal pain, fever, headache, sore throat and muscle aches. Transmission occurs through fecal-oral or, less commonly, person-to-person, through droplets or contaminated objects.
2. Notification: - Notification by email (contacts below) of cases with the following signs and symptoms: severe pain in the cervical and trapezius regions, sudden onset, followed by intense muscle pains in the arms and / or back, and / Or thighs, and / or calves, with no apparent cause. - Carry out an active search for compatible cases in the medical records of patients treated as of November 1, 2016. If compatible cases are identified in this period, broaden the search to the previous month.
3. From the Laboratory: - Collect samples of serum and feces for laboratory examination for arbovirus and enterovirus, respectively. - Forward the samples to the State LACEN, to the care of Francisco Barroso, accompanied by the individual notification form of SINAN, duly identified: "suspicion of epidemic myalgia" - The sample must be kept refrigerated until the moment of sending it to the laboratory, which Should not exceed 24 hours.
4. Treatment: The disease has no specific treatment. In the occurrence of suspected cases, it is recommended to test for creatine phosphokinase (CPK) or OGT to observe the increase of muscle enzymes. Observe the color of urine (dark) as a warning sign and the development of rhabdomyolysis, because in this case, the patient should be rapidly hydrated for 48 or 72 hours, and the use of anti-inflammatories and acetylsalicylic acid (ASA) .
5. Prevention: - Guidance to the population on the modes of transmission. - Care of the hygiene of the objects and washing of the hands. -Individual with suspected infection should not circulate in public and closed environments.
6. Contacts for additional information - Coordination of Research and Strategic Information on Health Surveillance (Cievs / BA) - Tel: (71) 3116-0018 / 37 (8 a.m. to 6 p.m.); 9994-1088 (on call) notifica.cievsbahia@gmail.com - Strategic Information Center Health Surveillance (CIEVS / SSA) Tel: (71) 3202-1721 / 1722; (71) 99982-0841 (on duty)
Communicated by: ProMED-PORT http://www.promedmail.org
[The Epidemiological Report presented here refers to the epidemiological event of the post [PRO / PORT> Unidentified disease - Brazil (03) (BA), myopathy, outbreak Archive Number: 20161216.4704355, http://www.promedmail.org/post/ 4704355]. As pointed out in previous comment [access http://www.promedmail.org/post/4704355] information is still scarce ... Faced with (in) available information, it is still difficult and potentially premature to point out the etiology of the disease. .. Or would the Health Department already have results of tests that suggest viral infection?
Several answers have not yet been presented: is there a link between families? What is the age profile of the cases? Has there been a food survey? What is the distribution of the cases according to the date of onset of symptoms? There was a report of fish consumption preceding the onset of symptoms: how long before the onset of symptoms? The 3 families consumed? What is the attack rate? Was there collection of samples for analysis? ...
Depending on the possible exposure to a common source and / or the temporal distribution of the onset of symptoms of the cases, the hypothesis of infectious etiology may be less likely, especially considering that incubation periods may vary widely and that infrequently All individuals from a viral disease outbreak will start symptoms on the same day after a common exposure (ie they will exhibit exactly the same incubation period).
Well, for now, without more robust clinical and epidemiological information, there are only hypotheses to be investigated, which should include viruses and toxins ... Bacterial or parasitic infection, possible but less (very) probable.
- Mod RNA
This entry was posted in Uncategorized Leave a Reply Click here to cancel reply. Name (required) Mail (will not be published) (required)
As we have always pointed out: information about person-time-place is essential for investigating any outbreak and formulating hypotheses.
What is the age group of the patients? Is there a link between the 3 families?
Information on the clinical picture suggests that the only two manifestations are myalgia (with rhabdomyolysis) and darkened urine (possibly myoglobinuria). There was, in fact, no fever, headache, rash, respiratory symptoms, gastrointestinal manifestations, lymphadenopathy ...?
Did the onset of symptoms occur on the same day? How many hours of difference between fish intake and the onset of symptoms? Have there been other laboratory changes? Were the fish consumed purchased in the same place? Was there any use of drugs or other substances?
What samples were taken from patients, fish and other possible foods? Was there environmental sampling, including water?
Additional information would be welcome.
UNIDENTIFIED DISEASE - BRAZIL (03) (BAHIA), MYOPATHY, OUTBREAK
************************************************** **************
A message / A message / from ProMED-PORT
ProMED-mail and a program from / is a program of the
International Society for Infectious Diseases
Date: Friday, December 16, 2016
[1]
Source: G1 [15/12/2016] [edited]
Mysterious virus in Salvador causes muscle pain and leaves black urine
-------------------------------------------------- --------------------------------------
Extreme muscle pain and black urine. These are the main symptoms of a disease that has already taken at least 9 people to the hospitals of Salvador in the last days and that, in more serious cases, can lead to renal failure. Dr. Gubbio Soares, a researcher at the virology laboratory at the Federal University of Bahia (UFBA) and a doctor of virology, says that the disease is caused by a virus that has not yet been identified.
"We already know that it is a virus that causes the disease, but we have not yet determined which type" [is it already known that the etiology is viral? What evidence has already been identified? - Mod RNA], says Dr. Gubbio, who adds already have collected samples of patients, to try to identify the virus. "We need about 10 to 15 days to get this ID."
The specialist believes that the transmission is via oral, through the respiratory apparatus [confused ... - Mod RNA]. He points out that another symptom of the disease is the increase in the body's enzyme CPK, which acts on regulating the metabolism of contractile tissues, such as the skeletal and cardiac muscles. "He had a patient with a CPK index of 100,000 units per liter of blood, while the normal one was 200 units per liter," Dr. Gubbio said. "Because of the risk of kidney failure, patients should be hospitalized until their urine returns to normal," he says.
The G.C. student, 24, was one of the people who had the disease in Salvador. She says her boyfriend, T.P. The same symptoms, in the same period as her. "Last Friday (9) [December / 2016], I felt a very strong pain in the whole body." It started at the neck, radiating, and took the whole body.I took a muscle relaxant and it did not work, then I took a second tablet And I felt a slight improvement.When I woke up on Saturday morning (10) [December / 2016], I was still in pain and went to the hospital, "says G., who reports that the pain was unbearable. "When you think about moving, it hurts every muscle you use to make the move you want. It's a pain I do not want for my worst enemy," says the student.
According to G., she was admitted to the hospital on Saturday until last Wednesday (December 14, 2016) when she was discharged. The infectious doctor Ant?nio Bandeira says that the treatment is done with hydration and analgesic. "The patient should not under any circumstances take anti-inflammatory, because it can worsen renal function," he warns. The improvement time, on average, lasts three days.
The doctor says that the capital of Bahia lives an outbreak of the disease. "This is an outbreak," said Dr. Ant?nio Bandeira. "It is an outbreak.
According to him, of the 9 confirmed patients, three had black urine and, of these, one patient had progressed to renal failure. "Despite the condition, the insufficiency was temporary and it improved," says the doctor.
Through a note, the Directorate of Epidemiological Surveillance (Divep) of the State Department of Health (Sesab) reported that it has already been notified about the disease [which disease? It has been notified about outbreak - Mod. RNA] and that it is investigating the cases.
-
Communicated by: ProMED-PORT http://www.promedmail.org
[2]
Source: Correio da Bahia [16/12/2016] [edited]
Sesab issues alert to health units after outbreak of mysterious disease in Bahia
-------------------------------------------------- -------------------------------------------------- ------
The State Health Department (Sesab) has issued an alert for health units in Bahia, on Friday (December 16, 2016), due to a mysterious illness that affected at least 11 people, some of them after visiting North Coast. The document was protocolated by the strategic information centers in health surveillance in Bahia and Salvador (CIEVS-BA and CIEVS Salvador). Sesab's communications adviser informed CORREIO that the alert is not directed at the population.
According to the publication, the cases are suspected of a possible variant of epidemic myalgia. On December 14 [2016] 9 suspected cases were reported by a hospital unit in Salvador to people from 3 different families.
The patients were treated and admitted to a health unit in the capital on December 2 and 10 [2016], presenting a clinical picture characterized by sudden onset of severe pain in the cervical region, trapezius, followed by intense muscular pains in the arms, back, Thighs and calves.
According to Sesab, the disease showed a rapid spread among the relatives, which suggests that transmission occurs through contact or droplets [or exposure to a toxic agent, for example, occurred simultaneously - RNA Mod.]. The clinical picture presented is compatible with a variant of Epidemic Myalgia Syndrome - usually caused by an Echovirus.
Epidemic myalgia is also known as Bornholm's disease. Muscle pain is caused by a viral infection and affects the upper abdomen and lower thorax. The pain is characterized as spasmodic and develops suddenly, worsening with each movement and deep breathing, causing shortness of breath for the affected individual (in the outbreak in question, the cases did not present respiratory compromise). In many cases, the disease also causes abdominal pain, fever, headache, sore throat and muscle. Transmission occurs through fecal-oral or, less commonly, person-to-person, through droplets or contaminated objects.
Experts investigate whether the consumption of the bull's eye fish, also known as Arabaiana, is related to the disease. According to the infectious physician Antonio Bandeira, the 11 patients who are receiving medical follow-up reported that they consumed fish meat before or during the onset of symptoms. The fish was bought fresh and prepared at home [this makes the hypothesis of intoxication more likely - mod. RNA].
"A family of four, which consumes a lot of fish, said that in the days before the onset of symptoms, they did not eat. But we have at least five people who fed on fish in Guarajuba, which is a couple of boyfriends, the aunt , A woman who bought the food and also her maid, "said the doctor.
According to him, the couple's aunt even confused the symptoms with a virus. "These five people who had the symptoms ate bull's eye, also known as the Arabavian, and so this is a hypothesis, the other is that we are looking for a virus that may be causing this," he said.
There is still no certainty as to the causes of the disease, but the advice is that when patients are aware of symptoms, they hydrate enough, avoid taking anti-inflammatories and seek a doctor. "The risk is that the person has dark urine, does not hydrate properly and end up having kidney failure, and that can happen," the doctor said.
The identification of the toxin or virus that is causing the mysterious disease will depend on the clinical analysis of the patients already registered. "Of course, if we remove the viral causes, and if more cases appear, they can lead to believing that there is such a situation," the doctor said about the relationship with the fish.
According to Bandeira, the analysis in fish is more difficult, since it can be a toxin or chemical, which is more difficult to discover than a bacterium or virus, for example. "So it's important that the Sanitary Surveillance and government agencies seek to investigate, because we can not do this," he concluded.
-
Communicated by: ProMED-PORT http://www.promedmail.org
[As we have always pointed out: information about person-time-place is essential for investigating any outbreak and formulating hypotheses.
What is the age group of the patients? Is there a link between the 3 families?
Information on the clinical picture suggests that the only two manifestations are myalgia (with rhabdomyolysis) and darkened urine (possibly myoglobinuria). There was, in fact, no fever, headache, rash, respiratory symptoms,
------------------------------------------------------------------------------------
Published Date: 2016-12-17 05:44:53
Subject: PRO / PORT> Unidentified disease - Brazil (04) (BA), outbreak, myopathy, update, epidemiological report
Archive Number: 20161217.4704477
DISEASE NON-IDENTIFIED - BRAZIL (04) (BAHIA), SURGERY, MYOPATHY, UPDATE, EPIDEMIOLOGICAL REPORT
************************************************** ************************************************** (I.e.
A message / A message / from ProMED-PORT
ProMED-mail and a program from / is a program of the
International Society for Infectious Diseases
Date: Saturday, December 17, 2016
Source: Directorate of Epidemiological Surveillance, Health Secretariat of the State of Bahia [16/12/2016] [edited]
Epidemiological Alert
----------------------------
The Centers for Strategic Information in Health Surveillance in Bahia and Salvador (CIEVS-BA and CIEVS Salvador) warn health units in Salvador about the occurrence of suspected cases of a possible variant of epidemic myalgia.
On December 14 [2016], 9 suspected cases of epidemic myalgia in people from 3 different families were reported by a hospital unit in Salvador: family 1 (N = 4); Family 2 (N = 3) and family 3 (N = 2). The cases were attended to and hospitalized at a health unit located in Salvador, on December 2 and 10 [2016], presenting a clinical picture characterized by sudden onset of severe pain in the cervical region, trapezius region, followed by intense muscle pain in the Arms, back, thighs and calves. All the patients presented significant elevations of the muscular enzymes, without fever, arthralgia or headache.
The disease had a rapid spread [hours, days? - Mod. RNA] among the relatives, which suggests that the transmission occurs through contact or droplets [or exposure to the same inoculum, toxin - Mod. RNA]. Since the clinical picture presented is compatible with a variant of Epidemic Myalgia Syndrome - usually caused by an Echovirus, the CIEVS-BA and the CIEVS / Salvador issue the present epidemiological alert with recommendations for conducts and guidelines for hospital and emergency health teams Of the capital, in order to elucidate the event, verify the occurrence of other cases, investigate in a timely manner and adopt appropriate measures.
1. About the disease: Epidemic myalgia is also known as Bornholm's disease. Muscle pain is caused by a viral infection and affects the upper abdomen and lower thorax. The pain is characterized as spasmodic and develops suddenly, worsening with each movement and deep breathing, causing shortness of breath for the affected individual (in the outbreak in question the cases did not present respiratory compromise). It sometimes causes abdominal pain, fever, headache, sore throat and muscle aches. Transmission occurs through fecal-oral or, less commonly, person-to-person, through droplets or contaminated objects.
2. Notification: - Notification by email (contacts below) of cases with the following signs and symptoms: severe pain in the cervical and trapezius regions, sudden onset, followed by intense muscle pains in the arms and / or back, and / Or thighs, and / or calves, with no apparent cause. - Carry out an active search for compatible cases in the medical records of patients treated as of November 1, 2016. If compatible cases are identified in this period, broaden the search to the previous month.
3. From the Laboratory: - Collect samples of serum and feces for laboratory examination for arbovirus and enterovirus, respectively. - Forward the samples to the State LACEN, to the care of Francisco Barroso, accompanied by the individual notification form of SINAN, duly identified: "suspicion of epidemic myalgia" - The sample must be kept refrigerated until the moment of sending it to the laboratory, which Should not exceed 24 hours.
4. Treatment: The disease has no specific treatment. In the occurrence of suspected cases, it is recommended to test for creatine phosphokinase (CPK) or OGT to observe the increase of muscle enzymes. Observe the color of urine (dark) as a warning sign and the development of rhabdomyolysis, because in this case, the patient should be rapidly hydrated for 48 or 72 hours, and the use of anti-inflammatories and acetylsalicylic acid (ASA) .
5. Prevention: - Guidance to the population on the modes of transmission. - Care of the hygiene of the objects and washing of the hands. -Individual with suspected infection should not circulate in public and closed environments.
6. Contacts for additional information - Coordination of Research and Strategic Information on Health Surveillance (Cievs / BA) - Tel: (71) 3116-0018 / 37 (8 a.m. to 6 p.m.); 9994-1088 (on call) notifica.cievsbahia@gmail.com - Strategic Information Center Health Surveillance (CIEVS / SSA) Tel: (71) 3202-1721 / 1722; (71) 99982-0841 (on duty)
Communicated by: ProMED-PORT http://www.promedmail.org
[The Epidemiological Report presented here refers to the epidemiological event of the post [PRO / PORT> Unidentified disease - Brazil (03) (BA), myopathy, outbreak Archive Number: 20161216.4704355, http://www.promedmail.org/post/ 4704355]. As pointed out in previous comment [access http://www.promedmail.org/post/4704355] information is still scarce ... Faced with (in) available information, it is still difficult and potentially premature to point out the etiology of the disease. .. Or would the Health Department already have results of tests that suggest viral infection?
Several answers have not yet been presented: is there a link between families? What is the age profile of the cases? Has there been a food survey? What is the distribution of the cases according to the date of onset of symptoms? There was a report of fish consumption preceding the onset of symptoms: how long before the onset of symptoms? The 3 families consumed? What is the attack rate? Was there collection of samples for analysis? ...
Depending on the possible exposure to a common source and / or the temporal distribution of the onset of symptoms of the cases, the hypothesis of infectious etiology may be less likely, especially considering that incubation periods may vary widely and that infrequently All individuals from a viral disease outbreak will start symptoms on the same day after a common exposure (ie they will exhibit exactly the same incubation period).
Well, for now, without more robust clinical and epidemiological information, there are only hypotheses to be investigated, which should include viruses and toxins ... Bacterial or parasitic infection, possible but less (very) probable.
- Mod RNA
This entry was posted in Uncategorized Leave a Reply Click here to cancel reply. Name (required) Mail (will not be published) (required)
As we have always pointed out: information about person-time-place is essential for investigating any outbreak and formulating hypotheses.
What is the age group of the patients? Is there a link between the 3 families?
Information on the clinical picture suggests that the only two manifestations are myalgia (with rhabdomyolysis) and darkened urine (possibly myoglobinuria). There was, in fact, no fever, headache, rash, respiratory symptoms, gastrointestinal manifestations, lymphadenopathy ...?
Did the onset of symptoms occur on the same day? How many hours of difference between fish intake and the onset of symptoms? Have there been other laboratory changes? Were the fish consumed purchased in the same place? Was there any use of drugs or other substances?
What samples were taken from patients, fish and other possible foods? Was there environmental sampling, including water?
Additional information would be welcome.
Comment