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Guyana: Health authorities probe if respiratory infection killed 2 Chinese workers, sickened several - Histoplasmosis confirmed

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  • #16
    Reported illnesses in Matthew’s Ridge contained – Min. Lawrence reports

    Apr 02, 2019 Government, Ministry of Public Health, News

    ─ persons still being monitored

    ─ illnesses not related to outbreaks in Venezuela

    DPI, Guyana, Tuesday, April 2, 2019

    Minister of Public Health, Volda Lawrence gave an update on the investigations in the recent spate of illnesses and one death reported in Matthew’s Ridge over the weekend of March 30 and 31, 2019.

    The minister said that while two of the reported cases are still critical, there are improvements in the others. Despite the “positive signs”, all cases are being monitored closely in Georgetown at Guyana’s premier health facility, the Georgetown Public Hospital Corporation (GPHC).

    “We are working with them; the doctors are very happy with the positive signs they are seeing, and we will continue to inform the people of Guyana with updates of these persons,” Minister Lawrence explained.

    According to a release coming out of the Ministry of Public Health on Monday, April 1, 2019, all the patients with the acute respiratory illness, rash and fever were transferred to GPHC where critical care was provided, and monitoring continues.

    “While the specialists continue to work on the seven patients admitted on Saturday, results have shown that two patients tested positive for Leptospirosis which is known to be spread by direct contact with rat urine or faeces. Further tests are being conducted locally and samples will be sent overseas with support from PAHO and CARPHA to get further tests done to rule out other possible infections,” the release noted.

    Meanwhile, the minister said the ultimate goal is to return the community to a state of normalcy by ensuring the health centre, and hospital in the area continues to have scheduled clinics.

    “The hospital is going to be sanitised and will be up and running; we are working also out of the community centre presently as we assess the other employees because we are talking about over 200 persons in the mining camp. So, we don’t want to have overcrowding, we want to assess those persons separately even as we provide the normal MCH outpatient and so on clinics to the members of the community.”

    Minister Lawerence also noted that these illnesses are in no way connected to the current series of outbreaks in the neighbouring country of Venezuela.

    “We are just dealing with persons who went into a particular tunnel and that is what we have been able to zero in on and those are the persons that have been affected, no one else in any of the villages there have reported to any of our medical facilities at this point with any of those illnesses.”

    Delicia Haynes.

    https://dpi.gov.gy/reported-illnesse...rence-reports/
    "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


    • #17
      Guyana News

      Second manganese miner succumbs

      By Staff Editor 1 h ago

      A second miner from the Guyana Manganese Inc (GMI) this morning succumbed at the Georgetown Public Hospital after being critically ill for days.

      The miner is said to be one of the two who were diagnosed with Leptospirosis last week by doctors at the hospital.
      ...

      https://www.stabroeknews.com/2019/ne...iner-succumbs/
      "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


      • #18
        Second Chinese worker from Manganese operation dies

        By Editor Last updated Apr 4, 2019

        A second Chinese worker has died after falling sick with a dozen others at the Manganese operation in Region One.

        The post mortem examinations on the two men were conducted on Thursday morning. The cause of death was found to be haemorrhagic pneumonia as a result of leptospirosis.

        The men were identified as 47-year-old Zhong Zhenglong and 45-year-old Zi Zheng Guo. The Ministry of Health has issued no official statement on the issue since Monday.
        ...
        https://newsroom.gy/2019/04/04/secon...peration-dies/
        "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


        • #19
          econd Chinese worker from Manganese operation dies
          By Editor Last updated Apr 4, 2019


          A second Chinese worker has died after falling sick with a dozen others at the Manganese operation in Region One.

          The post mortem examinations on the two men were conducted on Thursday morning. The cause of death was found to be haemorrhagic pneumonia as a result of leptospirosis.

          The men were identified as 47-year-old Zhong Zhenglong and 45-year-old Zi Zheng Guo. The Ministry of Health has issued no official statement on the issue since Monday.
          ...
          https://newsroom.gy/2019/04/04/secon...peration-dies/
          Twitter: @RonanKelly13
          The views expressed are mine alone and do not represent the views of my employer or any other person or organization.

          Comment


          • #20
            GPHC discharges two Guyana Manganese Inc. workers

            Apr 04, 2019 Government, Ministry of Public Health, News, Press Releases

            Georgetown, MOPH – The Georgetown Public Hospital Corporation (GPHC) successfully treated and discharged two Chinese national made ill by an outbreak of infectious disease at the Guyana Manganese Inc. (GMI)-owned tunnel in Matthews Ridge, Barima/Waini (Region One).

            Chief Medical Officer (CMO) Dr Shamdeo Persaud who made the announcement early Thursday also disclosed that another ailing GMI employee died from complications associated with leptospirosis Wednesday night while undergoing treatment at the GPHC.

            “We are saddened at the passing of another worker”, CMO Persaud said.

            Another mining employee, who was also tested positive for leptospirosis, is in “critical but stable condition” an Internal Medicine specialist at the tertiary institution confirmed Thursday.

            The latest casualty has doubled the number of manganese workers who have died from leptospirosis since the outbreak of infectious disease at the manganese mining tunnel at Matthews Ridge, in the Barima/Waini (Region One) interior location.

            Regional Health Officer (RHO) Dr Vishal Ramjas said Thursday that another GMI employee was admitted at the Pakera Hospital and is undergoing treatment for “a respiratory tract infection”. The patient is also in a stable condition, Dr Ramjas said.

            Meanwhile, CMO Persaud reiterated that “all precautionary measures are still in place at the Matthews Ridge tunnel site and immediate surroundings and essential medical supplies are in stock to treat employees of the mining firm and residents of the area.

            Since last week’s outbreak, the area has been deemed a ‘Red Zone’ by Ministry of Public Health (MOPH) authorities and “no one is allowed to enter the site,” Dr Persaud reminded Thursday.


            https://dpi.gov.gy/gphc-discharges-t...e-inc-workers/
            "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


            • #21
              Second Matthew’s Ridge manganese miner dies

              By Alva Solomon - April 5, 2019
              ...
              This publication was also informed that no one from the manganese company showed up at the GPHC to witness an autopsy, which was expected to be performed on the first miner who died last weekend. The pathologist waited at the facility for more than three hours and the exercise was subsequently called off.

              Company official, Major General (retired) Norman McLean told the Guyana Chronicle that he could not pronounce on the issue. He said officials of BOSAI, the company associated with GWI, would be able to speak on such matters. The Guyana Chronicle understands that there are approximately 100 Chinese nationals and 113 Guyanese nationals on the mining concession.
              ...
              http://guyanachronicle.com/2019/04/0...ese-miner-dies
              "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


              • #22
                China to evacuate its critically ill manganese workers from Guyana

                Posted by: Denis Chabrol in Business, Health, Mining Industry, News April 6, 2019 1 Comment

                China is to evacuate at least 12 of its critically ill manganese mine workers from Guyana on Monday, a well placed Public Health Ministry official said Saturday.
                ...
                Indications are that plans are already being made for at least two Chinese experts to accompany the sick men back to China.
                ...
                Sources said 47-year old Zhenglong Zong died on March 30 from septic shock and bilateral haemorrhagic pneumonia, and 45-year old Zengguo Ji died on April 3 from a similar condition.

                No mention was made of leptospirosis, although medical experts say pneumonia and influenza-like symptoms are sometimes associated with leptospirosis.
                ...

                https://demerarawaves.com/2019/04/06...s-from-guyana/
                "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


                • #23
                  GMI to remain closed until “certain requirements are met” – EPA

                  April 8, 2019
                  ...
                  Meanwhile, officials are making it clear that only Chinese workers that worked in the tunnel are affected by this illness and no other residents of that or neighbouring villages have been infected.
                  ...
                  Another meeting is scheduled for today in the region and the Chief Medical Officer and two Pan American Health Organisation (PAHO) representatives are expected to be in attendance.

                  Reports are that Chinese miners presently being treated at the Georgetown Public Hospital Corporation (GPHC) are expected to leave for China today.

                  A well-placed source at the GPHC told this newspaper that doctors are of the view that the miners are not infected with Leptospirosis and their symptoms are similar to those of H1N1, however, efforts to obtain a confirmation from the Chief Medical Officer on Sunday were unsuccessful.
                  ...
                  https://guyanatimesgy.com/gmi-to-rem...s-are-met-epa/
                  "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


                  • #24
                    10 Chinese nationals to fly back home

                    By Staff Reporter - April 9, 2019 055
                    ...
                    “The Chinese authority did arrange for a flight to come in with some experts to review with us some of the little more technical details and that flight has the capacity to take some of the patients back. So far we’ve shortlisted 10 of them to travel back. Some of them are in better condition and they’ve actually been discharged. So the plan is to work towards the evacuation of those men,” Chief Medical Officer (CMO) Dr. Shamdeo Persaud told the Guyana Chronicle on Monday.

                    Persaud added that medical personnel seeking to address the matter are yet to unequivocally determine the cause of the conditions experienced.
                    ...
                    Persaud stated that while the local and international medical teams have been able to confirm that the condition is not contagious, much caution is still being taken. “We have also ascertained that the condition doesn’t seem to be going from one person to another. It’s related more to direct exposure but we still want to observe all precautions until we have full and complete information,” he said.
                    ...

                    https://guyanachronicle.com/2019/04/...-fly-back-home
                    "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


                    • #25
                      H/T @Crof

                      Manganese mine incident…‘Mystery’ illness identified as Histoplasmosis- Infection caused by Fungus found in droppings of birds, bats and rats in humid areas
                      Apr 16, 2019 News 0 Comments



                      Chief Medical Officer Dr. Shamdeo Persaud addresses the media

                      The mystery illness which was erroneously assumed to be H1N1 (Swine Flu) and as leptospirosis in two cases, affecting employees working in the Guyana Manganese Inc. tunnel in Matthew’s Ridge, Region One, Barima-Waini, has finally been determined to be Histoplasmosis, an infection by a fungus found in the droppings of birds, bats and rats in humid areas.
                      This was confirmed when the Ministry of Public Health held a press conference yesterday in its Mental Health Unit Boardroom, to provide an update on the recent outbreak and related issues.
                      Samples were collected from all patients and initially some testing was done at the National Public Health Reference Laboratory (NPHRL). Further samples were sent to the Caribbean Public Health Agency Laboratory (CARPHA) in Trinidad for confirmation.
                      ...
                      https://www.kaieteurnewsonline.com/2...n-humid-areas/
                      Twitter: @RonanKelly13
                      The views expressed are mine alone and do not represent the views of my employer or any other person or organization.

                      Comment


                      • #26
                        Published Date: 2019-04-16 21:20:46
                        Subject: PRO/AH/EDR> Undiag. resp. illness - Guyana (04): (BA) mine tunnel exp. histoplasmosis conf.
                        Archive Number: 20190416.6426033
                        UNDIAGNOSED RESPIRATORY ILLNESS - GUYANA (04): (BARIMA-WAINI) MANGANESE MINE TUNNEL EXPOSURE, HISTOPLASMOSIS CONFIRMED
                        ************************************************** ************************************************** ******************
                        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 16 Apr 2019
                        Source: Kaieteur News Online [edited]
                        https://www.kaieteurnewsonline.com/2...n-humid-areas/


                        The mystery illness, which was erroneously assumed to be H1N1 (swine flu) and as leptospirosis in 2 cases, affecting employees working in the Guyana Manganese Inc. tunnel in Matthew's Ridge, Region One, Barima-Waini has finally been determined to be histoplasmosis, an infection by a fungus found in the droppings of birds, bats and rats in humid areas. [Histoplasmosis is caused by a fungus _Histoplasma capsulatum_ that lives in soil enriched by bird or bat, not rat, droppings. - Mod.ML]

                        This was confirmed when the Ministry of Public Health held a press conference yesterday [15 Apr 2019] in its Mental Health Unit Boardroom to provide an update on the recent outbreak and related issues.

                        Samples were collected from all patients, and initially some testing was done at the National Public Health Reference Laboratory (NPHRL). Further samples were sent to the Caribbean Public Health Agency Laboratory (CARPHA) in Trinidad for confirmation.

                        The results initially were negative for influenza A and B inclusive of H1N1, chikungunya, Zika and dengue. All patients underwent malaria tests in Matthews Ridge, and they were also negative.

                        Chief Medical Officer (CMO) Dr. Shamdeo Persaud provided a detailed update.

                        Relating the developments sequentially, the CMO said that the 1st 4 cases were reported on 28 Mar [2019]; one died while receiving care at Pakera District Hospital in Region One. The following day, 4 more were brought in to Pakera District Hospital complaining of similar symptoms (fever, headaches, joint pains, mild shortness of breath). Subsequently, the 7 Chinese workers were transferred to the Georgetown Public Hospital Corporation (GPHC).

                        An additional 6 employees, including one Guyanese, were attended to at the Port Kaituma Hospital but later transferred to the GPHC. One of the 6 persons visited the hospital on his own. He was evaluated but not admitted.

                        Once the cases were reported, several teams visited the site from the regional level. The teams included the Regional Health Officer and the Regional Environmental Health Officer, along with some supporting medical staff.

                        "In the initial stage, we weren't sure what we were dealing with, but since it was a febrile illness with respiratory symptoms, we took all the necessary precautions to restrict access to both the site and the hospital where the patients were being kept. The additional staffers that were sent to the region set up a temporary facility at the community centre in Matthews Ridge where they were seeing the regular patients," the CMO recounted. "Following the transfer of the patients on 3 Apr [2019], they cleaned up the Pakera District Hospital and closed down the temporary sites. Work resumed as normal at the hospital for Maternal Child Health and other services."

                        "Two persons are dead; one died at Pakera District Hospital and one at GPHC. Of those admitted at the GPHC, 2 were discharged. An additional person was discharged from Pakera District Hospital. Ten workers were transferred to China on Mon 9 Apr [2019]. 16 Chinese workers were under care and treatment. Following the transfer, 2 more were admitted to Pakera Hospital bringing it to a total of 18."

                        Blood, sputum and urine samples were collected from those that were under care, while tissue samples were collected during the post mortem from the 2 deceased. Testing for these samples was done locally at the National Public Health Reference Laboratory (NPHRL), and confirmation was done at Caribbean Public Health Agency (CARPHA) in Trinidad.

                        "All tests were negative for influenza A & B, dengue, chikungunya and Zika. Even though [it was] reported we had 2 positive for leptospirosis, according to the NPHRL, those were later found negative through confirmation from CARPHA. On the weekend of 7 Apr [2019], a team was flown in to Matthews Ridge. The team included officers from the Environmental Protection Agency and Occupational Safety and Health, and they did an evaluation of the work site and looked at some of the risk factors relating to the environment. A community meeting was also held with residents," Dr. Persaud said.

                        It was disclosed that from 8-10 Apr [2019], 2 consultants from the Pan American Health Organization/World Health Organization (PAHO/WHO) along with the Chief Medical Officer and a team from the Ministry of Public Health visited the area. A team of 9 officers from the Centre for Disease Control (CDC), China was also part of the visiting team. "During the visit, the team met with the hospital staff. We reviewed their procedures for infectious disease control and prevention, and we met with company officials. Interviews were conducted with the persons who were working in the mine." A total of 23 Chinese workers were interviewed. They were working in the 4 different tunnels.

                        The CMO continued: "On 10 Apr [2019], we received word from CARPHA that 5 samples were tested for histoplasmosis; 4 were positive. The Chinese CDC tested an additional 6 persons, and 5 were positive for histoplasmosis.

                        One person tested showed weak positive hantavirus, but this may have been because of a past exposure to that germ.

                        "Currently, we are monitoring persons at Matthews Ridge. During the last 2 days, 2 persons developed fever, and they were admitted to Pakera District Hospital and are under close observation and treatment for hantavirus, which is a fungal infection. [Hantavirus infection is a viral, not fungal infection. - Mod.ML] We also took samples from them, and they are presently being processed for shipment to CARPHA."

                        Meanwhile, the absence of safety gear for workers was highlighted. Interviews were done with employees who had not developed any illness. And this revealed the shortcomings. Officials were told that the safety gear was in the country but was not on site. They had not cleared customs at the wharf at that time. However, that claim was never confirmed. Occupational Safety and Health (OSH) Consultant Gwyneth King said, "Our information to date is that the workers were not wearing [any] personal safety gear. That is to say that they were not wearing respirators, so they were exposed to breathing in the fungus. If you have to do a job like that, you need to wear personal safety gear; otherwise, you could expose yourself."

                        King said that officials will be working within the confines of the Occupational Safety and Health Act to see what action, if any, can be taken against the company for this major inadequacy. However, they are only now going through their findings and preparing the report.

                        --
                        Communicated by:
                        ProMED-mail Rapporteur Mary Marshall

                        [As I assumed in my moderator comments in the last ProMED-mail post on this outbreak, the cause of the acute respiratory illness in workers in manganese mine tunnels in Guyana is apparently histoplasmosis.

                        We were initially told (ProMED-mail post (Undiagnosed resp. illness - Guyana: (Barima-Waini) manganese mine, fatal, RFI 20190401.6396933) that workers at a manganese mining company in Guyana, owned by a subsidiary of Chinese company Bosai Minerals Group Guyana Company Limited, developed what was said to be an influenza-like illness with "respiratory discomfort, rash, and high-grade fever." More than a dozen miners were affected, and 2 of the workers died. Post-mortem examinations on the 2 dead miners initially were said to have "revealed that they died from haemorrhagic pneumonia as a result of leptospirosis;" we now learn the diagnosis of leptospirosis was erroneous.

                        Initially, we were told that all infected persons were exposed to one common area, without evidence of person-to-person transmission (that is, presumably there were no secondary cases), but we were not told what that common area was. We were subsequently told the common area is the "Matthews Ridge tunnel site."

                        Manganese mines are usually open pits, which are subject to flooding that could lead to exposure to leptospirosis if there is also rat infestation. However, tunnels could be infested with bats and their guano, which would place mine workers at risk for histoplasmosis, a fungal pulmonary infection that follows unprotected inhalation of large inocula of _Histoplasma capsulatum_ spores. The fungus lives in soil fertilized by bird or bat droppings. Contaminated soil can remain potentially infectious for years. Microconidia spores become airborne when the contaminated soil is disturbed, for example, by digging in contaminated soil. Most infected individuals remain asymptomatic. Symptomatic illness is primarily caused by an intense exposure, and the severity of disease is related to the number of spores inhaled.

                        ProMED-mail previously reported on a histoplasmosis outbreak in tunnel workers in the Dominican Republic (see "See Also's" below).

                        Symptoms of histoplasmosis usually include non-specific flu-like symptoms (fever, chills, muscle aches, dry cough, and chest discomfort); potentially fatal adult respiratory distress syndrome (ARDS) may occur when larger inocula are inhaled (http://journal.publications.chestnet...icleid=1047573 and http://www.ncbi.nlm.nih.gov/pubmed/7...?dopt=Abstract). The pulmonary infection can disseminate throughout the body, and immunocompromised individuals may develop a severe form of histoplasmosis called progressive disseminated disease.

                        Histoplasmosis cannot be transmitted from person to person or from animals to people. The diagnosis can be made by culture of the organism from sputum or tissues, by serology, or by tests for antigen in urine and serum specimens. For treatment guidelines, see Clinical Practice Guidelines for the Management of Patients with Histoplasmosis: 2007 Update by the Infectious Diseases Society of America. Clin Infect Dis 2007; 45(7): 807-25. Available at http://cid.oxfordjournals.org/content/45/7/807.full. - Mod.ML

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                        • #27
                          Tests on Guyana Manganese Inc. workers rule out possible swine flu, H1N1

                          Apr 15, 2019 Government, Ministry of Public Health, News

                          ─ investigations on manganese workers’ illnesses conclude

                          ─ EPA, Occupational Health and Safety unit of the Ministry of Social Protection on board to prevent future occurrences


                          DPI, Guyana, Monday, April 15, 2019

                          The investigation in the illnesses of several Guyana Manganese Incorporated (GMI) workers of Matthew’s Ridge has concluded. Subsequent tests, conducted in patients who fell ill, rule out the possibility of swine flu or H1N1 as a primary cause.

                          According to the Chief Medical Officer (CMO) of the Ministry of Public Health, Dr. Shamdeo Persaud, “all tests were negative for Influenza A & B, Dengue, Chikungunya and Zika. Even though reported we had two tests positive for leptospirosis… those were later found negative through confirmation from the Caribbean Public Health Agency (CARPHA) laboratory.”

                          During the investigation phase, blood, sputum and urine samples were collected from ill GMI workers. Testing for these samples was done at the local National Public Health Reference Laboratory (NPHRL) with confirmation testing at CARPHA in Trinidad.

                          CARPHA has confirmed that five of the samples were tested for histoplasmosis, four of which were positive. Further, the Centre for Disease Control (CDC) China tested six additional persons, and five were positive for histoplasmosis.

                          Histoplasmosis is an infection caused by a fungus found in the droppings of birds and bats in humid areas. It is not serious if confined to the lungs but can be fatal if spread throughout the body. Common symptoms of this infection are like the flu and include fever, chills, shortness of breath etc.

                          The CMO added that “we had one person tested showing weak positive hantavirus, but this may have been because of past exposure to that germ.”

                          Upon initial reports of the illness of the GMI workers, it was speculated that they might have contracted swine flu or H1N1. However, the Ministry of Public Health, after learning of the situation, launched an immediate investigation to ascertain the cause of illness and contain the cases.

                          The report from the CMO on the conclusion of investigations noted that from April 8 to 10, 2019, Consultants from Pan American Health Organisation/World Health Organisation (PAHO/WHO), a team from the Ministry of Public Health, nine officers from CDC China along with Dr. Persaud visited Matthew’s Ridge.

                          The visiting team met with company officials and conducted interviews with persons working in the four different tunnels. They also evaluated the work area and examined risk factors relating to environmental health, occupational safety and other health-related concerns in the work environment.

                          The Occupational Health and Safety unit of the Ministry of Social Protection’s Department of Labour is engaging GMI on enforcing and upkeeping safety practices and safeguards for employees. Also, the Environmental Protection Agency (EPA) is looking into ensuring that GMI’s work in the hinterland conforms to national policies and standards.

                          This was done to ensure there is no future occurrence of such illnesses which resulted in the death of two Chinese nationals who were working in one of the tunnels. The Chinese, who were ill along with the remains of the two who succumbed to illnesses, have been airlifted to China for further tests to be conducted.

                          Delicia Haynes.

                          https://dpi.gov.gy/tests-on-guyana-m...wine-flu-h1n1/
                          "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

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