Published Date: 2016-12-22 08:28:08
Subject: PRO / PORT> Unidentified disease - Brazil (06) (BA), outbreak, myopathy, update, information received from EpiCore
Archive Number: 20161222.4716699
UNIDENTIFIED DISEASE - BRAZIL (06) (BAHIA), OUTBREAK, MYOPATHY, UPDATE, INFORMATION RECEIVED FROM EPICORE
************************************************** ************************************************** **************
A message / A message / from ProMED-PORT
ProMED-mail and a program from / is a program of the
International Society for Infectious Diseases
Date: Thursday, December 22, 2016
[1]
Source: Member, EpiCore Global Surveillance Project [21/12/2016] [edited]
Below is information sent / shared by Dr. Tatiana Otero Melendez in response to some questions pointed out in the previous post [PRO / PORT> Unidentified disease - Brazil (05) (BA), outbreak, myopathy, Number: 20161221.4713256, http://www.promedmail.org/post/4713256]:
1) ProMED-PORT Question: Is there any other link between patient families and non-fish consumption?
Answer EpiCore: "Most consumed fish".
2) Question ProMed-PORT: What is the age range of the cases?
EpiCore: "There are families with children and adults affected. I [Dr. Melendez] saw a family with 5 members who were 4, 11, 30-40 years old."
3) Question ProMed-PORT: What is the time interval between fish consumption and the onset of symptoms?
EpiCore responds: "It depends on the amount of fish consumed The day before, the mother, who consumed the most fish, had symptoms the next day, a few hours after [consumption, probably - RNA Mod.].
4) Question ProMed-PORT: What was the attack rate among those who consumed fish?
EpiCore Response: "All patients who consumed fish had symptoms."
5) Question ProMED-PORT: Have samples of the fish (s) incriminated (s) / suspect (s) been carried out for laboratory tests?
EpiCore Response: "So far no, since in most cases all fish has been used [consumed? Scorned? - RNA Modified?].
6) ProMED-PORT Question: Is there any link between the most recently reported cases and the first suspected cases of the outbreak?
EpiCore Response: "No. There are no other reported links."
7) ProMED-PORT Question: Are the last reported cases a case of recent onset of symptoms or are they old but only recently reported?
EpiCore: "I [Dra Melendez] made contact with surveillance, I have cases since July."
[It would be important to know how many cases, their clinical characteristics, their epidemiological history - Mod RNA].
8) ProMED-PORT Question: Have the most recently reported cases reported laboratory changes suggestive of myopathy?
EpiCore Response: "Cases had fairly elevated levels of CPK [creatine phosphokinase enzyme - Mod. RNA] and pain, and some of them had renal failure."
9) Question ProMed-PORT: It was mentioned that biological samples from 4 patients were analyzed. Is there any result?
EpiCore Response: "There is no information."
9) Question ProMed-PORT: How long will the symptoms and laboratory changes last?
EpiCore Response: "Few Days".
Epicore Information: the fish incriminated and potentially associated with the outbreak of myopathy are whiting and "bulls eye".
-
Posted by: Tatiana Otero Melendez, medical infectologist, member of the Member, EpiCore Global Surveillance Project
Communicated by: ProMED-PORT http://www.promedmail.org
-
[2]
Source: Member, EpiCore Global Surveillance Project [21/12/2016] [edited]
The Municipal Health Department of Salvador (SMS) reported that up to Monday (19) [December / 2016], 22 cases of the as yet unidentified disease that causes intense muscular pain and black urine have been reported. The data were released on Tuesday (20) [December / 2016] by the agency, which tracks the cases.
The secretariat's latest bulletin on Monday [December 19, 2016] reported 19 reported cases of the disease. There is still no information from other cities in Bahia where there are case records. The State Health Department (Sesab) also took a stand on the case and issued an epidemiological alert so that health professionals pay attention and report cases of the disease. According to Sesab, all reported patients reside in the state capital of Bahia, 14 reported the consumption of fish, while eight do not remember or did not consume.
By means of a note, the State Department of Health informed that a process of investigation is in progress that brings together professionals of epidemiological surveillance, sanitary and environmental vigilance, as well as the technicians of the State Central Laboratory (Lacen).
Sesab warns that the population should immediately seek a health facility if they present symptoms such as severe muscle pain, sudden onset, mainly affecting the cervical region (neck), shoulders, back, thighs or calves. All emergency and urgency units are designed to immediately notify suspected cases of acute myalgia, which makes it possible to speed up the investigation process.
The virology laboratory of the Federal University of Bahia (UFBA), coordinated by Professor G?bio Soares, has already analyzed urine, feces and blood samples from four patients who presented with symptoms, such as severe neck and back pain. 24 hours spread to arms and legs. The suspicion raised by the research is that the disease is caused by the enterovirus type "b" or the human parechovirus. Both cause myalgia, which is muscle pain. According to the researcher, the biggest suspicion is that parechovirus is responsible for the outbreak, since the pain caused by it is stronger. In the last 10 years, in France and Japan, contaminations of at least 60 people who have experienced pain caused by parechovirus have been recorded.
The form of transmission may be by air or by the feces of contaminated persons, which are scattered at sea. Some of the patients were in Guarajuba, on the North Coast of Bahia, before presenting the symptoms. Contamination from fish ingestion was not ruled out. "If in Guarajuba the sewage is being thrown into the sea, this sea will probably be contaminated. All this opens up a range of research and an opportunity to study," he explained.
The Institute of Environment and Water Resources (Inema) reported that although they are responsible for assessing the quality of water in the North Coast, the subject is the responsibility of the State Department of Health (Sesab), who said that the case is being investigated. Embasa said that the sewage of the region is properly treated and destined for the Pojuca River, which flows into the sea, between the beaches of Guarajuba and Praia do Forte.
The infectologist Ant?nio Bandeira had already pointed out that the disease can be caused by a virus or a toxin present in salty fish, on account of reports of patients who presented symptoms. In one of the most serious cases in Bahia, the disease eventually caused renal failure.
[The information above is the same as previously disclosed in the post [PRO / PORT> Unidentified disease - Brazil (05) (BA), outbreak, myopathy, update, increase in the number of suspected cases Archive Number: 20161221.4713256, http: // www .promedmail.org / post / 4713256 - Mod. RNA].
-
Posted by: Member, EpiCore Global Surveillance Project
Communicated by: ProMED-PORT http://www.promedmail.org
[For now, nothing conclusive yet.
ProMED-PORT greatly appreciates the prompt response of the EpiCore Global Surveillance Project members and hopes that the partnership will become increasingly intense, frequent and profitable.
Additional information is always welcome.
See the comment from the previous post: [PRO / PORT> Unidentified disease - Brazil (05) (BA), outbreak, myopathy, update, increase in suspect cases Archive Number: 20161221.4713256, http://www.promedmail.org/ Post / 4713256].
As always, we are following ...
Subject: PRO / PORT> Unidentified disease - Brazil (06) (BA), outbreak, myopathy, update, information received from EpiCore
Archive Number: 20161222.4716699
UNIDENTIFIED DISEASE - BRAZIL (06) (BAHIA), OUTBREAK, MYOPATHY, UPDATE, INFORMATION RECEIVED FROM EPICORE
************************************************** ************************************************** **************
A message / A message / from ProMED-PORT
ProMED-mail and a program from / is a program of the
International Society for Infectious Diseases
Date: Thursday, December 22, 2016
[1]
Source: Member, EpiCore Global Surveillance Project [21/12/2016] [edited]
Below is information sent / shared by Dr. Tatiana Otero Melendez in response to some questions pointed out in the previous post [PRO / PORT> Unidentified disease - Brazil (05) (BA), outbreak, myopathy, Number: 20161221.4713256, http://www.promedmail.org/post/4713256]:
1) ProMED-PORT Question: Is there any other link between patient families and non-fish consumption?
Answer EpiCore: "Most consumed fish".
2) Question ProMed-PORT: What is the age range of the cases?
EpiCore: "There are families with children and adults affected. I [Dr. Melendez] saw a family with 5 members who were 4, 11, 30-40 years old."
3) Question ProMed-PORT: What is the time interval between fish consumption and the onset of symptoms?
EpiCore responds: "It depends on the amount of fish consumed The day before, the mother, who consumed the most fish, had symptoms the next day, a few hours after [consumption, probably - RNA Mod.].
4) Question ProMed-PORT: What was the attack rate among those who consumed fish?
EpiCore Response: "All patients who consumed fish had symptoms."
5) Question ProMED-PORT: Have samples of the fish (s) incriminated (s) / suspect (s) been carried out for laboratory tests?
EpiCore Response: "So far no, since in most cases all fish has been used [consumed? Scorned? - RNA Modified?].
6) ProMED-PORT Question: Is there any link between the most recently reported cases and the first suspected cases of the outbreak?
EpiCore Response: "No. There are no other reported links."
7) ProMED-PORT Question: Are the last reported cases a case of recent onset of symptoms or are they old but only recently reported?
EpiCore: "I [Dra Melendez] made contact with surveillance, I have cases since July."
[It would be important to know how many cases, their clinical characteristics, their epidemiological history - Mod RNA].
8) ProMED-PORT Question: Have the most recently reported cases reported laboratory changes suggestive of myopathy?
EpiCore Response: "Cases had fairly elevated levels of CPK [creatine phosphokinase enzyme - Mod. RNA] and pain, and some of them had renal failure."
9) Question ProMed-PORT: It was mentioned that biological samples from 4 patients were analyzed. Is there any result?
EpiCore Response: "There is no information."
9) Question ProMed-PORT: How long will the symptoms and laboratory changes last?
EpiCore Response: "Few Days".
Epicore Information: the fish incriminated and potentially associated with the outbreak of myopathy are whiting and "bulls eye".
-
Posted by: Tatiana Otero Melendez, medical infectologist, member of the Member, EpiCore Global Surveillance Project
Communicated by: ProMED-PORT http://www.promedmail.org
-
[2]
Source: Member, EpiCore Global Surveillance Project [21/12/2016] [edited]
The Municipal Health Department of Salvador (SMS) reported that up to Monday (19) [December / 2016], 22 cases of the as yet unidentified disease that causes intense muscular pain and black urine have been reported. The data were released on Tuesday (20) [December / 2016] by the agency, which tracks the cases.
The secretariat's latest bulletin on Monday [December 19, 2016] reported 19 reported cases of the disease. There is still no information from other cities in Bahia where there are case records. The State Health Department (Sesab) also took a stand on the case and issued an epidemiological alert so that health professionals pay attention and report cases of the disease. According to Sesab, all reported patients reside in the state capital of Bahia, 14 reported the consumption of fish, while eight do not remember or did not consume.
By means of a note, the State Department of Health informed that a process of investigation is in progress that brings together professionals of epidemiological surveillance, sanitary and environmental vigilance, as well as the technicians of the State Central Laboratory (Lacen).
Sesab warns that the population should immediately seek a health facility if they present symptoms such as severe muscle pain, sudden onset, mainly affecting the cervical region (neck), shoulders, back, thighs or calves. All emergency and urgency units are designed to immediately notify suspected cases of acute myalgia, which makes it possible to speed up the investigation process.
The virology laboratory of the Federal University of Bahia (UFBA), coordinated by Professor G?bio Soares, has already analyzed urine, feces and blood samples from four patients who presented with symptoms, such as severe neck and back pain. 24 hours spread to arms and legs. The suspicion raised by the research is that the disease is caused by the enterovirus type "b" or the human parechovirus. Both cause myalgia, which is muscle pain. According to the researcher, the biggest suspicion is that parechovirus is responsible for the outbreak, since the pain caused by it is stronger. In the last 10 years, in France and Japan, contaminations of at least 60 people who have experienced pain caused by parechovirus have been recorded.
The form of transmission may be by air or by the feces of contaminated persons, which are scattered at sea. Some of the patients were in Guarajuba, on the North Coast of Bahia, before presenting the symptoms. Contamination from fish ingestion was not ruled out. "If in Guarajuba the sewage is being thrown into the sea, this sea will probably be contaminated. All this opens up a range of research and an opportunity to study," he explained.
The Institute of Environment and Water Resources (Inema) reported that although they are responsible for assessing the quality of water in the North Coast, the subject is the responsibility of the State Department of Health (Sesab), who said that the case is being investigated. Embasa said that the sewage of the region is properly treated and destined for the Pojuca River, which flows into the sea, between the beaches of Guarajuba and Praia do Forte.
The infectologist Ant?nio Bandeira had already pointed out that the disease can be caused by a virus or a toxin present in salty fish, on account of reports of patients who presented symptoms. In one of the most serious cases in Bahia, the disease eventually caused renal failure.
[The information above is the same as previously disclosed in the post [PRO / PORT> Unidentified disease - Brazil (05) (BA), outbreak, myopathy, update, increase in the number of suspected cases Archive Number: 20161221.4713256, http: // www .promedmail.org / post / 4713256 - Mod. RNA].
-
Posted by: Member, EpiCore Global Surveillance Project
Communicated by: ProMED-PORT http://www.promedmail.org
[For now, nothing conclusive yet.
ProMED-PORT greatly appreciates the prompt response of the EpiCore Global Surveillance Project members and hopes that the partnership will become increasingly intense, frequent and profitable.
Additional information is always welcome.
See the comment from the previous post: [PRO / PORT> Unidentified disease - Brazil (05) (BA), outbreak, myopathy, update, increase in suspect cases Archive Number: 20161221.4713256, http://www.promedmail.org/ Post / 4713256].
As always, we are following ...
Comment