Viet Nam - Quang Ngai: Undiagnosed illness, 26 fatalities since April 2011

[Treyfish]

Re: Viet Nam - Quang Ngai: Undiagnosed illness, 23 fatalities since April 2011 in Ba To commune, 4 in Son Ky

"Strange disease" appeared in Quang Ngai expression "strange" new
19/06/2012 14:14




These days, at Ba Dien Commune, Ba district, Quang Ngai province, many patients with "unknown disease" are faced with the fear from the new expression outside the thick horn syndrome, dermatitis hands, feet. This makes it local people more confused, because the cause of this evil disease has not yet been determined.

During the latest visit of the delegation Dr. Bach Mai Hospital - Hanoi, although many patients have been cured, or ordinary people in Ba Dien communes, also have additional symptoms such as shortness of breath , chest,eat less, vomiting, burning face ... http://translate.googleusercontent.com/translate_c?hl=en&ie=UTF8&prev=_t&rurl=translate.g oogle.com&sl=vi&tl=en&u=http://hanoimoi.com.vn/newsdetail/Doi-song/550908/benh-la-o-quang-ngai-xuat-hien-bieu-hien-la-moi.htm&usg=ALkJrhigg7IX-XXiLD7-sCrbaYnh7dB_Yg

[Treyfish]

Re: Viet Nam - Quang Ngai: Undiagnosed illness, 23 fatalities since April 2011 in Ba To commune, 4 in Son Ky

...Particularly, the index is higher due to microbial contamination of water sources. Institute recommends Enter Three people held communal sanitary accommodation and use of water to boil.

Institute participants only tests samples of soil, water and health authorities in Quang Ngai province to find references cause dermatitis hands and feet horn in Quang Ngai Province.

According to the health sector in Quang Ngai province, since the first cases were discovered in 19 - 4-2011 to 15 - 6 - 2012, has infected 239 people, most Ba Dien in which 23 cases were fatal, 45 serious relapse. There are 28 cases being treated at the medical facility from District II to Children's Hospital in Ho Chi Minh City.http://www.tienphong.vn/xa-hoi/58148...n-su-tpol.html

[Treyfish]

Re: Viet Nam - Quang Ngai: Undiagnosed illness, 23 fatalities since April 2011 in Ba To commune, 4 in Son Ky

......An opaque eye paralyzed, signs of elevated liver enzymes, fatal symptoms common in patients, "stranger". I heard Mr. Le Han Feng, chairman of Ba To district information, a few days, who suffered chest, abdomen, vomiting foot without arms and legs in this community suddenly increased, hepatic enzyme tests show high, but not recognized as unknown disease.

The villagers do not know it, just know that the panic is growing. The number of sick people, "strange" the district has up to 240 cases, of which 16 cases of particularly serious, are unlikely to survive. Farmers are not going to give up farming fields.A district leaders say that, upon the occurrence of disease, we have noted that, where cattle drink water, near the end when they die...
http://www.tienphong.vn/xa-hoi/58133...g-Reu-tpp.html

[Treyfish]

Re: Viet Nam - Quang Ngai: Undiagnosed illness, 23 fatalities since April 2011 in Ba To commune, 4 in Son Ky

WHO: Look for causes of disease "strange" is a challenge
Wednesday, 06.20.2012, 08:12 AM (GMT +7)
Event: "strange disease" in Quang Ngai
There were two experts from the World Health Organization (WHO) and the United States for Disease Control (CDC) to support the investigation of Quang Ngai cause "strange" horns inflammatory skin thickness in the hands and feet day.
Tuy course, 19-6 Monday, information from the Health Ministry said initial reports about the disease by health professionals VN, CDC and WHO that have yet to find the root cause, even Although scientists seem increasingly closer to the destination.

Because mycotoxins mycotoxin group?

The investigation by the Ministry of Health, WHO and CDC found some patients to eat rice crop before harvest and mold aflatoxin found in some samples of rice, many patients suffer from malnutrition and liver damage.

However, the study found no evidence of heavy metals or agrochemicals with high levels in samples of human and environmental occurrence area. In particular, also found no evidence of infection due to root disease.

Implement screening measures cause, the Health Ministry said that fungi mycotoxins, including aflatoxin, is likely to lead to disease causes a whole lot more.

Accordingly, dioxin is very little possibility, even very rare cause, because if related to dioxin, the consequence is the rate of birth defects cases higher, but this is not true for sick phenomenon "weird" Quang Ngai. If acute poisoning, the expression must be an expansion, all the facial deformity as a former head of Ukraine had been poisoned by the encounter.While the phenomenon in Quang Ngai have liver damage, but long-term exposure to high levels of aflatoxin can lead to liver damage (in Quang Ngai, aflatoxin has been detected in several samples of grain, rice brewed, people here is brewed rice feeding practices).

Undiscovered reason, to do?

While not yet discovered the cause of the disease, there were many comments tackle the situation. In particular, Quang Ngai Province has proposed to relocate the entire population living Ba Dien commune area (areas with the largest number of patients in social diseases "strange"), but Luong Ngoc Khue - chief of the Administration medical reasons, the Ministry of Health - that consideration be given this proposal very carefully, because the last time just put the patient to the hospital they did not know and many have fled the hospital.




If relocation of a large community of 1,400 people, with the practices, customs, many lives would be very difficult. Initially, to minimize the morbidity and recurrence, people should use white rice provided by local authorities, vitamins and nutritional supplements, ensuring environmental sanitation and personal hygiene, and disease detection Early and timely personnel to medical facilities.

Repeat is an expression of new patients / recurrent skin infections horns thick hands and feet for about two weeks significantly decreased, similar to 2011 almost no new patients in two months 6-7 .

Ministry of Health said this precious time will be spent to search for the possibility of interference, avoid repeating the phenomenon of massive increase of morbidity and mortality as early as 2012. WHO is also committed to continue to support the VN technique, but recommends "finding the cause can be longer than expected and is a challenge." By the WHO, chronic skin thick hands and feet horn in Quang Ngai unprecedented in the world.
http://us.24h.com.vn/suc-khoe-doi-so...62a463181.html

[Treyfish]

Re: Viet Nam - Quang Ngai: Undiagnosed illness, 23 fatalities since April 2011 in Ba To commune, 4 in Son Ky

Mushrooms are the true perpetrators unknown disease?

Updated at: 6:42 AM, 21/06/2012

(Land Vietnam) Ministry of Health is very likely that the aflatoxin mold that causes strange disease raging in Quang Ngai. On 20/6, at the press meeting, the Minister of Health Nguyen Thi Kim Tien said the results of the study from 4/2011 showed no evidence of infection lead to "strange" .
Ability due to dioxin poisoning are few. Currently, the Health Ministry said that fungi mycotoxins, including aflatoxin, it is likely that the root cause to most diseases. By following these tests be performed at Bach Mai Hospital in Quang Ngai people, the most elevated liver enzymes. In Quang Ngai, aflatoxin has been detected in various rice samples annealed (people here have brewed rice feeding practices).
Meanwhile, prolonged exposure to aflatoxin can lead to liver damage. Ms. Tien also said the Health Ministry is proposing to support water treatment plan and provide essential vitamins, especially vitamin B3 for the people.http://baodatviet.vn/Home/doisong/Na...218024.datviet

[Ronan Kelly]

Re: Viet Nam - Quang Ngai: Undiagnosed illness, 23 fatalities since April 2011 in Ba To commune, 4 in Son Ky

Killer skin disease in Vietnam once seen in Kenya: Minister
Last Updated: Thursday, June 21, 2012 02:40:00


The mysterious skin disease that has killed 23 people in the central province of Quang Ngai over the past year has similarities with a case once recorded in Kenya, Vietnam's health minister said Wednesday.
A Tuoi Tre newspaper report Thursday quoted Minister Nguyen Thi Kim Tien as saying that in the Kenya case, people contracted the disease because they had eaten molded corn and the death rate among those afflicted was 25 percent.

The disease was controlled after people were given clean food, she said, without giving further details about the case.
...

http://www.thanhniennews.com/index/pages/20120621-minister%20says%20vietnam-fatal-skin-condition-once-recorded-in-kenya.aspx

[alert]

Re: Viet Nam - Quang Ngai: Undiagnosed illness, 23 fatalities since April 2011 in Ba To commune, 4 in Son Ky

The article also contains the revealing line, potentially driving the start of this outbreak back a decade:

http://www.thanhniennews.com/index/pages/20120621-minister%20says%20vietnam-fatal-skin-condition-once-recorded-in-kenya.aspx

According to Tien, the skin condition actually appeared in Ba To in 2003, but not many cases were recorded then.

[Ronan Kelly]

Re: Viet Nam - Quang Ngai: Undiagnosed illness, 23 fatalities since April 2011 in Ba To commune, 4 in Son Ky

Dubious herbs confiscated in district plagued by fatal skin disease
Last Updated: Sunday, June 24, 2012 01:25:00




Health officials in central Vietnam have confiscated a large amount of herbs of unclear origins being used by people who live in an area that has been plagued by a mysterious skin condition that killed 23 people so far.

Officials from Quang Ngai Province's Health Department have sent samples of the medicine found in Ba Dien Commune of Ba To District to the Health Ministry for testing.

Locals have been asked to stop using the medicine, which is in the form of a powder, ostensibly of roots, branches and dry leaves. Chinese labels found on the package say the medicine is for treating liver cancer.

...

http://www.thanhniennews.com/index/pages/20120624-dubious-herbs-taken-from-vietnam-district-plagued-by-skin-disease.aspx

[alert]

Re: Viet Nam - Quang Ngai: Undiagnosed illness, 23 fatalities since April 2011 in Ba To commune, 4 in Son Ky

http://english.vietnamnet.vn/en/society/24262/strange-skin-disease-is-chronic-intoxication.html

Last update 29/06/2012 02:18:21 PM (GMT+7)

Strange skin disease is chronic intoxication
VietNamNet Bridge ? The Ministry of Health and the World Health Organization (WHO) on June 28 made a joint-statement on the bizarre skin disease in Ba To district of the central province of Quang Ngai.

According to the Ministry of Health, the strange disease in Quang Ngai is actually a chronic intoxication, which can cause inflammation and wounds in hands, feet and liver. Only people in Ba To district are discovered to suffer from this syndrome.

The first patients were reported in Ba To district last April. By June 2012, a total of 216 cases have been recorded, including 12 deaths, in five communes of Ba To district. At present, 18 people are being treated at hospitals in Quang Ngai and neighboring provinces.

The Ministry of Health has conducted many surveys in Ba To and until now, it has not found out the reasons causing this strange disease. However, the Ministry has excluded infection as a cause.

In addition, many patients were malnourished and many of them ate rice that contained aflatoxins, which is toxic for human. Experts also did not find out heavy metal or agricultural chemicals in samples collected from patients or environment in Ba To.

The WHO and the US Center for Disease Control (USCDC) have closely combined with the Ministry of Health to research this disease. In early June, two WHO and USCDC?s experts came to Vietnam to work with the Preventive Medicine Agency.

?We support the Ministry of Health?s measures to control the disease in Quang Nam and we believe that the Ministry is going in the right direction. As we do not know about the source of this syndrome, seeking for the cause may be longer than schedule and would be a challenge,? said Dr. Takeshi Kasai, chief WHO representative in Vietnam.

[alert]

Re: Viet Nam - Quang Ngai: Undiagnosed illness, 23 fatalities since April 2011 in Ba To commune, 4 in Son Ky

http://www.tuoitrenews.vn/cmlink/tuoitrenews/society/relocation-proposed-for-people-in-bizarre-disease-area-1.78011

Relocation proposed for people in bizarre disease area
Updated : Fri, June 29, 2012,12:34 PM (GMT+0700)

In the face of an unidentified skin syndrome that broke out in April 2011 and has killed 23 local residents so far, authorities of Quang Ngai Province?s Ba To District have proposed a relocation of 79 families there.

Pham Viet Nho, secretary of the district Party Committee, raised the proposal at the 9th conference of the provincial Party Committee yesterday.

He said these families, consisting of with 344 people in Ba Dien Commune?s Reu Village, should be relocated to a new residential area to get rid of the strange disease, which is characterized by thickened skin (keratosis) over the palms and soles, causing stiffness in the limbs and ulcers on victims? hands and feet that look like burns.

The bizarre disease has so far affected more than 240 district residents, most of who live in the village, Nho said.

If the proposed relocation is carried out, authorities will continue to monitor the disease to see if the removal helped ease its spread, Nho added.

Le Quang Thich, deputy chairman of the provincial People?s Committee, said the committee has discussed the issue many times but has yet to come to a decision, since the resettlement of more than 300 people is not a simple task.

The committee will have to consider this proposal carefully before approving it, Thich said.
Also yesterday, the World Health Organization Office in Vietnam and the country?s Ministry of Health jointly issued a press release saying that they have yet to identify the cause of the strange skin syndrome.

Earlier this month, two experts from WHO and the US Center for Disease Control and Prevention (CDC) arrived in Vietnam to take part in the investigation of the mysterious disease, which first occurred in the district on April 19, 2011 and has so far spread to five communes in the district, including Ba Dien, Ba Ngac, Ba Xa, Ba Vinh and Ba To.
.

[Emily]

Re: Viet Nam - Quang Ngai: Undiagnosed illness, 23 fatalities since April 2011 in Ba To commune, 4 in Son Ky

Relocation proposed for people in bizarre disease area

Tuoi Tre
Updated : Fri, June 29, 2012,12:34 PM (GMT+0700)
Pham Van Trach, 16, one of the patients of the strange disease in Reu Hamlet, Quang Ngai Province
Photo: Tuoi Tre

In the face of an unidentified skin syndrome that broke out in April 2011 and has killed 23 local residents so far, authorities of Quang Ngai Province?s Ba To District have proposed a relocation of 79 families there...

[alert]

Re: Viet Nam - Quang Ngai: Undiagnosed illness, 23 fatalities since April 2011 in Ba To commune, 4 in Son Ky

http://www.promedmail.org/

Published Date: 2012-07-01 11:49:59
Subject: PRO/EDR> Undiagnosed illness - Viet Nam (08): (QG) WHO/CDC input
Archive Number: 20120701.1186507

UNDIAGNOSED ILLNESS - VIET NAM (08): (QUANG NGAI) WHO/CDC INPUT
************************************************** *************
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: Fri 29 Jun 2012Source: thanhniennews.com [edited]http://www.thanhniennews.com/index/pages/20120629-with-help-vietnam-skin-disease-still-mysterious.aspx


The World Health Organization (WHO) and the US-based Centers for Disease Control and Prevention (CDC) have been unable to solve the mystery of the fatal skin disease plaguing the central province of Quang Ngai.

According to a press release issued by WHO and Vietnam's Ministry of Health on Thursday, early this month two experts from WHO and the CDC were invited to help local agencies identify the disease that has affected 216 people and caused 12 deaths in Ba To District since April of last year.

However, the cause of the disease, referred to as inflammatory palmoplantar hyperkeratosis (IPPH) syndrome by WHO, is still unknown. "We do no know what causes the syndrome, or its source of transmission, identifying the cause may take longer than anticipated or prove elusive," the press release quoted WHO representative for Vietnam, Dr. Takeshi Kasai, as saying.

So far it has been confirmed that the syndrome is characterized by a chronic intoxication that can lead to inflammation and lesions of the hands, feet and liver.
Several field investigations conducted by the health ministry have established that the syndrome may not be infectious in origin and that most patients suffered from inflammation of liver, according to the press release.

Other results included the discovery of aflatoxins - a fungus that contaminates grains before harvest or during storage - in few rice samples, and no presence of elevated levels of heavy metals or agrochemicals taken from human or environmental samples, it said.

The health ministry will continue focusing its efforts in treating current patients and monitoring new cases as they occur. Meanwhile, further investigations will be conducted to measure and evaluate the effectiveness of interventions as well as to identify other risk factors associated with IPPH syndrome, the press release said.

--
Communicated by:
ProMED-mail Rapporteur Mary Marshall


[The news article above concerns an outbreak in several villages in the Bo To district of Quang Ngai province, Viet Nam, on which ProMED-mail has previously reported. Those affected are reported to have developed an acute febrile illness [or not?? - alert] with loss of appetite and respiratory symptoms followed by a rash on the hands and feet described as "palmoplantar keratoderma" (http://emedicine.medscape.com/articl...rview#aw2aab6b), accompanied by liver dysfunction and, in some patients, by multi-organ failure and death. Ulcers on the hands, feet, mouth, back, and abdomen, eye disease, stiffness of the limbs, and miscarriage are also described. Mainly children and young adults have been affected.

The disease is said to have started in April 2011, subsided somewhat between November 2011 and February 2012, and picked up pace again in March and April 2012. The numbers of patients affected and the death toll has varied in the news reports, but the news report above says that the number affected is 216 people and caused 12 deaths in Ba To District since April of last year.

Pictures of the rash on the hands and feet of the affected Vietnamese villagers are available at http://www.saigon-gpdaily.com.vn/Health/2012/4/100698 and http://www.eyedrd.org/2012/04/breako...l-vietnam.html.

Chronic arsenic toxicity (http://icmr.nic.in/ijmr/2008/october/1007.pdf) and dioxin toxicity (Patel S, Zirwas M, English JC: Acquired palmoplantar keratoderma. Am J Clin Dermatol. 2007; 8(1): 1-11; abstract available at http://www.ncbi.nlm.nih.gov/pubmed/17298101) can produce skin lesions similar to those seen in the Vietnamese villagers. In fact, hair samples taken from a 9-year-old boy who died contained arsenic at a level 100 times higher than the country's acceptable limit (ProMED-mail post Undiagnosed illness - Viet Nam (06): (QG) toxin susp. RFI 20120601.1153587). However, the news reports in prior ProMED-mail posts say that authorities did not find residues of dioxin or heavy metals, presumably including arsenic, in the affected villages, and now the above news report says that WHO and the US-based Centers for Disease Control and Prevention (CDC) experts have also failed to find a cause for this outbreak.

Quang Ngai is a Vietnamese province located in the South Central Coastal region along the South China Sea, 883 km (549 miles) south of Hanoi and 838 km (521 miles) north of Ho Chi Minh City (http://en.wikipedia.org/wiki/Quang_Ngai_province). The province has a large plain along the coast and in the center of the province and has mountains and hills in the west. Ba To is a rural district of Quang Ngai province with a population of 47 268 in 2003 (http://en.wikipedia.org/wiki/Ba_To_District).

A map of Viet Nam provinces can be seen at http://upload.wikimedia.org/wikipedi...ovincesMap.png. Viet Nam may also be found on the interactive HealthMap/ProMED-mail map at http://healthmap.org/r/2bxT. - Mod.ML]

[Ronan Kelly]

Re: Viet Nam - Quang Ngai: Undiagnosed illness, 23 fatalities since April 2011 in Ba To commune, 4 in Son Ky

Mysterious skin disease reduces in Quang Ngai
QUANG NGI -- The Health Department of central Quang Ngai Province reported no new cases of the mysterious skin disease that has killed 23 people and continues to baffle scientists.
The main symptoms of the disease are thickened skin on the palms and soles (keratosis), stiffness in the limbs and ulcers on hands and feet that look like burns.
Department office head Le Huy said there had been no new cases since June 8. He said four out of six patients with the disease at Quang Ngai Hospital had been discharged on July 1 while 18 other patients remained at Ba To District clinic. Five patients in Ha Noi for treatment had returned in good health.
...

http://vietnamnews.vnagency.com.vn/social-issues/226928/mysterious-skin-disease-reduces-in-quang-ngai.html

[Ronan Kelly]

Re: Viet Nam - Quang Ngai: Undiagnosed illness, 23 fatalities since April 2011 in Ba To commune, 4 in Son Ky

Belgian experts aid in mystery skin disease
Two Belgian experts, an epidemiologist and a hepatologist, have assisted doctors from the HCM City Children's Hospital No. 2 in finding out the cause of the strange skin disease in Quang Ngai Province's Ba To District.
...
Tuoi Tre (Youth)

http://vietnamnews.vnagency.com.vn/Domestic-Press-Highlights/227094/belgian-experts-aid-in-mystery-skin-disease.html

[alert]

Re: Viet Nam - Quang Ngai: Undiagnosed illness, 23 fatalities since April 2011 in Ba To commune, 4 in Son Ky

http://www.thanhniennews.com/index/pages/20120705-belgium-health-experts-inspect-skin-condition-in-central-vietnam.aspx

Belgian experts study mystery skin disease in central Vietnam
Last Updated: Thursday, July 05, 2012 03:00:00

Two Belgian doctors Wednesday visited a central Vietnamese province plagued by a mysterious skin condition that has caused the deaths of at least 23 people so far, hoping to crack the mystery.

The two, one an epidemiologist and the other a liver expert, took rice samples from Ba Dien Commune in Quang Ngai Province's Ba To District to check for harmful fungi.

Arriving with doctors from Ho Chi Minh City's Children?s Hospital No.2, they also checked water sources, living conditions, and medicines victims have been using.

Since April last year at least 239 people have contracted the disease, which causes thickened skin and blisters on hands and feet, and leads to multiple organ failures, starting with the liver. Most patients see liver enzyme levels shooting up to many times normal levels.

The visiting experts observed that the outbreak peaks during the monsoon from November to April. Only two cases have been reported since early June.

The Ministry of Health has also sought the help of the World Health Organization and the US Centers for Disease Control and Prevention.