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

[Ronan Kelly]

Published Date: 2011-09-16 23:03:10
Subject: PRO/MBDS> Undiagnosed illness - Viet Nam: Quang Ngai, RFI
Archive Number: 20110916.2829

UNDIAGNOSED ILLNESS - VIET NAM: QUANG NGAI, REQUEST FOR INFORMATION
************************************************** *****************

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: Thu 15 Sep 2011
Source: VietNamNet Bridge [edited]
http://english.vietnamnet.vn/en/soci...n-disease.html

Quang Ngai: 50 people contract unknown disease
----------------------------------------------
The General Hospital of Quang Ngai Province, in central Viet Nam, has received nearly 50 people affected by an unknown disease. The local health department has asked for the Ministry of Health's assistance.

According to the Quang Ngai Department of Health, nearly 50 local residents were reported to have contracted the disease from 19 Apr to 24 May 2011. One of them died of viscera failure. The Quang Ngai General Hospital early this week received 2 more patients.

The common symptoms include ulcers in mouth, thick scales on the soles of the feet and palms, which look like scalds.

Doctors of the Quang Ngai General Hospital said that the 2 new patients are a father, 59, and his son, 24, from Ba To district. The 2 patients have the symptoms described above. Tests show that they have anemia and kidney failure.

Doctors said that this disease causes skin wounds, caused by contamination. They said that patients were highly possibly infected with a strange type of virus. Most of the patients came from Ba Dien commune in the mountainous district of Ba To. Local people are very afraid of the disease.

In late April [2011], 4 patients (2 adults, 2 children) were transferred to the Central Dermatology Hospital in Hanoi for treatment. However, even central hospitals are unable to define the disease.

In late 2010, 2 children 10 and 12 years old in Ba Dien commune were treated at the Quang Ngai General Hospital for the same disease. The 12-year-old patient died while the younger was quickly rescued after experiencing blood filtering at a hospital in Da Nang city.

Quang Ngai has asked the Ministry of Health to send experts to Ba To district to investigate the disease.

[Byline: Dam De]

-- Communicated by: PRO/MBDS

[Within one month, more than 50 people (one of whom died) in Quang Ngai province contracted an illness with similar symptoms. This suggests a significant outbreak with high morbidity, worth further active investigation. Since the most recent cases are a father and his son, it seems the disease is highly transmissible to close contacts. However, more clinical information is needed to develop a differential diagnosis for the associated illness.

PRO/MBDS would appreciate further information from knowledgeable sources regarding this undiagnosed illness in Quang Ngai province, Viet Nam.

For a map of Viet Nam with provinces, see http://upload.wikimedia.org/wikipedi...ovincesMap.png. ProMED-mail map with direct links to other outbreaks in Viet Nam and surrounding countries reported on ProMED-mail and PRO/MBDS, - Mods.QCN/YMA]

[The information provided on the few more serious cases suggests a progression to possible sepsis with multiorgan failure, which could be a result of secondary bacterial infection following the initial manifestations. More information on the clinical presentations at the onset of illness might help to further clarify the etiology of this disease and would be greatly appreciated. - Mod.MPP]


...................................yma/qcn/mj/yma/mj/yma

http://beta.promedmail.org/direct.php?id=20110916.2829

[alert]

Re: Undiagnosed illness - Viet Nam: Quang Ngai, ProMED RFI

Note a possibly different time period for this outbreak below. There may also be suspicion of a poisoning:

http://vietbao.vn/vi/Suc-khoe/Them-2-benh-nhan-mac-benh-la-o-Quang-Ngai/75303214/70/

Vietnamese see marked
Them two patients was o Quang Ngai
Tags: Quang Ngai, Ba To, who died, health, long-fingered hands, the patient, the disease is, hospitals, had, disease, cause, ket, huyen, skin, central
- From this year, more than 50 people in the mountainous district of Ba To (Quang Ngai) is sick, someone died, but health sector can not yet conclude what causes the disease.


This morning, representatives of Quang Ngai province, says it has a written request to the Ministry of Health directed the concerned agencies to send their officials, support specialists to investigate and survey conditions unexplained ear Ba To district.

According to the Quang Ngai functional departments, expenditure from the date of 19 / 4 den 23 / 8 [that is 19 April to 23 August, not May 24 as above - alert], the areas of remote Dien Ba, Ba Vinh, Ngoc Ba Xa and Ba (Ba To) has more than 50 cases skin lesions in addition to unknown causes making people very confused.





One patient's hand ball "disease to", said the classes are similar burns

In which a patient after conversion to a maternity hospital - Children's care, the Da Nang die with a diagnosis of skin-organ failure due to suspected poisoning. Male cases are transferred to the Central Hospital Dermatology (Singapore) are already general hospital with a diagnosis: Day sung palms, feet suffer from the poison, but not read chat meant.


According to Dr Le Thi Bich Lien, Truong Dermatology, Hospital of Quang Ngai, vien king received them two patients' disease was "the father by Pham Van Kieu bees (59) and Pham Van Di (24 years old, in remote Dien Ba, Ba To), as manifested by mouth sores, long-fingered hands, feet up the scales da noi giong day burns ... Test results showed that patients high liver enzymes bi, anemia, kidney failure.

"Thuong Hospitalized patients hospitalized with symptoms: Long-fingered hands, feet lop da noi len giong burn day, insanity transducer. Test test results: Men liver, anemia, kidney failure ... ", three Lien, said.


To ensure safety for the life of patients, Quang Ngai Hospital has suggested specialized health patients in Ha Noi de la specified day medical problems, treatments given reasonable.

According to Mr. Le Huy, account director of the Health Medicine Quang Ngai, "the fourth unit is the poison center Bach Mai Hospital in central cardiovascular centers blood transfusion National Central Hospital Dermatology supply de hoi chan determined the patient's disease. However the test results remains unclear. "

Nghia Binh

[Laidback Al]

Re: Undiagnosed illness - Viet Nam: Quang Ngai, ProMED RFI

machine translated . . .

More patients with skin lesions unexplained

Hospital of Quang Ngai has received a patient has symptoms of ulcers, palms, feet, rise thick black scales like burns ..., nearly 50 people with similar diseases, "strange "unknown causes.

After more than half a month to run medical treatment at the district level but the disease did not improve, the family has decided to Pham Thi Lieu (35) in the rural village Moss, Ba Dien commune, Ba mountainous districts, to the dermatology treatment at hospital in Quang Ngai.
The patient said that two weeks ago suddenly emerged limbs hardened black scales and sores caused numbness, aches throughout the body. At first her doctor at the district hospital, doctors diagnosed skin diseases, for drug treatment but does not improve.
Within a week, Rural Village Moss has infected three people were hospitalized with similar symptoms common mouth sores, palms, feet floating up the thick layer of scaly skin like a burn ... Test results showed that patients with elevated liver enzymes, anemia, kidney failure.
According to the Quang Ngai Department of Health, from the beginning of the year, more than 50 people infected were hospitalized with the disease "strange" above, in which one person died of multiple organ failure suspected poisoning.
Doctors as well as results of diagnostic testing center, so patients can be a strange virus that cause disease. Most patients in Ba To district so many people become confused, afraid. Earlier, in April, Quang Ngai Department of Health sent four patients directly to Hanoi for testing, monitoring, treatment is justified. There are four units of poison control center Bach Mai Hospital in central cardiovascular, blood transfusion center of the district national central hospitals with dermatology consultation to confirm the diagnosis. But the test results remains unclear, it is not able to diagnose what the disease.
According to Nguyen Thanh Tan, Director of Hospital Rooms - Central Dermatology Quy Hoa (Binh Dinh), to identify disease "strange", the Ministry of Health to help Quang Ngai send samples abroad for testing with modern analytical equipment. Initially, the patient's condition changes in weight, the health sector can be transferred to Quang Ngai Hospital Phong - Hoa Quy Central Dermatology for treatment. The difficult cases, no health insurance, hospitals will be waived or reduced cost treatment.
In this situation, Quang Ngai has sent written request the Ministry of Health sent the Ba Mission to investigate causes and treatment solutions.

http://vnexpress.net/gl/suc-khoe/2011/09/them-benh-nhan-ton-thuong-da-chua-ro-nguyen-nhan/

PHOTO

<table align="center" border="0" cellpadding="3" cellspacing="0" width="1"><tbody><tr><td></td></tr><tr><td class="Image" style="font-family: Arial; font-size: 8.5pt; color: rgb(0, 0, 0); ">Hand, foot ulcers Pham Thi Lieu, black flakes floating ... similar condition of nearly 50 people but the health sector so far unknown what the illness is. Photo: Tri T</td></tr></tbody></table>

[Sally Furniss]

Re: Undiagnosed illness - Viet Nam: Quang Ngai, ProMED RFI

The disease is "strange" that four patients danger
Tags: Quang Ngai hospital, palms, patients, diseases, foot, central, danger, dermatology, 4, makes

Palms, feet thick skin to emerge like burns, high liver enzymes, anemia, kidney failure ... 4 patients Quang Ngai Hospital Dermatology transferred to the central antitrust experts meeting diagnosis.

Related to this disease, one patient who died late last year. The remaining four patients, including 2 children, 2 adults in critical condition. In which a child must transfer to Danang for new dialysis survived. The patient under three different families living in mountainous Ba To, Quang Ngai.

Last April, the district health center Ba 4 patients were transferred to hospital emergency Quang Ngai. Dr. Nguyen Tan Phu, head of the Department of Pediatrics, Hospital of Quang Ngai, patients hospitalized with symptoms of hand, foot thick layer of skin emerges like burns, severe disease evolution. Test for abnormal results, anemia, kidney failure ... "It is not clear what the illness is," said Dr. Accessories.

Hospital of Quang Ngai Department of Health has proposed to the skin 4 to the Central Hospital in Hanoi to determine specifically what this disease, from which a reasonable treatment plan.

Mr Le Huy, Head of Health Profession Quang Ngai Department of Health said: "The fourth unit is a poison control center in Bach Mai Hospital in central cardiovascular centers mystical national blood transfusion, hospital dermatology center same level consultations to determine the patient's illness. But the test results remains unclear. "

The medical professionals that, more likely four patients with the disease in thickening of the palms, feet. Thick horn palms, feet is caused by congenital and genetic causes with clinical manifestations in the skin is thick horn palms and feet. This is a disease caused by a mutation of the gene encoding epidermal structure in the cause.

Tri Tin

http://vietbao.vn/Doi-song-Gia-dinh/Can-benh-la-khien-4-benh-nhan-nguy-ngap/11223217/111/

[Sally Furniss]

Re: Undiagnosed illness - Viet Nam: Quang Ngai, ProMED RFI

According to the Quang Ngai Department of Health, on 19 / 4 to 24 / 5, nearly 50 people infected, including one death from multiple organ failure suspected poisoning. Quang Ngai Hospital has also received two emergency cases with clinical and subclinical cases like these before.

Le Thi Bich Lien, head of Dermatology Department - Quang Ngai hospital said two patients are father and son Pham Van Kieu (59) and Pham Van Go (24) was born in Ba Dien commune, Ba Silk. Both were mouth sores, palms, feet floating up the thick layer of scaly skin like a burn ... Test results showed that patients with elevated liver enzymes, anemia, kidney failure.

Many experts, doctors of Quang Ngai Department of Health identified the disease is skin lesions with thick horn expression in palms, feet poisoning. But the provincial health sector has not found anything toxic. Through the treatment at the hospital as a result of the testing center, it is possible that patients with a strange virus that cause disease. Patients most at Ba Dien commune, Ba mountain districts, so many people here become confused, afraid.

Last April, the district health center has moved Ba 4 patients (2 adults, 2 children) to the Quang Ngai hospital emergency treatment. Later, General Hospital of Quang Ngai Department of Health has proposed to the four people in the Central Hospital dermatologist to follow appropriate treatments. But many months of treatment, sample and test the clinical method, to date the central hospital in Hanoi is not able to determine what disease this is.

Earlier, around the end of 2010, Pham Thi Bong two patients (12 years) and Pham Van plasticity (10 years) and rural communes in Ba Dien, emergency hospital in Quang Ngai province with similar symptoms mentioned above . Events severe illness, she died Cotton, a child must be moved flexibly of the hospital in Da Nang dialysis should be saved.

http://vnexpress.net/gl/suc-khoe/2011/09/gan-50-nguoi-bi-benh-la-gay-ton-thuong-da-suy-than/

[alert]

Re: Undiagnosed illness - Viet Nam: Quang Ngai, ProMED RFI

The medical professionals that, more likely four patients with the disease in thickening of the palms, feet. Thick horn palms, feet is caused by congenital and genetic causes with clinical manifestations in the skin is thick horn palms and feet. This is a disease caused by a mutation of the gene encoding epidermal structure in the cause.

Tri Tin

http://vietbao.vn/Doi-song-Gia-dinh/.../11223217/111/

That's interesting. If this is a genetic condition, that would explain the father and son both being affected, but a relatively simultaneous onset would be unusual. But 50 (milder? unrelated?) cases might be more difficult to explain. However, the most recent post (#4) actually only mentions the four severe cases.

[alert]

Re: Undiagnosed illness - Viet Nam: Quang Ngai, ProMED RFI

http://www.tienphong.vn/Suc-Khoe/552762/Dieu-tra-nguyen-nhan-benh-la-o-Quang-Ngai-tpp.html

Health 07:38 | 24/09/2011
Investigating the cause of strange diseases in Quang Ngai

> Bridge at the Ministry of Health

TP - The Health Ministry has decided to set up an expert in Ba To district - Quang Ngai to understand a disease epidemic diseases like thick horn-foot palm has liver dysfunction but not the cause ( Pioneers on 15-9-2011 view, all strange disease in mountainous Ba-Quang Ngai: Bridge at the Ministry of Health).



The feet of a patient being treated in Quang Ngai Hospital DLTU.


Dr. Tran Hau Khang, Director of the Central Hospital Dermatology (DLTU), initially identified this nature epidemic disease, occurring in a certain area, a family of 2-3 people to questions. Through years of free treatment for most severe cases from the Quang Ngai province in May, experts pre-condition for this is the thick horn palms, feet with liver dysfunction. DLTU Hospital held a consultation with experts from the Bach Mai Hospital, Central Institute of Hematology, Hospital for Tropical Diseases Surgeons and dermatologists from Japan, Canada, the United States. They also agreed with the diagnosis.

The skin disease is hand, foot thick horns, then lumpy ball floating layers, some with mouth ulcers. Tests showed high liver enzymes. After one month treatment regimen that offers DLTU Institute, in severely ill patients recovered and discharged.

Survey this field, the experts will directly check the health status of patients mentioned above as well as more than 40 patients were treated locally. Referring the case of a 12-year-old girl died with similar symptoms, said Dr. Khang, to determine whether patients have died of the disease properly or not.

Initial tests at the hospital found no signs DLTU of toxic chemicals in water such as arsenic (arsenic). Just have not found the relevant environmental factors, infections, fungus or virus. The Health Ministry has decided to establish expert teams, chaired by the Institute DLTU, the local early October to find out the cause.


After a lull time since the first recorded back in May, recently recorded three new cases, bringing to 52 the total number of infected people.

[alert]

Re: Undiagnosed illness - Viet Nam: Quang Ngai, ProMED RFI

I have no clue what this might be. It doesn't look contagious; cases have been reported since May with no spread to HCW or to other villages. The lack of fever also argues against an infectious etiology. It doesn't look genetic, as it seems to have all started in the past year or so. And no evidence of toxin has been found yet.

http://vnexpress.net/gl/suc-khoe/2011/09/bo-y-te-vao-cuoc-dieu-tra-benh-la-o-quang-ngai/

VideoTieu phamDOI LIFE> HEALTH KHOEThu Saturday, 24.09.2011, 11:14 GMT +7 E-mail Print Ministry of Health to survey patients 'views' in Quang Ngai
The Health Ministry has decided to establish expert teams to investigate the epidemiological disease skin lesions unexplained in mountainous Ba To, Quang Ngai province. Already more than 50 people infected, including one death.
> Nearly 50 people sick 'strange' cause skin lesions, kidney failure / disease 'strange' cause danger four patients
Delegation of the Central Institute of Dermatology is expected to lead to the communal areas, remote districts Ba early in October to find out causes "strange". The experts will directly examine the health status of groups of patients with symptoms: sores, palms, feet thick scales emerged burns like black ...


Hands, feet ulcers, floating on thick black scales, leading to kidney failure ... a patient's home in Ba Dien commune, Ba To district. Photo: Tri Tin

According to the Quang Ngai Department of Health, after a lull period, the province has also recorded three new cases, bringing the total number of patients with "strange" to 52. Test results showed that patients with elevated liver enzymes, anemia, kidney failure, in which one person died of multiple organ failure suspected poisoning.

Initially, the Central Academy of Dermatology is getting to bring the epidemic disease, occurring in a certain area. The initial tests found no sign of toxic chemicals in water such as arsenic (arsenic), yet detect the relevant environmental factors, infections, fungus or virus.

Associate Professor, Dr Tran Hau Khang, Director of the Central Hospital of Dermatology, said: "Through free treatment for most severe cases from five provinces of Quang Ngai province to Hanoi early in May, this conjecture is a disease thick horny palms, feet with liver dysfunction. " After one month treatment regimen of the Institute, five patients with severe health recovery and was discharged.

Then the Central Academy of Dermatology held further consultations with health professionals, including: Bach Mai Hospital, Central Institute of Hematology, Hospital of Central and tropical disease expert from Japan, Canada, the United States. All basically agreed with the diagnosis.

The patients said that their arms and legs suddenly emerged hardened black scales and sores caused numbness, aches throughout the body. Doctor at the district hospital, provincial doctors diagnose skin diseases, the drug for several weeks but not less.
Tri Tin

[Emily]

Re: Undiagnosed illness - Viet Nam: Quang Ngai, ProMED RFI

I'm not suggesting this is what the people in Viet Nam have, but the cases made me remember reading about this:

http://www.aad.org/skin-conditions/d...ets-and-causes
Lichen planus: Who gets and causes
http://www.ncbi.nlm.nih.gov/pubmed/16502199
Familial bullous lichen planus (FBLP): Pedigree analysis and clinical characteristics.

The AAD article says an autoimmune mechanism is suspected but not proven. Metal fillings in your teeth are one trigger, according to AAD.

I'm not clear on if the familial cases are suspected of being autoimmune.

[alert]

Re: Undiagnosed illness - Viet Nam: Quang Ngai, ProMED RFI

Copper poisoning sounds possible...

http://vietnamnews.vnagency.com.vn/Social-Isssues/216232/Strange-disease-sweeps-communes-.html

Strange disease sweeps communes

QUANG NGAI ? A disease that has swept through four communes in the central province of Quang Ngai's Ba To District has left doctors scratching their heads.
Patients have been suffering from skin problems and liver disorders.

Symptoms include swelling and itching between the fingers and toes after 4-7 days, with skin becoming thick and chapped, and even hair loss after two weeks.

Statistics from the provincial Health Department showed that 59 people had contracted the disease since April, resulting in one fatality. Fifty others recovered after being treated in the provincial General Hospital, while eight have yet to be discharged.

The youngest patient was four years old and the oldest, 72.

However, children under the age of 15 have suffered the most.

"Result of initial tests show that there are high levels of copper in blood of the patients, and signs of damage to the liver," said Director of the National Hospital of Dermatology and Venereology, Associate Professor Dr Tran Hau Khang.

"We suspect that victims may have been contaminated with toxic chemicals," he said.

Intensive tests were being conducted to discover the cause of the disease, he added . ? VNS

[alert]

Re: Undiagnosed illness - Viet Nam: Quang Ngai, ProMED RFI

The last line here is not clear and may be a translation error; who are these four deaths? All previous articles have indicated only one fatality.

http://vietbao.vn/Suc-khoe/Benh-la-o-Quang-Ngai-nghi-nhiem-doc-tu-moi-truong-song/75305958/70/

Wednesday, October 5, 2011, 18:04 GMT +7 Font


. Strange disease in Quang Ngai Province: suspected contamination from the environment
Tags: Quang Ngai, specimens, habitat, working groups, health workers, strange diseases, patients, hospitals, disease, poisoning, collecting samples, to, now, hand-It is getting to the head of the delegation of the Ministry of Health directly to the test, sample of patients with unknown disease in Quang Ngai.





Yesterday, the delegation of the Ministry of Health by Dr. Tran Hau Khang, Director of the Central Hospital of Dermatology, as head of the delegation of Quang Ngai, inspect, take samples for testing to clarify the cause the skin disease for more than 60 people Ba district.





Hands, feet of a strange illness in Quang Ngai

As reported by the Health Department, Quang Ngai, on 19 / 4 to date, there have been 59 people in four ethnic H're Ba Dien commune, Ba Xa, Ba Amazingly, Vinh Ba (Ba district), strange disease , as manifested by mouth sores, palms, feet floating up the thick layer of scaly skin like a burn ... Test results showed that patients with elevated liver enzymes, anemia, kidney failure.



Soon to Quang Ngai, the medical experts have conducted tests, sampling tests to clarify the cause of the disease. Preliminary results show that this is a disease epidemic nature, appearing in a certain area. Most samples have the same results in the blood, liver damage and some patients show signs of haemolysis suspected poisoning.


According to Dr. Tran Hau Khang, Director of the Central Hospital of Dermatology, said that initially, these patients may be infected by the influences of their environment. However, there is currently able to identify the causes of disease because they have not found signs of toxic chemicals in water, yet detection of relevant environmental factors, infections, fungus or virus.




The feet are a strange disease patients treated at the Central Hospital of Dermatology, has cured (photo provided by the hospital)

While undergoing treatment for five patients due to hospital transfer of Quang Ngai, the doctors at the Central Hospital of Dermatology, said that the treatment of this disease is not difficult (just lift high state of the patient, for transmission lines and dry skin cream anti ...). To date, all five patients were discharged from hospital and no signs of recurrence.

"However, this is a very strange disease, there were four deaths in the families of patients, including one baby died in hospital in Quang Ngai province," the medical professionals warning.

[alert]

Re: Undiagnosed illness - Viet Nam: Quang Ngai, ProMED RFI

These are the symptoms of copper poisoning. Close, but not an exact match. It is also possible the copper could be a byproduct of the body breaking down a more complicated toxin.

http://health.nytimes.com/health/guides/poison/copper-poisoning/overview.html

Symptoms
Swallowing large amounts of copper may cause vomiting, abdominal pain, diarrhea, and yellow skin (jaundice). Touching large amounts of copper can result in hair discoloration (green).

Symptoms may include:

Anemia
Burning sensation
Chills
Convulsions
Diarrhea (often bloody and may be blue in color)
Fever
Liver failure
Metallic taste
Muscular aches
Nausea
No urine output
Pain
Shock
Vomiting
Weakness
Yellow eyes
Yellow skin

[alert]

Re: Undiagnosed illness - Viet Nam: Quang Ngai, ProMED RFI - environmental contamination suspected

Warning: Fairly crude machine translation.

http://vietbao.vn/vi/Suc-khoe/Vao-vung-benh-la/2131375493/248/

Disease is the zone
Tags: Ba Dien, Ba To, Quang Ngai, medical experts, the disease is, sick people, family, case, poisoning, remote hands, you know, or districts, chan
55 people in remote Dien Ba, Ba To (Quang Ngai) mac la diseases, the medical experts identified as contaminated by toxic substances but do not know what is


The medical professionals discover and blood samples from an infected tomato paste for examination
Now 50-10, the delegation of the Ministry of Health by Prof. Dr. Tran Hau Khang, Director Central Hospital Dermatology, drew away from Dien Ba, Ba To, Quang Ngai province inspection and search for disease labels and some of the villagers, examine the lay population and blood samples tested in hopes of finding the root cause "the disease is" dang gay bombshell in this district last time. Day is the distance that people mac 'disease is the "highest 55 cases, including children and adults; in the skin of people who get a case of death from organ failure suspected skin toxicity.
Very similar expression

Most cases here are there clinical manifestations are quite similar: the skin back of hands, feet, head and ke of the fingers, chan brought with dark red skin, swelling, dau nhe, it ngua. From 4-7 days after infection competition palms, nut ban chan signs, ne and day, and some patients have lesions in areas which,, 2 ben nose, front and in the forearm.

Ba Dien Commune, le da clinic for those who are sick were healed and some who have been infected water flow sampling to test those who are ill and who never get sick, who just awaiting , suspected recurrence and relatives in families with sick people.

"Unknown disease" gay sores on their feet a guide

Ong Pham Van Tam (ngu welcomed thon Go) is a bot disease was contained, said early detection of not den in hands and feet, an object is bi should not over water, only use treatments thong often, but not so. Two days later, he sicker in Ba To district hospital clinic, showed no fever, painful, blue ray ve normal, after 4 days of competition lan chan gunmen and start button. "My family so far as never getting sick is this. Yes, they are only as simple diseases. Follicle test dengue fever, malaria is submitted. I am very concerned over "- bee Tam said.

Dan worries

Pham Van Vang's family (ngu lang moss) may have six people but no one sick man. When doan know with experts, he dua Vang family to check. "I am very worried because my village become infected, there are many cases of family illness, I am not in contact with a family history of disease. Many times seen people get sick from muon den of corruption "- he Vang tam su.

There are cases suspected of infection did not dare to go out although it may be no expression soreness or itching. According to Khang, there are many cases where all members of the family disease. "The disease has spread and, if the execution path would lay still a mystery" - Bee Khang drilling ban.

Hundreds of people here and dang worried than spread from person to person alert. From "the disease is" appears, the life of the locals disturbed seriously. Many cases instead of on the road who is sick or run away. People expect health sector som investigation is what causes the disease to encourage the business, living song.

Hospital Phong Hien - The United Dermatology, Central Hospital Dermatology, Nha Trang Pasteur Institute were involved ... examination, laboratory tests but still it is stated moi general poisoning and unexplained hien doc undiscovered What is chat.
For a month

Through the initial assessment, many health experts for that environment here as well as many other mountainous localities, is hard to tell the causes of the disease. But Pham Van Ong, CPC Chairman Ba Dien, to know here as well as in neighborhoods hit happens a lot these diseases epidemics so far have never seen.

According to Prof. Dr. Tran Hau Khang, the tests from patients showed high blood flow, damage the liver and some patients show signs of suspected poisoning tan color. However, they need to wait a month after conducting an examination of the blood king lay in the regions de comparisons can diagnose the cause of the disease.

[alert]

Re: Undiagnosed illness - Viet Nam: Quang Ngai, ProMED RFI - environmental contamination suspected

http://beta.promedmail.org/mbds

Published Date: 2011-10-14 04:33:39
Subject: PRO/MBDS> Undiagnosed illness - Viet Nam (02): Quang Ngai, RFI
Archive Number: 20111014.3076

UNDIAGNOSED ILLNESS - VIET NAM (02): QUANG NGAI, REQUEST FOR INFORMATION
************************************************** **********************

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: Thu 6 Oct 2011Source: Viet Nam News (VNS) [edited]http://vietnamnews.vnagency.com.vn/Social-Isssues/216232/Strange-disease-sweeps-communes-.html


A disease that has swept through 4 communes in the central province of
Quang Ngai's Ba To District has left doctors scratching their heads.
Patients have been suffering from skin problems and liver disorders.

Symptoms include swelling and itching between the fingers and toes after
4-7 days, with skin becoming thick and chapped, and even hair loss after
2 weeks. Statistics from the provincial Health Department showed that 59
people had contracted the disease since April [2011], resulting in one
fatality. 50 others recovered after being treated in the provincial
General Hospital, while 8 have yet to be discharged. The youngest
patient was 4 years old and the oldest, 72. However, children under the
age of 15 have suffered the most.

"Result of initial tests show that there are high levels of copper in
blood of the patients, and signs of damage to the liver," said Director
of the National Hospital of Dermatology and Venereology, Associate
Professor Dr Tran Hau Khang. "We suspect that victims may have been
contaminated with toxic chemicals," he said. Intensive tests were being
conducted to discover the cause of the disease, he added.

--
Communicated by:
PRO/MBDS


[The article above updates the situation of the undiagnosed disease in
Quang Ngai, Viet Nam, which PRO/MBDS reported in "Undiagnosed illness -
Viet Nam: Quang Ngai, RFI 20110916.2829". Since April 2011, 59 people
have been reported to have the same symptoms of skin problems and liver
disorders. The latest test results showed a high level of copper in the
blood of the patients. A ProMED-mail toxicology expert speculates that
these patients might have been suffering from copper toxicity. They
might have been exposed to copper in cooking utensils or drinking water.

Copper toxicity can cause through inhalation, consumption of food and
water and dermal contact with air, water and soil that contains copper.
When acidic foods are cooked in uncoated copper cookware, or in lined
cookware where the lining has worn through, copper can leech into the
foods being cooked. Exposure to excessive level of copper can result in
gastrointestinal distress, liver and kidney damage, anemia,
immunotoxicity and developmental toxicity. It can also cause headache,
joint pain and arthritis, strange odors, mood swing, skin rashes and
chronic skin problems which can range from acne to psoriasis.

More information on copper toxicity is available from the toxicological
profile for copper from the Agency for Toxic Substances and Disease
Registry (ATSDR), US Department of Health and Human Services, at
http://www.atsdr.cdc.gov/toxprofiles/tp132-c2.pdf.

PRO/MBDS would appreciate further information from knowledgeable sources
regarding this undiagnosed illness in Quang Ngai province, Viet Nam.

For a map of Viet Nam with provinces, see
http://upload.wikimedia.org/wikipedi...ovincesMap.png.
For the interactive HealthMap/ProMED-mail map with direct links to other
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Re: Undiagnosed illness - Viet Nam: Quang Ngai, ProMED RFI - environmental contamination suspected

This contradicts previous reports that copper levels were elevated.

http://thanhniennews.com/2010/Pages/20111123-Vietnam-fatal-dermatitis-may-caused-by-planting-chemicals.aspx

Planting chemicals likely cause fatal dermatitis in central Vietnam
Last updated: 11/23/2011 18:05

Skin ulcers on a person in central Vietnam. The condition has not been named and its cause is suspected to be plant protection chemicals.

Dermatologists suggested that strange skin ulcers affecting many people in central Vietnam is caused by plant protection chemicals.

The conclusion was made by experts at the Vietnam Central Dermatology Hospital after a study conducted in early October on the 61 victims from the mountainous district Ba To, Quang Ngai Province, news website VnExpress reported.

All of the victims have ulcers that look like the aftermath of severe burns on their hands and feet.


An 8-year-old girl who suffered from the condition died on May 10. Doctors said she was injected with toxics through the burns that caused multiple organ failure.


Dr. Tran Hau Khang, head of Vietnam Dermatology Institute, said the dermatitis was possibly due to exposure to plant protection chemicals.


Khang said a report has been sent to the Health Ministry for further study to identify the exact cause of the condition.


According to the report, the levels of copper, lead and zinc in the victims’ blood have been normal.


Most of the victims range between 16 and 49 years old. The youngest is 4, and the oldest is 72 years old.