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Acute illness in Ivory Coast

yielddude

Senior Moderator
UN OCHA: Health authorities in Cote d'Ivoire are investigating an acute illness in a northern village that claimed the lives of 31 people and sickened at least 73 others. People began to fall ill in the village of Diobala in the third week of December with symptoms including headache, high fever, neck and chest pain, and respiratory problems, according to a report by the Ministry of Health and Public Hygiene obtained by IRIN. The illness progressed rapidly over the course of three to five days and the first death was reported on 18 December, the report said. Villagers delayed reporting the illnesses to health authorities until 5 February. By then, 31 people had died among the 104 who had fallen ill, the report said. Victims in the village of 1,500 included men and women, young and old. "Almost every family was touched" in the village, an official with the Seguela health department told IRIN. Seguela, 44km away, is the largest town near Diobala. Seguela is 450km north of the main city, Abidjan. Local health authorities reported the deaths to officials in Abidjan and investigators went to Diobala. The team included specialists from the Pasteur Institute and the Ministry of Health and Public Hygiene.

They discovered that beginning in October animals in the village had begun falling ill. The report said 90 percent of the village's poultry, as well as about 500 goats and sheep, had died. Villagers consumed sick animals, but it was not immediately clear if this was how humans contracted the illness. Health authorities said patients treated with antibiotics responded well. "They did an investigation and took blood samples and nasal swabs of the people, the poultry, the goats and the sheep," the Seguela health official said. Water samples were also taken. "Surveillance is continuing to see if other cases come up," he said. The last cases of human illness were reported on 14 February. There have been no reports of illness in neighbouring villages. People in the area have been told to quickly report any illnesses to local health authorities. Cote d'Ivoire has been divided between a rebel-held north and government-run south since a brief civil war in 2002. As a result, humanitarian agencies say health and sanitary conditions in the north have deteriorated.

http://hisz.rsoe.hu/alertmap/woalert_read.php?id=10091&cat=dis&lang=eng
 
Re: Acute illness in Ivory Coast

This is bad...

Not that bad, yet not good, either.

-- It started the third week of December, that's 8 weeks ago.
-- It responded to antibiotics.
--There haven't been any recent illnesses or deaths in the last 2 or 3 weeks.
-- No trensmission to neighboring villages (known).
--checking Google Earth, it isn't near a wetlands.

So if it was IT, it burst and died out in the 3rd or 4th generation. Yet there are still lots of things it could have been besides IT.
 
Re: Acute illness in Ivory Coast

Should it turn out to be have been bird flu, it will at least tell us what the virus is capable of at this point--killing 30+% of infected people of all ages from mid-December to mid-February, and killing sheep, goats, and poultry. There may well have been hundreds of transmissions between various species of animals and between people--we only know about the sheep and goats, but cats and dogs are well-known to be affected by bird flu too. This infection cycle may also have been going on for 5 or more months, since they say that animals started dying in October.

Not that bad, yet not good, either.

-- It started the third week of December, that's 8 weeks ago.
-- It responded to antibiotics.
--There haven't been any recent illnesses or deaths in the last 2 or 3 weeks.
-- No trensmission to neighboring villages (known).


So if it was IT, it burst and died out in the 3rd or 4th generation. Yet there are still lots of things it could have been besides IT.
 
Re: Acute illness in Ivory Coast

Not that bad, yet not good, either.

-- It started the third week of December, that's 8 weeks ago.
-- It responded to antibiotics.
--There haven't been any recent illnesses or deaths in the last 2 or 3 weeks.
-- No trensmission to neighboring villages (known).
--checking Google Earth, it isn't near a wetlands.

So if it was IT, it burst and died out in the 3rd or 4th generation. Yet there are still lots of things it could have been besides IT.

This points out the fact that the only clear measure of a pandemic will be geometrically expanding cases over time. We just won't have much time once we recognize the increasing case load. The only thing we can do now is look back several weeks in retrospect and say "it hasn't started yet". Not very comforting.
 
Re: Acute illness in Ivory Coast

<table summary=""><tbody><tr><td align="right" nowrap="nowrap">Archive Number</td> <td colspan="1" rowspan="1" align="left" nowrap="nowrap">20070228.0719</td></tr><tr><td align="right" nowrap="nowrap">Published Date</td> <td colspan="1" rowspan="1" align="left" nowrap="nowrap">28-FEB-2007</td></tr><tr><td align="right" nowrap="nowrap">Subject</td> <td colspan="1" rowspan="1" align="left" nowrap="nowrap">PRO/AH/EDR> Undiagnosed deaths, human, livestock - Cote d'Ivoire: RFI</td></tr> </tbody></table>

UNDIAGNOSED DEATHS, HUMAN, LIVESTOCK - COTE D'IVOIRE: 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: Tue 27 Feb 2007
From: Naomi Bryant <naomi.bryant@uclh.nhs.uk>
Source: All Africa / UN Integrated Regional Information Networks (IRIN)
[edited]
<http://allafrica.com/stories/200702270341.html>


Health authorities in Cote d'Ivoire are investigating an acute illness in a
northern village that has claimed the lives of 31 people and sickened at
least 73 others.

People began to fall ill in the village of Diobala in the 3rd week of
December [2006], with symptoms including headache, high fever, neck and
chest pain, and respiratory problems, according to a report by the Ministry
of Health and Public Hygiene obtained by IRIN [UN Integrated Regional
Information Networks.] The illness progressed rapidly over the course of 3
to 5 days and the 1st death was reported on [18 Dec 2006], the report said.

Villagers delayed reporting the illnesses to health authorities until [5
Feb 2007]. By then, 31 people had died among the 104 who had fallen ill,
the report said. Victims in the village of 1500 included men and women,
young and old.

"Almost every family was touched" in the village, an official with the
Seguela health department told IRIN. Seguela, 44 km. [27 miles] away, is
the largest town near Diobala. Seguela is 450 km. [280 miles] north of the
main city, Abidjan.

Local health authorities reported the deaths to officials in Abidjan and
investigators went to Diobala [13-17 Feb 2007]. The team included
specialists from the Pasteur Institute and the Ministry of Health and
Public Hygiene.

They discovered that beginning in October [2006] animals in the village had
begun falling ill. The report said 90 per cent of the village's poultry, as
well as about 500 goats and sheep, had died. Villagers ate sick animals,
but it was not immediately clear if this was how humans contracted the
illness. Health authorities said patients treated with antibiotics
responded well.

"They did an investigation and took blood samples and nasal swabs of the
people, the poultry, the goats and the sheep," the Seguela health official
said. Water samples were also taken. "Surveillance is continuing to see if
other cases come up," he said.

The last cases of human illness were reported on [14 Feb 2007]. There have
been no reports of illness in neighbouring villages. People in the area
have been told to quickly report any illnesses to local health authorities.

Cote d'Ivoire has been divided between a rebel-held north and
government-run south since a brief civil war in 2002. As a result,
humanitarian agencies say health and sanitary conditions in the north have
deteriorated.

--
Naomi Bryant
Information Officer
National Travel Health Network and Centre (NaTHNaC)
<naomi.bryant@uclh.nhs.uk>
<www.nathnac.org>

[Given the above description of a livestock die-off (including poultry,
sheep, and goats) preceding morbidity and mortality of the human
population, one automatically thinks of zoonotic diseases that might be
consistent with this picture. Adding to the picture is a reported case
fatality rate (CFR) of 30 per cent (31/104), with an estimated attack rate
of 7 per cent (104/1500) with all age groups affected. When one checks
GIDEON (Global Infectious Disease and Epidemiology Network
<http://www.gideononline.net>) for the clinical picture associated with
contact with animals, one gets 3 main possibilities -- Q fever, ornithosis,
and bunyaviridae. Of the bunyaviridae family, one does think of Rift Valley
fever (RVF) as consistent with this clinical picture, but the involvement
of poultry rules this out, as the RVF virus does not affect avians. Gideon
also gives a "1st case scenario", where it "ignores" the geographic
location of the outbreak in the event that this is a new geographic
extension of an otherwise known pathogen. In this case, the GIDEON program
suggested Congo-Crimean hemorrhagic fever (CCHF).

The above report mentions individuals improving with antibiotics. This
suggests a clinical diagnosis of a bacterial disease, such as Q fever, but
the reported CFR in this outbreak is way above that seen with Q fever (Q
fever has a 1-2 per cent mortality associated with untreated cases).

If one decides that the animal outbreak information is a red herring, and
repeats the GIDEON search omitting an ongoing epizootic, the following
comes up as most likely candidates: Leptospirosis, Q fever, legionellosis,
Ebola, Lassa fever, ornithosis, and brucellosis to mention a few -- and
when one looks at the "1st case scenario" plague is on the list.

Anthrax is not on the list provided by GIDEON, but it too could possibly
meet the clinical definition, although one might expect to hear of more
gastrointestinal symptoms.

This moderator has now "mused out loud" probably more than would have been
prudent, so at this point appeals to sources knowledgeable on the findings
of the investigation to enlighten and educate us on what has been going on.
- Mod.MPP]

..................mpp/mj/sh

</www.nathnac.org>http://www.promedmail.org/pls/prome..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,36499
 
Re: Acute illness in Ivory Coast

COTE D IVOIRE: Ivorians feel economic impact of avian flu

ABIDJAN, 28 February (IRIN) - Although only two outbreaks of avian influenza among poultry have been reported in C?te d'Ivoire, and no human deaths, the illness has taken a significant financial and humanitarian toll.

The H5N1 virus has resulted in a loss of more US$20 million to traditional and industrial poultry producers as demand has dropped, according to a recent study on the impact of avian influenza on the country's economy.

Poultry processing plants have suffered the biggest losses, said the study requested by the government's Commission for the Fight Against Avian Influenza. A two-day workshop in Abidjan last week examined the impact of avian flu and discussed ways to offset losses, including compensation, to the country's poultry industry.

"Each hatchery has lost on average nearly US$7 million each month since the discovery of the two cases of the H5N1 virus in 2006 in the country," the study said. The first case of avian flu was reported last April in C?te d'Ivoire and a mass culling of poultry followed.

Isac Kouam? Adi, director general of Coco Service, which specialises in the production of fresh eggs, said his company has suffered the consequences of avian flu.

"We have seen a drop in consumption," he said. "But I think that consumers should not worry. We have taken all sanitary precautions to assure safe consumption."

The government report said poultry importers had lost some $4.5 million while the producers of poultry products were down about $4.2 million dollars. Egg wholesalers individually lost on average $156,000.

The consumption of poultry and poultry products has dropped by about 51 percent, according to the report.

"Today it's risky to eat chicken," said student Olivier Kacou. "Personally, I decided with some friends to no longer eat poultry since the appearance of the H5N1 virus. I think that other hygiene measures should be taken to truly offer reassurance."

Because of the drop in demand for poultry and poultry products, 450 farm laborers have lost their jobs and another 15,000 risk being out of work.

"Today, 53 percent of the poultry retailers and 71 percent of the wholesalers have partially abandoned their activities," the study said.

"The situation is worrying," said Alphonse Douaty, minister of Animal Production and Marine Resources. "But it is necessary to think about preserving what is there and to try to inspire consumer confidence."

C?te d'Ivoire stepped up its surveillance of avian flu after the death of a woman in Nigeria from the virus in February. It was the first human death of H5N1 in sub-Saharan Africa.

The Ivorian government formed its central avian flu committee last April. Another outbreak at a poultry farm outside of Abidjan occurred in November.
 
Re: Acute illness in Ivory Coast

I'm surprised that they waited almost 2 months before reporting this.
 
Re: Acute illness in Ivory Coast

This is what the start of a pandemic will look like, and this is how the news will reach us from Africa. I doubt this is H5N1 (though anyone who is reassured by the fact that antibiotics have helped must bear in mind that pneumonia is a secondary opportunistic bacterial infection that kills a lot of flu victims).

But note how long this news took to reach us, know that H5N1 is endemic in these highly stressed nation-societies, and consider that whatever is taking place in Africa is thoroughly beyond the control of the WHO.

THIS is why Nabarro et al are convinced that, once H5N1 reached Africa, the odds of escaping a pandemic plummeted. I'm with them on that.

Whole families could be dying from H5N1 at this moment in Africa and we wouldn't hear a thing until it begins to transmit to whole villages. By which time people who read Flu Trackers will go into intelligent panic mode and our friends will begin to ask decent questions while we pack.

Nothing to look forward to. Perhaps we'll just be (happy go) lucky.

Be well,
DA
 
Re: Acute illness in Ivory Coast

We have a lead here at Flu Trackers. Many of the African countries are former France or Belgium colony and some news gets into the African French media.

On the Ivory Coast strange disease for instance we have in French one to two day leads from French speaking African countries,

Usually for our French forums it is the opposite, we have the news in French one to two days late.

At least we have some leads there.

For instance yesterday was available in french some details concerning Ivory Coast and with Babelfish and my limited english it was not so bad translated yesterday.

This news should be available in english today but we had it yesterday.
 
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