Beriberi kills 3 AU troops; sickens at least 19

[alert]

Re: Mysterious illness kills 3 AU troops; sickens at least 19

Re: Mysterious illness kills 3 AU troops; sickens at least 19

Leptospirosis can cause a rash.

Symptoms of leptospirosis include high fever, severe headache, chills, muscle aches, and vomiting, and may include jaundice (yellow skin and eyes), red eyes, abdominal pain, diarrhea, or a rash.

http://www.cdc.gov/ncidod/dbmd/diseaseinfo/leptospirosis_g.htm

Symptomatically, lepto is possible. But they would have diagnosed it by now, and lepto is not contagious. And jaundice has not been mentioned as a symptom, something that is common in severe cases of lepto.

 

[alert]

Re: Mysterious illness kills 3 AU troops; sickens at least 19

Re: Mysterious illness kills 3 AU troops; sickens at least 19

What I am doing right now is posting both articles and comments in this thread, and news articles only in the Current News thread here:

http://www.flutrackers.com/forum/showthread.php?t=118348

If the moderators wish to merge the two threads, that is fine with me. If not, then the title of this thread needs to be drastically changed, as this is now an outbreak affecting people in four countries, with at least six deaths and hundreds of cases.

I am not ruling out lepto, but this would be a very large lepto outbreak, and should not have remained undiagnosed this long. I do tend to rule out H1N1.

 

[alert]

Re: Mysterious illness kills 3 AU troops; sickens at least 19

Re: Mysterious illness kills 3 AU troops; sickens at least 19

In tracking this outbreak, it does appear that the Ugandan sources will be far more reliable than those coming out of Somalia or Burundi. Also of note is the Ugandan source in post #40 indicated that there may be far more deaths than reported.

 

[Rwilmer]

Re: Mysterious illness kills 3 AU troops; sickens at least 19

Re: Mysterious illness kills 3 AU troops; sickens at least 19

Could a possible H5N1 be here?

 

[alert]

Re: Mysterious illness kills 3 AU troops; sickens at least 19

Re: Mysterious illness kills 3 AU troops; sickens at least 19

To me, H5N1 is as likely as a mutant H1N1 - both are incredibly unlikely, but would be VERY bad news.

At this point, I'm praying this is leptospirosis. If not, this is going to be a major problem.

 

[Rwilmer]

Re: Mysterious illness kills 3 AU troops; sickens at least 19

Re: Mysterious illness kills 3 AU troops; sickens at least 19

I am at a loss for this. I have basically had enough of all of this undiagnosed disease. Are the health facilities really that bad that they cannot diagnose anything?

 

[alert]

Re: Mysterious illness kills 3 AU troops; sickens at least 19

Re: Mysterious illness kills 3 AU troops; sickens at least 19

In my opinion, there are two reasons why there can be an undiagnosed outbreak. First, you can have an undiagnosed outbreak simply because of poor laboratory facilities as you mentioned. But when the outbreak occurs in a major city, and spreads to multiple countries, you have to confront the other possiblity: Something novel is at work.

But you are right. The number of reported 'undiagnosed fatalities" worldwide has increased sharply in the past couple months, and the symptoms and epidemiology vary enough to as not to be a single hidden agent. I suspect some of this is a side effect of H1N1 - the declaration of a pandemic has caused people and governements everywhere to pay more attention to public health, and things are getting reported that might not have been reported otherwise. I think some of this is also due to the increasing frequency of which humans have been exploring new areas and encountering new agents. Maybe some of this is also due to my ability to find articles that weren't getting posted on FT before (joke).

Then again, this one is bad enough and big enough to be reported even before the pandemic was announced.

 

[Rwilmer]

Re: Mysterious illness kills 3 AU troops; sickens at least 19

Re: Mysterious illness kills 3 AU troops; sickens at least 19

Deleted

 

[alert]

Re: Mysterious illness kills 3 AU troops; sickens at least 19

Re: Mysterious illness kills 3 AU troops; sickens at least 19

If this is lepto, the red text would explain why this is taking so long to diagnose.

http://www.english.globalarabnetwor...nion-peacekeepers-deaths-under-spotlight.html

Ugandan public health experts are investigating a disease that has killed at least five African Union peacekeepers in Somalia and infected another 50, who have been evacuated to a Kenyan hospital, officials said.

"Our head of public health, Lt-Col Sam Kasule, is in Mogadishu [the Somali capital] to investigate and we are waiting for his report to find a proper response to the outbreak," Col Felix Kulaigye, spokesman for the Ugandan army, told IRIN on 30 July.

Uganda and Burundi have contributed a total of 4,300 troops to the AU Mission in Somalia (AMISOM), with the majority (2,700) Ugandan.

The symptoms include chest pain, fever, headache, swelling of the lower limbs, rapid heart-beat and respiratory problems.

?The ailment first hit the Burundian contingent... [several] were flown to Nairobi for treatment," Kulaigye said. "It eventually hit our camp and has since killed two, while 17 are in intensive care in Nairobi."

He said preliminary reports pointed to an outbreak of Leptospirosis, a bacterial disease caused by exposure to water contaminated with the urine of infected animals.
A spokesperson for the UN Children?s Fund said the agency's health officers had not received reports of Leptospirosis in the general population of Mogadishu.

According to the UN World Health Organization (WHO), Leptospirosis is a bacterial disease that affects humans and animals. Its early stages include high fever, severe headache, muscle pain, chills, redness in the eyes, abdominal pain, jaundice, haemorrhages in skin and mucous membranes, vomiting, diarrhoea and a rash.

Humans become infected through contact with water, food or soil containing urine from infected animals, such as dogs or rats, according to the US Centers for Disease Control (CDC). This may happen by swallowing contaminated food or water, through skin contact, such as the eyes or nose, or contact with broken skin.

WHO says the disease is often difficult to diagnose clinically, requiring laboratory support.

The CDC says if untreated, a Leptospirosis patient can develop kidney damage, meningitis (inflammation of the membrane around the brain and spinal cord), liver failure and respiratory distress.

The disease is not known to spread from person to person. The time between exposure and developing symptoms is about four weeks and the illness lasts from a few days to three weeks.

Leptospirosis is an occupational hazard for people who work outdoors or with animals, such as farmers, veterinarians, fishermen, or the military. (IRIN)

 

[Rwilmer]

Re: Mysterious illness kills 3 AU troops; sickens at least 19

Re: Mysterious illness kills 3 AU troops; sickens at least 19

Obviously the who is investigating, and aware of the situation.

 

[alert]

Re: Mysterious illness kills 3 AU troops; sickens at least 19

Re: Mysterious illness kills 3 AU troops; sickens at least 19

Quite likely. One thing I have learned from tracking these undiagnosed illnesses is that organizations like the CDC and WHO are often aware of outbreaks long before they are reported even in the local press. It is the rare outbreak that the WHO learns about here.

 

[alert]

Re: Mysterious illness kills 3 AU troops; sickens at least 19

Re: Mysterious illness kills 3 AU troops; sickens at least 19

And one of the above articles has hit the ProMed East Africa listing. Notable is that this one did NOT go as undiagnosed fatalities; it went as suspected Leptospirosis. Also no mention in the title of exportation; this could have been indentified as Kenya, Uganda, Burundi ex Somalia.

Perhaps we should do the same here and rename this thread: Leptospirosis (susp.), ex Somalia.

http://eafr.promedmail.org/

ProMED-EAFR:East Africa

Most Recent Alert
View printable version
Published Date
2009-07-30 16:25:20
Subject
PRO/EAFR> Leptospirosis - Somalia: (Mogadishu) susp
Archive Number
20090730.200977
Full Text

LEPTOSPIROSIS - SOMALIA: (MOGADISHU) SUSPECTED
**********************************************
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: Wed 29 Jul 2009
Source: The New Vision (Uganda) [edited]
http://www.newvision.co.ug/D/8/12/689604

A strange disease has killed 2 Ugandan peace-keepers in Somalia and
affected 17 others who were flown to a hospital in Nairobi yesterday
[28 Jul 2009], according to the UPDF [Uganda People's Defense Force].

One died in Mogadishu on Tuesday [28 Jul 2009] evening while another
one died on Wednesday [29 Jul 2009] morning in Nairobi, said
spokesperson Col. Felix Kulayigye. Another 17 are admitted at the
intensive care unit of Nairobi Hospital.

UPDF has dispatched a medical team to Mogadishu to establish the
cause of the problem.

"The symptoms are chest pain, fever, headache, swelling of the lower
limbs, rapid heart-beat, and difficulties in breathing," said
Kulayigye.

"We have no confirmation yet on what disease they are suffering
from." By the end of last week [25 Jul 2009], over 50 Burundians had
been hit by the same mysterious disease, killing 4. Dr. Col. James
Kiyengo, the force medical officer, on Friday [24 Jul 2009] said they
suspected the disease to be leptospirosis.


"Leptospirosis is a bacterial disease caused by exposure to water
contaminated with the urine of infected animals," Dr. Kiyengo
explained. "For example, a rat could have urinated in a water tanker
and spread the disease."

Al Shabaab, the Islamist insurgents fighting the Somali government
and the peace-keepers, claimed responsibility, saying they had
poisoned them. But the claim was dismissed by medical officers of the
African Union peace-keeping force, who said it was a bacterial
infection as a result of poor hygiene and living conditions
associated with the job.

According to the US Centers for Disease Control [and Prevention
-CDC], leptospirosis is a bacterial disease that affects humans and
animals.

In humans it causes a wide range of symptoms, such as high fever,
severe headache, chills, muscle aches, and vomiting. It may include
jaundice (yellow skin), red eyes, abdominal pain, diarrhoea, or a
rash. If not treated, the patient could develop kidney damage,
meningitis (inflammation of the membrane around the brain and spinal
cord), liver failure, and respiratory distress. In rare cases death
occurs.

Humans become infected through contact with water, food, or soil
containing urine from infected animals, such as dogs, or rats,
according to the US Centers for Disease Control. This may happen by
swallowing contaminated food or water, through skin contact, such as
the eyes or nose, or contact with broken skin.

The disease is not known to be spread from person to person. The time
between a person's exposure to a contaminated source and becoming
sick is about 4 weeks.

The illness lasts from a few days to 3 weeks. Without treatment,
recovery may take several months. Leptospirosis is an occupational
hazard for many people who work outdoors or with animals, such as
farmers, veterinarians, fishermen, or the military.

Dr. Kiyengo said the disease can be treated with antibiotics and
prevented by boiling water and keeping out rats.

There are 4300 AU [African Union] peace-keepers in Somalia, of whom
2700 are Ugandan. The current Ugandan contingent will be replaced
next month [August 2009]. Col. Nathan Mugisha is taking over from
Gen. Francis Okello as force commander.

--
Communicated by:
ProMED-EAFR



[Leptospirosis is a zoonotic water-related disease caused by
pathogenic _Leptospira_ species. The organisms have been found in
rodents, insectivores, dogs, cattle, pigs, and horses. Hence it is an
occupational hazard for people who work outdoors or with animals,
such as military personnel, farmers, sewer workers, veterinarians,
and dairy workers. Human infection occurs through direct contact with
the urine of infected animals or by contact with a urine-contaminated
environment, such as surface water, soil, and plants. The bacteria
gain entry through cuts and abrasions in the skin and through mucous
membranes of the eyes, nose, and mouth. Disease symptoms include high
fever, severe headache, muscle pain, chills, and redness in the eyes,
abdominal pain, jaundice, hemorrhages in skin and mucous membranes
(including pulmonary bleeding), vomiting, diarrhoea, and a rash
(http://www.who.int/water_sanitation_health/diseases/leptospirosis/en/index.html).

In a suspected outbreak, attempts to diagnose leptospirosis must be
encouraged to enable prompt treatment with appropriate antibiotics.
When an outbreak of leptospirosis is suspected or identified, and if
it has been possible to identify the serovar concerned, the source
must be identified and appropriate environmental measures
implemented, with public information to people at risk (including
clinicians and health care workers and health authorities;
http://www.who.int/zoonoses/diseases/Leptospirosissurveillance.pdf).

The HealthMap/ProMED-mail map of Somalia showing Mogadishu is
available at http://healthmap.org/r/00Cu. - Mod.JFW]

[Background information on leptospirosis is available from the
general ProMED-mail list. The postings below can be found at
http://www.promedmail.org. - Mod.JFW]

Leptospirosis, fatal, detention camp - Malaysia: (PG) susp 20090518.1859
Leptospirosis - India (02) 20090404.1296
Leptospirosis - India: (north), 2007 20090403.1292
Leptospirosis - Fiji (03) 20090225.0772
Leptospirosis - Fiji (02) 20090207.0554
Leptospirosis - Fiji 20090204.0502
Leptospirosis - Guyana (coastal) 20081231.4131
Leptospirosis - Sri Lanka (07): (NW) 20081231.4127
Leptospirosis, fatal - UK (02) 20081010.3210
Leptospirosis, fatal - UK: rodent scratch 20081007.3173
Leptospirosis, sea mammals - USA: (CA) 20081003.3125
Leptospirosis - Sri Lanka (06) 20080927.3058
Leptospirosis - Sri Lanka (05) 20080922.2984
Leptospirosis - Sri Lanka (04) 20080909.2810
Leptospirosis - Philippines: (Davao Region) 20080626.1967
Leptospirosis - Sri Lanka (03): background 20080610.1836
Leptospirosis - Sri Lanka (02): hantavirus also susp. 20080606.1808
Leptospirosis - Sri Lanka: RFI 20080605.1801
Leptospirosis - New Caledonia (02): background 20080408.1291
Leptospirosis - New Caledonia 20080407.1281
Leptospirosis - Peru: (Loreto), new species 20080407.1279
Leptospirosis - Jamaica 20080125.0312
Leptospirosis - Dominican Republic 20071124.3804
Leptospirosis - Jamaica (02) 20071018.3409
Leptospirosis - Ukraine (Lvov, Kiev, Kherson) 20071018.3401
Leptospirosis - Jamaica 20071016.3383
Leptospirosis, fatal - Sri Lanka (Matara) 20070914.3051
Leptospirosis - China (Hong Kong) 20070821.2725
Leptospirosis - Argentina (Santa Fe) 20070429.1395]
...................................jfw/be/mj

 

[alert]

Re: Mysterious illness kills 3 AU troops; sickens at least 19

Re: Mysterious illness kills 3 AU troops; sickens at least 19

The bad news is that the number of ill keeps increasing, and that the soldiers that were admitted were in critical condition. There have now been at least 100 cases of illness in the troops (more than a 2% attack rate). The good news is that the hospital is stabilizing the troops (suggesting that the disease is treatable and might thus be bacterial), and that the WHO has a team investigating as well.

http://www.monitor.co.ug/artman/pub..._UPDF_soldiers_flown_from_Somalia_89009.shtml

More ill UPDF soldiers flown from Somalia
Francis Mugerwa

Kampala/Hoima

Another 23 UPDF soldiers deployed in Somalia have been flown to Kenya for treatment after contracting the illness that hit the army last week.
Defence and army spokesman Lt. Col. Felix Kulayigye said the soldiers have been flown to Nairobi International Hospital for treatment.

“We are awaiting to see how best they will recover,” Lt. Col. Kulayigye told Sunday Monitor on phone on Friday.

He said the soldiers were evacuated to Kenya on Friday morning, after developing symptoms similar to those presented by 17 other soldiers who were admitted in critical condition.
“The seventeen soldiers who have been on treatment in Kenya are now stable” he said.

The illness hit both the Uganda and Burundi camps. The two armies who are in Somalia to pacify the country that has had one of the longest running armed conflicts on the African continent.

Over 4,000 UPDF soldiers are deployed in Somalia to pacify the country from warring parties in a war that has destabilised the Horn of Africa nation for over two decades.

Lt.Col. Kulayigye said a team from the World Health Organisation has joined the UPDF medical team to diagnose the disease.

 

[Rwilmer]

Re: Mysterious illness kills 3 AU troops; sickens at least 19

Re: Mysterious illness kills 3 AU troops; sickens at least 19

IMO Leptospirosis is suported further in the new article by it looking to be treatable.

 

[alert]

Re: Mysterious illness kills 3 AU troops; sickens at least 19

Re: Mysterious illness kills 3 AU troops; sickens at least 19

And now the story hits the main ProMed server. Perhaps someone should send the updated article with the additional Ugandan cases to ProMed as well.

http://www.promedmail.org/pls/otn/f..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,78583

LEPTOSPIROSIS - SOMALIA: SUSPECTED, 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: Wed 29 Jul 2009
Source: The New Vision (Uganda) [edited]
<http://www.newvision.co.ug/D/8/12/689604>


A strange disease has killed 2 Ugandan peacekeepers in Somalia and
affected 17 others who were flown to a hospital in Nairobi yesterday
[28 Jul 2009], according to the UPDF [Uganda People's Defense Force].

One died in Mogadishu on Tuesday [28 Jul 2009] evening while another
one died on Wednesday [29 Jul 2009] morning in Nairobi, said
spokesperson Col Felix Kulayigye. Another 17 are admitted at the
intensive care unit of Nairobi Hospital.

UPDF has dispatched a medical team to Mogadishu to establish the
cause of the problem.

"The symptoms are chest pain, fever, headache, swelling of the lower
limbs, rapid heart-beat, and difficulties in breathing," said Kulayigye.

"We have no confirmation yet on what disease they are suffering
from." By the end of last week [25 Jul 2009], over 50 Burundians had
been hit by the same mysterious disease, killing 4. Dr Col James
Kiyengo, the force medical officer, on Friday [24 Jul 2009] said they
suspected the disease to be leptospirosis.

"Leptospirosis is a bacterial disease caused by exposure to water
contaminated with the urine of infected animals," Dr Kiyengo
explained. "For example, a rat could have urinated in a water tanker
and spread the disease."

Al Shabaab, the Islamist insurgents fighting the Somali government
and the peacekeepers, claimed responsibility, saying they had
poisoned them. But the claim was dismissed by medical officers of the
African Union peacekeeping force, who said it was a bacterial
infection as a result of poor hygiene and living conditions
associated with the job.

According to the US Centers for Disease Control [and Prevention -
CDC], leptospirosis is a bacterial disease that affects humans and animals.

In humans it causes a wide range of symptoms, such as high fever,
severe headache, chills, muscle aches, and vomiting. It may include
jaundice (yellow skin), red eyes, abdominal pain, diarrhoea, or a
rash. If not treated, the patient could develop kidney damage,
meningitis (inflammation of the membrane around the brain and spinal
cord), liver failure, and respiratory distress. In rare cases death occurs.

Humans become infected through contact with water, food, or soil
containing urine from infected animals, such as dogs or rats,
according to the US Centers for Disease Control. This may happen by
swallowing contaminated food or water, through skin contact, such as
the eyes or nose, or contact with broken skin.

The disease is not known to be spread from person to person. The time
between a person's exposure to a contaminated source and becoming
sick is about 4 weeks.

The illness lasts from a few days to 3 weeks. Without treatment,
recovery may take several months. Leptospirosis is an occupational
hazard for many people who work outdoors or with animals, such as
farmers, veterinarians, fishermen, or the military.

Dr Kiyengo said the disease can be treated with antibiotics and
prevented by boiling water and keeping out rats.

There are 4300 AU [African Union] peacekeepers in Somalia, of whom
2700 are Ugandan. The current Ugandan contingent will be replaced
next month [August 2009]. Col Nathan Mugisha is taking over from Gen
Francis Okello as force commander.

--
Communicated by:
ProMED-EAFR
<promed-eafr@promedmail.org>

[Leptospirosis has a variable clinical picture, and can be
complicated by heart and kidney damage, meningitis, liver failure,
and respiratory distress. The news release above mentions that
patients in the outbreak had chest pain, fever, headache, swelling of
the lower limbs, rapid heartbeat, and difficulties in breathing, but
these findings are too non-specific to lead to a diagnosis. In
addition, no mention is made in the news release of myalgias or
conjunctival suffusion, predominant presenting findings of
leptospirosis; neither is jaundice, a prominent finding of severe
leptospirosis, mentioned. - Mod.ML]

[Leptospirosis is a zoonotic water-related disease caused by
pathogenic _Leptospira_ species. The organisms have been found in
rodents, insectivores, dogs, cattle, pigs, and horses. Hence it is an
occupational hazard for people who work outdoors or with animals,
such as military personnel, farmers, sewer workers, veterinarians,
and dairy workers. Human infection occurs through direct contact with
the urine of infected animals or by contact with a urine-contaminated
environment, such as surface water, soil, and plants. The bacteria
gain entry through cuts and abrasions in the skin and through mucous
membranes of the eyes, nose, and mouth. Disease symptoms include high
fever, severe headache, muscle pain, chills, and redness in the eyes,
abdominal pain, jaundice, hemorrhages in skin and mucous membranes
(including pulmonary bleeding), vomiting, diarrhoea, and a rash (see
<http://www.who.int/water_sanitation_health/diseases/leptospirosis/en/index.html>).

In a suspected outbreak, attempts to diagnose leptospirosis must be
encouraged to enable prompt treatment with appropriate antibiotics.
When an outbreak of leptospirosis is suspected or identified, and if
it has been possible to identify the serovar concerned, the source
must be identified and appropriate environmental measures
implemented, with public information to people at risk (including
clinicians and health care workers and health authorities; (see
<http://www.who.int/zoonoses/diseases/Leptospirosissurveillance.pdf>).

The HealthMap/ProMED-mail map of Somalia showing Mogadishu is
available at <http://healthmap.org/r/00Cu>. - Mod.JFW]

[see also:
Leptospirosis - India (02) 20090404.1296
Leptospirosis - India: (north), 2007 20090403.1292
Leptospirosis - Fiji (03) 20090225.0772
Leptospirosis - Fiji (02) 20090207.0554
Leptospirosis - Fiji 20090204.0502
2008
----
Leptospirosis - Guyana (coastal) 20081231.4131
Leptospirosis - Sri Lanka (07): (NW) 20081231.4127
Leptospirosis, fatal - UK (02) 20081010.3210
Leptospirosis, fatal - UK: rodent scratch 20081007.3173
Leptospirosis, sea mammals - USA: (CA) 20081003.3125
Leptospirosis - Sri Lanka (06) 20080927.3058
Leptospirosis - Sri Lanka (05) 20080922.2984
Leptospirosis - Sri Lanka (04) 20080909.2810
Leptospirosis - Philippines: (Davao Region) 20080626.1967
Leptospirosis - Sri Lanka (03): background 20080610.1836
Leptospirosis - Sri Lanka (02): hantavirus also susp. 20080606.1808
Leptospirosis - Sri Lanka: RFI 20080605.1801
Leptospirosis - New Caledonia (02): background 20080408.1291
Leptospirosis - New Caledonia 20080407.1281
Leptospirosis - Peru: (Loreto), new species 20080407.1279
Leptospirosis - Jamaica 20080125.0312
2007
----
Leptospirosis - Dominican Republic 20071124.3804
Leptospirosis - Jamaica (02) 20071018.3409
Leptospirosis - Ukraine (Lvov, Kiev, Kherson) 20071018.3401
Leptospirosis - Jamaica 20071016.3383
Leptospirosis, fatal - Sri Lanka (Matara) 20070914.3051
Leptospirosis - China (Hong Kong) 20070821.2725
Leptospirosis - Argentina (Santa Fe) 20070429.1395
2006
----
Leptospirosis - India (Gujarat): not hantavirus 20060831.2476
Leptospirosis - India (Kerala) 20060609.1612
Leptospirosis - India (Karnataka) 20060123.0226]

 

[alert]

Re: Mysterious illness kills 3 AU troops; sickens at least 19

Re: Mysterious illness kills 3 AU troops; sickens at least 19

I didn't think this was going to be Leptospirosis. Now the CDC is investigating as well. I think I agree that this is waterborne and bacterial, but the identification of the agent would be nice. I don't think the reference to only one death is a denial of the second Ugandan death; he seems to be working with old figures.

I still also wonder if typhoid has been ruled out.

http://www.australia.to/index.php?o...-ecoterra-smcm&catid=71:world-news&Itemid=201

Mogadishu disease waterborne, says UPDF by Steven Candia
The army has identified the mysterious disease that hit Ugandan peacekeepers on an African Union mission in war torn Somalia as a strain of a bacterial, water borne infection.
The UPDF's Chief of Medical Services, Dr. James Makumbi, said investigations are yet to establish the exact disease.
"There are many water borne diseases but we are still to put a finger on the exact disease," Makumbi said.
The disease, which caused 17 Ugandans to be flown to Nairobi hospital on Wednesday and has affected over 50 Burundian peacekeepers, had fuelled speculation of poisoning.
"This has nothing to do with poisoning. Cases of poisoning do not present themselves in such a way," Makumbi said.
Contrary to earlier media reports with varied death tolls, Makumbi said only one UPDF soldier had died due to the disease.
The patients suffer from chest pain, fever, headache, swelling of the lower limbs, fast heart beat and respiratory problems.
The outbreak of the disease in Mogadishu has been caused by a number of factors including the terrain of the area, which is flat and a swamp, coupled with poor sewerage disposal, Makumbi said.
Matters were worsened by the fact that Mogadishu is a war-torn coastal city where huge numbers of displaced are concentrated in a small area.
"Owing to the fact that the water table is close, even underground water sources became contaminated with feacal matter."
Makumbi said although a few new cases were emerging, the situation had been contained.
Apart from stepping up water purification measures, he said, the army headquarters has dispatched to Mogadishu a team comprising of a public health expert and a health inspector.
Their efforts are being supported by a team from the World Health Organisation already in the area and another team from the US Center for Disease Control (CDC) which is on the way.
"Samples have already been collected and taken by the WHO team for further investigations," he said.
The epidemic broke out about a week ago, affecting both the Ugandan and Burundian contingents.
Uganda and Burundi are the only two countries that have heeded the call from the African Union to send peacekeepers to Somalia. But the 4,300 force, the majority of whom are Ugandans, falls short of the 8,000 needed to secure Mogadishu alone.

 

[alert]

Re: Mysterious illness kills 3 AU troops; sickens at least 19

Re: Mysterious illness kills 3 AU troops; sickens at least 19

Some of the original 17 Ugandan cases have now been discharged. This is the first article that mentions jaundice as a symptom. Leptospirosis is looking more likely.

http://www.hiiraan.com/news2_rss/2009/Aug/our_soldiers_in_somalia_not_poisoned_au.aspx



Monday, August 03, 2009




The African Union Mission in Somalia has ruled out water poisoning as the cause of a ??strange?? disease that has struck its soldiers in Mogadishu.

Amisom spokesman Gaffel Nkolokosa said in Nairobi on Monday that the organisation was waiting for an official medical report on what has made Ugandan and Burundian soldiers to fall sick.

The soldiers have been admitted to Aga Khan Hospital. ?It is not true the water was poisoned,? he said. The AU soldiers are defending the Somali government from an array of Islamic rebels fighting to topple it. Al-Shabaab, the biggest of the rebel groups, had claimed that it poisoned water used by Amisom.

In Kampala, defence and military spokesperson Felix Kulayigye confirmed that 11 UPDF soldiers admitted to hospital had been discharged. Two of the six remaining soldiers are still in intensive care.

The rest of the soldiers have been released and would not be returning to their camp in Somalia, sources have said. Seventeen Ugandan soldiers were flown to Aga Khan Hospital after exhibiting symptoms similar to those afflicting Burundian troops.

Doctors have also confirmed that the Ugandans had not been poisoned as had earlier been claimed by al-Shabaab. Symptoms of the illness include fever, swelling in the lower limbs and jaundice (yellowing of the skin and eyes).

The illness is believed to be Leptospirosis, also known as Weil?s syndrome. It is said even the locals around the Amisom bases were suffering the same ailment, thus ruling out poisoning. The World Health Organisation has been carrying out investigations but is yet to release results.

Source: Daily Nation, August 3, 2009

 

[alert]

Re: Mysterious illness kills 3 AU troops; sickens at least 19

Re: Mysterious illness kills 3 AU troops; sickens at least 19

Another ProMed report. This one also suggests and discounts the possiblity that the illness is anthrax. I think I agree with the moderator on this one.

http://www.promedmail.org/pls/otn/f..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,78623

Archive Number 20090804.2741
Published Date 04-AUG-2009
Subject PRO/AH/EDR> Leptospirosis - Somalia (02): susp, RFI


LEPTOSPIROSIS - SOMALIA (02): SUSPECTED, 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>

[1]
Date: Thu 30 Jul 2009
Source: Daily Monitor (Uganda) [edited]
<http://www.monitor.co.ug/artman/publish/news/UPDF_soldiers_poisoned_in_Somalia_88893.shtml>


By press time, 8 Ugandan soldiers on the Somali peacekeeping mission
were still in intensive care at a Nairobi hospital battling a strange
ailment suspected to be a result of poisoning. The soldiers are
feared to have been poisoned through water sources by the Islamist
fundamentalists, Al Shabaab, who are opposed to the interim
government in Somalia and the peacekeeping mission, sources told
Daily Monitor. But Maj Barigye Ba-Hoku, the African Union Peace
Keeping Mission spokesman, yesterday [29 Jul 2009] dismissed the
poisoning claims. "It's not true because this ailment is general and
it has affected the Somalis outside the camps. It's not only the
peacekeepers," he said.

"[Kenyan and Amisom (African Union Mission in Somalia)] doctors are
studying the cause of the illness and they will soon come up with the
report," Maj Ba-Hoku told Daily Monitor by telephone from Mogadishu.
The infected Ugandan peacekeepers are part of the over 50 who have
contracted the ailment that has in the last 3 weeks hit the Burundian
and Ugandan camps in Mogadishu. Al Shabaab early this month [July
2009] claimed they had poisoned Burundian peacekeepers.

Sources who did not want to be named because of the sensitivity of
the subject said 4 of the Ugandan soldiers were evacuated from the
Somali capital, Mogadishu, and flown to Nairobi on Tuesday [28 Jul
2009] for treatment at Nairobi International Hospital. The Ugandan
and Burundian camps are about 2 kilometres [1.2 mi] apart, each with
its water tanks. Last week [week of 20 Jul 2009], the Deputy Amisom
Commander, Gen Juvinele Niyoyunguriza, told a group of Ugandan
journalists in Mogadishu that Burundian forces had been infected with
a strange disease.

Gen Niyonyunguriza said 50 soldiers had been admitted and 4 died at
Nairobi International hospital. Mr Gaffel Nkolokosa of the African
Union Mission for Somalia [Amisom] in Nairobi yesterday [29 Jul 2009]
said 12 of the 50 were evacuated from Mogadishu 3 weeks ago and
brought to Kenya for treatment after exhibiting symptoms similar to
those of their colleagues who had been admitted. He, however, said
they had recovered and returned to Burundi.

According to sources, the Ugandan soldiers had developed fever and
skin rash, before developing body organ failure. Amisom Medical
Officer James Kiyengo said on Friday [24 Jul 2009] that the strange
ailment is a bacterial infection caused by rat urine. He identified
the infection as leptospirosis. "It is spread by a rat. A rat could
have urinated in the water tank. We need to keep hygiene and keep
rats off," he said last week [week of 20 Jul 2009]. He said the
ailment causes fever and skin rash, but added that its spread can
stopped through isolation of cases and giving them doxycycline injections.

Col Kiyengo said they had received drugs from the Islamic Relief
Association in the United States and Korean International Cooperation
Agency for treatment of the force and the general Somali community.
Amisom, which comprises 4300 Ugandan and Burundian soldiers, has come
under intense attack from Al Shabaab, who consider the peacekeepers
as an occupying force. 12 Ugandan peacekeepers have been killed since 2007.

Al Shabaab, a youthful group that has been terrorising Somalis since
2006, has now turned to using both psychological and combat war to
scare Somalis from supporting Amisom and the Transitional Federal
Government, which has been in place for barely 7 months.

[Byline: Risdel Kasasira, Andrew Bagala]

--
Communicated by:
ProMED-mail
<promed@promedmail.org>

******
[2]
Date: Mon 3 Aug 2009
Source: Daily Nation (Kenya) [edited]
<http://www.nation.co.ke/News/-/1056/634368/-/ulkh44/-/>


The African Union Mission in Somalia (Amisom) has ruled out water
poisoning as the cause of a ''strange'' disease that has struck its
soldiers in Mogadishu. Amisom spokesman Gaffel Nkolokosa said in
Nairobi on Monday [3 Aug 2009] that the organisation was waiting for
an official medical report on what has made Ugandan and Burundian
soldiers to fall sick. The soldiers have been admitted to Aga Khan
Hospital [in Nairobi, Kenya]. "It is not true the water was
poisoned," he said. The AU soldiers are defending the Somali
government from an array of Islamic rebels fighting to topple it.
Al-Shabaab, the biggest of the rebel groups, had claimed that it
poisoned water used by Amisom.

In Kampala, defence and military spokesperson Felix Kulayigye
confirmed that 11 UPDF [Uganda People's Defence Force] soldiers
admitted to hospital had been discharged. 2 of the 6 remaining
soldiers are still in intensive care. The rest of the soldiers have
been released and would not be returning to their camp in Somalia,
sources have said. 17 Ugandan soldiers were flown to Aga Khan
Hospital after exhibiting symptoms similar to those afflicting
Burundian troops.

Doctors have also confirmed that the Ugandans had not been poisoned
as had earlier been claimed by al-Shabaab. Symptoms of the illness
include fever, swelling in the lower limbs, and jaundice (yellowing
of the skin and eyes).

The illness is believed to be leptospirosis, also known as Weil's
syndrome. It is said even the locals around the Amisom bases were
suffering the same ailment, thus ruling out poisoning. The World
Health Organisation has been carrying out investigations but is yet
to release results.

--
Communicated by:
ProMED-mail
<promed@promedmail.org>

******
[3]
Date: Fri 31 Jul 2009
From: Steve Berger <mberger@post.tau.ac.il> [edited]


Re: ProMED-mail Leptospirosis - Somalia: susp, RFI 20090802.2706
----------------------------------------------------------------
I ran this scenario through Gideon [Global Infectious Disease &
Epidemiology Network]. Assuming that these findings represent a
single infectious disease, the most likely diagnosis is anthrax. If,
as claimed, the peacekeepers were intentionally infected, anthrax is
the only relevant disease in Somalia, which has bioterror potential.

--
Dr Steve Berger
Geographic Medicine
Tel Aviv Medical Center
Israel
<mberger@post.tau.ac.il>

[Although according to the news releases, officials seem sure that
leptospirosis was the diagnosis for the disease affecting the Ugandan
and Burundian peacekeepers in Mogadishu, the clinical picture that
was given in the prior ProMED post (Leptospirosis - Somalia: susp,
RFI 20090802.2706) lacked certain features that are characteristic of
leptospirosis, such as myalgias, conjunctival suffusion, and
jaundice. However, the 2nd news release above now includes jaundice
in the clinical picture. In addition, although the outbreak was
thought to be intentionally perpetrated by Al Shabaab, who consider
these peacekeepers as an occupying force, the news releases above
discount this, mentioning that Somalis in the community were
suffering from the illness as well.

Dr Berger brings up the possibility that the cause of the outbreak in
the Ugandan and Burundian forces is anthrax, having assumed this
event was bioterrorism. I presume he means the inhalation form of
anthrax, which could account for chest pain and difficulty breathing
that has been part of the clinical picture (see ProMED post
Leptospirosis - Somalia: susp, RFI 20090802.2706), and multiorgan
failure mentioned in the news release above.

"Skin rash" that was not further characterized in the news release
above could be cutaneous anthrax that was seen in half of the 22
infected persons exposed to anthrax spores in the 2001 bioterrorism
event in the USA. However, the appearance of cutaneous anthrax is
distinctive and I assume would be identified as such by the
physicians in Nairobi. A detailed description of the skin rash in the
Ugandan and Burundian cases would be helpful.

In addition, many of the patients with the clinical picture that
included respiratory symptoms were said to have recovered, whereas
the mortality rate for inhalation anthrax is very high; even in the
2001 outbreak in the USA the case-fatality rate for inhalation
anthrax was 45 percent. Also, no mention was made in the Ugandan and
Burundian cases of radiologic findings of mediastinal widening
consistent with adenopathy or large pleural effusions, which are
commonly seen in patients with inhalation anthrax, and no one was
said to have meningitis, which was seen as the presenting illness in
the index case in the 2001 outbreak in the USA, and occurred in half
the autopsied cases with inhalation anthrax in the 1979 Russian
outbreak. For these reasons, I doubt anthrax is the cause of illness
in the Ugandan and Burundian peacekeepers.
The HealthMap/ProMED-mail interactive map of Somalia showing
Mogadishu is available at
<http://healthmap.org/r/00Cu>. - Mod.ML]

[see also:
Leptospirosis - Somalia: susp, RFI 20090802.2706
Leptospirosis - India (02) 20090404.1296
Leptospirosis - India: (north), 2007 20090403.1292
Leptospirosis - Fiji (03) 20090225.0772
Leptospirosis - Fiji (02) 20090207.0554
Leptospirosis - Fiji 20090204.0502
2008
----
Leptospirosis - Guyana (coastal) 20081231.4131
Leptospirosis - Sri Lanka (07): (NW) 20081231.4127
Leptospirosis, fatal - UK (02) 20081010.3210
Leptospirosis, fatal - UK: rodent scratch 20081007.3173
Leptospirosis, sea mammals - USA: (CA) 20081003.3125
Leptospirosis - Sri Lanka (06) 20080927.3058
Leptospirosis - Sri Lanka (05) 20080922.2984
Leptospirosis - Sri Lanka (04) 20080909.2810
Leptospirosis - Philippines: (Davao Region) 20080626.1967
Leptospirosis - Sri Lanka (03): background 20080610.1836
Leptospirosis - Sri Lanka (02): hantavirus also susp. 20080606.1808
Leptospirosis - Sri Lanka: RFI 20080605.1801
Leptospirosis - New Caledonia (02): background 20080408.1291
Leptospirosis - New Caledonia 20080407.1281
Leptospirosis - Peru: (Loreto), new species 20080407.1279
Leptospirosis - Jamaica 20080125.0312
2007
----
Leptospirosis - Dominican Republic 20071124.3804
Leptospirosis - Jamaica (02) 20071018.3409
Leptospirosis - Ukraine (Lvov, Kiev, Kherson) 20071018.3401
Leptospirosis - Jamaica 20071016.3383
Leptospirosis, fatal - Sri Lanka (Matara) 20070914.3051
Leptospirosis - China (Hong Kong) 20070821.2725
Leptospirosis - Argentina (Santa Fe) 20070429.1395
2006
----
Leptospirosis - India (Gujarat): not hantavirus 20060831.2476
Leptospirosis - India (Kerala) 20060609.1612
Leptospirosis - India (Karnataka) 20060123.0226]
...................................ml/mj/dk

 

[alert]

Re: Mysterious illness kills 3 AU troops; sickens at least 19

Re: Mysterious illness kills 3 AU troops; sickens at least 19

The news reports here are contradictory as to how many are ill (and who), how many have died, and even the name of the hospital that is treating them (Aga Khan or Nairobi International). It also appears that there has been similar illness in the local Somali civilian population. But it is truly bizarre that for over two weeks Kenyan authorities and the WHO (and now the CDC) have been investigating an failed to reach a diagnosis.

It is certainly possible that there is more than one disease going on here. It is also possible that the disease is caused by an unusual exposre to a common bacteria (strep, staph, etc.). I would be very surprised if the cause was not bacterial, as noted by the marked difference in the prognosis between treated and untreated patients. I see no evidence that treatment consists of anything other than antibiotics (no tamiflu, no ribavirin, no anti-parasitics).

 

[Shiloh]

Re: Mysterious illness kills 3 AU troops; sickens at least 19

Re: Mysterious illness kills 3 AU troops; sickens at least 19

Source: http://www.newvision.co.ug/D/8/13/690529

15 UPDF soldiers survive strange disease
Thursday, 6th August, 2009

By Barbara Among

Fifteen of the 17 Ugandan peacekeepers in Somalia, recently admitted at a Nairobi hospital suffering from a strange waterborne disease, have been discharged.

The soldiers serving on the African Union Mission in Somalia were last week evacuated to Nairobi for treatment after they got infected in Mogadishu.

The group was on Monday flown to Uganda for a week?s holiday before they can resume duty.

The army, however, yesterday reported that the Ugandan base had recorded three new cases. They have been taken to Nairobi for treatment.

Army spokesman Lt. Col. Felix Kulayigye said medical experts were still trying to identify the disease.

Last Friday, 23 Ugandan soldiers were evacuated to Nairobi for treatment. A total of 40 Ugandans have been affected by the disease that has so far killed one UPDF soldier and four Burundians.

Earlier, UPDF?s chief of medical services Dr. James Makumbi ruled out poisoning.

He said the epidemic could have been caused by the terrain, which is flat and swampy, coupled with poor sewerage disposal.

The symptoms include chest pain, fever and headache, swelling of the lower limbs, a fast heartbeat and respiratory problems.

Matters were worsened by Mogadishu being a war-torn coastal city, where many displaced people are concentrated in a small area.

?Owing to the fact that the water table is close, even underground water sources became contaminated with fecal matter,? Makumbi said.

Over 50 Burundians have been affected. By last week, four had died.

Uganda and Burundi are the only countries that have heeded the call from the African Union to send peacekeepers to Somalia.

But the 4,300 force, among them 2,700 Ugandans, falls short of the 8,000 soldiers needed to secure Mogadishu.