Re: Bihar: Mysterious disease kills 48 children - undetermined encephalitis - samples negative for JE, Nipah and Chandipura
Re: Bihar: Mysterious disease kills 48 children - undetermined encephalitis - samples negative for JE, Nipah and Chandipura
http://www.promedmail.org/pls/apex/..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,89116
Archive Number 20110628.1972
Published Date 28-JUN-2011
Subject PRO/AH/EDR> Japanese encephalitis - India (03): (BH) NOT
JAPANESE ENCEPHALITIS - INDIA (03): (BIHAR) NOT
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[1]
Date: Mon 27 Jun 2011
Source: The Hindu [edited]
<http://www.thehindu.com/news/states/other-states/article2137344.ece>
With 41 children falling prey to the 'mystery disease' ravaging North
Bihar, the Muzaffarpur district administration on Sunday [26 Jun 2011]
recommended that the State government invoke the Epidemic Diseases Act
throughout the afflicted area. While 41 is the official death toll,
unconfirmed reports from different pockets of the Tirhut division put
the figure at 48.
On Sunday [26 Jun 2011], the district magistrate and the civil
surgeon sent a letter to the State Health Department, recommending
that Muzaffarpur be declared an epidemic-zone.
None of the 18 samples sent to the National Institute of Virology,
Pune has tested positive for Japanese encephalitis (JE) [virus], the
Nipahvirus (named after Nipah in Malaysia), or the Chandipura virus
(named after the village in Maharashtra's Nagpur division).
A 5-member expert committee has been constituted to formulate the
kind of treatment to be administered in the district's afflicted
blocks.
[Byline: Shoumojit Bamjaree]
--
Communicated by:
Ronan Kelly
<ronankelly@comcast.net>
******
[2]
Date: Mon 27 Jun 2011
Source: Express India [edited]
<http://www.expressindia.com/latest-news/Toll-47--Bihar-may-declare-mystery-disease-epidemic/809168/>
With the death toll in the mysterious disease rising to 47 on Sunday
[26 Jun 2011], the Bihar government is likely to declare it an
epidemic. Under the epidemic Act, the Health Ministry will be
empowered to take samples of brain tissues of the mystery disease
victims.
During the last 48 hours, 6 deaths have been reported, including 5 at
KD Kejriwal Maternity Hospital. The hospital, which has admitted 82
patients since [11 Jun 2011], reported 24 deaths till Sunday evening
including one on Sunday [26 Jun 2011]. 17 children are being treated
at the hospital. Muzaffarpur's government hospital, Sri Krishna
Medical College and Hospital, reported one death during the last 48
hours. It has been treating 8 patients. Patna Medical College and
Hospital has 7 patients.
At the National Institute of Virology, Pune, and Rajendra Memorial
Research Institute, Patna, 24 blood and cerebral spinal fluid samples
have tested negative for Japanese encephalitis (JE) [virus or
antibody? - Mod.TY]. These institutes now want brain tissue samples to
ascertain the disease that experts describe as a kind of viral
encephalitis. _Culex_ mosquitoes are suspected to carry virus from
animals to humans [if it is JE virus, which apparently it is not, as
indicated in the report above. - Mod.TY]
Muzaffarpur district magistrate recommended the state government late
on Saturday night [25 Jun 2011] to declare Gandak catchment and
suburban areas of Bochaha, Minapur, Mushahari, Kanti, Ahiyapur,
Sahebganj, and Paru as epidemic zone. The district administration has
set up a 5-member doctors' committee to advise line of treatment and
help prepare a contingency plan. Dr Arun Shah, one of the members of
the committee, said Muzaffarpur cases needed the same treatment as
Saharanpur encephalitis that led to a large number of deaths every
year till 2000. "A study by the Indian Council of Medical Research
concluded that a toxin from kasaundhi trees, being transmitted to
humans through insects, caused the disease. The trees were cut and the
disease subsided. Litchi trees and mosquitoes present in the region
should be studied for this disease," suggested Shah.
Health minister Ashwini Kumar Choubey said, "We have received
Muzaffarpur administration's advice to declare the disease as
epidemic. We have started the process. We urgently need brain tissues
to decode the mystery. The government will take a final call on Monday
[27 Jun 2011] after assessing the situation. Experts have given us
enough hints of it being some kind of a viral disease affecting brain
and causing sudden death. Declaration of epidemic would help us get
the exact diagnosis," he said.
Chief minister Nitish Kumar said that irrespective of blood sample
tests ruling out Japanese encephalitis, JE vaccine should be given to
all children below 15 years in affected areas.
[Byline: Santosh Singh]
[3]
Date: Tue 28 Jun 2011
Source: Times of India
<http://timesofindia.indiatimes.com/city/patna/Mysterious-disease-hits-Dar=bhanga-claims-2/articleshow/9031469.cms>
[Mysterious disease hits Darbhanga, claims 2
BY Binay Kumar Jha]
There is not enough information in this report from the Times of
India to even guess what is responsible for the deaths of these
children - possibly poisoning of some kind, but given the outbreak in
Muzaffarpur around 30 miles away, I thought that this may be of
interest.
-
Communicated by:
Ronan Kelly for FluTrackers.com
<ronankelly@comcast.net>
[Unfortunately, there still is not a diagnosis for these cases, with
JE, Nipah, and Chandipura viruses having been ruled out. Although JE
virus has been discarded as the etiological agent in this outbreak,
vaccination against JE in this endemic area is a wise decision.
ProMED-mail awaits with interest further information as tests and
epidemiological studies progress.
An alert ProMED subscriber pointed out that in an earlier report, the
locale of this outbreak was given both as Muzaffarpur and,
incorrectly, as Muzaffarnagar.
A HealthMap/ProMED-mail interactive map of Muzaffarpur, Bihar, India
can be accessed at <http://healthmap.org/r/01v2>. - Mod.TY]
[With reference to the toxic plant:
Source:
<http://childhealthfoundation.net/Proceeding%20&%20Recommendations.pdf>
"In many districts of western UP, Uttarakhand and Haryana, outbreaks
of an acute ?€œencephalopathy?€? syndrome dubbed as ?€œmysterious
disease?€? have been an annual feature for many years. The disease
affects rural young children during winter months of September to
December, and carries case fatality rates of around 75-80%. Most
investigators assume it to be viral ?€œencephalitis?€?. According to a
rough estimate, at least 500-700 young previously healthy children are
losing lives every year for last many years in this region. Many
national investigating agencies failed to diagnose the entity despite
investigating for many consecutive years. Year after year the doctors
were mute witnesses of hundreds of child-deaths without cause,
treatment or prevention.
A team of investigators published their findings in form of three
papers in the reputed peer reviewed journals of the country. At the
end of the extensive work of 4 years, it was concluded that the
disease was not encephalitis as believed so far but a fatal
multi-system disease affecting liver, muscle and brain called,
?€œacute hepatomyoencephalopathy (HME) syndrome?€? induced by the some
phytotoxin. Later, the epidemiological investigations showed that it
was due to consumption of beans of a ubiquitous herb called ?€œCassia
occidentalis?€? by the poor, unsupervised children of the area
responsible for the development of this syndrome."
"
A paste of Kasaundhi (Cassia occidentalis L.) on p.18 of 305 in
<http://etd.uasd.edu/ft/th8613.pdf>
_Cassia occidentalis_ was renamed to _Senna occidentalis_ by the
taxonomist some 10 years ago. In animals we see this plant causing a
syndrome referred to as alset downers. the animals are down, not
depressed and will eat and drink if feed is provided to them, but they
are unable to rise to their feet. They generally have diarrhea, some
degree of weakness, dark urine (being down, and unable to rise, an
indication of muscle damage and likely myoglobin being dumped into the
urine). The toxic agent is poorly characterized but appears to be
throughout the plant.
Therefore the problem was easily solved by cutting down the senna
plants. But the idea that insects transmitted to toxin from the plant
to the humans is pure fabrication, and litchi [lichi] trees are not
toxic. -Mod.TG/JW
rogid
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