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Cambodia - 74 pediatric cases of unknown disease- - 56 deaths - fever, respiratory and neurological symptoms - Enterovirus EV71 identified

Re: 60 kids die in Cambodia - WHO investigates

Re: 60 kids die in Cambodia - WHO investigates

http://www.theprovince.com/health/H...sease+that+killed+children/6881918/story.html


Health officials in Cambodia probe mystery disease that killed 61 children
By The Associated Press July 4, 2012 10:10 PM PHNOM PENH, Cambodia - Health officials in Cambodia are searching for the cause of a mystery disease that has killed more than 60 children over the past three months, the World Health Organization said Thursday.

The "undiagnosed syndrome" has killed 61 of the 62 children admitted to hospitals since April, but there's no indication that is it spreading from person to person, said WHO spokeswoman Aphaluck Bhatiasevi.

She said health workers are trying to determine whether the cases were all the same disease or a collection of various illnesses.

The children were less than 10 years old and first fell ill with a high fever, followed by neurological symptoms and severe respiratory problems that quickly progressed. The cases have been reported in hospitals in 14 provinces, with most occurring in southern Cambodia.
--------------------------

http://rendezvous.blogs.nytimes.com/2012/07/04/whats-killing-cambodias-children/

HONG KONG ? This is the grim track of a mysterious new illness that has already killed scores of children in Cambodia: First, there?s a severe fever. Then comes encephalitis, a swelling of the brain. Finally, the lungs go, and the child dies. All this happens within 24 hours.

The disease is absolutely murderous in its efficiency ? Dr. Beat Richner, the physician who first sounded the alarm about the outbreak, said Wednesday that 64 of 66 his patients with the illness have died. All children. All under 7.

Dr. Richner, a Swiss physician, is the founder of the Kantha Bopha children?s hospitals located in the capital Phnom Penh and in Siem Reap, home to the famed Angkor Wat temple complex. He first notified the Cambodian government about the appearance of the deadly new disease on June 20.

[snip]
 
Re: 60 kids die in Cambodia - WHO investigates

Re: 60 kids die in Cambodia - WHO investigates

Probe into mystery illness ongoing
Thursday, 05 July 2012 Bridget Di Certo and Chhay Channyda
...
WHO public-health specialist Dr Nima Asgari said the UN agency was providing support for the Ministry of Health to investigate the cases.

?The investigations will try to identify any linkages in time, place and person between the cases and also if there has been exposure to similar factors and how that can be linked . . . to a possible causative agent.?

Dr Denis Laurent, from Kantha Bopha Children?s Hospitals, which first raised the alarm about the deadly illness, said the hospital was independently pursuing its own investigation.

?We are working very hard, but there is no update. We are still waiting for results, hopefully tomorrow,? Laurent said.

Communicable disease health officials from the Ministry of Health could not be contacted yesterday, and rapid- response hotline officials declined to comment.
...
http://www.phnompenhpost.com/index....-news/probe-into-mystery-illness-ongoing.html
 
Re: 60 kids die in Cambodia - WHO investigates

Re: 60 kids die in Cambodia - WHO investigates

Cambodia Outbreak Is Unlikely to Be Influenza

By JAMES HOOKWAY

International health officials investigating the outbreak of an unidentified disease in Cambodia that has killed more than 60 children since early April say it is unlikely to be a form of influenza, but they still face a long struggle to identify the precise nature of the illness.

Describing the initial finding as "positive," World Health Organization physician and public-health specialist Nima Asgari said the mystery illness "doesn't look like any kind of influenza."

"There doesn't seem to be any kind of transmission taking place between patients who were placed next to each other in hospitals, nor has there been any transmission to medical staff," Dr. Asgari said.

Cambodia for years has been on the front lines of the fight against avian influenza, which has killed over 600 people across Southeast Asia and East Asia in recent years. In February, Cambodian authorities were dealt a grim reminder of the threat when a mother and child contracted the H5N1 bird-flu virus after coming into contact with sick poultry at a family farm. Both died. Cambodian health officials say another child, who was 10 years old, also died from H5N1 influenza in May.

...

http://online.wsj.com/article/SB10001424052702303684004577508372906028072.html?mod=googlenews_wsj
 
Re: 60 kids die in Cambodia - WHO investigates

Re: 60 kids die in Cambodia - WHO investigates

The experts said the fatal strange disease of children in Cambodia may be mixed disease

Nima Asgari, public health experts of the World Health Organization in Cambodia, the Xinhua News Agency reporter that fatal abnormal Cambodian children may be mixed illness of several known diseases, including viral diseases, bacterial diseases, the specific cause is still under investigation.:tiphat:http://translate.googleusercontent.....shtml&usg=ALkJrhgsnxDDgQxD-CUwaf9oIuXJAY_dsQ
 
Re: 60 kids die in Cambodia - WHO investigates

Re: 60 kids die in Cambodia - WHO investigates

Phl warned of unknown respiratory disease in Cambodia
By Sheila Crisostomo July 06, 2012 12:00


MANILA, Philippines - The Philippines and neighboring countries have been warned of an “unknown respiratory disease” that has killed 61 children in Cambodia..
..The WHO said the neighboring countries of Cambodia “have already been officially informed through a posting made through the International Health Regulations (IHR) event information system.:tiphat:http://www.philstar.com/Article.aspx?articleId=824581&publicationSubCategoryId=63
 
Re: 60 kids die in Cambodia - WHO investigates

Re: 60 kids die in Cambodia - WHO investigates

Mystery disease kills Cambodian children
06-07-2012

The World Health Organisation and Cambodian officials are investigating an unknown disease that has killed more than 60 children. The Cambodian Ministry of Health said the disease starts with high fever followed by rapid deterioration of respiratory functions.
The Controller of the Centre for Health Protection in Hong Kong, Thomas Tsang, said they are in close contact with their Cambodian counterparts and the WHO. He said letters would be sent out to alert local doctors.

The Travel Industry Council is closely monitoring developments. Its executive director, Joseph Tung, said there are Hong Kong tour groups in Cambodia.

But, he said the affected area is a long way from popular tourist spots, and there does not appear to be a need at present to warn people to avoid Cambodia.

:tiphat:http://rthk.hk/rthk/news/englishnews/20120706/news_20120706_56_853060.htm
 
Re: 60 kids die in Cambodia - WHO investigates

Re: 60 kids die in Cambodia - WHO investigates

http://www.ctvnews.ca/world/who-too...r-mystery-disease-in-cambodia-is-new-1.866358


The World Health Organization says it's too early to know whether an entirely new disease is responsible for the deaths of more than 60 children in Cambodia.

The mystery disease has killed 61 of the 62 children who have been hospitalized since April. The affected patients, all of them under the age of seven so far, suffer a high fever, followed by a brain infection called encephalitis and severe breathing problems. It’s the respiratory problems that eventually kill the patients, often within 24 hours, doctors report.

Patients have turned up in several provinces in southern and central Cambodia.

But while many fear a new SARS or bird flu could be at hand, there's no indication the illness is spreading from person to person. Indeed, none of the hospital workers who are treating these sick children are becoming ill.

Dr. Nima Asgari of the WHO in Phnom Penh said Thursday that health workers are combing through victims' records to try to determine whether the problem is a combination of known ailments or a new disease.

Infectious diseases expert Dr. Neil Rau, who is not involved in the investigation, says there are too many unanswered questions right now to speculate on a cause. He says the WHO workers need to have a better understanding of the disease’s course.

“The part that I would be most interested in trying to figure out is whether this is kids who have a brain infection, known as encephalitis, or whether it’s kids with a respiratory illness, some of whom end up with encephalitis,” Rau told CTV’s Canada AM.

“If it’s a bad respiratory illness, there’s a possibility this could be something that’s transmitted person to person quite easily, whereas if it’s a brain infection, it’s less likely to be transferred person to person and therefore less likely to be a global concern.”

Rau says it’s interesting that no seniors have arrived in hospital with this illness as well, since most infectious diseases affect the extremes of age -- the very young and the very old – since they typically have weak immune systems.

“I have a feeling that once they start looking into further they will actually start to find more people who are elderly who have the same illness,” he said.

Rau says he’s reassured by comments from the WHO that they’re not seeing clusters of illness, which also suggests it’s not passing person to person.

“I have a feeling it’s more an environmental issue. In other words, kids who are being exposed to sick animals or to mosquitoes that are carrying a new cause of disease,” Rau said.

[snip]
 
Re: 64 children die of unknown illness in Cambodia - WHO investigates

Re: 64 children die of unknown illness in Cambodia - WHO investigates

Warning as disease kills Cambodia kids

<!-- Travelers to Cambodia are being advised to take precautions as the World Health Organization and the country's health ministry race to identify a disease that has killed 61 children since April.

//-->Mary Ann Benitez and Phoebe Man

Friday, July 06, 2012

Travelers to Cambodia are being advised to take precautions as the World Health Organization and the country's health ministry race to identify a disease that has killed 61 children since April.

However, the WHO is yet to issue a global alert regarding the disease.
Some 150 Hong Kong tourists in five groups are currently in Phnom Penh and Ankor Wat, and about 500 more in 30 tour groups are set to leave for Cambodia, which is bordered by Thailand, Laos and Vietnam..

..Laboratory test results suggest that this syndrome is unlikely to be associated with avian influenza. It can be a mixture of known diseases which have been reported as one syndrome, or something new," said Joy Rivaca Caminade, technical officer (risk communications) of the WHO Regional Office for Western Pacific.:tiphat:http://www.thestandard.com.hk/news_detail.asp?pp_cat=30&art_id=124110&sid=36947782&con_type=1
 
Re: 64 children die of unknown illness in Cambodia - WHO investigates

Re: 64 children die of unknown illness in Cambodia - WHO investigates

I just remembered this. During the SARS outbreak of 2003, Cambodia reported at least 24 cases of an unidentified atypical pneumonia with 7 deaths, several of which occurred within 24 hours of onset, that was determined not to be SARS:

http://www.mongabay.com/external/mystery_sars_cambodia.htm

No diagnosis was ever released, but bacterial agents were suspected. Read the full article.
 
Re: 64 children die of unknown illness in Cambodia - WHO investigates

Re: 64 children die of unknown illness in Cambodia - WHO investigates

Deadly Disease Claims Child Victims Across Cambodia, WHO Says
By Jason Gale on July 05, 2012
...
A review of 57 cases found 46 of them died within 24 hours of admission, with the rest suffering the same fate within three days, she said. The stricken children were aged three months to seven years.
...
http://www.businessweek.com/news/20...claims-child-victims-across-cambodia-who-says
 
Re: 64 children die of unknown illness in Cambodia - WHO investigates

Re: 64 children die of unknown illness in Cambodia - WHO investigates

Ronan Kelly said:
Deadly Disease Claims Child Victims Across Cambodia, WHO Says
By Jason Gale on July 05, 2012
...
A review of 57 cases found 46 of them died within 24 hours of admission, with the rest suffering the same fate within three days, she said. The stricken children were aged three months to seven years.
...
http://www.businessweek.com/news/20...claims-child-victims-across-cambodia-who-says
Click to expand...

The problem is the complete lack in details of the clinical course of the illness: the time from symptoms onset to hospitalization, type of care received, hematobiochemical abnormalities detected through common blood tests, gross histopathological change detected during rapid necropsies (an in-depht examination may have been out of the local hospital capabilities or not feasible because of unwillingness of parents).

Several instances of children unexplained illness were recorded during recent months in an area spanning from India to Vietnam but the WHO did not issue any statement.

If this specific incident was put under scrutiny I suspect some ideas are on the table. (IOH)
 
Re: 64 children die of unknown illness in Cambodia - WHO investigates

Re: 64 children die of unknown illness in Cambodia - WHO investigates

EMERGENCY MESSAGES AND PUBLIC ANNOUNCEMENTS

?Mystery? Disease affecting kids

According to the Phnom Penh Post some sixty younger children have died from something that affects the brain and lungs, mainly in southern provinces. The exact cause has yet to be determined. Very early evidence suggests that it is not Dengue or pandemic flu. According to the article, Kantha Bopha hospital?s officials were also concerned about initial management of these very sick children, which may have contributed to so many deaths. The Cambodian Ministry of Health, international health organizations, and Kantha Bopha officials are conducting investigations to try to determine the cause.

Should I worry? No. The details are still very early. At this time there does not appear to be spread of this illness within households and none of the hospital staff who took care of the sick children have become sick.

What should I do if I have a young child? It is important to remember that most Western children have excellent immunization coverage. If your child gets a high fever and cough you should have them seen by a medical provider as you normally would.

Should I take other precautions? Simple measures like hand washing and yearly flu vaccination go a long way to reduce disease spread.
We will continue to closely monitor the situation. Our Centers for Disease Control and Naval Medical Research Unit experts are monitoring the situation closely.

We encourage you notify us of your presence in Cambodia by enrolling in the Department of State?s Smart Traveler Enrollment Program (STEP).
The American Citizen Services Unit of the U.S. Embassy is located at #1 Street 96, Phnom Penh, Cambodia and can be reached by calling 023-728-000, or by e-mailing ACSPhnomPenh@State.gov. :tiphat:http://cambodia.usembassy.gov/acs_disease_affecting_kids.html
 
Re: 64 children die of unknown illness in Cambodia - WHO investigates

Re: 64 children die of unknown illness in Cambodia - WHO investigates

Investigators probe mystery disease killing Cambodian children





By Madison Park, CNN
July 6, 2012


http://www.blogger.com/blogger.g?blogID=7219042034689344733
STORY HIGHLIGHTS
  • 62 dead out of 64 cases in mysterious disease in Cambodia, says doctor
  • Surrounding countries notified of disease; doctors on alert in Hong Kong
  • Children suffered swelling in their brain and died because lungs failed

Hong Kong (CNN) -- The World Health Organization (WHO) and Cambodian health officials are investigating why at least 61 children in the country have died mysteriously after suffering severe neurological and respiratory complications.
Dr. Beat Richner, of the Kantha Bopha Children's Hospitals who first alerted Cambodia's health authorities about the unknown disease said as of Friday, he knew of 64 cases, in which only two children have survived.
Countries surrounding Cambodia were informed of a deadly disease that killed dozens of children earlier this week, through the International Health Regulations event information system, which provides public health communications.
In Hong Kong, a major air hub in the region, health officials responded by alerting doctors to be watchful for patients returning from Cambodia who have respiratory symptoms. Travelers who have been to Cambodia were told to visit their doctors if they developed respiratory symptoms.
The unknown illness appears in children, according to the WHO and the Cambodian Ministry of Health.
The children who fell ill first experienced a high fever followed by respiratory problems. Some of them also had neurological symptoms that included convulsions, according to the WHO.

Richner said the patients suffered from encephalitis, which is the inflammation of the brain.
"They are hospitalized," he said. "They arrive in our hospital, in the last moments... they die because their lungs are destroyed."
They arrive in our hospital, in the last moments... they die because their lungs are destroyed.
Dr. Beat Richner, Kantha Bopha Children's Hospitals



When asked what he thought caused the deadly illness, he said: "I think our idea is an enterovirus or an intoxication of a drug," or a combination of both.
Richner added that the number of cases affected by the unknown disease is low -- 34 cases in June compared with the 75,000 sick children at Kantha Bopha's outpatient clinics and 16,000 hospitalized kids.
The majority of the cases came from the southern part of the country, but there haven't been signs of clustering, according to the WHO.
The young patients were brought to hospitals in the capital, Phnom Penh, and the northern tourist hub of Siem Reap -- the two biggest cities of Cambodia. The Angkor Hospital for Children in Siem Reap reported one case of the mysterious illness as of Friday, according to an email received by CNN from Dr. Bill Housworth, executive director of the hospital.
"WHO supports the Ministry with the investigation and detailed analysis of each of these cases to find out the cause," wrote Dr. Pieter Van Maaren, a representative of WHO in Cambodia in an email Friday.
 
Re: 64 children die of unknown illness in Cambodia - WHO investigates

Re: 64 children die of unknown illness in Cambodia - WHO investigates

.."At this stage, we cannot rule out if this is a mixture of a number of known diseases (virological, bacterial or toxicological) which have been reported as one syndrome or something new," Dr. Nima Asgari of the WHO in Phnom Penh said in an email Thursday.
The patients reported were under 7 years old and spread across several provinces in southern and central Cambodia. However, work is being done to determine whether other age groups may also be affected, he said.
Health Ministry officials alerted WHO on July 1 after learning about the cases from a doctor at Kantha Bopha Children's Hospital in the capital. Many patients first visited local health facilities before coming to the city, and investigators are now trying to piece together those reports to determine more about their conditions and what treatments were given, Asgari said.:tiphat:http://news.yahoo.com/mystery-disease-kills-61-kids-cambodia-091836375.html
 
Re: 64 children die of unknown illness in Cambodia - WHO investigates

Re: 64 children die of unknown illness in Cambodia - WHO investigates

<TABLE border=0 cellSpacing=0 cellPadding=0 width="100%"><TBODY><TR><TD class=pageTitle>Cambodia: undiagnosed illness affecting children</TD></TR><TR><TD>06 Jul 2012
</TD></TR><TR><TD>
pic_epi_update_general.jpg
ECDC

An outbreak of an undiagnosed illness affecting children has been reported by the Ministry of Health of the Kingdom of Cambodia to World Health Organization (WHO). Out of the 62 children, 61 have died. No apparent clustering of cases or signs of transmission have been reported so far.
Between April and June, a total of 58 children below age of 7 years have been admitted to a hospital in Phnom Penh. Further 4 children were admitted to a hospital in Siem Reap, with high fever and encephalitic and/or respiratory symptoms. In total, 62 cases were reported, the majority being on children under 3 years of age.
Fifty-six of 58 patients hospitalized in Phnom Penh and four of four patients hospitalized in Siem Reap have died. Of these cases, 46 died within 24 hours of admission, and the majority of the rest died between 1-3 days after admission. Sixty-one deaths were reported.
The Cambodian Ministry of Health and WHO are conducting an active investigation in order to determine cause and source of the illness. ECDC is closely monitoring the situation. :tiphat:http://ecdc.europa.eu/en/press/news...t=32e43ee8-e230-4424-a783-85742124029a&ID=666


</TD></TR></TBODY></TABLE>
 
Re: 64 children die of unknown illness in Cambodia - WHO investigates

Re: 64 children die of unknown illness in Cambodia - WHO investigates

Philippines DOH ready for 'mysterious' respiratory disease
By Sheila Crisostomo July 07, 2012 12:00 AM


<!-- start of photo and caption--><!-- start of photo and caption-->
<!-- end of photo and caption--><!-- end of photo and caption-->
MANILA, Philippines - The Philippines has prepared plans for cases like the ?mysterious? respiratory disease that had claimed the lives of 61 children in Cambodia, the Department of Health (DOH) said yesterday.
?For cases like this, the DOH has prepared plans, and usually, the National Epidemiology Center is the responsible agency within the department while the Bureau of Quarantine increases its surveillance for such disease crossing the borders,? the DOH said in a statement...

?We are advising the public to understand the risk of travel to Cambodia and to withhold unnecessary travel to this country. People going to the area should practice necessary precautions,? the DOH noted...

..But DOH Undersecretary Dr. Ted Herbosa said there is no need yet to place in quarantine travelers from Cambodia who will manifest any illness upon arrival in the country?s airports.
?There is no cause for alarm. The monitoring is just part of our contingency measures. The WHO had issued the advisory so that people can be forewarned... that there is this thing there,? he said in a telephone interview. ? With Rudy Santos :tiphat:http://www.philstar.com/Article.aspx?articleId=824906&publicationSubCategoryId=63
 
Re: 64 children die of unknown illness in Cambodia - WHO investigates

Re: 64 children die of unknown illness in Cambodia - WHO investigates

Hattip Pathfinder

CAMBODIA - A disease whose origin is still unknown, killed 63 children since last April

Since April, Cambodia, on 64 infected children, only one girl survived this unknown disease. The Pasteur Institute, in collaboration with the Kantha Bopha Foundation, attempts to locate the origin of this pathology.A mysterious disease, hitherto unknown to researchers, has killed 63 children since April in central and southern Cambodia. 90% of them were under 5 years.
In collaboration with the Kantha Bopha Foundation, researchers at the Pasteur Institute are examining samples from the patients and try to find the origin of pathology.Which symptoms does one recognize this strange disease? Two recurring syndromes characterize it: infection encephalitis - affecting one part of the brain - and a lung infection.
"Usually, we get a lot of children in the hospital for dengue, pneumonia, encephalitis and meningitis, explains Denis Lawrence, a biologist for the Kantha Bopha Foundation. But since April 20, we were surprised by a very serious development of acute pneumonia. Children die very quickly, between 24 and 48 hours after arrival.

"Kantha Bopha FoundationThe Kantha Bopha foundation has existed since 1992 and is led by the Swiss pediatrician Beat Richner. It comprises five hospitals (three in Phnom Penh to Siem Reap and two). These establishments do not care for the children from poor families, free of charge. Its budget is fed mainly by private donations.

Nevertheless, the expert believes that there is no cause for alarm: no new cases have been recorded since the beginning and the risks of epidemics are lower.
In addition, doctors have "done a lot of samples that have helped to eliminate the origins of the most dangerous in terms of contagion," says Philippe Buchy, head of virology division at the Pasteur Institute. "This disease could simply be the most severe form of a common disease in Cambodia and in neighboring countries," said he

.Another avenue is explored: a link between a virus and a drug reaction or chemical. "All children who died had taken drugs prior to their arrival at the hospital. The girl who survived the disease had not received the other hand, says the biologist. There is a real problem of self-medication in Cambodia. more poor buy medicines, often counterfeit, without the original packaging and it is difficult for doctors to know what patients have ingested.

"WHO rushed"
The warning from the WHO [World Health Organization, ed] on this disease has caused some panic in Phnom Penh. People call us to know whether to leave the country. This announcement was made too early, we do not have enough information about the disease, "laments Denis Lawrence.
Researchers at the Pasteur Institute hope to receive conclusive results explaining the cause of the disease within a week and a half.:tiphat:http://www.lexpress.fr/actualite/sc...-mysterieuse-maladie-au-cambodge_1135343.html
 
Re: 64 children die of unknown illness in Cambodia - WHO investigates

Re: 64 children die of unknown illness in Cambodia - WHO investigates

Undiagnosed illness in Cambodia - update

6 JULY 2012 - The Ministry of Health of the Kingdom of Cambodia is conducting active investigation into the cause of a recent undiagnosed syndrome that has caused illness and deaths among children in the country.

Preliminary findings of the investigation identified a total of 74 cases who were hospitalised from April to 5 July 2012. Of these, 57 cases (including 56 deaths), presented a common syndrome of fever, respiratory and neurological signs, which is now the focus of the investigation.

The majority of the identified cases to date were under three years old. Most of them were from the southern and central parts of the country and received treatment at Kantha Bopha Children?s hospital, which is a reference paediatric hospital. Despite all efforts, many of the children died within 24 hours of admission.

Available samples have been tested at the Institut Pasteur in Cambodia. Although a causative agent remains to be formally identified, all these samples were found negative for H5N1 and other influenza viruses, SARS, and Nipah.

The Ministry of Health was first alerted to this by Kantha Bopha Children?s hospital in Phnom Penh, where the majority of the cases were hospitalised.

The Ministry of Health notified WHO about this event through the IHR notification mechanism as it met the criteria for notification of any event where the underlying agent or disease or mode of transmission is not formally identified.

WHO and partners are assisting the Ministry of Health with this event which focuses on hospitalised cases, early warning surveillance data, laboratory data and field investigations.

While this event is being actively investigated, the Government is also looking at other diseases occurring in the country, including dengue, hand-foot-mouth and Chikungunya.

Parents have been advised to take their children to hospital if they identify any signs of unusual illness. The Government is also reinforcing awareness of good hygiene practices to the public, which includes frequent washing of hands.

http://www.who.int/csr/don/2012_07_06a/en/index.html
 
Re: 64 children die of unknown illness in Cambodia - WHO investigates

Re: 64 children die of unknown illness in Cambodia - WHO investigates

:tiphat: Go Ronan!:D
 
Re: 64 children die of unknown illness in Cambodia - WHO investigates

Re: 64 children die of unknown illness in Cambodia - WHO investigates

Available samples have been tested at the Institut Pasteur in Cambodia. Although a causative agent remains to be formally identified, all these samples were found negative for H5N1 and other influenza viruses, SARS, and Nipah.:magnify:
 
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