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Cholera Outbreak in Papua New Guinea?s Morobe Province

Re: 41 dead, hundreds affected by mystery illness in Papua New Guinea?s Morobe Province

Re: 41 dead, hundreds affected by mystery illness in Papua New Guinea?s Morobe Province

Updated Fri Aug 28, 2009 5:00pm AEST


Authorities in Papua New Guinea are investigating a mysterious disease that reportedly claimed the lives of more than 40 people in a remote District of Morobe province last week. Ten villages with no health facilities and poor road and communication links are reported to have been affected by the disease.

Presenter: Firmin Nanol
Speaker: Morobe Province Health Advisor, Dr Theo Likei


While local media reports say 70 people have died from the mysterious disease, the Morobe Provincial Health Office has denied that. The Health Advisor Dr Theo Likei says that 20 people died of dysentery in the remote Menyamya District last week, and 21 died of a mysterious influenza-like disease. He says more than 800 people have been affected from nearly 10 villages. He says the worst affected are children and pregnant women.

The Morobe Provincial Health authorities say they have responded as soon as the reports of the deaths reached them. However Doctor Theo Likei says medicines could not be delivered on time as the area is so remote and there are no road links.

Officials from both the World Health Organisation and PNG's Health Department have visited the affected villages and will test samples collected, to determine the cause of the deaths.


http://www.radioaustralia.net.au/pacbeat/stories/200908/s2670180.htm
 
Re: 70 dead, 800+ hundred affected by mystery illness in Papua New Guinea?s Morobe Province

Re: 70 dead, 800+ hundred affected by mystery illness in Papua New Guinea?s Morobe Province

UNDIAGNOSED DISEASE - PAPUA NEW GUINEA (MOROBE), 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: Fri 28 Aug 2009
Source: ABC, Radio Australia [edited]
<http://www.radioaustralia.net.au/pacbeat/stories/200908/s2670180.htm>


Morobe people dying of mysterious disease
-----------------------------------------
Authorities in Papua New Guinea [PNG] are investigating a mysterious
disease that reportedly claimed the lives of more than 40 people in a
remote District of Morobe province last week. A total of 10 villages with
no health facilities and poor road and communication links are reported to
have been affected by the disease.

While local media reports say 70 people have died from the mysterious
disease, the Morobe Provincial Health Office has denied that. The health
advisor Dr Theo Likei says that 20 people died of dysentery in the remote
Menyamya District last week, and 21 died of a mysterious influenza-like
disease. He says more than 800 people have been affected from nearly 10
villages. He says the worst affected are children and pregnant women.

The Morobe Provincial Health authorities say they have responded as soon as
the reports of the deaths reached them. But Dr Theo Likei says medicines
could not be delivered on time as the area is so remote and there are no
road links.

Officials from both WHO and PNG's Health Department have visited the
affected villages and will test samples collected, to determine the cause
of the deaths.

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

******
[2]
Date: Fri 28 Aug 2009
Source: Radio New Zealand International [edited]
<http://www.rnzi.com/pages/news.php?op=read&id=48764>


41 dead, hundreds affected by mystery illness in Papua New Guinea's Morobe
Province
-----------------------------------------------------------------------------------

Outbreaks of dysentry and influenza in the Menyamya district of Papua New
Guinea's Morobe Province have claimed the lives of 41 people in the past 3
weeks. The provincial health advisor for Morobe, Dr Theo Likei, confirmed
more than 800 people have become unwell and 21 have died from influenza and
a further 20 are dead due to dysentry. He says the cause is not yet known
and more villagers may die.

"The centre of the outbreak is in one village in Menyamya district but
people in 9 other villages have also become unwell. The location of the
problem seems to be centred around one particular village, that's Akwanda
village. There are 9 other villages being involved, but with fewer numbers
than Akwanda. Akwanda definitely had about 99 per cent of the total. Out of
830 700 plus are from Akwanda. Out of 41 deaths, 40 deaths are from Akwanda
alone."

A total of 27 people have been transported out of Akwanda village for
further treatment. A medical team from Port Moresby, including staff from
WHO, and supplies have been dispatched. The situation is being continuously
monitored but communication with the villages is difficult due to their
remote locations.

Dr Likei says medical staff are working around the clock to contain the
illness outbreak and, if there is any further spread, more help from
outside the district will be needed.

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

[These 2 reports are conflicting. The 1st suggests a specific outbreak of
influenza-like illness (possibly influenza pandemic H1N1 2009 influenza
virus) on account of the vulnerability of children and pregnant women. The
2nd suggests a more extensive multifaceted outbreak. Further information is
awaited.

The province of Morobe can be located using the HealthMap/ProMED-mail
interactive map of Papua New Guinea at <http://healthmap.org/r/00JW>. - Mod.CP]

[see also:
2007
---
Undiagnosed deaths, human, swine - Papua New Guinea (02) 20070305.0781
Undiagnosed deaths, human, swine - Papua New Guinea: RFI 20070221.0641
2004
---
Undiagnosed deaths - Papua New Guinea (Southern Highlands) (03): RFI
20040801.2101
Undiagnosed deaths - Papua New Guinea (Southern Highlands) (02): RFI
20040728.2062
Undiagnosed deaths - Papua New Guinea (Southern Highlands): RFI 20040721.1978
Undiagnosed deaths - Papua New Guinea: RFI 20040419.1083]

...................mpp/cp/ejp/sh

http://www.promedmail.com/pls/otn/f?p=2400:1001:2711562508994087::NO::F2400_P1001_BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,78985
 
Re: 70 dead, 800+ hundred affected by mystery illness in Papua New Guinea?s Morobe Province

Re: 70 dead, 800+ hundred affected by mystery illness in Papua New Guinea?s Morobe Province

Thanks ProMED.
 
Re: 70 dead, 800+ hundred affected by mystery illness in Papua New Guinea?s Morobe Province

Re: 70 dead, 800+ hundred affected by mystery illness in Papua New Guinea?s Morobe Province

Thank you, Sharon for sending in the articles.
 
Re: 70 dead, 800+ hundred affected by mystery illness in Papua New Guinea?s Morobe Province

Re: 70 dead, 800+ hundred affected by mystery illness in Papua New Guinea?s Morobe Province

Mysterious killer illness strikes PNG province

<!--headlinesBar--><!--headlinesRelated-->
r418533_1986324.jpg

PHOTO

Villagers help unload supplies in Papua New Guinea. [Australian Defence Force]







<!--headlinesRelated--><!--headlinesCopy-->Firmin Nanol, Port Moresby
Last Updated: Fri, 28 Aug 2009 08:12:00 +1000
Authorities in Papua New Guinea are investigating diseases that claimed the lives of more than 40 people in a remote district of Morobe province last week.

Health adviser for Morobe province, Dr Theo Likei, says 20 people died of dysentery in the remote Menyamya district, and 21 died of a mysterious influenza-like disease.

He says more than 800 people have been affected and fears children and pregnant women are at risk.

''The most important people are, of course, our children, under-fives," he says.

"Then the second will be followed by our women, particularly those who are pregnant, we want to make sure they are safe.''

He says officials from the World Health Organisation and PNG's health department are in the area to determine the cause of the deaths.

Ten villages with no health facilities and poor road and communication links are reported to have been affected by the disease.:tiphat:http://australianetworknews.com/stories/200908/2669338.htm?desktop
 
Re: 70 dead, 800+ hundred affected by mystery illness in Papua New Guinea?s Morobe Province

Re: 70 dead, 800+ hundred affected by mystery illness in Papua New Guinea?s Morobe Province

Location of Morobe Province in Papua New Guinea.

Morobe Papua New Guinea.webp
 
Re: 70 dead, 800+ hundred affected by mystery illness in Papua New Guinea?s Morobe Province

Re: 70 dead, 800+ hundred affected by mystery illness in Papua New Guinea?s Morobe Province

communities affected included those in the Karanas and Kundi catchment areas, Wailala and Wawoka catchment in Wapi LLG. (Local Level Government (LLG) areas.)
Kome local level government manager Desmond Timiyaso feared that the death toll would increase further
Morobe Province
-Menyamya District
--Kapao Rural
--Nanima Kariba
--Kome Rural
--Wapi Rural

District Capital is Menyamya


Subdivisions of Papua New Guinea in local languages (capitals in brackets)
eng: Morobe Province
tpi: Morobe Provins
eng: 9 districts | tpi: 9 distrik: Bulolo; Finschhafen (Gagidu); Huon (Salamaua); Kabwum; Lae; Markham (Kaiapit); Menyamya; Nawae (Boana); Tewae-Siassi (Wasu)
http://www.geonames.de/coupg-sub.html



morobe1.gif

http://www.christianvisionpng.info/page30.htm
 
Last edited:
Re: 70 dead, 800+ hundred affected by mystery illness in Papua New Guinea?s Morobe Province

Re: 70 dead, 800+ hundred affected by mystery illness in Papua New Guinea?s Morobe Province

I cannot help but wonder if any of the locals are in panic mode? That is a very ugly CFR.
 
Re: 70 dead, 800+ hundred affected by mystery illness in Papua New Guinea?s Morobe Province

Re: 70 dead, 800+ hundred affected by mystery illness in Papua New Guinea?s Morobe Province

Untreated cholera or dysentery in Africa has been reported to have CFR as high as 40-60%. That is only ugly if this is flu.
 
Re: 70 dead, 800+ hundred affected by mystery illness in Papua New Guinea?s Morobe Province

Re: 70 dead, 800+ hundred affected by mystery illness in Papua New Guinea?s Morobe Province

Map of Morobe Province.

Menyama district is in lower left hand corner of map
menyamamorobe.gif

KOME ward

households/people/male/female
-Wailala 25 135 73 62

WAPI Ward
households/people/male/female
Akwanja Ward 144 742 362 380
-Wasukwaka 38 189 100 89
-Akwanja 51 258 117 141........is this Akwanda?
-Wiakopa 55 295 145 150.........is this Wawoka?

Villages that poll in Akwanja are Akwanji, Hozei, Topa

There are a huge number of village names and health stats for Morobe district on this document
http://nchsr.arts.unsw.edu.au/pdf%20reports/International/Morobe%20report.pdf



The Evangelical Lutheran Church in Papua New Guinea, ELC-PNG Lutheran Health Services is divided into three main regions: Morobe Province (Lae), Madang Province, and Western Highlands.

ELC-PNG Morobe Province

Hospitals (2): Braun & ETEP

Health Centres (3): LabLab, Mindik, Wagezaring

Sub-Health Centres (8): Kalasa, Kapo, Makini, Tawa, Tent City, Toroa, Yalumet, Zaka

Aid Posts (18): Ampo, Aronai, Asakumdi, Barum, Bibuai, Buang, Buingim, Bumbu, Giam, Heldsbach, Lalang, Logaweng, Lokep, Mabi, Mandok, Masele, Pinaka, Sirasira

Day or Mobile Clinics (2): Menyamya & Aseki

http://www.ghm.org/countries/png.html

http://www.elcpng.org.pg/LHS.htm
 
Re: 70 dead, 800+ hundred affected by mystery illness in Papua New Guinea?s Morobe Province

Re: 70 dead, 800+ hundred affected by mystery illness in Papua New Guinea?s Morobe Province

my concern is that influenza has been reported with dysentery
 
Re: 70 dead, 800+ hundred affected by mystery illness in Papua New Guinea?s Morobe Province

Re: 70 dead, 800+ hundred affected by mystery illness in Papua New Guinea?s Morobe Province

Hawkeye:

Are you thinking that the cause is not influenza, but another dysentery disease, OR that the dysentery is an underlying condition that will mean the H1N1 will become more lethal?

.
 
Re: 70 dead, 800+ hundred affected by mystery illness in Papua New Guinea?s Morobe Province

Re: 70 dead, 800+ hundred affected by mystery illness in Papua New Guinea?s Morobe Province

Well, I don't think there is enough information to know either way. But we should definitely keep an eye on this, but I'm not very hopeful we'll get much more information. As seems to be the case with reports from remote locations, they tend to just disappear from the radar.
 
Re: 70 dead, 800+ hundred affected by mystery illness in Papua New Guinea?s Morobe Province

Re: 70 dead, 800+ hundred affected by mystery illness in Papua New Guinea?s Morobe Province

Do we have enough information to make a general statement that any underlying disease, even temporary illnesses, can exasterbate an H1N1 infection? I would assume the answer is yes, but different underlying conditions may have different relationships with influenza. Perhaps dysentery is a critical underlying condition.

.
 
Re: 70 dead, 800+ hundred affected by mystery illness in Papua New Guinea?s Morobe Province

Re: 70 dead, 800+ hundred affected by mystery illness in Papua New Guinea?s Morobe Province

Latest figures put the death toll at over 70 now.
More medicine cannot be flown in due to poor weather conditions and road deterioration.

Article in the National (Aug 24, 2009).
A mystery disease that 'spreads like wildfire' has killed 29 people in five villages in Morobe's Menyama district since last month. (as you can see in my 'general location map' that Menyama is a very remote part of PNG -actually Menyama is slightly to the West of my highlighted region)
Twelve have died in Akwange, fifteen in Ikunda and one in Lagai, all located in Kome LLG (local Level Government area).
They suffered sever headache, high fever, dysentery, sore throat, running nose and sneezing but the Menyama health centre only had medicines for normal flu.
Bina David (health centre manager) said it needed immediate government action.
Last Monday the Morobe health division officer was sent from Lae. He returned on Wednesday and on Friday a batch of drugs was sent to Menyama and then dispatched to the affected villages.
Mrs David said the roads and communication links in the area were poor and appealed for a specialist team to be stationed at Menyama. She feared more people would be affected.
(I have seen a picture of the main menyama road where the height of the 4WD is lower than the heights of the ruts on either side. The car was like it was driving down a small mud canyon.)

http://lewisinpng.blogspot.com/

map here http://4.bp.blogspot.com/_Zi9vkdB7V...AAgw/IUkIti_mRSw/s1600-h/menyama+location.JPG
 
Re: 70 dead, 800+ hundred affected by mystery illness in Papua New Guinea?s Morobe Province

Re: 70 dead, 800+ hundred affected by mystery illness in Papua New Guinea?s Morobe Province

The word "dysentery" could mean: "diarrhea" , dysentery not used as a diagnosis, but to describe symptoms.
 
Re: 70 dead, 800+ hundred affected by mystery illness in Papua New Guinea?s Morobe Province

Re: 70 dead, 800+ hundred affected by mystery illness in Papua New Guinea?s Morobe Province

The word "dysentery" could mean: "diarrhea" , dysentery not used as a diagnosis, but to describe symptoms.

That is certainly possible. I'm not sure this is all a single illness, though. While influenza (including H1N1) can cause diarrheal symptoms, most fatalities due to influenza are respiratory. While some (but not all) of the articles have mentioned cough as a symptom, none yet have mentioned difficulty breathing (or pneumonia, ARDS, etc.).

The mention of poor weather (storms? floods?) also gives indication that water issues might be involved, which might suggest multiple contaminants. The wide range of symptoms is also very difficult to fit to a single illness.

I also have some problems with some of the reported symptoms. Red eyes might be a sign of hemorrhage, but it is a very unusual way to describe that. The only previous undiagnosed outbreak I have seen that mentioned red eyes was from Uganda, and that turned out to be hepatitis E (which could be the diagnosis here) and the red eyes were the villagers' way of expressing jaundice. Sneezing as a reported symptom is also unusual in this type of report and has (in my experience) been a way of villagers reporting neurological involvment such as seizures.

The repeated mention of influenza in the articles also suggests that the villagers are aware of H1N1 (and maybe H5N1) so that bias might be reflected in the reports. Several other countries in the past four months have reported undiagnosed outbreaks that turned out to be not related to flu, even symptomatically, by invoking H1N1. That might be the case here.

The severe headaches, combined with the possible neurological symptoms might also suggest cerebral malaria. A large outbreak just like this was reported out of PNG about five years ago (I posted the ProMed link above) that was caused by cerebral malaria.

We are a long way from determining what this illness or illnesses are.
 
Re: 70 dead, 800+ hundred affected by mystery illness in Papua New Guinea?s Morobe Province

Re: 70 dead, 800+ hundred affected by mystery illness in Papua New Guinea?s Morobe Province

WAPI Ward
households/people/male/female
Akwanja Ward 144 742 362 380
-Wasukwaka 38 189 100 89
-Akwanja 51 258 117 141........is this Akwanda?
-Wiakopa 55 295 145 150.........is this Wawoka?

Something is inconsistent here. I think you are right in your identification of the villages, but the articles mention over 700 ill in Akwanda. That isn't possible with a total population of 258 in the village. I don't trust the counts here too much at all.
 
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