Cholera Outbreak in Papua New Guinea?s Morobe Province

[Rwilmer]

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 feeling here is that there is a bunch of different diseases at work here.

 

[alert]

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 think you're probably right. Cholera is definitely there. The "dysentery" might really be cholera as well, but could also be bacterial dysentery (i.e. E. coli, Shigella, etc.)

The one that concerns us most is the flu-like illness that has killed at least 27 people, mostly in one village, and infected 1800-2000 people across Morobe.

 

[Shannon Bennett]

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 believe Alert is correct here. Cholera is changing to have symptoms that are more flu-like, not mixing with the flu or, genetically becoming a flu virus or, able to swap genes with a flu virus.

 

[alert]

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

Here's what is odd, and in my opinion the most worrying. Both the dysentery and influenza outbreak appear to be centered on the same village. That's unusual, especially because it is not a particularly large village. Statistically, even if the same province was to be hit by simultaneous outbreaks, they are not likely to be centered on the same village.

If the cholera had not been confirmed elsewhere, and the case counts having risen so high (2000 already) I would be starting to think this is a novel agent with symptoms including both diarrhea and flu-like symptoms. Flu-like symptoms plus diarrhea to the point of fatal dehydration is often the symptoms reported in Africa in VHF outbreaks in remote villages. But VHF wouldn't cause 2000 cases in under a month, no matter what bizarre circumstances were going on. 2000 cases in one month almost has to be some kind of flu.

And also of note is that there is no report yet of a patient with both illnesses, something that almost everyone would have in the single agent case. It is possible that the cause could be something that produces different syndromes depending on whether it is inhaled or ingested (something like anthrax or plague comes to mind, although neither is likely here - the fatality rate is too low for either illness).

 

[Snowy Owl]

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 will let Sally who is from new Zealand respond.

Snowy

 

[sharon sanders]

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

News and pertinent information on the news threads please.

Discussion in the discussion forum.


Thanks!

 

[Jeremy]

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

http://www.rnzi.com/pages/news.php?op=read&id=48813

Posted at 23:38 on 31 August, 2009 UTC
The World Health Organisation says Papua New Guinea’s health system has only a limited capacity to cope with an outbreak of cholera, that’s killed at least five people.

A WHO medical team has just returned from coastal villages in Morobe Province where more than 80 people have contracted the waterborne disease.

It comes as health authorities are dealing with a separate outbreak of dysentry and influenza that’s killed at least 48 people.

The WHO’s representative in PNG, Dr Eigel Sorenson says the outbreak is unusual because cholera has not occurred in the country in more than 40 years.

He says the WHO is providing technical support, but managing the diseases will be an issue because of the weakness in the country’s health care system

“Health services in general in Papua New Guinea are not very strong, and particularly in rural areas. A cholera outbreak is a major concern, their capacity to deal with this, when it comes to communicable disease control I think there is limited capacity within the country.”
​

Dr Sorenson says the difficult terrain in PNG makes it more challenging and costly to treat people.

 

[hawkeye]

Re: Breaking: PNG Death toll at 177

Re: Breaking: PNG Death toll at 177

Alert, if I recall correctly, the 212 deaths are from three villages, but I'm concerned that the CFR is ~9%

http://www.flutrackers.com/forum/showpost.php?p=287249&postcount=28


The lastest poste from Treyfish isn't promising either. Authorities are clearly drawing lines between the outbreaks. i find this particularly interesting.

A little quick math: 27 deaths due to flu in about 1,800 cases (2,000 total - 212 dysentery) is a 1.5% CFR so far, for what its worth. Without knowing how many have recovered and how many are still ill, we cannot compute a true CFR. This appears to be well within the range of any influenza, either seasonal, pandemic, bird, or novel.

 

[alert]

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

Alert, if I recall correctly, the 212 deaths are from three villages, but I'm concerned that the CFR is ~9%

Sorry if my calculation wasn't clear. I was subtracting the 212 cases (there aren't 212 deaths - I hope) of dysentery from the total number (across all 12 villages, not just the one) of 2000 illnesses, to get 1,800 cases of flu. Then dividing the 27 supposed flu deaths by the 1,800 flu cases to get a flu CFR of 1.5%. That is my lower bound on this one.

As an upper bound, note that some reports have indicated 40+ deaths in Akawanda (sp?) a village of supposedly 258 residents, for a CFR of over 15%, even if the entire village is ill.

And as far as lines between the outbreaks, that seems obvious, but a bit bizarre. They do seem to think the cholera, dysentery, and flu outbreaks are three separate etiologies, but the last two are centered in the same village, which is EXCEEDINGLY odd.

 

[Rwilmer]

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

Over 100 die from illnesses
Tue, 01/09/2009 - 09:02 | mlipen
Source:
PISAI GUMAR
THE death toll from influenza and dysentery in Menyamya district and cholera in Tewai-Siassi district of Morobe province has gone past 100 with fears that the figure could be higher as medical teams return to Lae today with updated figures.The worst affected mountainous area of Menyamya, in which the villages of Watama, Kataya, Wawaka, Akwanja and Ikumdi are located, is at the border of Morobe and Gulf provinces.
So far, the medical teams there had tallied 102 deaths from the Lagai village, Tamoi, Zipa, Kaingye, Anzua, Awapango, Angaibu, and Akwange.
In the village of Akwange, in which more than 27 people had died, about 200 villagers had been infected.
At Kwaplalim village, no deaths were reported but 109 people were diagnosed and were admitted to the Kwaplalim health centre.
Medical assistance was delivered since last Thursday by the World Health Organisation (WHO) and the Health Department with provincial officers who flew into the area.
According to Kome LLG manager Desmond Timiyaso, the specialists flew direct to Akwange and Ikumdi villages and took specimens of the disease.
Additional medical supplies were received in Menyamya on Saturday.
Mr Timiyaso said the outbreak was placing a strain on the meagre staffing levels of the district.
Officers from other departments were being roped in to assist the medical teams, Mr Timiyaso added.

The separate outbreak of cholera in Tewai-Siassi on the northwest coast of the province had killed seven adults and sickened 73 other people, provincial health adviser Theo Likei told AFP news agency yesterday.
But Health Minister Sasa Zibe, who confirmed the outbreak at the weekend, put the death toll at more than 40, saying he had directed health officials to immediately contain its spread.
However, Nambariva village councillor Tom Less told The National yesterday that four people were confirmed dead out of 70 people admitted to Etep Health Centre in Wasu.
According to Cr Less and Wasu High School teacher Jerry Nema, 45 people from Nambariva and 27 from Lambutina were admitted.
The disease had started to spread to the Gitua at the Sialum council area, he said.
Cr Less said that according to 10 specimens received by the three WHO specialists, four were confirmed with having cholera.
He said two boatloads of medical supplies were sent into the area to treat the patients.
This is the first time cholera has officially been confirmed in PNG.

http://www.thenational.com.pg/?q=node/269

 

[Rwilmer]

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

Sally you are in new zealand, do you have any additional info on this outreak?

 

[Sally Furniss]

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

http://www.straitstimes.com/Breaking+News/World/Story/STIStory_423655.html

Aug 31, 2009
47 dead, 2,000 ill from disease

PORT MORESBY - TWIN outbreaks of a mystery flu and dysentery in a remote region of Papua New Guinea have killed 47 people and infected another 2,000 villagers, a senior medical official said on Monday.

WORRIED local health officials warned that the dual outbreak of illness was proving difficult to control as the eruption was in an isolated area some eight hours' rough drive from PNG's second city of Lae.

'The problem is that once it gets started in remote areas it's very hard to stop and the area is hard to reach, but we are hoping the illness will remain isolated to pockets of the area so we can manage it,' Mr Likei said. 'This is the worst such crisis we have seen here. The situation is not that encouraging as of today but we will monitor closely over the next two days or so and hope it comes under control.'
... more
And a separate eruption of cholera in the Pacific island nation has killed seven adults and sickened 73 other people, provincial health adviser Theo Likei told AFP.

Twenty-seven villagers in the Menyamya district of Morobe province, on the northeast coast, have died from an as-yet unidentified influenza since August 3, while a further 20 were felled by dysentery.

'Roughly 2,000 people are sick in about 12 villages and we suspect influenza and dysentery are the cause,' Mr Likei told AFP.

'So far there have been about 47 deaths, about 90 per cent of them in the village of Akwanda,' where 95 per cent of the reported flu and dysentery infections were reported.

It was not immediately known whether the flu-like illness was H1N1 flu or another strain. The World Health Organization has taken samples from stricken villages and test results could be available within days, a WHO official said.

'We cannot rule out swine flu at the moment but the outbreak is in a remote area, which would be a little surprising if it is H1N1 (swine flu)', said the WHO representative in PNG, Eigil Sorensen.

'But the number of sick and fatalities are certainly higher than normal so we take both of these outbreaks seriously,' he told AFP.

Papua New Guinea has reported around 10 cases of swine flu but they were traced back and appeared to have been imported into the country, Mr Sorensen said. -- AFP

This news report is muddling the dysentery/flu reports in Menyamya with the location of the cholera outbreak in Wasu.

See this map of Morobe province Attachment 4030
Menyama is in the west in a highland area. Wasu, the area affected by cholera is on the north east coast in the Finschhafen District

This map pinpoints Wasu on the coast relatively near Finschhafen town
http://www.flutrackers.com/forum/showpost.php?p=288114&postcount=67

 

[Gert van der Hoek]

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

Let's try to stick to reporting in this thread , may be with short comments.

Discussion and speculation may be best in this thread:

http://www.flutrackers.com/forum/showthread.php?t=123555

 

[Sally Furniss]

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 Dutchy!

 

[Roehl_JC]

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

80 now thought dead from influenza/dysentery and 7 confirmed dead from cholera in PNG

87 now dead in two separate outbreaks of disease in PNG?s Morobe Province
Posted at 06:02 on 01 September, 2009 UTC

The death toll in Papua New Guinea has soared with eighty people now dead from either influenza and dysentery in rural villages in Morobe province.

In a separate cholera outbreak in two coastal villages in the province, another person has died from the waterborne disease bringing the total dead there to seven.

The provincial health advisor Dr Theo Likei says further medical teams are flying in to help combat the hundreds of others suffering from the illnesses.

?Two thousand plus would be from influenza and three hundred plus are from dysentery. And out of those cases you would be looking at about three thousand or so cases if you add dysentery and influenza together. And out of that we have eighty deaths reported so far.?
Dr Likei says the strain of influenza is unknown at this stage but he hopes to have results back from samples by the end of the week.

Dr Likei says help from the World Health Organisation and the Red Cross has been accepted and a decision will be made in a few days about requesting further outside assistance.

News Content ? Radio New Zealand International
PO Box 123, Wellington, New Zealand

http://www.rnzi.com/pages/news.php?op=read&id=48825

 

[Treyfish]

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

Updated at 8:38pm on 1 September 2009
Papua New Guinea has accepted international help following outbreaks of influenza, dysentery and cholera which have claimed nearly 90 lives.
The death toll from influenza and dysentery has soared, with at least 80 people now dead in rural villages in the province of Morobe, Radio New Zealand International reports.
The province is also coping with its first cholera outbreak in 40 years. The death toll stands at seven on Tuesday.
Provincial health adviser Theo Likei says extra medical teams are being flown in to help treat hundreds of others suffering from the illnesses.
Dr Likei says help from the World Health Organisation and the Red Cross has been accepted and a decision will be made in a few days about requesting further outside assistance.:tiphat:http://www.radionz.co.nz/news/stories/2009/09/01/1245c707854b

 

[Treyfish]

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

Remote area of PNG struck by outbreak

Firmin Nanol-Port Moresby
Last Updated: 18 hours 17 minutes ago

An outbreak of cholera, dysentery and an unidentified influenza-like disease has so far claimed more than 87 lives in Papua New Guinea's Morobe province in the past month.

Seven people have reportedly died of cholera in the remote Tewai-Siassi District of Morobe, the first known cases in PNG in up to 50 years.

Another 80 people have died of a dysentery and influenza-like disease in the Menyamya district.

The Morobe provincial health adviser Dr Theo Likei says both districts are very remote with no proper health facilities and road links.

He says there is no clean drinking water and personal hygiene is lacking.

''We have engaged our health team there right they are right at the site of the problem. They are providing medicines for the sick ones and also conducting awareness on the personal hygiene,'' he said.

Looking for causes


Both the PNG Government and World Health Organisation officials are investigating the causes of the outbreak.

Cholera expert, Clare-Lise Chaignat says it is unlikely a traveller brought the illness to PNG and it may have been transmitted through food, such as shell fish.

She has told Radio Australia's Pacific Beat program the outbreak has been contained and health authorities are attempting to ensure villagers have access to uncontaminated water.

"The Government has put in place already a lot of control measures, and what is important is to have a continued surveillance system and active surveillance system so that cases can be traced," she said.

"That is the best way to see how and whom we have to address with control measures.":tiphat:http://australianetworknews.com/stories/200909/2673543.htm?desktop

 

[Treyfish]

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

Cause of PNG cholera outbreak still unknown

PHOTO

AUDIO from Pacific Beat

PNG cholera outbreak
Audio not operating

Created: 12 hours 31 minutes ago


Geraldine Coutts
Last Updated: Tue, 01 Sep 2009 03:17:00 -0400
The World Health Organisation says it's not clear what caused an outbreak of cholera which has killed more than 40 people in a remote part of Papua New Guinea.
Government officials say hundreds of other villagers in Morobe Province have also fallen ill and cholera is suspected to be the cause in at least some of those patients.
Cholera expert, Clare-Lise Chaignat says it is unlikely a traveller brought the illness to PNG and it may have been transmitted through food, such as shell fish.

Tracing the origin


She has told Radio Australia's Pacific Beat program the outbreak has been contained and health authorities are attempting to ensure villagers have access to uncontaminated water.
"The Government has put in place already a lot of control measures, and what is important is to have a continued surveillance system and active surveillance system so that cases can be traced," she said.
"That is the best way to see how and whom we have to address with control measures.":tiphat:http://australianetworknews.com/story.htm?id=21288

 

[Treyfish]

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

01 September 2009

Cholera returns to PNG with a vengeance

<?XML:NAMESPACE PREFIX = O /><O:SMARTTAGTYPE name="PlaceType" namespaceuri="urn:schemas-microsoft-comffice:smarttags"></O:SMARTTAGTYPE><O:SMARTTAGTYPE name="PlaceName" namespaceuri="urn:schemas-microsoft-comffice:smarttags"></O:SMARTTAGTYPE><O:SMARTTAGTYPE name="place" namespaceuri="urn:schemas-microsoft-comffice:smarttags"></O:SMARTTAGTYPE>BY ILYA GRIDNEFF<O></O>
An outbreak of cholera is being blamed for the deaths of up to 41 villagers in <?XML:NAMESPACE PREFIX = ST1 /><ST1LACE w:st="on"><ST1LACENAME w:st="on">Morobe</ST1LACENAME> <ST1LACETYPE w:st="on">Province</ST1LACETYPE></ST1LACE>.<O></O>
Scores of other unexplained deaths are expected to be either cholera or swine flu, PNG Health Department Secretary Dr Clement Malau told AAP.<O></O>
"There has been two outbreaks in two different parts of the <ST1LACE w:st="on"><ST1LACENAME w:st="on">Morobe</ST1LACENAME> <ST1LACETYPE w:st="on">Province</ST1LACETYPE></ST1LACE>, Menyamia and Wasu. We've confirmed cholera in Wasu and are trying to assess whether the other disease is swine flu or an influenza strain," he said.<O></O>
"We are very concerned and hope cholera hasn't established itself in PNG as it would be another great burden to an already strained health system,"<O></O>
PNG health officials had been receiving information about a mystery illness causing havoc in Morobe for the past month.<O></O>
PNG?s last case of cholera occurred in the 1960s. It is thought the disease originated in marine life.<O></O>
The PNG Government has reported the disease to the World Health organisation as required under international health regulations.:tiphat:http://asopa.typepad.com/asopa_people/<O></O>

 

[Treyfish]

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

Tuesday, September 1, 2009


7} WHO says PNG health system limited to cope with cholera outbreak

The World Health Organisation says Papua New Guinea?s health system has only a limited capacity to cope with an outbreak of cholera, that?s killed at least five people.
A WHO medical team has just returned from coastal villages in Morobe Province where more than 80 people have contracted the waterborne disease.
It comes as health authorities are dealing with a separate outbreak of dysentry and influenza that?s killed at least 48 people.
The WHO?s representative in PNG, Dr Eigel Sorenson says the outbreak is unusual because cholera has not occurred in the country in more than 40 years.
He says the WHO is providing technical support, but managing the diseases will be an issue because of the weakness in the country?s health care system
?Health services in general in Papua New Guinea are not very strong, and particularly in rural areas. A cholera outbreak is a major concern, their capacity to deal with this, when it comes to communicable disease control I think there is limited capacity within the country.?
Dr Sorenson says the difficult terrain in PNG makes it more challenging and costly to treat people. {RNZ}:tiphat:http://philippe-voiceofmelanesia-ph.../7-who-says-png-health-system-limited-to.html