Infectious disease with life threatening complications and at least 3 deaths reported

[Anne]

Re: Infectious disease with life threatening complications and at least 3 deaths repo

Re: Infectious disease with life threatening complications and at least 3 deaths repo

I m trying to find the location with google map.
It seems to me there is a lot of green at satellite view.
Is there a lot of forest in this region? ( mosquitoes, bats ? )

you said this illness is periodical ? ( 10 years ago.. )

how do your patient feels : after effects?

 

[sharon sanders]

Re: Infectious disease with life threatening complications and at least 3 deaths repo

Re: Infectious disease with life threatening complications and at least 3 deaths repo

Today, Monday EST, I have checked some of the newspapers in the area and did not find any new fever reports.

 

[drjagathv]

Re: Infectious disease with life threatening complications and at least 3 deaths repo

Re: Infectious disease with life threatening complications and at least 3 deaths repo

[/IMG][/IMG]

I m trying to find the location with google map.
It seems to me there is a lot of green at satellite view.
Is there a lot of forest in this region? ( mosquitoes, bats ? )

you said this illness is periodical ? ( 10 years ago.. )

how do your patient feels : after effects?

This area is green, trees found among paddy fields. Mostly villages and small towns found along the main roads.


http://img206.imageshack.us/my.php?image=1kekirawadsc00149yt2.jpg

Kekirawa on 15th January 2008 sunny after heavy rain one week ago


This image shows the reservoir Kalawewa ( Wedge shaped area on the google earth) on 15th January 2008 filled to the maximum capacity http://img179.imageshack.us/my.php?image=8kalawewadsc00143oq9.jpg

 

[drjagathv]

Re: Infectious disease with life threatening complications and at least 3 deaths repo

Re: Infectious disease with life threatening complications and at least 3 deaths repo

Today, Monday EST, I have checked some of the newspapers in the area and did not find any new fever reports.

Thank you very much indeed regarding your update. We did not come across any new patients. Rain has stopped. It is now sunny around the north central province.

http://profile.imageshack.us/user/drjagathv/images/detail/#179/7kalawewadsc00129zy1.jpg

http://img179.imageshack.us/my.php?image=8kalawewadsc00143oq9.jpg

That was the view while traveling over bund of the Kalawewa reservoir in the North central province on 15th January 2008.

 

[sharon sanders]

Re: Infectious disease with life threatening complications and at least 3 deaths repo

Re: Infectious disease with life threatening complications and at least 3 deaths repo

Thank you Dr. Vasanthathilaka. We are monitoring. I will perform another news scan today.


S.

 

[sharon sanders]

Re: Infectious disease with life threatening complications and at least 3 deaths repo

Re: Infectious disease with life threatening complications and at least 3 deaths repo

I am not seeing any new reports of the fever.


S.

 

[drjagathv]

Re: Infectious disease with life threatening complications and at least 3 deaths repo

Re: Infectious disease with life threatening complications and at least 3 deaths repo

I am not seeing any new reports of the fever.


S.

Patient presented to us with fever and pancytopenia has now completely recovered from this illness except for an on and off headache, blood counts have returned to normal. Public health authorities in the affected areas have taken strict preventive measures. Public have been advised not to swim in the rivers in the affected areas. There is no flooding for the last two weeks, and it is sunny. Those patients who died of this febrile illness were otherwise young and healthy individuals, they also had fever weakness and joint pains. They were all residents living near the waterways, no more deaths reported thereafter.

 

[drjagathv]

Re: Infectious disease with life threatening complications and at least 3 deaths repo

Re: Infectious disease with life threatening complications and at least 3 deaths repo

I am not seeing any new reports of the fever.


S.

We visited the area affected and awaiting any new information. Please keep us informed on any new information. We informed the our regular follow up patients to seek immediate medical treatment if the develop any febrile illnesses.
Dr V W Jagath Vasanthathilaka.

 

[drjagathv]

Re: Infectious disease with life threatening complications and at least 3 deaths repo

Re: Infectious disease with life threatening complications and at least 3 deaths repo

We visited the area affected and awaiting any new information. Please keep us informed on any new information. We informed the our regular follow up patients to seek immediate medical treatment if the develop any febrile illnesses.
Dr V W Jagath Vasanthathilaka.

Three weeks after initial reports of fever and 3 deaths, we do not hear about any new case reports of unusual febrile illnesses from that region or elsewhere.

Dr. V W Jagath Vasanthathilaka.

 

[sharon sanders]

Re: Infectious disease with life threatening complications and at least 3 deaths reported

Thank you Dr. Vasanthathilaka for all of your work.

 

[drjagathv]

Re: Infectious disease with life threatening complications and at least 3 deaths reported

New outbreak of an infections disease and four deaths have been reported in the North Central Province of Sri Lanka in March 2008.

Dr V W Jagath Vasanthathilaka
Consultant Rheumatologist.
Teaching Hospital Kandy

 

[drjagathv]

Re: Infectious disease with life threatening complications and at least 3 deaths reported

New outbreak of an infections disease and four deaths have been reported in the North-Central Province of Sri Lanka in March 2008. At least one of the patients reported this time was from the same area which was Galnewa where there were three deaths due to an unidentified illness during the period of December 2007 and January 2008. Whether it is the same illness or is it a different infectious disease still remains to be seen. However, we have not come across any new patients with an unusual fever and joint pains in an around Kandy in the Central Province so far.

Dr. V. W. Jagath Vasanthathilaka
Consultant Rheumatologist.
Teaching Hospital Kandy

 

[Shiloh]

Re: Infectious disease with life threatening complications and at least 3 deaths reported

Could it be as follows?:

No "Mystery" illness in A'pura - Health Ministry

Nadira Gunatilleke

Healthcare and Nutrition Ministry has rejected news reports of a "mysterious" illness sweeping the Anuradhapura area saying the disease has been detected as Dengue and Chikungunya."It is dengue and Chikungunya and not a mysterious disease stated by some media", Healthcare and Nutrition Ministry spokesman said.

The spokesman said that Dengue and Chikungunya hit Padaviya, Welioya and the front lines of the Armed Forces and these two diseases are rarely reported from villages and other areas of the district.

According to the findings of the two special teams dispatched by the Epidemiology Unit, the main cause of the rapid increase of Dengue and Chikungunya is empty artillery casings (shelves) and spent bullets used by armed forces during attacks.

According to the team these empty artillery casings and spent bullets harbour rainwater making ideal places for mosquito breeding.

Most of the affected persons are members of the armed forces. Instructions have already been given to dispose these empty artillery casings and spent bullets in order to avoid mosquito breeding, he said.

The Medical Research Institute (MRI) is now testing blood samples of the members of the Armed Forces and there are about 300 Dengue and Chikungunya patients reported from the Anuradhapura hospital so far. Steps have been taken to provide the victims all required treatment and care. At a later stage Dengue can advance into Dengue Haemorrhagic Fever with various other symptoms.
Source: http://www.dailynews.lk/2008/03/28/news21.asp

 

[drjagathv]

Re: Infectious disease with life threatening complications and at least 3 deaths reported

This could well be dengue fever or any other form of a viral fever. It is up to the clinicians and the medical officers of health in the north central province to clarify all doubts and confirm diagnosis in order to arrange appropriate preventive measures. Dengue and Chikungunya fever are prevalent in the Kandy district as well. At least one of the patients presented to Kandy Hospital from Galnewa in January was repeatedly negative for Dengue antibodies and Chikungunya antibody tests and the presentation was totally different from dengue fever and Chikungunya fever. It is always worth investigating for other possible infectious diseases found among large number of patients presented to us with fever during these days rather than attributing all deaths to unconfirmed dengue fever. It is important be alert to the possibility of detecting other forms of infections diseases amoung patients presenting with joint pains and fever among suspected patients with dengue fever. Presence of dengue and chikungunya is well known and the clinicians are clearly aware of the problem, we will have to stress the importance of detecting emerging new infections and this whole exercise is to be alert to the possibility of piking up unusual and new forms of illnesses among our population. Problem of attributing all undiagnosed deaths due to infections to a particular known diseases without proper investigations is that newly emerging infections and new threats will be completely ignored and appropriate precautions would not be taken in time in order to prevent dissemination of such disorders.

Dr. V . W . Jagath Vasanthathilaka.

Consultant Rheumatologist
Teaching Hospital Kandy

 

[drjagathv]

Re: Infectious disease with life threatening complications and at least 3 deaths reported

This could well be dengue fever or any other form of a viral fever. It is up to the clinicians and the medical officers of health in the north central province to clarify all doubts and confirm diagnosis in order to arrange appropriate preventive measures. Dengue and Chikungunya fever are prevalent in the Kandy district as well. At least one of the patients presented to Kandy Hospital from Galnewa in January was repeatedly negative for Dengue antibodies and Chikungunya antibody tests and the presentation was totally different from dengue fever and Chikungunya fever. It is always worth investigating for other possible infectious diseases found among large number of patients presented to us with fever during these days rather than attributing all deaths to unconfirmed dengue fever. It is important be alert to the possibility of detecting other forms of infections diseases amoung patients presenting with joint pains and fever among suspected patients with dengue fever. Presence of dengue and chikungunya is well known and the clinicians are clearly aware of the problem, we will have to stress the importance of detecting emerging new infections and this whole exercise is to be alert to the possibility of piking up unusual and new forms of illnesses among our population. Problem of attributing all undiagnosed deaths due to infections to a particular known diseases without proper investigations is that newly emerging infections and new threats will be completely ignored and appropriate precautions would not be taken in time in order to prevent dissemination of such disorders.

Dr. V . W . Jagath Vasanthathilaka.

Consultant Rheumatologist
Teaching Hospital Kandy

One of the best examples for detection of other illnesses amoung patients with Dengue fever and Chikungunya was that we encountered few patients with Murine typhus, in and around Kandy among those patients with fever where the treatment and the approach for preventive measures are totally different from that of mosquito borne illnesses.

 

[Malcolm]

Re: Infectious disease with life threatening complications and at least 3 deaths reported

Thank you, Dr. Vasanthathilaka. Your contributions are very valuable.

Best regards,

Malcolm

This could well be dengue fever or any other form of a viral fever. It is up to the clinicians and the medical officers of health in the north central province to clarify all doubts and confirm diagnosis in order to arrange appropriate preventive measures. Dengue and Chikungunya fever are prevalent in the Kandy district as well. At least one of the patients presented to Kandy Hospital from Galnewa in January was repeatedly negative for Dengue antibodies and Chikungunya antibody tests and the presentation was totally different from dengue fever and Chikungunya fever. It is always worth investigating for other possible infectious diseases found among large number of patients presented to us with fever during these days rather than attributing all deaths to unconfirmed dengue fever. It is important be alert to the possibility of detecting other forms of infections diseases amoung patients presenting with joint pains and fever among suspected patients with dengue fever. Presence of dengue and chikungunya is well known and the clinicians are clearly aware of the problem, we will have to stress the importance of detecting emerging new infections and this whole exercise is to be alert to the possibility of piking up unusual and new forms of illnesses among our population. Problem of attributing all undiagnosed deaths due to infections to a particular known diseases without proper investigations is that newly emerging infections and new threats will be completely ignored and appropriate precautions would not be taken in time in order to prevent dissemination of such disorders.

Dr. V . W . Jagath Vasanthathilaka.

Consultant Rheumatologist
Teaching Hospital Kandy

 

[sharon sanders]

Re: Infectious disease with life threatening complications and at least 3 deaths reported

<table id="apex_layout_271110100662109808" class="formlayout" summary=""><tbody><tr><td align="right" nowrap="nowrap">Archive Number</td> <td colspan="1" rowspan="1" align="left" nowrap="nowrap">20080328.1154</td></tr><tr><td align="right" nowrap="nowrap">Published Date</td> <td colspan="1" rowspan="1" align="left" nowrap="nowrap">28-MAR-2008</td></tr><tr><td align="right" nowrap="nowrap">Subject</td> <td colspan="1" rowspan="1" align="left" nowrap="nowrap">PRO/AH/EDR> Undiagnosed deaths - Sri Lanka (North Central): RFI</td></tr> </tbody></table>
UNDIAGNOSED DEATHS - SRI LANKA (NORTH CENTRAL), 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: 27 Mar 2008
Source: The Mirror [edited]
<http://www.dailymirror.lk/DM_BLOG/Sections/frmNewsDetailView.aspx?ARTID=10291>


Four die of mysterious disease
----------------------
Four persons have died last week [week of 17 Mar 2008] at the
Anuradhapura Teaching Hospital due to an unidentified disease, doctors said.

Judicial Medical Officer (JMO) of the Anuradhapura hospital Dr. Ajith
Jayasena told the Daily Mirror that investigations are underway by
the hospital authorities to ascertain whether this was an infectious
viral disease

Three males and a female from Welioya, Maradankadawala and Galnewa
have died on 3 successive days last week at the hospital and the JMO
has cited the malfunctioning of several organic systems of the
patients as the cause of death.

Some soldiers were admitted to the hospital last week and doctors
suspect that the same virus had attacked them.

Tissue specimens extracted from lungs and hearts of the dead persons
are to be examined to ascertain the nature of the disease, Dr. Jayasena said.

[Byline: Rohana Chandradasa]

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

[The Anuradhapura Teaching Hospital is the main hospital in the North
Central region and the 3rd largest hospital in Sri Lanka. Over 1.3
million people reside in the Anuradhapura District and the adjoining
districts of Vavuniya, Mannar, Trincomalee and Puttalam where
healthcare facilities are comparatively poor.
(<http://www.news.lk/index.php?option=com_content&task=view&id=5123&Itemid=44>)

The above newswire does not provide sufficient clinical details for
this moderator to venture speculations as to the possible etiology of
these fatal cases. While there is mention that there is multiple
organ failure, the newswire does mention that hearts and lungs are
being examined. There is also mention that soldiers have been
admitted with similar illness but non-fatal.

Of note, in 2005, ProMED-mail had a series of postings on an
undiagnosed cardiomyopathy/myocarditis in Badulla and Monaragala
districts, Uva province of Sri Lanka. (see prior postings referenced
below). A review of the literature reveals that the etiology of that
outbreak was dengue fever with cardiac manifestations. (see
Kularatnea SAM, Pathiragea MMK, Kumarasirib PVR, Gunasenac
S, Mahindawansea SI. Cardiac complications of a dengue fever
outbreak in Sri Lanka, 2005. Trans. Royal Soc Trop Med
Hygiene. August 2007. 101(8):804-808. abstract available at:
<http://www.sciencedirect.com/scienc...serid=10&md5=69091cb721989874be3513fcea69f938>).
One can't help but wonder if the deaths and non-fatal cases mentioned
in the above newswire might be a repeat of the 2005 experience with
dengue fever.

More information on the above mentioned outbreak with details on the
epidemiologic investigations as well as pathology findings would be
greatly appreciated.

For a detailed map of Sri Lanka see
<http://www.un.org/Depts/Cartographic/map/profile/srilanka.pdf>.
Welioya, Maradankadawala and Galnewa are located to the south of
Anuradhapura city (see maps linkable at
<http://www.bhoomi.lk/srilanka_cities_in-north_central_province-6-W.aspx#>
<http://www.bhoomi.lk/srilanka_cities_in-north_central_province-6-M.aspx> and
<http://www.bhoomi.lk/srilanka_cities_in-north_central_province-6-G.aspx#>).

- Mod. MPP]
</pre>