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Pakistan-Mysterious disease strikes children

Treyfish

Moderator
20091205_e05.jpg
By Amar Guriro

Saturday, December 05, 2009
KARACHI: A strange disease has spread in the coastal belt of Karachi paralysing the lower limbs and some times the arms and other body parts of the victims, the majority of whom are children.

Earlier, there was an outbreak of a similar disease in Achhro Thar (White Desert) of district Sanghar and other areas of the Tharparkar desert. Now this disease has taken its toll in the Rehri Myan Goth in Bin Qasim Town, where office-bearers of the Pakistan Fisher Folk Forum (PFF) claim that there are about 200 victims, most of them children.

The residents of the area told this scribe that the victims of the disease are first afflicted with fever for a few days and then their lower limbs and sometimes the arms and other body parts are completely paralysed. Though this disease remains unidentified, geologists contend that it is caused due to the consumption of fluoride-contaminated underground water. Experts have also expressed fear that the disease could engulf the entire coast of Sindh. The victims mostly blood-related, and in some cases, there are around six patients in the same family.

Muhammad Hussain, a resident of Rehri village, is a fisherman who has braved many cyclones in the Arabian Sea during his fishing voyages, but is completely helpless to do anything for his four children, who have been paralysed. His three sons, Nazir, Dilbar and Mubarak, and a daughter Hajira, were normal, but they suddenly feel victim to the disease.

?My first child developed a fever one day and within a week, he was paralysed,? he said narrating his woes. ?First we thought it?s weakness due to the fever, but later we realised his lower limbs were paralysed.? He took his children to several doctors and also sought the help of faith healers, but all went in vein. Sami Memon of the PFF said his organisation has compiled a list of the victims? names and most of them are children. ?We have a list of about 173 children affected by this disease, but there are several other victims whose names we could not collect,? he said.

According to the PFF list, some of the victims include fisherman Esa, who is suffering the same ailments following the paralysis of his four daughters Fatima, Sheraan, Bhaan and Ameer Bano; Aamnat, daughter of Ismail; Hyder Ali, son of Allah Dino; Ibrahim, son of Mehmood; Hussain, son of Hassan Ali; Nazia, daughter of Ali Hussain, Mohammad Noor?s son Moosa and daughters Hawa and Nadia; Hakeem, son of Abdullah; Azam, son of Umar; Usman, son of Ismail, and Abdul Hussain, son of Ahmed Ali.

When this scribe contacted Sindh Health Minister Dr Sagheer Ahmed for his comments on this issue, he was not available, however his PRO said the issue does not come under the jurisdiction of the provincial health department, and the CDGK EDO (health) might be the right man to contact. When this scribe asked him how this matter that concerns the lives of so many children does not come under the jurisdiction of the Sindh government, he suggested contacting the provincial health secretary.

But that proved to be anything but useful as Sindh Health Secretary Hashim Raza Zaidi simply refused to comment on the issue. This wasn?t surprising since the health department avoiding talking to media personnel over such issues has become a routine practice. CDGK Health Group of Offices Executive District Officer Attur Das Sanjnani claimed that the issue was nothing more than media-created hype. ?There are just four children of a family residing in Ibrahim Hyderi whose lower limbs have been paralysed,? he said.

?We have conducted a complete survey of these areas and found that the disease is hereditary and for such diseases, there is no treatment even in advanced countries.? The residents of the area told this scribe that since the creation of Pakistan, the people living in the coastal belt of the city are yet to receive basic facilities such as healthcare, educational institutes and above all drinking water supply schemes.

?Most of the residents of Ibrahim Hyderi, Rehri Goth and others areas of the coastal belt of the city are consuming the underground water, but no one knows about the quality of this water,? said PFF?s Sami Memon.

?It could possibly be the increasing level of fluoride in the underground water that has caused this mysterious disease,?:magnify: said renowned geologist and faculty member of the Department of Geology, University of Karachi, Prof Dr Shahid Naseem. Dr Naseem has visited about 400 small villages of district Umerkot and other parts of Tharparkar to acquire water samples for laboratory testing.

According to his findings, the underground water had high levels of fluoride. Earlier, this scribe reported the outbreak of a similar disease in Achhro Thar in district Sanghar where around 17 people had dead in only one village and several others were paralysed.

?The disease has not only spread in Karachi, but perhaps spread along the entire coast of the province and also in Balochistan up to Iran, as we have received reports of the same disease affecting people in Quetta and a small village on the Iranian border,? Dr Naseem said.

?We have to conduct a detailed survey of the coastline to learn more about this disease.? Dr Naseem said arsenic contamination was first reported in Punjab, but now the problem has moved on to Sindh. ?The contamination of underground water with both arsenic and fluoride could possibly be the cause of this disease, but only a detailed survey can confirm this,? he said.:tiphat:http://www.dailytimes.com.pk/default.asp?page=2009\12\05\story_5-12-2009_pg12_1
 
Re: Pakistan-Mysterious disease strikes children in coastal areas of city

Re: Pakistan-Mysterious disease strikes children in coastal areas of city

http://www.flutrackers.com/forum/showthread.php?p=325770

I believe this is the same "outbreak" mentioned in this thread, especially the same mention of 173 cases. It seems unclear what the cause of this is, as both articles seem to attribute this to several causes, including birth defects, known diseases, poisoning, and unknown illnesses.
 
Re: Pakistan-Mysterious disease strikes children in coastal areas of city

Re: Pakistan-Mysterious disease strikes children in coastal areas of city

Sounds like some of the cases could be viral.

?My first child developed a fever one day and within a week, he was paralysed,? he said narrating his woes.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1804272/
BMC Infect Dis. 2007; 7: 6.
Published online 2007 February 15. doi: 10.1186/1471-2334-7-6.

PMCID: PMC1804272
Epidemiology and clinical findings associated with enteroviral acute flaccid paralysis in Pakistan

Background
Enteroviruses are among the most common viruses infecting humans worldwide and they are associated with diverse clinical syndromes. Acute flaccid paralysis (AFP) is a clinical manifestation of enteroviral neuropathy, transverse myelitis, Guillian-Barre Syndrome, Traumatic neuritis and many other nervous system disorders. The objective of this study was to understand the role of Non-Polio Enteroviruses (NPEV) towards this crippling disorder.
Methods
Stool specimens of 1775 children, aged less than 15 years, suffering from acute flaccid paralysis were collected after informed consent within 14 days of onset of symptoms during January 2003 to September 2003. The specimens were inoculated on RD and L20B cells using conventional tube cell culture while micro-neutralization test was used to identify the non-polio enterovirus (NPEV) serotypes. Detailed clinical information and 60-days follow-up reports were analyzed for NPEV-associated AFP cases.
Results
NPEV were isolated from 474 samples. The male to female ratio was 1.4:1. The isolation of NPEV decreased significantly with the increase in age. Cases associated with fever at the onset of NPEV-associated AFP were found to be 62%. The paralysis was found asymmetrical in 67% cases, the progression of paralysis to peak within 4 days was found in 72% cases and residual paralysis after 60 days of paralysis onset was observed in 39% cases associated with NPEV. A clinical diagnosis of Guillian-Barre syndrome was made in 32% cases. On Microneutralization assay, echo-6 (13%) and coxsackievirus B (13%) were the most commonly isolated serotypes of NPEV along with E-7, E-13, E-11, E-4 and E-30. The isolates (n = 181) found untypable by the antiserum pools were confirmed as NPEV by PCR using Pan-Enterovirus primers.
Conclusion
The present study suggests that NPEV are a dominant cause of AFP and different serotypes of NPEV are randomly distributed in Pakistan. The untypable isolates need further characterization and analysis in order to determine their association with clinical presentation of a case.


And since the area affected is coastal, I was wondering about the calicivirus since I was just reading about that. They can cause paralysis in some animals and the CDC views the feline calicivirus which also infects marine mammals as a possible zoonotic.
Calicivirus Emergence from Ocean Reservoirs: Zoonotic and Interspecies Movements
http://www.cdc.gov/ncidod/eid/vol4no1/smith.htm
 
Re: Pakistan-Mysterious disease strikes children in coastal areas of city

Re: Pakistan-Mysterious disease strikes children in coastal areas of city

I think its the old "several illnesses" bit. Some of it might be polio (which is viral, and is what you are looking for with AFP surveillance), soe is likely due to other enteroviruses, some is likely typhoid, some might be birth defects, and some might be toxins.
 
Re: Pakistan-Mysterious disease strikes children in coastal areas of city

Re: Pakistan-Mysterious disease strikes children in coastal areas of city

But apparently the WHO is investigating.

http://www.dailytimes.com.pk/default.asp?page=2009\12\06\story_6-12-2009_pg12_12

WHO team visits Rehri affected with mysterious disease

By Amar Guriro

KARACHI: A three-member team of the World Health Organisation (WHO), headed by Dr Soomar Khoso, visited the homes of the children suffering from paralysis of the lower limbs, after the news of a strange disease affecting the people of Rehri Myan Goth in Bin Qasim Town.

Though the Sindh government has not taken any action yet, the news has spread like wildfire and a WHO team rushed to the area to meet with the families of the children.

Talking to this scribe, one of the WHO members disclosed that they were not allowed to talk to the media. However, confirming the authenticity of the news, the WHO official was unable to give an estimated number of victims suffering from the disease.

?We have met the families, taken firsthand knowledge of the victims and would send the reports to Islamabad so that WHO could plan better treatment of the victims,? said the official and added, ?I feel the disease could have resulted from pregnant women not getting quality healthcare and being deprived of nutrition and potable water, but only the final report would be able to shed proper light on the situation.?

However, water experts said fluoride and arsenic contamination could be a possible reason of
this disease.

Daily Times had previously reported that a mysterious disease had gripped the coastal belt of the city whereby 200 people, majority of them children, had been affected with paralysis of the lower limb.

On contact, Provincial Health Minister Dr Sagheer Ahmed said he had no knowledge of the situation, adding that he would call a press conference on the issue after talking with the officials of the concerned departments. However, until the filing of this report, he was unavailable for further comment.

Earlier, the minister?s PRO had claimed the issue did not come under the jurisdiction of the provincial health ministry, suggesting contacting the health department of the City District Government Karachi.

When contacted, Adviser to Sindh Chief Minister Sharmila Farooqi said that after coming to know about the situation through the media, she had visited the affected area and constituted a committee, headed by Provincial Secretary Health Hashim Zaidi, who would visit the area on Monday.

The vast coastal belt of the city, where historical settlements are located, are deprived of basic facilities, including healthcare and potable water supply.

Daily Times had previously disclosed that more than 200 children had fallen victim to this disease in Rehri Myan Goth.
 
Re: Pakistan-Mysterious disease strikes children in coastal areas of city

Re: Pakistan-Mysterious disease strikes children in coastal areas of city

Apparently, this has not been going on for a while - this sounds like a new problem. Although it is also possible that this is an old problem that is just now getting attention. Could also be due to malnutrition/vitamin deficiency as this article suggests.

http://www.dailytimes.com.pk/default.asp?page=2009\12\09\story_9-12-2009_pg12_4

4-member team examines 45 kids in Rehri

KARACHI: A four-member team, formed by Adviser to Sindh Chief Minister Sharmila Farooqi and headed by Dr Neel Kanth, visited different areas of Rehri Myan Goth on Tuesday and examined 45 children suffering from paralysis of the lower limbs. According to the team’s initial medical investigation, the children in the area might be suffering from deficiency of iron, calcium and other minerals, but nothing can be said decidedly at this point. The cause behind the disease could be a virus, or water or fluoride contamination, since all the area residents consume underground water, concluded the team. It is pertinent to mention here that despite reporting this strange disease in Daily Times on Friday and Saturday, the Sindh government has yet to take any significant steps to diagnose and treat this disease. Provincial Health Minister Dr Sagheer Ahmed had previously claimed ignorance on the issue and he is unwilling to disclose any information regarding the same. More than 200 children are suffering from this disease, but many of the major hospitals have refused to admit them, since the provincial health department has not shown an interest in officially playing its role on the issue. amar guriro
 
Re: Pakistan-Mysterious disease strikes children in coastal areas of city

Re: Pakistan-Mysterious disease strikes children in coastal areas of city

And here's a story from three years ago in the SAME village, a different (symptomatically) "mystery disease".

With the mentions of sewage in several of the articles, some kind of poisoning is possible as well.

http://www.dailytimes.com.pk/default.asp?page=2006\04\02\story_2-4-2006_pg7_29

Girls in fishing village swamped by skin disease

By Aziz Sanghur

KARACHI: Twelve-year-old Urooj has no aspirations in life. She knows none. She lives an extremely modest life in a coastal village in Bin Qasim Town. The name of her village is Dabla Mohallah, and the inhabitants here earn their living by fishing. The village has 350 housing units.

Urooj is studying at the D A Fisherfolk Forum Primary School with 55 other students. She is one of four girls who have been afflicted by a mysterious disease that has left her covered with sores. "I have been suffering from this disease for the past two weeks," she says.

Urooj says she doesn't know what the problem is. "I told my father. He will do something," she said.

Urooj's father says he cannot do anything for his daughter. He has no money to take her to the closest hospital, which is a private one and is located in Rehri Goth, which is four kilometres away.

Inhabitants, meanwhile in the mohallah are afraid that this could be the start of an epidemic. Urooj's sores have spread all over her body-they started off with her hands and legs.

Urooj says she has to scratch her entire body because the disease is itchy. "It's not only Urooj. Mariam, Zelikha and Mah Gul, who study with her are also suffering with the same disease," said Akhtar Hussain Shaikh, a social worker of the Pakistan Fisherfolk Forum (PFF), while speaking to Daily Times.

Shaikh said that the people were faced with a dual problem. "There is no hospital here for them, and the ones that are available to them are not only far away, they are also expensive. They do not have the money to treat their sick," he said.

Shaikh also said that the government had done nothing so far.

Mariam said she could not sleep because of the disease. She says it itches too much for her. Surriya, who teaches at the same school said the disease was spreading fast. "I am worried that it will spread to other students. Four have already been affected. The numbers could increase," she said. When approached, the Bin Qasim Town officials were ignorant about the matter.

"We have not received any complaints from the local people," said an official who requested that his name not be published.

The mohallah is surrounded by mangroves forests. They are also now surrounded by poisonous effluent, which is discharged by factories located in the industrial units of Landhi and Korangi, the Export Processing Zone and tanneries.

"The industrial waste is destroying marine life. It is also the reason behind the spread of this disease," claimed Pakistan Fisherfolk Forum chairman Muhammad Ali Shah.

Shah said that the fishermen had approached the city government several times but nothing had been done so far. He also said that the government claimed that effective steps were being taken to protect marine environment. He said all this was a lie.

Shah also said that the Sindh Environmental Protection Agency (SEPA) was not doing anything. He said it was sad that though SEPA had its headquarters in Korangi, it had still failed to take any action against these tanneries.

"Pollution is major problem which has caused all the widespread destruction of the mangrove forests. Shrimp depend on the mangroves for food. If things are not checked, the entire ecosystem of the coasts would simply evaporate.

"The Landhi and Korangi industrial zones discharge all their effluent to the sea, where Dabla Mohallah is. The union council of the area has passed several unanimous resolutions in their meetings. These resolutions have also been sent to the nazim but nothing is being done," he said.

Hasan Dablo, 46, was upset: "The mangroves provide us food and fuel, and we collect fodder for our animals. We are aware about the importance of these trees. Our children cannot just see them destroyed. We are traditional custodians of these waters and forests."
 
Re: Pakistan-Mysterious disease strikes children in coastal areas of city

Re: Pakistan-Mysterious disease strikes children in coastal areas of city

http://www.dailytimes.com.pk/default.asp?page=2009\12\11\story_11-12-2009_pg12_10

No relief yet for 200 children in Rehri Goth

By Amar Guriro

karachi: The fate of around 200 children in Rehri Goth, Ibrahim Haidery, who were afflicted with a mysterious disease that paralyses the lower limbs, still hangs in the balance as the government has so far done nothing for their treatment.

After Daily Times reported the issue some days ago, a medical team constituted by Adviser to Sindh Chief Minister Sharmila Farooqui visited the area and advised the sick children?s parents to take them to the Civil Hospital, Karachi. But it is impossible for the poverty-stricken parents of these children to afford the expenses for a visit.

?If we could have afforded taking them (children) to the hospital for treatment, we would have done so long ago,? said Haji Mohammad Younus, a worried parent.

?We want the government to provide the expenses for our children?s treatment as we are not in a position to afford it.? The children were afflicted with an unidentified disease, which experts believe is caused due to consuming fluoride-contaminated underground water.
 
Re: Pakistan-Mysterious disease strikes children in coastal areas of city

Re: Pakistan-Mysterious disease strikes children in coastal areas of city

I think this thread should now be merged with the one in post #2 of this thread, as it is now clear that they represent the same developing situation. Certainly a poisoning in the water would be consistent, and high levels of fluoride could produce neurological symptoms, but other toxins should be investigated as well. Due to a lower body weight and developing body, any toxin is likely to have a disproportionately higher effect on children.

A ProMed post will likely follow soon.
 
Re: Pakistan-Mysterious disease strikes children in coastal areas of city

Re: Pakistan-Mysterious disease strikes children in coastal areas of city

I just found an article about the "earlier" outbreak in Achhro Thar. It was 18 months ago, but many of the people had been suffering symptoms for years.

This adds crediblility to the theory that the situation has developed over many years, but just became public now.

http://www2.fluoridealert.org/Alert...minated-water-kills-17-and-paralyzes-hundreds

Location: News > Pakistan

Achhro Thar : Contaminated water kills 17 and paralyzes hundreds

Latest News from Pakistan

Achhro Thar : Contaminated water kills 17 and paralyzes hundreds
Focus on poisoned water and disabilities
Killed by lethal waste
Bone disease spurs Pakistan to environmental action
Pakistan: Fluoride Tainted Water Cripples Villagers

Read more news from Pakistan




Daily Times (Lahore)
May 05, 2008


Achhro Thar : Contaminated water kills 17 and paralyzes hundreds

By Amar Guriro


(See original article)
KARACHI: Forty-eight year old Sahanti was lying on the sand inside her traditional Thari hut and her daughter was trying to ease her pain by massaging her head. She has been lying in this position for the last 26 years with lower body paralysis, and experts say that underground supplies of water, contaminated with high quantities of fluoride, are responsible for her paralysis.

She lives in Achhro Thar (White Desert), 80 km from Khipro, District Sanghar, and 50 km from the Indian border. Her three sons and one daughter, while normal, have teeth discolored by the water supply.

The residents in her village told Daily Times that in the last three years, at least 17 from the Hajam and Rajar clan have died and dozens have been paralyzed. The Ideal Rural Development Programme (IRDP), a local organization, organized a visit of the area for journalists and the residents shared never-ending stories of their miseries.

?Many of those who died were disabled before their death and civil society workers say they died because of the contaminated water,? said Muhammad Hashim Hajam, chieftain of the Thooraho village.

For most, the Thar Desert brings to mind beautiful natural scenes with women in traditional colorful attire carrying pitchers, walking between the dunes, and some artists are dying to paint such scenes, but in reality locals face horrible conditions.

?Behind these scenes, the reality is that women and children have to walk miles in the summer to get potable water. Besides that, fluoride causes children to look much older than they are, causing white hair, curved backs, and wrinkles,? said Wakeel Rajar of the Chowanro Goth.

Almost every child has a thick layer of fluoride on their teeth, making their smiles a dirty yellow, dashing their self-confidence against the rocks and making many socially unacceptable for marriage.

?When I talked to my cousin in Khipro about the engagement of my son with her daughter, he refused mentioning the teeth color of my son,? said Satar Rajar.

Experts say that fluoride levels have increased alarmingly. ?The international standard for fluoride level in potable water is one g per liter, but in this area, it is more than 17 g,? said University of Karachi Department of Geology Prof. Dr Shahid Naseem, who has visited about 400 small villages of Thar to get water samples for laboratory testing. The source of the fluoride is likely underground granite mountains, he said.

He said that although granite mountains have been present since ancient times, environmental changes and increasing population are causing the increase in fluoride levels.

The increased fluoride levels affect teeth, bone, nervous system, senses and movement, while the increased salts in the body cause increased blood pressure, which damages the kidneys.

Since there is no state-run medical facility in the area, the people receive eclectic prescriptions, said IRDP President Muhammad Ali Kumbhar, who added that many would rather visit spiritual healers than visit doctors in a city.

Sindh Graduates Association Khipro representatives tested water samples from 12 villages of Achhro Thar and found that in 8 villages, the water is dangerous for human consumption. ?Safe chloride levels are 250 mg per liter, whereas we found 2,144 mg per liter on average. Levels of TDS are 5,414 mg per liter, against the allowed level of 1,000 mg per liter,? said Muhammad Ali Lashari.

He said that the new government must provide fresh river water. ?It is not that difficult, as the Nara Canal is only about 60 km away and all the government has to do is lay a pipeline, which will protect human life in the area,? said Lashari.
 
Re: Pakistan-Mysterious disease strikes children in coastal areas of city

Re: Pakistan-Mysterious disease strikes children in coastal areas of city

I'm glad that WHO is investigating and hope the paralysis can be reversed.
 
Re: Pakistan-Mysterious disease strikes children in coastal areas of city

Re: Pakistan-Mysterious disease strikes children in coastal areas of city

OK. We now have an acute outbreak. If the disease has fever and paralysis within one week, this is not a chronic poisoning - we have a major outbreak of something here. But what?

http://www.dailytimes.com.pk/default.asp?page=2009\12\13\story_13-12-2009_pg12_3

Rehri Goth residents to protest for medical aid

KARACHI: Rehri Goth?s residents, whose children are suffering from paralysis of the lower limbs, have held a meeting and decided to protest outside the Karachi Press Club (KPC) against the delay in relief by the Sindh government, the provincial health department and the World Health Organisation (WHO). The meeting was held after five more children were reported with high fever on Saturday. The locals told this scribe that the fever would leave the children paralysed within a week, raising the total number of children affected with the strange disease to 217.

Pakistan Fisherfolk Forum?s Sami Memon reported that Eisa Jat?s four daughters, Fatima, Sheeran, Bhana and Ameer Bano, and Nawaz Jat?s daughter Nazia were suffering from high fever. ?These children would be paralysed by next week. However, despite such a high number of these cases, the government is doing nothing for these children,? he added.

Daily Times previously reported the case of over 200 children suffering from the strange disease, following which a team of WHO and the Sindh government had visited the area, but despite the passage of more than a week, no relief has been so far provided in the area.

A resident of Jat Paro, Rehri Goth said, ?The children of ages between four and 14 first get high fever and within a week, paralysis affects their lower limbs and sometimes their arms and other parts of the body.

There are already around 200 such children in the area and more are being affected.? Nothing has been done so far despite different teams visiting the area, which is why the parents have no other option besides taking these children to the KPC to show these cases to the media, he added. The meeting organised by the PFF did not decide a final date of protest demonstration, but it would be held sometime next week. amar guriro

Home | Karachi
 
Re: Pakistan-Mysterious disease strikes children in coastal areas of city

Re: Pakistan-Mysterious disease strikes children in coastal areas of city

And they suspect this is waterborne. Possibly some type of parasitic infection. And it is also clear that this is a low attack rate, as the 200 or so illnesses are spread over a significant area.

The two things odd about this outbreak are:

1. It seems that only children (or at least mostly children) are affected. The ages most affected seem to be from 4 to 14, despite the fact that everyone would be drinking the same water.
2. Despite all the paralysis, no deaths have been reported. Most illnesses that cause paralysis have fairly high fatality rates. Odd. Perhaps paralysis is the wrong word.

Also of note is the timing indicated in the above article - all four children in the same family got ill on the same day, suggesting a common exposure.

The only real infectious disease with symptoms like this is polio, and that would explain the predominance in children (breakdown in vaccination?), but with that many severe cases of polio, there would be some deaths.

Someone should send something to ProMed now.

http://www.dailytimes.com.pk/default.asp?page=2009\12\13\story_13-12-2009_pg12_8

Ibrahim Hyderi and Rehri Goth provided relief

2 water purification plants supplying 100,000 gallons per day installed by KESC

By Amar Guriro

KARACHI: Following the reports by Daily Times on the issue of around 200 children suffering from a mysterious disease, the residents of Ibrahim Hyderi received good news on Saturday as the Karachi Electricity Supply Corporation, in collaboration with the Pakistan Fisherfolk Forum (PFF), set up two water purification plants in the area.

Rehri Goth and other coastal areas are suffering from acute shortage of potable water and in some areas, water contamination has been causing dangerous waterborne diseases, badly affecting the nearby settlements. In the absence of state-run water supply system in the Ibrahim Hyderi area, most residents had been consuming underground water, which is severely contaminated with fluoride and arsenic substances.

Daily Times had reported a week ago that around 200 children in different settlements of Rehri Goth were suffering from paralysis of the lower limbs, for which underground water contamination was held responsible by water quality experts. Recognising the worsening situation, KESC's Corporate Social Responsibility Department decided to set up water plants in the area. The two water purification plants installed in Ibrahim Hyderi - one in Baloch Para and the other near the water pump area - would purify 50,000 gallons of water daily.

In a ceremony held on Saturday, Provincial Minister Muzaffar Ali Shajra, Pakistan Fisherfolk Forum Chairman Mohammad Ali Shah and, KESC Corporate Social Responsibility Department official Zehra Mehdi and a considerable number of Ibrahim Hyderi's fisher folk inaugurated the water purification plants.

Shajra said the Sindh government would cooperate with the PFF to provide safe drinking water facilities to other areas with fishermen's settlements. The Pakistan People's Party's government is trying its very best for providing basic facilities to everyone equally, he added.

He regretted that there is an artificial shortage of water in many areas. Action would be taken against all those involved in creating this shortage, as per the complaints received, he added.

Shah thanked the KESC, who has agreed to work with the PFF for providing pure drinking water facility for Ibrahim Hyderi, and said as per the new national water policy issued by the Central Cabinet of Pakistan, it is the responsibility of the state to provide 120 litres of water to every citizen daily. The total population of Ibrahim Hyderi is 120,000, which means the government should provide 3 million gallons of water to the residents, but they are only receiving 300,000 gallons, he added.

Zehra Mehdi said there was a dire need of pure drinking water in Ibrahim Hyderi and that the KESC had provided two water purification plants to relieve the residents. The new management of the KESC also wants to work on health and education issues in the area, she added.

Home | Karachi
 
Re: Pakistan-Mysterious disease strikes children in coastal areas of city

Re: Pakistan-Mysterious disease strikes children in coastal areas of city

[

According to the PFF list, some of the victims include fisherman Esa, who is suffering the same ailments following the paralysis of his four daughters

The disease has not only spread in Karachi, but perhaps spread along the entire coast of the province and also in Balochistan up to Iran, as we have received reports of the same disease affecting people in Quetta and a small village on the Iranian border,” Dr Naseem said.

“We have to conduct a detailed survey of the coastline to learn more about this disease.” Dr Naseem said arsenic contamination was first reported in Punjab, but now the problem has moved on to Sindh. “The contamination of underground water with both arsenic and fluoride could possibly be the cause of this disease, but only a detailed survey can confirm this,” he said.:tiphat:http://www.dailytimes.com.pk/default.asp?page=2009\12\05\story_5-12-2009_pg12_1

A closer reading of this article reveals some odd facts. Apparently, although children are predominantly affected, adults are affected too, based on the fact that Esa was affected after his children (and that might mean he got it from his children).

The distance from Karachi to the Iranian border is about 200 miles - they would not all be drinking the same contaminated water, and if they were, many more would be ill. The cases also seem to be happening in family clusters. Person-to-person spread of this is possible, and that is inconsistent with any known agent. We might have a major problem here. You seem to have a disease that paralyzes almost everyone it infects.

I am also ruling out polio. While symptomatically this description does match paralytic polio, ony about 1% of polio cases are paralytic. The odds of six in the same family is zero.

We also get a fairly detailed symptomatic description: fever, weakness, and paralysis of limbs within a week.

We also know that the WHO has been investigating this for at least a week (since examining 45 affected children). I would hope they release an official statement soon. This seems like a fairly widespread outbreak, having spread all along Pakistan's southern coast.
 
Re: Pakistan-Mysterious disease strikes children in coastal areas of city

Re: Pakistan-Mysterious disease strikes children in coastal areas of city

OK guys. Time for a lesson in false outbreaks again. I was suspecting this for the past 24 hours or so, but didn't want to post this without some supporting link. Most of the really alarming articles came from a single source by a single author, who was making a really big deal about contaminated water, despite very little evidence that this was waterborne. Only one article about this occurred in a different source (and that attributed this to several factors), and now that source has generated this article.

My post above mentions that the outbreak depicted doesn't really match any known disease (not that I know them all). That was one of the first clues. That much paralysis without a recent death was another clue.

Another odd point was the current status of those "affected". The articles said that none were hospitalized. Clearly, they hadn't "recovered", or there would be no one to show the WHO. And they had been "ill" for at least three weeks since this story broke. Were they still febrile?

The questionable source mentioned three days ago that a new source of clean water was provided, then it shut up completely, going to press three times now without mentioning this story. That is the textbook picture of screaming "outbreak" in order to improve the local health conditions (get them better drinking water).

I would put a " - possibly unfounded" on the end of the title of this thread now.

The 16 localities mentioned have a total of 166 paralyzed children out of a population of 60,000, which isn't really that high for that much "inbreeding".

http://www.thenews.com.pk/print1.asp?id=213628



Genetic factors responsible for Rehri Goth misfortune



Wednesday, December 16, 2009
By By Shahid Husain

Karachi

Contrary to the general perception that the children suffering from paralysis in Rehri Goth, a coastal village in the suburbs of Karachi, are victims of contaminated water, findings of an international health organisation point out that Vitamin D deficiency in childhood and genetic factors are essentially responsible for their misery.

It’s true that water is contaminated in the area but the disease has not been caused by some chemical in water,” a senior doctor of an international organisation who was part of a fact-finding mission in Rehri Goth some 10 days ago, told The News on condition of anonymity.

“We have submitted our report to our organisation and the government and have also sent water samples of the area to National Institute of Health (NIH), Islamabad, but we are pretty sure that contamination has not caused crippled them,” he said.

“The occurrence of the disease is not acute and it is not communicable,” he said. “It’s prevalent in 5-18 years age group and seems to be genetic in nature because marriages amongst close relatives are quite common in the area,” he said.

The World Health Organisation (WHO) defines close-kin marriage, or consanguineous marriage, as one between individuals who are second cousins or more closely related. In the Sub-continent and the Middle East close-kin marriages are commonplace. Close-kin marriages are associated with a higher frequency of genetic disorders and birth defects than marriages between unrelated individuals.

“In several religions and sub-sects, marriages between first cousins are prohibited. Without knowing the reasons, these prohibitions were imposed by various societies,” said Dr. Abid Azhar, Professor and Co-Director-General, Dr. A.Q. Khan Institute of Biotechnology and Genetic Engineering (KIBGE), University of Karachi.

“The scientific basis of genetic diseases lies in the occurrence of many or single abnormalities of chromosomes and these abnormalities are passed on to the offspring by the parents,” he said.


“During fertilisation, one half of the genetic material is inherited from each of the two parents. In case an abnormality exists in any of the two parents it is passed on to the next generation. In a number of these complications, the symptoms of the disease show up when a pair of such abnormal genes appears together. In many cases the characteristics remain dormant in singular form. In inter-marriages, marriages between the cousins, the chances of these diseases are much higher than from marriages between two un-related individuals,” he explained.

According to a survey conducted by the Pakistan Fisherfolk Forum (PFF), a grassroots organisation in the area, as many as 200 children have been affected by the disease in Rehri Goth. The PFF survey says 16 colonies with a population of about 60,000 have been affected by the disease. The PFF’s activists along with a team of journalists visited Rehri Goth and observed the affected children lying helpless in the courtyards of their homes. Most of the affected children were males.

“Initially, the children suffered from high grade fever and their lower limbs and body had got paralysed,” the PFF report said.

Since the large majority of the population is illiterate, they are not only superstitious but also have no concept of time and space. No wonder many of them attribute the disease to some Djinn (spirit entity) that has struck the locality.

According to the PFF survey, five children in Syed Para, 18 in Khalefay Jat Para, 20 in Malkani Para, 21 in Mosani Para, 10 in Syarani Para, six in Veryani Para, eight in Sheikh Para, 12 Khaskheli Para, 16 in Qasmani Para, eight in Pan Para, 13 in Sidique Khaskheli Para, 9 in Bakhtawar Para, 10 in Dabla Para and 10 in Baloch Para have fallen victim to the crippling disease.
 
Re: Pakistan-Mysterious disease strikes children

And the story is not over yet. The parents refuse to take the WHO's report, and this article now comes out in the Daily Times. I thought this thread was dead. I'm not sure what happens next, but I'll continue to follow it.

Apparently the WHO report blamed this on many factors, including mostly genetic disease, plus malnutrition and vitamin deficiencies. I believe, based on previous articles in this thread, that the severe fever mentioned in this article is likely typhoid (although could be other infections of the nervous system such as JE or meningitis). Either way, the cases paralyzed by fever do not appear to be recent.

Certainly, many genetic diseases do not manifest themselves until children grow up, and the consistency of the symptoms seems to indicate that perhaps the same genes are widespread in this population, so perhaps many of these children have the same genetic disease.

At least there is no mention of "new" cases, and the description of fever followed by certain paralysis in a week is gone.

The biological contamination in the water is likely E. coli or something of that nature, that might cause some fever, but is unrelated to the paralysis. My reading of the fluoride contamination in Achhro Thar presents a much different picture than this "outbreak", with symptoms like fluorosis on the teeth and things of that nature that are markedly absent here.

Despite this report, I tend to trust the WHO over the parents of these children, but I do admit that the previous article was a bit condescending. At least the Daily Times has stopped yelling "mystery disease".

http://www.dailytimes.com.pk/default.asp?page=2009\12\19\story_19-12-2009_pg12_11

Paralysed children of Rehri Goth: ‘Controversial’ WHO report irks parents of victims

By Amar Guriro

KARACHI: The controversial report issued by the World Health Organisation (WHO) about the mysterious disease that caused paralysis of lower limbs in more than 200 children in Rehri Goth, irked the parents of the children and they decided to protest against it.

Around 200 children of different age groups living in Rehri Goth along the coastal belt of the city were reported to be affected with a mysterious disease causing lower limb paralysis.

After media reports of these affected children, a three-member team of the WHO, headed by Dr Soomar Khoso, visited the area and held meetings with 17 afflicted children.

Talking to this scribe one official of WHO Sindh on condition of anonymity, as officials are strictly bound not to talk to media persons on-record, confirmed the news that WHO has issued the said report.

Disclosing details of the report, he said that multiple reasons have been cited as the cause of the disease.

“Some of the children are afflicted with genetic disorders, others have Vitamin D shortage and a few were affected with severe fever causing lower limb paralysis
,” he said.

On a question he confirmed that no blood samples were taken to diagnose the actual cause of the disease. “The report was issued on the basis of physical appearance and medical history,” he said, adding that only three samples of tap-water in the area were sent to the WHO laboratory in Islamabad that rejected the presence of fluoride, arsenic and other chemical contamination, however, biological contamination was detected in the water samples. The report also states that close-kin marriages could also be one reason behind the disease.

However, as per local residents, the majority of the population is consuming underground water, and according to the water-quality experts’ fluoride and arsenic contamination in aquifers could be a reason for the diseases, but WHO has not taken the samples of the underground water.

Similarly, Vitamin D deficiency among fisher folk is also debatable because medical experts say they not only have high fish intake, but also spend long hours under the sun, both known sources for Vitamin D.

The parents of the children reacted severely over the report, “We reject genetic disorder to be the reason as most of the children got this disease at the age of 16 and we suppose that the report was issued only to get rid of the patients. Therefore, we are thinking we will protest against WHO at Karachi Press Club,” said Hussain, a fisherman and father of four affected children. Talking about the close-kin marriages, he rejected saying it is not an isolated practice pertinent only to this colony but happens throughout Sindh and other parts of Pakistan. “We demand the government of Pakistan and WHO to go through the detailed medical examination of these children and then start treating them,” he concluded.
 
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Re: Pakistan-Mysterious disease strikes children

This is a different source, and a strange article. While poverty may be the root cause, it is not an etiology. The last line of this article, combined with blaming poverty suggests that these disabilities may still be being used to draw attention to the background health situation.

http://www.thenews.com.pk/updates.asp?id=94245


Strange disease plagues Karachi locality of fishermen
Updated at: 1025 PST, Wednesday, December 23, 2009
KARACHI: A mysterious disease has come to haunt the fishermen locality Rehri Goth situated in Karachi causing mental and physical handicap to dozens of residents, Geo News reported Wednesday.

Karachi’s backward area of Ibrahim Hyderi and adjoining impoverished Rehri Goth are awash with the spectacles of helplessness and vulnerability at every step.

The 16-year son of Jam Panhon, a resident of the indigent locality Ibrahim Hyderi, his brother and two sisters have turned physically and mentally retarded, shoving also Jam at the threshold of the handicap.

Stricken by surprise and curiosity, when Geo News team arrived in the adjoining Rehri Goth, they were received by the fact that the inexplicable disorder is the plight story of none less than 200 children and adults.

According to social workers, the strange illness has taken in its fold not only children but also the adults.

Geo News team took along Health Consultant Dr Humaira Javed to the impecunious locality. The team found four disabled children lying down in a row on floor in the house of Muhammed Hussain resident of Rehri Goth. The basis of all reasons told by the consultant stipulate the poverty as the root cause of this unexplained disease.

If only the breaths can be termed as life, then these children can be believed to be alive; however, in an era of government by people who raise the slogan of the people’s government, the very thought of nation having future sans healthcare and hygiene sends chills down the spine.
 
Re: Pakistan-Mysterious disease strikes children

And an article suggesting the possiblity that this is several diseases.

Also of note is that this source is taking credit for getting the children treatment.

http://www.dailytimes.com.pk/default.asp?page=2009\12\24\story_24-12-2009_pg12_4

Efforts to help children of Rehri Goth pay off

KARACHI: Repeated efforts of Daily Times to highlight the woes of around 200 children in Rehri Goth that are suffering from a mysterious paralysing disease and the government’s apathy over the issue, the hard work finally paid off with Sindh Health Minister Dr Sagheer Ahmed visiting the area and assuring the victims’ parents that they would be provided free of cost treatment.

Ahmed later told Daily Times that he met 12 children affected with the disease. He said the children are not suffering from a single disease, but different illnesses. “Some of them are suffering from a genetically inherited disease, while others are afflcited with thalassaemia, rickets and diabetes. We are setting up two camps to ascertain the number of patients and the diseases they are afflcited with,” he said.

It is pertinent to mention that Daily Times was the first one to take the initiative of bringing this issue to public knowledge and subsequently published follow-up stories over how the health authorities were being negligent in dealing with the problem.

Earlier, the Infection Control Society (ICS) arranged a medical camp in Rehri Goth in Bin Qasim Town to ascertain reasons behind the mysterious disease. Medical experts of ICS, including Dr Azra, Dr Saeed Abassi and Dr Khurshad Hashmi, took blood samples of the affected children and physically examined them. The Pakistan Fisherfolk Forum, in collaboration with a medical team of ICS, organised the medical camp in the area, where child specialists examined the children and distributed medicines. A team of the Sindh government and the World Health Organisation (WHO) had also visited the area, but nothing was done for the affected children. amar guriro
 
Re: Pakistan-Mysterious disease strikes children

Certainly looking like several factors, if not several illnesses.

http://www.thenews.com.pk/print1.asp?id=214993

Cause of Rehri Goth child paralysis remains contentious



Thursday, December 24, 2009
By By Jan Khaskheli

Karachi

Contrary to the recent findings of an international health organisation, a team of doctors from the Infection Control Society (ICS) has concluded that contaminated water cannot be ruled out as a causative factor for the rampant child paralysis in Rehri Goth.

This revelation from the ICS, which is a non-governmental organisation working on health issues, comes in the wake of recent reports from an international health organisation, which had concluded that contaminated water could not have caused paralysis among children in Rehri Goth. While conceding that the water in the area was contaminated, the organisation had categorically cited Vitamin-D deficiency and genetic factors as the essential culprits.

Dr Azra, who was part of the five-member ICS team, told The News that according to her team?s findings, there are multiple reasons for the disease found in children in the coastal locality. She said that they had initially thought that these cases of paralysis were related to polio, but they were wrong.

Dr Azra linked poverty and lack of health facilities with the problem, and said that the team believed that due to lack of awareness, people did not take their children to hospitals once the symptoms of the disease appeared. As a result, the problems multiplied, leading to paralysis. She added that the ICS team has taken blood samples and conducted other tests for further analysis in order to suggest proper treatment.

Doctors in the ICS team detected a host of causes for the disease among children, and said that they could not overlook the negative impacts of lack of sanitation, contaminated water and deadly chemicals flowing into the nearby sea.

Meanwhile, a Pakistan Fisherfolk Forum (PFF) spokesperson told The News that they have approached the ICS team to set up emergency centres for the rehabilitation of the victims, especially those who the team thinks need immediate treatment. He said that the ICS team agreed to the PFF?s proposal and such centres will be established soon.

The PFF has also received information from the Illyas Jat locality in the same neighbourhood, where at least 15 children are said to be suffering from similar symptoms. The fisherfolk forum has formed a team which will visit all neighbouring coastal localities to ascertain the prevalence of the disease.

The PFF spokesman said that they have already highlighted the issue of increasing marine pollution, but the ?ignorant authorities? are not taking this seriously.

Meanwhile, residents of the area have appealed to the provincial government to look into the matter sympathetically and diagnose the real causes of the disease which has caused immense panic in the entire coastal zone of Karachi.
 
Re: Pakistan-Mysterious disease strikes children

Pollution and poor hygiene is also being blamed for an outbreak of skin diseases in the coastal areas of Karachi
Source: http://www.dailytimes.com.pk/default.asp?page=2009\12\24\story_24-12-2009_pg12_14


Thursday, December 24, 2009

Skin diseases hit coastal areas of city

Text and photos by Amar Guriro

KARACHI: A large number of people living in the coastal areas of the city, majority of them children and women, are suffering from various skin diseases such as scabies, ectoparasite skin infection and eczema due to polluted water and lack of hygiene.

The residents of these areas are mostly poor fishermen, and according to a local non-governmental organisation, Kalachi Social Viable Association (KSVA), the skin diseases have spread on a vast scale in coastal areas such as Rehri Goth, Ibrahim Hyderi and other areas of Bin Qasim Town.

The organisation has estimated that 1,218 children of 720 families in Ibrahim Hyderi alone have been inflicted with skin diseases. Their initial findings reveal that water pollution and lack of hygiene could possibly be the cause behind the outbreak of the diseases, while a lack of proper state-run healthcare facilities in these areas has worsened the situation.

?Every third adult and second child in Ibrahim Hyderi is suffering from a skin disease and it seems that outbreak is spreading rapidly,? said Dr Taju Nisa Farooquie alias Farah, a doctor at a medical centre run by KSVA.

?Most of the skin disease patients are poor and cannot afford proper treatment, thus their family members also become affected,? said Farah, who attends around 100 patients daily, majority of them suffering from skin diseases.

This scribe visited several affected families and observed that the diseases have reaced epidemic levels in some areas.

A teenager fisherman Imran Dhorai, resident of Kariyani Paro of Ibrahim Hyderi, was born with rashes on his skin.

The rashes became so severe that as he grew up, almost all of his body became covered with strange patches.

The disease rendered him unable to continue his profession as a fisherman and he had started working as a mechanic in an auto garage. The disease also destroyed his social life as he feels strange while mingling with his peers and also feels that he would never get married. ?Sometimes, I can?t even sleep...during summers I feel as if my body is on fire and in winters, scaly pieces of skin shed from my body that feels unbearable,? he told this scribe with teary eyes.

He consulted several doctors and also visited hakeems. He even went to take a bath in natural hot water fountain in Manghopir that is believed to heal skin diseases, but all went in vain.

The disappointed fisherman even resorted to consulting faith healers, but even that did not work.

Another fisherman blamed the increasing sea pollution for the situation and said the pouring of untreated highly toxic effluent directly into the sea has created the problem.

He backed his claim by saying that hundreds of industrial units in the Korangi Industrial Area release effluent directly into Arabian Sea through the Korangi Nullah.

Dr Ashok Kumar, who also works at the KSVA medical centre, said there is a lack of proper hygiene in these areas, and this could be one of the reasons behind fungus infections.

?Most of the residents in these coastal areas are fishermen and therefore lack of hygiene and polluted water could be the reason behind the skin diseases.?

Bin Qasim Town Town Nazim Jan-e-Alam Jamot said there are several families afflicted with skin diseases in his town. ?There are state-run hospitals in these areas, but they lack medicines and proper funding,? he said.

?We are arranging a medical camp in Ibrahim Hyderi for immediate relief of patients,? said Kiran Jamot, a KSVA office-bearer.

Sindh Health Minister Dr Sagheer Ahmed said his department has arranged two camps in Ibrahim Hyderi for the patients.
 
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