Re: UNDIAGNOSED FATALITIES - SOUTH AFRICA ex ZAMBIA: REQUEST FOR INFORMATION [ProMedMail.org]
Re: UNDIAGNOSED FATALITIES - SOUTH AFRICA ex ZAMBIA: REQUEST FOR INFORMATION [ProMedMail.org]
Published Date 08-OCT-2008
Subject PRO/AH/EDR> Undiagnosed fatalities - South Africa ex Zambia (04)
UNDIAGNOSED FATALITIES - SOUTH AFRICA ex ZAMBIA (04)
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A ProMED-mail post
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Date: Tue 7 Oct 2008
Source: The Star, South African Press Association (SAPA) report [edited]
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http://www.thestar.co.za/?fSectionId=493&fArticleId=nw20081007174346216C145841>
About 121 people who came into contact with 3 people who died of an
unknown kind of viral haemorrhagic fever remain under observation
although all appear fine, Joburg [Johannesburg] doctors said on
Tuesday [7 Oct 2008].
Doctor Lucille Blumberg of the National Institute of Communicable
Diseases said while the illness was currently "controlled," doctors
would have to wait for 21 days before they could possibly declare it
contained. Twenty-one days is the period doctors believe the illness
could still move from exposure to incubation to manifestation.
A list of 121 people who came into contact with the deceased has been
compiled and those people were having their temperatures taken every
6 hours for the 3-week period. "If we are not sure of their symptoms
we will put them in isolation to evaluate," said treating doctor
Nivesh Sewlall.
On 12 Sep 2008, a 36-year-old woman was airlifted from Zambia to the
Morningside Medi Clinic in Sandton. She was treated for tick bite
fever and other potential infections, but died 2 days later. A
Zambian paramedic who accompanied her into the country died last
week, and a nurse at the clinic died on Sunday [5 Oct 2008]. On
Tuesday, Sewlall said of those being observed, 6 people had been
taken to hospital but 4 had already been discharged. A 51-year-old
cleaning supervisor who was admitted to Chris Hani Baragwanath
hospital with symptoms of the illness was also ready to be discharged
on Tuesday. Blumberg said her blood tests had come back clear and she was fine.
The 11-year-old son of a nurse that passed away, and his 23-year-old
nanny, were still being kept in hospital although neither displayed
any symptoms. "He is fine, but it is a traumatic time and it's more
for trauma counselling," said Sewlall.
His nanny had initially
displayed a marginally high fever, but was now fine, with her blood
test normal.
Doctors said while the recent death of a cleaning staff member at the
Morningside Medic-Clinic was probably not related to the other deaths
at the hospital, they could not disregard anything at this stage.
"Scientifically we can not exclude anything until we get to 21 days,"
said Sewlall.
Sewlall and other medical officials held a news conference at the
Morningside Medi-Clinic on Tuesday [7 Oct 2008], because they said
they wanted to dispel misconceptions and panic around the illness.
Intensive care specialist professor Guy Richards said: "The public at
large are not at risk, only those with direct exposure to the 3
cases." Morningside Medi-Clinic Gauteng marketing manager Melinda
Pelser said: "This hospital is at no risk, this is where there is a
huge misunderstanding. You cannot contract the illness through air,
[you cannot contract it] unless you have had direct contact with a
patient mostly though blood, stool, and urine. We don't want panic out there."
Blumberg said there was also no outbreak of the illness in Zambia
itself and there was no risk of contracting the disease through
travel to Zambia. Sewlall said the idea that it was a disease that
doctors had never heard of and knew nothing about was incorrect.
Blumberg said: "We don't have a diagnosis as yet. It is a viral
haemorrhagic fever but we don't know what caused it." Not knowing the
cause made no difference to how patients were managed, said Richards.
"Treatment is not harmed by the fact it has not been identified."
Blumberg said various tests were being done but these could take some
time. Her institute was also collaborating with the US Centres for
Disease Control (CDC).
On Tuesday [7 Oct 2008] the World Health Organisation (WHO) said it
had flown in a laboratory expert and a disease surveillance expert to
help the South African health authorities determine the illness.
Blumberg said the 1st victim, a tourism operator, probably contracted
the illness in Lusaka [Zambia]. She lived on the outskirts of the
city in a place where there were horses and exposure to ticks.
Sewlall said she was ill for about 10 days before coming to [South
Africa] and did have a tick bite but had not identified a specific
incident of when she got ill. Sewlall said all precautions had been
in place such as masks and gowns for the nurse who contracted the illness.
--
Communicated by:
ProMED-mail Rapporteur Mary Marshall
[This report reinforces the interpretation that this is an isolated
incident stemming from a single case of an as yet unidentified 'tick
fever virus' infection contracted in Zambia and spread by nosocomial
infection in South Africa. No further cases have been recorded in
Zambia and the nosocomial spread in South Africa has been contained.
Precise identification of the tick fever virus is pending.
The HealthMap/ProMED-mail interactive map of Zambia, showing the
location of Lusaka, can be accessed at
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http://healthmap.org/promed?v=-14,27.8,5>. - Mod.CP]:tiphat:
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he said. 
