Sindhuli, Nepal: Undiagnosed Disease - 6 Dead/150 sick (High Fever, Vomiting Blood, etc)

[Jeremy]

Re: Sindhuli, Nepal: Undiagnosed Disease - 5 Dead/150 sick (High Fever, Vomiting Blood, etc)

Re: Sindhuli, Nepal: Undiagnosed Disease - 5 Dead/150 sick (High Fever, Vomiting Blood, etc)

Also, VHF typically causes diarrrhea, often bloody. Diarrhea has specifically been excluded as a symptom here.
...
Hantavirus is possible, but I don't think we would ever find out. Dengue and DHF are also possible, too.

Well, I do believe that this Sindhuli is located in the Terai Belt so Dengue and DHF are also both possible.

However, isn't explosive diarrhea a symptom of Hantavirus? Which has already been ruled out in these cases.

 

[Rwilmer]

Re: Sindhuli, Nepal: Undiagnosed Disease - 5 Dead/150 sick (High Fever, Vomiting Blood, etc)

Re: Sindhuli, Nepal: Undiagnosed Disease - 5 Dead/150 sick (High Fever, Vomiting Blood, etc)

The only thing that I know of that is ruled out is malaria.

 

[alert]

Re: Sindhuli, Nepal: Undiagnosed Disease - 5 Dead/150 sick (High Fever, Vomiting Blood, etc)

Re: Sindhuli, Nepal: Undiagnosed Disease - 5 Dead/150 sick (High Fever, Vomiting Blood, etc)

More news - SEND THIS TO PROMED! I have absolutely NO CLUE what this could be now, especially with many children affected (whooping cough?).

http://www.gorkhapatra.org.np/gopa.detail.php?article_id=22641&cat_id=8

Meanwhile, the team of health experts has stopped from reaching to Kyaneshwor and Kalpabriksha VDCs of Sindhuli district to identify the unknown disease. Five people have died in two VDCs within two days due to the unidentified disease.

CA member of the Sindhuli-3, Neeru Darlami said the team has been stopped to visit the areas under the instruction of the Health Minister.

She informed that she would discuss the matter with the Prime Mnister.

Around 200 peoples are still affected by the disease. Analyzing the situation, the District Administration Office (DAO) had decided to invite the s health team from Kathmandu to control the disease.

Two people from each VDC are seriously affected by the disease, the DAO said. They are suffering from high fever, bleeding from nose and difficulties in respiration. Almost all the affected people have the same problems. Many children of the areas have been affected by the unknown disease. The affected area is 16 miles away from the district headquarter.

 

[Rwilmer]

Re: Sindhuli, Nepal: Undiagnosed Disease - 5 Dead/150 sick (High Fever, Vomiting Blood, etc)

Re: Sindhuli, Nepal: Undiagnosed Disease - 5 Dead/150 sick (High Fever, Vomiting Blood, etc)

Wonder why they stopped the team. Either they think is a very bad disease or it is something they think is not worth their time.

 

[wotan]

Re: Sindhuli, Nepal: Undiagnosed Disease - 5 Dead/150 sick (High Fever, Vomiting Blood, etc)

Re: Sindhuli, Nepal: Undiagnosed Disease - 5 Dead/150 sick (High Fever, Vomiting Blood, etc)

More news - SEND THIS TO PROMED! I have absolutely NO CLUE what this could be now, especially with many children affected (whooping cough?).

http://www.gorkhapatra.org.np/gopa.detail.php?article_id=22641&cat_id=8

Meanwhile, the team of health experts has stopped from reaching to Kyaneshwor and Kalpabriksha VDCs of Sindhuli district to identify the unknown disease. Five people have died in two VDCs within two days due to the unidentified disease.

CA member of the Sindhuli-3, Neeru Darlami said the team has been stopped to visit the areas under the instruction of the Health Minister.

She informed that she would discuss the matter with the Prime Mnister.

Around 200 peoples are still affected by the disease. Analyzing the situation, the District Administration Office (DAO) had decided to invite the s health team from Kathmandu to control the disease.

Two people from each VDC are seriously affected by the disease, the DAO said. They are suffering from high fever, bleeding from nose and difficulties in respiration. Almost all the affected people have the same problems. Many children of the areas have been affected by the unknown disease. The affected area is 16 miles away from the district headquarter.

Google reports that source website as potentially installing malicious software without consent and that the server could be compromised. Is there a better source for the report?

 

[alert]

Re: Sindhuli, Nepal: Undiagnosed Disease - 5 Dead/150 sick (High Fever, Vomiting Blood, etc)

Re: Sindhuli, Nepal: Undiagnosed Disease - 5 Dead/150 sick (High Fever, Vomiting Blood, etc)

Google reports that source website as potentially installing malicious software without consent and that the server could be compromised. Is there a better source for the report?

Unfortunately not, I fear. I bit the bullet and went to the site though to find and post that report.

 

[Rwilmer]

Re: Sindhuli, Nepal: Undiagnosed Disease - 5 Dead/150 sick (High Fever, Vomiting Blood, etc)

Re: Sindhuli, Nepal: Undiagnosed Disease - 5 Dead/150 sick (High Fever, Vomiting Blood, etc)

Wonder why they stopped the team. Either they think is a very bad disease or it is something they think is not worth their time.

I have a feeling that they think that it is bad.

 

[wotan]

Re: Sindhuli, Nepal: Undiagnosed Disease - 5 Dead/150 sick (High Fever, Vomiting Blood, etc)

Re: Sindhuli, Nepal: Undiagnosed Disease - 5 Dead/150 sick (High Fever, Vomiting Blood, etc)

Unfortunately not, I fear. I bit the bullet and went to the site though to find and post that report.

So did I. Since I am running Linux I consider my vulnerability to that kind of attack fairly small. I would not recommend anyone open that site in IE on Windows.

 

[Jeremy]

Re: Sindhuli, Nepal: Undiagnosed Disease - 5 Dead/150 sick (High Fever, Vomiting Blood, etc)

Re: Sindhuli, Nepal: Undiagnosed Disease - 5 Dead/150 sick (High Fever, Vomiting Blood, etc)

More news - SEND THIS TO PROMED! I have absolutely NO CLUE what this could be now, especially with many children affected (whooping cough?).

http://www.gorkhapatra.org.np/gopa.detail.php?article_id=22641&cat_id=8

Meanwhile, the team of health experts has stopped from reaching to Kyaneshwor and Kalpabriksha VDCs of Sindhuli district to identify the unknown disease. Five people have died in two VDCs within two days due to the unidentified disease.

CA member of the Sindhuli-3, Neeru Darlami said the team has been stopped to visit the areas under the instruction of the Health Minister.

She informed that she would discuss the matter with the Prime Mnister.

Around 200 peoples are still affected by the disease. Analyzing the situation, the District Administration Office (DAO) had decided to invite the s health team from Kathmandu to control the disease.

Two people from each VDC are seriously affected by the disease, the DAO said. They are suffering from high fever, bleeding from nose and difficulties in respiration. Almost all the affected people have the same problems. Many children of the areas have been affected by the unknown disease. The affected area is 16 miles away from the district headquarter.

Yeah...this is kinda what I was hoping NOT to hear.

So, it looks like District team from Janakpur was sent to site but was stopped for some reason (Myabe inadequate equipement, Scared Doctor, etc?) and they have instead decided to go with a team from Kathmandu.

The number have been flucuating with these reports but it would appear that 3 out of 4 that mention numbers speak of large number of people, ergo I am going to speculate that this is a rather large outbreak.

What is really worrying are the reports of all the people being affected by the same problem. If there are 200 people all sick and vomiting blood and bleeding from the nose than this situation needs immediate attention.

 

[alert]

Re: Sindhuli, Nepal: Undiagnosed Disease - 5 Dead/150 sick (High Fever, Vomiting Blood, etc)

Re: Sindhuli, Nepal: Undiagnosed Disease - 5 Dead/150 sick (High Fever, Vomiting Blood, etc)

I am going to speculate that this is a rather large outbreak.

What is really worrying are the reports of all the people being affected by the same problem. If there are 200 people all sick and vomiting blood and bleeding from the nose than this situation needs immediate attention.

I agree with you. And remember, it says 200 STILL ill, meaning there are others who have recovered. This is a very large outbreak (and one of the reasons I rule out that kind of VHF). What is odd is the relatively low number of fatalities so far. If 200 people are vomitting blood, one would expect a lot more fatalities. There was an outbreak in Rolpa, Nepal three months ago with 60+ people vomitting blood and NO fatalities. Odd.

(And I don't suspect that we're about to see those mass fatalities because the five we've seen so far seem to be evenly distributed across the villages, 3 in one, 2 in the other. If this were spreading outward from a single source, we would more likely see five deaths in one family. If this was that, then you'd be seeing those "Hey!! Call the CDC!!" posts that the moderators don't like.)

 

[Jeremy]

Re: Sindhuli, Nepal: Undiagnosed Disease - 5 Dead/150 sick (High Fever, Vomiting Blood, etc)

Re: Sindhuli, Nepal: Undiagnosed Disease - 5 Dead/150 sick (High Fever, Vomiting Blood, etc)

I agree with you. And remember, it says 200 STILL ill, meaning there are others who have recovered. This is a very large outbreak (and one of the reasons I rule out that kind of VHF) What is odd is the relatively low number of fatalities so far. If 200 people are vomitting blood, one would expect a lot more fatalities. There was an outbreak in Rolpa, Nepal three months ago with 60+ people vomitting blood and NO fatalities. Odd.

Yes very interesting.

The difference of course it that now we definitely have some fatalities. My sense is this is going to be worse than these initial reports are letting on...very rarely have we seen a medical response team go out and NOT even get to the site to do the investigation.

 

[Treyfish]

Re: Sindhuli, Nepal: Undiagnosed Disease - 5 Dead/150 sick (High Fever, Vomiting Blood, etc)

Re: Sindhuli, Nepal: Undiagnosed Disease - 5 Dead/150 sick (High Fever, Vomiting Blood, etc)

:tiphat:Not seeing much on this story, but plenty of diareah stories. Here is another small story of an unknown disease in Nepal.

TWO CHILDREN DIE OF UNKNOWN DISEASE IN RUKUM
Date: 11th Aug 2009
Two children died of an unknown disease in Pol VDC -8 of north-eastern Rukum.

According to the District Police Office in Rukum, more than 100 children under 14 years of age are affected from the disease.

The District Health Office has demanded medicines from the centre.
:tiphat:http://www.radionepal.org/radionepal/news_detail.php?id=379412627856

 

[Rwilmer]

Re: Sindhuli, Nepal: Undiagnosed Disease - 5 Dead/150 sick (High Fever, Vomiting Blood, etc)

Re: Sindhuli, Nepal: Undiagnosed Disease - 5 Dead/150 sick (High Fever, Vomiting Blood, etc)

There is alot of undiagnosed diseases in nepal.

 

[alert]

Re: Sindhuli, Nepal: Undiagnosed Disease - 5 Dead/150 sick (High Fever, Vomiting Blood, etc)

Re: Sindhuli, Nepal: Undiagnosed Disease - 5 Dead/150 sick (High Fever, Vomiting Blood, etc)

There are a lot of undiagnosed diseases in Nepal because there is nothing even resembling medical infrastructure. No labs, few doctors, no medicine in most areas. Any outbreak will be an undiagnosed outbreak. The outbreak under consideration in Sindhuli could be almost anything, even H1N1 (and it really might be).

 

[alert]

Re: Sindhuli, Nepal: Undiagnosed Disease - 5 Dead/150 sick (High Fever, Vomiting Blood, etc)

Re: Sindhuli, Nepal: Undiagnosed Disease - 5 Dead/150 sick (High Fever, Vomiting Blood, etc)

Here's a ProMed post from four years ago in the same general area with very similar symptoms.

http://www.promedmail.org/pls/otn/f...,F2400_P1001_USE_ARCHIVE:1001,20050824.2493,Y

UNDIAGNOSED DEATHS - NEPAL (UDYAPUR): 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>

Sponsored in part by Elsevier, publisher of
International Journal of Microbial Agents
<http://intl.elsevierhealth.com/journals/ijaa>

Date: 24 Aug 2005
From: ProMED-mail <promed@promedmail.org>
Source: Xinhua Net, 23 Aug 2005 [edited]
<http://news.xinhuanet.com/english/2005-08/23/content_3394057.htm>


Mysterious disease kills 5 in eastern Nepal
-----------------------------------------------
At least 5 people have succumbed to a mysterious disease in eastern Nepal,
a government officer confirmed here Tuesday [23 Aug 2005].

"The unknown disease has claimed the lives of 3 patients in Beltar village
and 2 in Siddipur village, Udyapur district, some 300 km east of
Kathmandu," Jeevan Prasad Oli, chief district officer, told reporters.

The symptoms included high fever, headache as well as bleeding from the
nose and vomiting blood, Oli noted, adding: "Patients infected with the
disease have been taken to a hospital in Dharan city for treatment."

A 3-member medical team has already been sent to the disease-affected area,
Oli said.

The same disease claimed 2 lives in Beltar and Sundarpur villages 2 weeks
ago [2nd week August 2005], he added.

--
ProMED-mail
<promed@promedmail.org>

[ProMED-mail would appreciate more information on the above case clusters.

Checking the symptom complex with Gideon (Global Infectious Disease and
Epidemiology Network <http://www.gideononline.net>, the most likely
disease, given the symptoms presented above, would be one of the old world
hantaviruses. Searching the available literature, there is an article in
the Japanese literature (abstract in English)
<http://www.jarmam.gr.jp/jarmam/8-2/e/2.html> which identified an overall
seropositivity rate of 8.7 percent of 322 specimens from patients attending
outpatient clinics at the Tribhuvan University Teaching Hospital in
Kathmandu. Of note, a higher positivity rate of 12 percent was seen in
those living outside of the Kathmandu valley (5.1 percent), suggesting
hantavirus infection was more prevalent in rural areas. Given the above
information, hantavirus infection should remain in the differential
diagnosis, at least until more information on these cases is available. -
Mod.MPP]
..............................mpp/msp/mpp

 

[alert]

Re: Sindhuli, Nepal: Undiagnosed Disease - 5 Dead/150 sick (High Fever, Vomiting Blood, etc)

Re: Sindhuli, Nepal: Undiagnosed Disease - 5 Dead/150 sick (High Fever, Vomiting Blood, etc)

And one from three years ago - same region, same symptoms.

http://www.promedmail.org/pls/otn/f...,F2400_P1001_USE_ARCHIVE:1001,20060820.2339,Y

UNDIAGNOSED DEATHS - NEPAL (NUWAKOT): REQUEST FOR INFORMATION
***********************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

[1]
Date: 19 Aug 2006
From: ProMED-mail <promed@promedmail.org>
Source: Xinhua [edited]
<http://english.people.com.cn/200608/19/eng20060819_294852.html>


Unidentified disease kills 14 in central Nepal
-----------------------------------------------
An unprecedented epidemic of an unidentified disease has killed at
least 14 people, including 7 children, in central Nepal in the past 2
weeks, The Kathmandu Post reported on Saturday [19 Aug 2006].

According to the newspaper, the disease, which was 1st detected in
dogs and chickens during the last week of June 2006, had started
spreading to humans in Netini, a far eastern village of Nuwakot
district, some 50 km northwest of Kathmandu.

Major symptoms of the disease are high fever with bleeding from the
nose and mouth at the time of death.

--
ProMED-mail
<promed@promedmail.org>

******
[2]
Date: 19 Aug 2006
From: Joe Dudley <jdudley@eaicorp.com>
Source: eKantipur Online [edited]
<http://www.kantipuronline.com/kolnews.php?&nid=83207>


An unprecedented epidemic of an unidentified disease has killed at
least 14 people, including 7 children, in Netini VDC, a far eastern
village of the district, in the past 2 weeks.

The disease, which was 1st detected in dogs and chickens in the last
week of June 2006, has started spreading to humans.

Major symptoms of the disease are high fever with bleeding from the
nose and mouth at the time of death.

--
Joe Dudley
Chief Scientist, Biosecurity & Biosurveillance
EAI Corporation
SAIC
<jdudley@eai.com>

[Given the paucity of symptoms provided in the 2 very similar
newswires above, it would be very hazardous to venture a differential
diagnosis at this time. That being said, it is important to mention
that we were 1st alerted to this outbreak by a subscriber (who,
though known to us, did not wish that identifying information be
given), who mentioned that chat rooms/blogs were speculating that
this might be due to H5N1, given the history of poultry and dogs
(although dogs have not been routinely identified as being affected
by H5N1). It seems that in today's environment, any mention of an
animal death preceding undiagnosed human deaths results in a "knee
jerk" response on the part of bloggers to attribute deaths to H5N1
immediately, even if the symptoms are not clearly those associated
with human H5N1 deaths as seen in the majority of cases confirmed and
officially reported.

This moderator did use the Global infectious disease epidemiology
network (GIDEON <http://www.gideononline.net>) and ran the above
given information complex (fatal outcome, hemorrhagic illness, fever,
contact with birds (no choice of poultry was given) and dogs in
Nepal, and came up with: "No known infectious diseases fit this complex."

Eliminating exposure to birds, the most likely infectious disease
mentioned was leptospirosis, known to be endemic in Nepal. Another
febrile hemorrhagic disease reported in the literature to occur in
Nepal is old world hantavirus (from Mod.MPP discussion in ProMED-mail
posting Undiagnosed deaths - Nepal (Udyapur): RFI 20050824.2493:
"There is an article in the Japanese literature (abstract in English)
<http://www.jarmam.gr.jp/jarmam/8-2/e/2.html> which identified an
overall seropositivity rate of 8.7 percent of 322 specimens from
patients attending outpatient clinics at the Tribhuvan University
Teaching Hospital in Kathmandu. Of note, a higher positivity rate of
12 percent was seen in those living outside of the Kathmandu valley
(5.1 percent), suggesting hantavirus infection was more prevalent in
rural areas.").

As one can see from the see also list below, ProMED-mail reports of
undiagnosed illnesses and deaths in Nepal have not been rare.
Unfortunately, what has been rare is for ProMED-mail to receive
information from knowledgeable sources in Nepal on results of
epidemiologic and laboratory investigations into these reported
outbreaks and clusters. We are still awaiting information on an
outbreak reported last month (July 2006), for which this moderator
postulated that the most likely diagnosis might be typhoid fever.
Once again, we are requesting that knowledgeable sources (either
Nepal-based or organizations that have knowledgeable sources based in
Nepal) shed light into what may be the etiology of the above
mentioned fatal febrile illness with hemorrhagic phenomena occurring
in the Nuwakot district of Nepal. - Mod.MPP]

[see also:
Undiagnosed deaths - Nepal (Sankhuwasabha)(03): RFI 20060806.2194
Undiagnosed deaths - Nepal (Sankhuwasabha)(02): RFI 20060730.2108
Undiagnosed deaths - Nepal (Sankhuwasabha): RFI 20060728.2088
2005
----
Undiagnosed deaths - Nepal (Udyapur): RFI 20050824.2493
Undiagnosed deaths - Nepal: RFI 20050617.1709
2003
----
Unexplained deaths - Nepal (Bajura): RFI 20030212.0377
1999
----
Unidentified disease - Nepal 19990308.0345
1996
----
Fever, fatal - Nepal (5) 19960422.0760
Fever, fatal - Nepal (3): Current status 19960418.0749
Mystery fever in Nepal. 19960416.0728
Fever, fatal - Nepal (2): ?possible diagnoses 19960411.0687
Fever, fatal - Nepal (press report) 19960409.0673]
....................mpp/msp/mpp

 

[alert]

Re: Sindhuli, Nepal: Undiagnosed Disease - 5 Dead/150 sick (High Fever, Vomiting Blood, etc)

Re: Sindhuli, Nepal: Undiagnosed Disease - 5 Dead/150 sick (High Fever, Vomiting Blood, etc)

Many undiagnosed reports out of ProMed about Nepal have included this comment, which is more appropriate now than ever:

"As one can see from the see also list below,
ProMED-mail reports of undiagnosed illnesses and deaths in Nepal have not
been rare. Unfortunately, what has been rare is for ProMED-mail to receive
information from knowledgeable sources in Nepal on results of epidemiologic
and laboratory investigations into these reported outbreaks and clusters."
As always, we are hoping that knowledgeable sources (either Nepal-based or
organizations that have knowledgeable sources in Nepal) might shed some
light on the above mentioned fatal febrile respiratory disease.

After reading through the history, this current outbreak really looks like what influenza (seasonal, pandemic, or bird) does in a population like this.

 

[alert]

Re: Sindhuli, Nepal: Undiagnosed Disease - 5 Dead/150 sick (High Fever, Vomiting Blood, etc)

Re: Sindhuli, Nepal: Undiagnosed Disease - 5 Dead/150 sick (High Fever, Vomiting Blood, etc)

And one more, again from three years ago, same region, similar symptoms. That outbreak turned out to be exaggerated. While that is unlikely here, the symptomatic description might be. This would explain the apparent low CFR for a hemorrhagic illness - it isn't really hemorrhagic. That would also explain calling off the medical team - they had the wrong drugs because they were treating the wrong symptoms. Note the bold text.

http://www.promedmail.org/pls/otn/f...,F2400_P1001_USE_ARCHIVE:1001,20061020.3019,Y

[In response to the request for information about an outbreak of an acute
febrile respiratory illness with 8 unexplained deaths in Dadeldhura Nepal
-- Undiagnosed deaths - Nepal (Dadeldhura): RFI 20061014.2954 -- reported
in a newswire, Dr. Khanchit Limpakarnjanarat, from the WHO South East Asian
Regional Office (SEARO) Outbreak group forwarded a series of correspondence
surrounding an investigation conducted by the WHO SEARO Outbreak Group in
collaboration with the WHO office in Nepal and the Nepali Ministry of
Health for an earlier "mystery" outbreak in Chamchet village, Kathmandu,
Nepal during September 2006.

The final conclusion of the investigation was that there was no unusual
outbreak, nor a cluster of unexplained deaths. "Persons who went to
investigate had reported that there was no unusual morbidity as claimed in
the press in that VDC [district]. Neither was there any mortality
attributable to an epidemic outbreak. Additional support was neither needed
nor requested. Press had exaggerated the normally prevailing ailments of
the locality it appears.... This confirms what was originally suspected
about this report, and that media is used to draw attention to underserved
regions by declaring phantom epidemics of rare diseases. This is not the
first time in the last year this has happened."

From the information provided in the follow-up newswire on the outbreak in
Dadeldhura above, it appears as though the news reports of this outbreak
were also distorted. This moderator frequently gives lectures on the value
of the informal sector in disease surveillance. One of the points in these
lectures deals with constraints with using informal sources -- the
possibility of a secondary agenda on the part of the source. In the above
case, it appears as though the media is being "used" to highlight
weaknesses in the health care delivery system in an area of a country.

In the specific case of the reported 8 undiagnosed deaths in Dadeldhura,
Nepal, the conclusion seems to be that there was no unusual outbreak, nor
were there unexplained deaths in the region, and that the media report was
in fact spurious. Fortunately, we have had a low percentage of spurious
reports posted on ProMED, and we continue to view the media as a valuable
source of early reports on disease outbreaks and unusual disease occurrence.

In many countries, a significant proportion of the population does not use
official ministry of health facilities as their first line of assistance
when an illness occurs, so these cases are not being seen by health care
providers, who would be reporting these cases through the official disease
surveillance system. An anecdotal report from one country epidemiologist
was that they learned of 60-70 percent of the outbreaks in their country
from local media reports. Fortunately, the number of false reports appears
to be low.

 

[Vibrant62]

Re: Sindhuli, Nepal: Undiagnosed Disease - 5 Dead/150 sick (High Fever, Vomiting Blood, etc)

Re: Sindhuli, Nepal: Undiagnosed Disease - 5 Dead/150 sick (High Fever, Vomiting Blood, etc)

alert - you have made some valid points. Given the annual regularity of outbreaks like this in this region perhaps we will gain more by measuring/ plotting the numbers, frequency and distribution of such outbreaks.

Whilst outbreaks seem to occur regularly they usually seem confined to a single locality and are seperated by time. It we start to see multiple loci simultaeneously or closely linked in time then it would be a stronger signal for immediate concern.

In the absence of proper facilities its probably about the best we can do. Hopefully WHO testing will at least identify the causative agents for this one.

 

[Jeremy]

Re: Sindhuli, Nepal: Undiagnosed Disease - 5 Dead/150 sick (High Fever, Vomiting Blood, etc)

Re: Sindhuli, Nepal: Undiagnosed Disease - 5 Dead/150 sick (High Fever, Vomiting Blood, etc)

http://www.myrepublica.com/portal/index.php?action=news_details&news_id=8552
Mystery disease kills one more

SINDHULI, Aug 12: A 13-year-old girl died of the mystery disease in Kapilakot VDC of Sindhuli on Tuesday, taking the toll to six including five in Kalpabriksha and Kyaneshwar VDCs.

Surprisingly, the government mechanism is yet to identify the disease in the not-so-remote district, 11 days after the first death.

The Epidemiology and Disease Control Division, which said on Sunday and Monday that the deaths are not due to diarrhea or malaria, has made no headway thereafter.

A team each from Kathmandu and Janakpur were sent to the area on Sunday while a team from district headquarters reached the area on Saturday but the division maintains that it has not found time to bring the samples to Kathmandu for test.

Dr Khanal claimed that the disease has been contained, but failed to justify how the disease, which has not even been identified, was contained.