Undianosed illness - From ProMed

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http://www.promedmail.org/pls/otn/f..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,78443

UNDIAGNOSED ILLNESS - INDIA: (GOA) REQUEST FOR INFORMATION
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Date: Wed 22 Jul 2009
Source: The Times of India (TOI) [edited]
<http://timesofindia.indiatimes.com/articleshow/4805287.cms>


All 41 households at Mascavrem village in Sanguem have been affected
by the mysterious fever that has been raging through remote and rural
areas of the taluka [administrative division] for the last one month.
This was discovered by a team from the directorate of health services
(DHS) that rushed to the affected areas following a report in this
newspaper on Tuesday [21 Jul 2009].

The team also discovered that the disease had spread to nearby
villages. "We have taken blood samples of 25 patients from Mascavrem
and 16 from Danolem. In Mascavrem, we found that at least one member
of each of the 41 households had suffered from the fever. The samples
will be sent to the microbiology department of the Goa Medical
College (GMC) for tests. The exact cause of the disease will be known
only after we get the results," said Dr Ravindra Nadkarni, chief
medical officer (non-communicable diseases), who led the DHS team.
The DHS team visited Cavrem, Colomb, Curpem, and adjoining areas and
surveyed the villages to identify possible causes of the suspected
fever.

The team, it is learnt, discovered that an abandoned tank, used for
distilling country liquor by the locals, had developed into a
breeding ground for mosquitoes. The team is of the view that the
unhygienic conditions prevailing at the site had led to the spread of
vector-borne diseases in the villages. "We started looking for
possible mosquito breeding grounds and stumbled across this tank at
Mascavrem that had been breeding plenty of mosquitoes. The tank was
possibly used for distilling country liquor and was mysteriously
covered by coconut leaves to camouflage it," Dr Nadkarni told TOI.

He added that DHS would soon launch an awareness campaign to educate
the villagers about the need to eliminate all possible breeding
grounds for mosquitoes and ensure proper sanitation in their
surroundings. "We have fogged the area today [21 Jul 2009], but
awareness needs to be created among the villagers about the steps to
be taken to prevent vector-borne diseases," he added.

Health Services director Rajananda Desai said on Tuesday [21 Jul
2009] that she is monitoring the mystery fever in remote rural areas
of Sanguem taluka. "The local health centre had already taken steps
to identify the cause of the illness," Dr Desai said.

Meanwhile, private medical practitioner from Colomb, Dr Avdhut
Prabhudesai, continues to get fresh cases showing similar symptoms.
"I got 4 more cases today [21 Jul 2009]. It is imperative that the
health authorities act fast and take steps to control the epidemic to
alleviate the sufferings of the rural poor," Dr Prabhudesai told TOI
on Tuesday [21 Jul 2009]. He added that he got in touch with the
director of health services on Tuesday and briefed her about the
cases treated by him during the last 4 weeks.

Dr Prabhudesai has urged the authorities to conduct a thorough
investigation of the cases. "People from as far as Mangal and Devrem
are coming here for treatment which suggests that the epidemic is not
limited to Colomb alone," Dr Prabhudesai said.

[Byline: Govind Kamat Maad]

--
Communicated by:
ProMED-mail Rapporteur Susan Baekeland

[Since the only symptom reported here is fever, a diagnosis of the
etiological agent involved in these cases is not possible until the
laboratory results or a more complete clinical picture are available.
This report indicates that the local health officials and field staff
think that mosquitoes are involved in this spreading outbreak.
ProMED-mail would appreciate receiving additional information, and
especially laboratory results, as they become available.

Interactive maps of India showing the location of Sanguem in South
Goa district can be accessed at
<http://www.maplandia.com/india/goa/south-goa/sanguem/>
and the HealthMap/ProMED-mail interactive map at
<http://healthmap.org/r/00Ce>. - Mod.TY]
...................................lm/ty/mj/lm

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[alert]

Re: Undianosed illness - From ProMed

Maybe someone should send this article to ProMed as it seems to suspect chikungunya.

http://timesofindia.indiatimes.com/...rages-through-Sanguem/articleshow/4801118.cms

Mystery fever rages through Sanguem
Govind Kamat Maad, TNN 21 July 2009, 05:05am IST
Print Email Discuss Bookmark/Share Save Comment Text Size: |

MARGAO: High fever accompanied by severe rashes and acute joint pains is raging through some remote and rural areas of Sanguem.


Sources say people started developing these symptoms about a month back. Villagers of Cavrem, some 4 km from Colomb, and surrounding areas are the worst hit. ?Many from the village are down with fever and quite a few have difficulty walking,? Milagres Dias, a villager, said.

Medical practitioner Avdhut Prabhudesai of Colomb told TOI on Monday that he had treated at least 70-75 patients with these symptoms during the last four weeks.

Though there is a primary health centre at Colomb, the directorate of health services is not aware of the large number of cases.

?I am unaware of any such cases. The local health centre may have taken some steps, it will have to be investigated,? health director Rajnanda Dessai told TOI when contacted.

State epidemiologist Rajendra Tamba, after being informed of the outbreak by TOI, contacted the health centre, which informed him that the cases have already been tested and found negative for malaria. They will now be tested for chikungunya.

Dr Tamba too was in the dark till this newspaper contacted him. ?We are yet to be notified by any medical practitioner from the area. I will inquire with the local health centre immediately,? he had told TOI earlier in the day.

?On an average, I have been getting four to five patients daily for the last three to four weeks. Most had complained of excruciating pain in the joints. The pain had forced some to stay in bed for almost a week,? said Dr Prabhudesai, the lone private medical practitioner in the 20 sq km area comprising Colomb, Kevona, Donolem, Cazur, Pirla, Kurpem, Kavrem, Jaki, Nunem, Managal and Devrem areas in Sanguem taluka.

?Identify virus strain?

MARGAO: A mystery fever has been raging through remote rural areas of Sanguem taluka for the last one month. Most patients are responding fairly well to the ?symptomatic treatment? provided by Dr Avdhut Prabhudesai, the lone private practitioner in the area. However, the lack of laboratory facilities in the village has rendered the task of identifying the disease difficult.

Though there has been no mortality, there has been substantial increase in morbidity and that remains a cause of concern, Dr Prabhudesai said.

Prabhudesai says the DHS should take immediate steps to identify the virus strain. He is however, yet to notify the development to the DHS. ?The sub-centre of the DHS is close to my clinic, anyway. They should have been aware of the spurt in such cases,? he said.

Associate professor at the department of preventive and social medicine of Goa Medical College, Dr Jagdish Kakodkar when contacted, said that only a serological survey could ascertain the disease.

?The symptoms appear to be similar to that of chikungunya, followed by dengue. However, the suspected outbreak of the disease has first to be reported to the nearest health centre by the medical practitioner treating such cases. The health centre will then inform the IDSP (Integrated Disease Surveillance Project) of the DHS which in turn will verify if there is any outbreak (of the epidemic) and then conduct a serological survey,? Kakodkar said.

Prabhudesai puts his patients on a course of analgesics and advises adequate rest and wholesome nutrition. ?This has worked well so far, as the symptoms disappear within a week. I had to refer just one case to the Goa Medical College ? that of a three-month infant from Kurpem after his condition turned serious,? Prabhudesai said