Unknown viral outbreak - Namibia - Min of Health reacts to poss viral outbreak

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<TABLE width="100%"><TBODY><TR><TD colSpan=2>http://www.nbc.com.na/news/today.php?newsid=255

The Ministry Of Health Reacts To A Possible Outbreak Of Viral Infection

The Ministry of Health and Social Services has reported 22 cases of a possible outbreak of a viral infection with acute paralysis in the Hardap, Khomas and Otjozondjupa regions.
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The disease has claimed five lives since the first case was reported on the 7th of last month.

The first case was reported at Aranos in the Hardap region, while Katutura in the Khomas region has reported 19 cases and the Otjozondjupa region two.

Five of the deceased were female of whom one was pregnant, while the rest were male. The infection is reported to affect those in the age groups between 14 and 55.

The Deputy Minister of Health and Social Services, Petrina Haingura says her Ministry has already taken steps to stop further infections.

"all patients are isolated and movement of visitors is limited to avoid further potential spread of the illness to others. All cases reported so far were thoroughly investigated e.g stool specimen of all patients were collected for laboratory investigation, blood specimens taken for various tests, urine specimens, as well as culture investigation on the spinal fluid taken from patients. Autopsy will be procedurally conducted on the cases that we lost"

The signs and symptoms of the infection range from lower limb weaknesses, paralysis, breathing with difficulties, unable to walk, chest pain, cold and flu, neck stiffness, headache and dizziness.

Haingura has assured the nation that her ministry is trying its utmost to mobilize the necessary human, financial, technical and material resources to address the situation.

"the Ministry of Health and Social Services would like to inform the public that the situation is getting the highest attention from the Ministry because of the uniqueness of the problem. Information to the public will be continuously provided through the media, as well as update of the situation at hand. The public is requested to stay calm and to please report any suspected cases with sudden weakness of the extremities to any health facility nearby without delay"

Meanwhile, the chairperson of the National Health Emergency and Management Committee, Dr Jack Vries says the Ministry has dispatched medical teams to the affected areas to carry out indepth investigations.

"at this moment we have teams that have gone out to go and find out where these people have been, who they came into contact with, find out the water they drink, food, we are looking for anything we can lay our hands on, to come to the definite diagnosis. We have an idea but it`s still useful that we get that information now"

She says the last case was reported on Thursday while describing the condition of the infected pregnant women as critical.

"Thursday night that has been the last reported case and the pregnant mother is still quiet sick, she is in a critical condition. The parts of the body that has been involved initially the legs are involved and moves upwards to involve the arms, most of the patients are not able to walk, that is the most outstanding parts of the body"

She assured the nation that the Ministry was doing its best to keep the patients alive while diagnoses are being made to determine the appropriate course of treatment.

"there is a clinical team meeting on a daily basis because the diagnosis is uncertain and so a team of specialists from different disciplines are organized at a treatment Protocol, the most urgent thing is to keep people alive"

The specimens taken from the patients have been sent to South Africa and results are expected by next Wednesday.</TD></TR></TBODY></TABLE>

 

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Re: The Ministry Of Health Reacts To A Possible Outbreak Of Viral Infection

Re: The Ministry Of Health Reacts To A Possible Outbreak Of Viral Infection

I don't know what this is but it doesn't look good.

 

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Re: Namibia: The Ministry Of Health Reacts To A Possible Outbreak Of Viral Infection

Re: Namibia: The Ministry Of Health Reacts To A Possible Outbreak Of Viral Infection

http://www.promedmail.org/pls/promed/f?p=2400:1001:11002679489767212827::NO::F2400_P1001_BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,33122

UNDIAGNOSED PARALYTIC DISEASE - NAMIBIA: REQUEST FOR INFORMATION
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A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: 2 Jun 2006
From: A-Lan.Banks@thomson.com
Source: The Namibian [edited]
<http://www.namibian.com.na/2006/June/national/06275E4F29.html>


Panic is sweeping through suburbs north of Katutura after 3 people
died and 19 others were hospitalised with a disease that still has to
be identified.

A press release from the Ministry of Health and Social Services last
night indicated that the disease was not confined to the Khomas
Region, and that cases of "undiagnosed paralysis" among adults had
been reported in the Otjozondjupa and Hardap regions.

A media briefing is scheduled for this morning to reveal information
related to the outbreak.

Well-placed hospital sources confirmed yesterday that 2 other people
were fighting for their lives in the Intensive Care Unit (ICU) of the
Windhoek Central Hospital after contracting the mystery disease.

Health personnel revealed that parts of the Katutura and Windhoek
Central Hospital have been declared restricted areas as Government
intensifies efforts to identify the disease and to deal with it.

When The Namibian visited the Okahandja Park informal settlement
yesterday to speak to a family who lost a baby, residents confirmed
that another child had died a few hours earlier in Babilon.

An emergency meeting took place late yesterday afternoon after health
personnel conducted a quick survey in Okuryangava and Okahandja Park.
They were reporting their findings to the Deputy Minister of Health,
Petrina Haingura, and other senior staff members of the Ministry.

Health sources said 18 adults and a child were hospitalised at the
Katutura and Windhoek Central hospitals and samples have been sent to
South Africa for analysis.

There were fears that they were all attacked by Guillain-Barre
syndrome (GBS) -- a disorder of the peripheral nervous system. It
causes the nerves to inflame, slowing communication to and from the
brain. Eventually, the brain is not able to effectively communicate
with the peripheral nerves, causing paralysis. Victims become
severely out of breath and unable to perform previously effortless
tasks, such as swallowing. Cramps and body aches often follow. After
approximately 2 weeks, the patient may deteriorate to a condition of
severe paralysis.

However, health personnel said the disease appeared not to be GBS,
although the symptoms were similar. "We can't say exactly what it is
but we also do not want to sound alarm.

"People must stay calm for now," said one senior health official.

A [father] who lost his 10-month-old baby on Monday, said it all
happened very quickly. "She started crying on Sunday night and we
took her to hospital where she got tablets. She was fine the next
morning when I went to work and took medicine. Next thing she started
vomiting and we took her back. She died while we were waiting for
treatment," he said. He also said the baby was not sick before that.
He is leaving for the North today to bury the baby.

A community activist in Okahandja Park, said she knew of a man who
died on board a bus to the North. "It is very strange. He stopped
speaking and his eyes started getting bigger before he died. He was
in the bus waiting for its departure to the North," she said.

Another volunteer at the Okahandja Park Bridging Children School said
they had 19 children absent yesterday. They were told that some had
polio symptoms but will only know today what exactly was wrong.

[Byline: Christof Maletsky]

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

[The above description of clinical illness is not very clear, making
a differential diagnosis difficult at this point. The newswire (and
presumably the reporter) are suggesting clinical symptoms consistent
with a diagnosis of Guillain-Barre Syndrome and or polio, although
the 2 cases that are described do not seem consistent with either
classical GBS or classical polio.

GBS, an acute ascending, usually symmetrical, paralysis, associated
with sensory deficits can be confused with polio, especially with the
formerly called "bulbar" version of polio, in which there is
accompanying respiratory compromise due to paralysis of the muscles
associated with respiration. Typically though, polio is an acute
flaccid paralysis that is asymmetrical and not associated with
sensory deficits.

Before venturing speculations on the etiology of the above illness,
this moderator would very much appreciate more information from
knowledgeable sources. - Mod.MPP]

 

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Re: Namibia: The Ministry Of Health Reacts To A Possible Outbreak Of Viral Infection

Re: Namibia: The Ministry Of Health Reacts To A Possible Outbreak Of Viral Infection

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JOHANNESBURG, 5 Jun 2006 (IRIN) - Five people have died from an as yet unnamed disease in Namibia and health authorities are eagerly awaiting the results from urine, stool and blood specimens sent to South Africa.

Tests carried out locally failed to yield conclusive results. "We really don't have an idea what the disease is, and investigations are going on," Erna Awaseb, acting director of primary healthcare, told IRIN.

Initially, the disease was confirmed in three informal settlements in Katutura, the capital's oldest township, but Awaseb said it had also been found south of Windhoek in the Karas Region and to the north in the Otjozondjupa Region.

"We are still investigating why it has been notified in these regions, but that can only happen after we identify what the disease is," Awaseb confirmed. The test results are expected on Wednesday this week.

Windhoek Central Hospital (WCH), Namibia's biggest referral center, is caring for 17 people ranging from 14 to 55 years old, one of whom is in critical condition, with 15 others at Katutura State Hospital.

Dr Helen Kandi-Shiimi, senior medical superintendent of WCH, said the disease caused paralysis or weakness of the lower limbs and had symptoms similar to those of poliomyelitis.

At a press conference on Friday last week, acting health minister Petrina Haingura said other symptoms included breathing difficulties, chest pains, headaches and dizziness.

Initial fears were that the disease was Guillain-Barre syndrome - a disorder of the nervous system - or a polio outbreak, but tests have ruled out both of these. Haingura said there "was more to the disease", and the government was working closely with the World Health Organisation (WHO) to identify and deal with it.

"It's too early to say what the disease is, but there is no need to panic," the programme officer at WHO, Dr Desta Eiruneh, told IRIN.

According to the Namibian, a local daily newspaper, the permanent secretary of health, Maggie Nghatanga, said the first case had been reported on 7 May in Aranos, a small town south of Windhoek, and the patient was still on ventilator support.

Health officials have not yet been able to confirm the number of new cases, but Nghatanga promised that "every possible action, in terms of investigation, is being taken".

http://www.irinnews.org/report.asp?ReportID=53736&SelectRegion=Southern_Africa&SelectCountry=NAMIBIA

 

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Re: Namibia: The Ministry Of Health Reacts To A Possible Outbreak Of Viral Infection

Re: Namibia: The Ministry Of Health Reacts To A Possible Outbreak Of Viral Infection

the first case had been reported on 7 May in Aranos
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May 7th: 1 Case

Windhoek Central Hospital (WCH), Namibia's biggest referral center, is caring for 17 people ranging from 14 to 55 years old, one of whom is in critical condition, with 15 others at Katutura State Hospital.

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This tells of two hospitals housing a total of 32 patients.

Windhoek Central Hospital (WCH) has 17 patients.
Katutura State Hospital has 15 patients.

Five people have died from an as yet unnamed disease in Namibia
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And a total of 5 people have already died from this unnamed disease.

So in doing all the math on this one we have definetly have 37 people who have become infected, maybe 38.

The 37 definte cases are a combination of the 32 currently in hospitals, along with the 5 that have already died.

It is unknown wheter or not the first reported case is one of the deceased, recovered, or currently one of the 32 patients in the hospital.

Regardless, we have some pretty explosive growth with this outbreak.

05/07/2006: 1 case
06/05/2006: 37 cases

This situation needs to watched very carefully as it is not currently reported what the disease could be.

"It's too early to say what the disease is, but there is no need to panic," the programme officer at WHO, Dr Desta Eiruneh, told IRIN.
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I have yet to see someone say, "Ok, it is time to panic".

Somehow these words are not reassuring and the fact that they still have no idea what is causing this more than 4 weeks into the outbreak is a 'major cause for concern'.

 

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Re: Namibia: The Ministry Of Health Reacts To A Possible Outbreak Of Viral Infection

Re: Namibia: The Ministry Of Health Reacts To A Possible Outbreak Of Viral Infection

http://www.bloomberg.com/apps/news?pid=10000087&sid=ahmoGwr3ZfFk&refer=top_world_news
Namibian Polio Outbreak Leaves Seven Dead, 34 Hospitalized

June 6 (Bloomberg) -- Seven people have died and 34 have been hospitalized in Namibia following an outbreak of polio, said Kalumbi Shangula, permanent secretary at the ministry of health.

The disease has been reported in the capital Windhoek and in the eastern town of Aranos, Shangula said at a press briefing today. Tests conducted in neighboring South Africa indicated that it was the Wild Virus Type 1 strain of the disease.

``The ministry shall embark on mass public education and vaccination campaigns,'' Shangula said.

Namibia's last polio case was reported in 1995, according to the World Health Organization. The virus is endemic in Nigeria, India, Pakistan and Afghanistan.

 

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Re: Namibia: The Ministry Of Health Reacts To A Possible Outbreak Of Viral Infection

Re: Namibia: The Ministry Of Health Reacts To A Possible Outbreak Of Viral Infection

Tests conducted in neighboring South Africa indicated that it was the Wild Virus Type 1 strain of the disease.



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South Africa says that the outbreak is due to Wild Virus Type 1 strain of polio.

It is very interesting because yesterday we got this report.

Initial fears were that the disease was Guillain-Barre syndrome - a disorder of the nervous system - or a polio outbreak, but tests have ruled out both of these. Haingura said there "was more to the disease", and the government was working closely with the World Health Organisation (WHO) to identify and deal with it.



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It makes you wonder if Namibia didn't have the ability to test for Wild Virus Type 1 strain and therefore could not find it or South African labs aren't telling the whole truth or maybe they do have polio.

It has been highly speculated that Bird Flu is running rampant in South Africa right now but they have yet to announce any cases of Bird Flu.

Currently South Africa has outbreaks of Newscastle Disease in Birds, African Swine Fever in swine, African Horse Sickness in horses and a litany of hemorhaggic fevers outbreaks in humans.

So therefore it is tough to take what South Africa says on face value.

Here is some information on WPV Wild Poliovirus Type 1. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5506a1.htm

You make the call.

 

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Re: Namibia: The Ministry Of Health Reacts To A Possible Outbreak Of Viral Infection

Re: Namibia: The Ministry Of Health Reacts To A Possible Outbreak Of Viral Infection

http://www.nytimes.com/2006/06/09/health/09cnd-polio.html?hp&ex=1149912000&en=37924d707196b4f4&ei=5094&partner=homepage
W.H.O. Judges Polio Outbreak as 'Highly Unusual'

An outbreak of polio in recent weeks in the southern African nation of Namibia, which had been free of the disease for a decade, is highly unusual because the disease is striking and killing adults, according to the World Health Organization.

The fast-moving outbreak has killed 7 Namibians and paralyzed 33 more, and panicked citizens have deluged hospitals seeking immunization against polio. But there was very little vaccine in the country ? only enough for routine vaccination of infants ? so supplies quickly ran out and people were turned away.

Once new shipments arrive, it should be relatively easy to bring the outbreak under control, said Dr. David L. Heymann, the W.H.O. director general's representative for polio eradication. The country's health minister said he did not expect to get a vaccination campaign under way until June 21.

Namibia, a desert country of 2 million people on Africa's southwest coast, is rarely in the news, but it has seen intense coverage in gossip columns recently because Angelina Jolie gave birth there on May 27 to her daughter with Brad Pitt.

It was not clear yesterday whether Namibia's most famous newborn, Shiloh Nouvel Jolie-Pitt, had been vaccinated against polio. The vaccine is not normally given until a child is two months old, but immunizations at birth are being done experimentally in parts of India where the disease is endemic, Dr. Heymann said.

Shiloh was born in Swakopmund, near a coastal resort where her parents had been staying; the outbreak is centered in Windhoek, the capital, about 150 miles inland.

Last year, Mr. Pitt narrated a public television documentary about disease eradication, including the effort to eliminate polio, which has been reduced by 99 percent since 1988 and has been hovering on the edge of eradication for years, but keeps breaking out in new countries.

Polio normally attacks infants and young children, not adults, and causes paralysis in about 1 of 200 of those cases. Children with withered limbs begging on street corners are a common site in parts of Africa and India.
In very rare cases, the infection goes up the spine to the brain stem and paralyzes the breathing muscles, killing victims unless they are quickly put on respirators. Mechanical respirators, which blow air into the lungs, have replaced the classic Western symbol of polio ? the iron lung machines of the 1950's, which drew in air by pressing on the patient's ribcage.

In the other 199 cases out 0f 200, the virus causes a mild flu-like illness or no symptoms at all, and the infected child gains lifelong immunity against the disease.

Because there can be so many of these hidden cases, the appearance of even a few cases of paralysis constitute a serious outbreak. Afghanistan, for example, has had fewer than 12 cases of paralysis a year since 2001, but has not been able to wipe out the stubborn disease.

In adults, however, the disease is far more serious than in children, and is much more likely to paralyze or kill.

Namibia's odd history makes it especially vulnerable. It was a German colony before World War I and the language is still common there, though Britain captured it during the war and it became a protectorate of South Africa afterward; it gained independence in 1990.

Before independence ? which ended a long civil war between Cuban-aided black nationalists and the American-aided white South African government ? polio vaccination was not routine in the country. Since 1990, the vaccine has been given only to children under 5, as is normal in the rest of the world, and the country last saw a case of polio in 1996.

Because the country is sparsely populated, with a desert climate and cities with paved boulevards, it lacks the overflowing open sewers where the virus thrives during the rainy season in countries like Nigeria and India.
(The virus is shed in feces, and can be picked up by, for example, touching a soccer ball that has rolled into a gutter and then putting fingers in the mouth. During the outbreak in the United States of the 1950's, public pools were shut down and children were told to watch out for drinking fountains, door handles and anything else that many people touched.)

As a result, Dr. Heymann explained, almost no one over 15 in Namibia has any protection from polio: they have not been vaccinated, and have no natural immunity from exposure to polio passing through the population.
The first detected case in the current outbreak, he said, was a 39-year-old farmer who went to Windhoek, a city of 125,000, in early May for a gall-bladder operation. He fell ill two weeks after returning to Aranos, his home town, and is now on a respirator.

The known cases in the outbreak, all discovered since then, are largely confined to people over the age of 20 in Windhoek and Aranos.

The strain of polio found in Namibia is also unusual because it is an Indian strain, unrelated to the Nigerian strain of the disease that has moved across Africa in recent years and has spread as far as Saudi Arabia, Yemen and Indonesia. There was an outbreak of the Indian strain last year in Angola, which borders Namibia and is the presumed source of the current outbreak.

 

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Re: Unknown viral outbreak - Namibia - Min of Health reacts to poss viral outbreak

Just unbelievable what's going on with Namibia's animals. Everything has apparently caught rabies! So bizarre. I wonder if somehow what's happening to the animals is what's happening to the people too...

Namibia: Rabies Scare 'Normal' This Year

New Era

June 22, 2006
Posted to the web June 22, 2006

Wezi Tjaronda
Windhoek

Veterinary officials have urged pet owners and farmers to vaccinate their animals against rabies, since what appears to be a kudu pest is actually a rabies outbreak.

Although there has been confusion among mostly farmers regarding the deaths amongst kudu populations in northern and central Namibia, with the disease being referred to as kudu pest, a private veterinarian, Dr Ulf Tubbesing says; "There is absolutely no doubt this is an outbreak as it occurred in 1977-85, when it caused severe mortality amongst the kudu population."

Apart from kudus, eland species are also at risk considering that some game farms have reported high mortality rates in this species, says the veterinarian.

A rabid domesticated animal becomes wild showing unexplained aggression, whereas wildlife become strangely tame by straying into towns, gardens and homes. Recent weeks have seen kudus straying into towns due to the same problems.

Official figures of rabies cases in 11 wildlife species stand at 115 as from January to date, with government figures saying that this was normal for any given year.

Of the 11 species that have been reported to the veterinary officials, cattle have the highest number of reported cases at 39, followed by kudus with 28 cases while dogs have 26 reported cases.

This week, the National Epidemiologist in the Ministry of Agriculture, Water and Forestry, Dr Alec Bishi, said the figures pointed to a normal situation with rabies that happens around this time of the year.

Compared to other years such as 2002 and 2001 when the country recorded 164 and 156 cases respectively, Dr Bishi said this year is a normal situation like the outbreak some three to four years ago.

The Namibia Professional Hunting Association also said there was no outbreak. But Dr Tubbesing said apart from killing some rabid kudus on his farm, many other farmers have complained about the situation, especially in the vicinity of Windhoek.

"Over the past two years I have personally observed how this disease diminished the once very healthy kudu population on our farm near Windhoek to a mere fraction of its original number," he said in a short overview to his clients, which was made available to New Era.

"Lots of cases are being reported. It's quite a big problem," he said.

He said official figures were low because many people who are sure of a rabies case do not go through the hassle of taking the infected animals to the laboratory for tests.

"Their behaviour is typical of rabies. Kudus are running into farms, they do not fear people, I can't see why it's not an outbreak," he said.

Dr Bishi also said that the only cases that the ministry is able to deal with are ones that are reported. The areas that have reported cases are East Caprivi, Gobabis, Grootfontein, Hereroland West, Kaokoland, Karasburg, Karas, Kavango, Okahandja, Omaruru, Outjo, Windhoek and the central northern areas. Apart from cattle, kudus and dogs, other species involved are six goats, nine cats, two jackals, one mongoose, sheep, pigs, hyenas and horses.

Bishi called on all pet, wildlife and livestock owners to vaccinate their animals especially where there are many jackals, where their animals would be bitten and infected with the virus, which has a mortality rate of 100 percent.

Tubbesing said that in a kudu population rabies starts with an individual being bitten by a rabid animal and is then spread through communal grooming and group feeding from the same bush or tree, a social behaviour of the species.

"Since in kudu the portal of infection is in very close proximity to both brain and salivary glands, it appears logical that both the course of disease in an animal and the spread of rabies within a kudu population is far quicker and more dramatic than in most species," said Tubbesing.

He also explains that not many other species are infected as much as kudus because most carnivores on commercial farmland tend to occur as solitary animals or in small groups which make them less susceptible to an 'outbreak' of rabies.

The ministry only vaccinates pets, while private veterinarians assist farmers to have their livestock and wildlife vaccinated.

Vaccination in kudu species is however costly, as Tubbesing says such a campaign could be executed within one week at a cost equivalent to the trophy fee of around 8 kudus.

Oral vaccines are not feasible in Namibia as is the case in Europe because of climatic conditions, the vastness of the country and the associated costs, which are exorbitant.

Another option could be a capture-and-release pro-gramme with the aid of a helicopter where the estimated the population can be herded into a boma where they could be vaccinated and marked to avoid duplication.

Rabies symptoms are aggressiveness, lack of fear for human beings, getting close to dwelling places, production of lots of saliva, chasing after moving objectives. In later stages, the animals are paralyzed, unable to drink and eventually die.