Re: Viet Nam - Quang Ngai: Undiagnosed illness, 24 fatalities since April 2011 in Ba To commune, 4 in Son Ky, 1 in Son Ha
Re: Viet Nam - Quang Ngai: Undiagnosed illness, 24 fatalities since April 2011 in Ba To commune, 4 in Son Ky, 1 in Son Ha
Published Date: 2013-03-12 14:02:00
Subject: PRO/EDR> Undiagnosed illness - Viet Nam (01): (QG) resurgence
Archive Number: 20130312.1583058
UNDIAGNOSED ILLNESS - VIET NAM (01): (QUANG NGAI) RESURGENCE
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[1]Date: Thu 28 Feb 2013
Source: Quang Ngai province Information and Communications Department [edited]
http://www.quangngai.gov.vn/eng/Pag...obesprayed-qnpnd-8094-qnpnc-68-qnpsite-1.html
After discovering 2 cases of the "strange disease" in Son Ba commune (Son Ha mountainous district), the Malaria Parasite-Insect Central in coordination with the Quang Ngai provincial General Hospital organized screening for the H're [an ethnic group] living in the commune.
During 23-24 Feb 2013, the doctor mission of the health sector conducted examination and screening tests for 341 cases, blood tests for 38 cases. Through test examination activities, 9 cases were discovered to [have] high liver enzymes, mainly concentrating in the 2 villages of Ka Khu and Ba.
In the morning of 27 Feb 2013, the provincial Preventive Medicine Center sprayed chemicals for disinfection and sterilization with chloramine B at a concentration of 2 per cent in the aforesaid villages with the ratio of 20 mg/100 sq m to prevent the disease epidemic.
[byline: Dai Kiet]
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[2]
Date: Mon 4 Mar 2013
Source: Thanh Nien News [edited]
http://www.thanhniennews.com/index/...-returns-in-central-vietnam-after-hiatus.aspx
Fatal skin disease returns to central Viet Nam after 3 month hiatus
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A fatal skin disease believed to have first appeared in Viet Nam has recurred in the central province of Quang Ngai, local authorities reported on Sunday [3 Mar 2013]. The mysterious disease has killed 24 of 240 people affected with it since first appearing in 2011. Since the end of last month [February 2013], after about 3 months of no reported cases, 6 people have been admitted to local hospitals in Ba To and Son Ha districts with the disease.
The new patients were diagnosed as having the illness that begins with blisters on the hands and feet and the loss of appetite, and can turn fatal due to organ failure, starting with the liver. It is officially known as the syndrome of dermatitis and horny layer thickening in foot and hand in Viet Nam.
Local and foreign experts, including those from the World Health Organization have yet to find the cause of the syndrome that has been mostly recorded in Ba To District, or come up with an effective treatment method. Speaking to Thanh Nien, Le Han Phong, chairman of Ba To District People's Committee, said 4 of the latest patients are from one family in Ba Dien Commune -- the disease's focal point with 124 cases of infection and 16 deaths from it so far. The youngest victim was 7 years old and the eldest was 75, Phong said.
Two others are from Son Ha District's Son Ba Commune, where authorities also detected 9 cases in which patients had slightly increased liver enzyme levels, one of the symptoms associated with the disease. All patients suspected of having the disease have been placed under close observation by local health workers.
Dinh Van Nun, head of a Ka Khu Village in Son Ba Commune, said people are "very scared" because they have heard that the disease killed many in Ba To District last year [2012].
In the meantime, the Quang Ngai Center for Preventive Health has sent teams to sterilize the environment, and take samples of the water and soil in Ba To. More health officials have also been sent to the locality to control the situation. The same measures have been launched in Son Ba.
Since the disease first broke out in April 2011, scientists from various fields have undertaken inspections and conducted tests to find its cause. They have concluded that it is caused by chronic poisoning, but have so far failed to identify the toxin responsible.
In an interview with the online newspaper VnExpress, Dr Babatunde Olowokure from the World Health Organization (WHO) in Viet Nam said the disease is not similar to any disease or illness that has ever been known in the world. He warned that it will therefore take more time to find the cause than expected, and that in some cases the cause may not be identifiable.
[byline: Hien Cu]
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[3]
Date: Mon 11 Mar 2013
Source: VietNamNet Bridge [edited]
http://english.vietnamnet.vn/fms/so...in-disease-outbreaks-again-in-quang-ngai.html
People in the area of the strange skin disease are anxious about their fate while the Ministry of Health is struggling to "decode" the disease. The disease that has killed 23 people in Quang Ngai is raging violently.
In 2012, [a woman] was infected with the disease. She was well again after 2 months of treatment. But the disease has recurred. The "strange" disease, which is called by the Ministry of Health as dermatitis syndrome on hands and feet, in the central province of Quang Ngai has recently returned with new cases, while the specific cause of the disease is still vague. Since late February 2013, the bizarre skin disease has come back in the mountainous districts of Quang Ngai. On 6 Mar 2013, the total number of patients was 12. Of the 12 patients, there are 2 cases of recurrence.
The latest case is a 60 year old [woman], in Reu village, Ba Dien commune. This is also a case of recurrence. Last year [2012], [this woman] had the disease and was well again after treatment. 2 members of her family [died of] this disease, including her 26 year old daughter, who died in July 2012, and [the daughter's] son, 4.
The disease has killed 23 people, but so far health experts have not found the cause. The 2nd case of recurrence is a 75 [year old woman], also a resident of Ba Dien commune. Notably, the "strange" disease not only broke out in Ba To district, but also appears in the mountainous district of Son Ha. The 2 patients here are a 63 year old man and his wife, 57 years old, in Ka Park Village, Son Ba commune. The 2 patients were treated at the dermatology ward of the Quang Ngai Province Hospital on 19 Feb 2013. The couple has escaped the hospital to go home.
Mr Le Han Phong, chairman of Ba To district, says that the "strange" disease is developing complicatedly. He wishes health experts will soon clarify the cause to definitively treat people.
Chief of the Department of Preventive Medicine -- Nguyen Van Binh says: "The test of rice that used by farmers in the area of the strange disease (in Ba Dien Commune, Ba To district) was performed at a Hong Kong laboratory for some kind of poisonous fungus, but it did not indicate the exact type of fungus which is the specific agent of the disease."
Many experts have come to survey and collect samples for testing but in the last 2 years they have yet to determine the cause. The health sector has made a lot of speculation about the cause, such as dermatitis caused by infection, fever caused by rickettsia, hepatitis E, malnutrition...
2012 was the peak of the "strange" disease. The minister of health -- Nguyen Thi Kim Tien visited Quang Ngai to inspect the disease. After that health experts said, "Eating moldy rice is one of the suspicious factors." However, the Ministry of Health has not confirmed that eating moldy rice as the cause of the disease.
Mr Pham Van But, chairman of Ba Dien Commune, says that he and the local people are very worried about this disease.
He adds that the district authorities firstly provided the local people 15 kg of rice per person per month. In August 2012, it reduced the amount to 4 kg and nothing. Since then the local people have eaten moldy rice again.
[byline: Le Ha]
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[The news articles above concerns an outbreak in several villages in the Ba To, and now the Son Ha districts, in Quang Ngai province, Viet Nam, on which ProMED-mail previously reported last year (2012). Those affected developed an acute febrile illness with loss of appetite and respiratory symptoms followed by a desquamating rash on the hands and feet described as "palmoplantar keratoderma" (
http://emedicine.medscape.com/article/1108406-overview#aw2aab6b), accompanied by liver dysfunction and, in some patients, by multi-organ failure and death. Ulcers on the hands, feet, mouth, back, and abdomen, eye disease, stiffness of the limbs, and miscarriage were also described. Mainly children and young adults have been affected.
The disease is said to have started in April 2011, subsided somewhat between November 2011 and February 2012, and picked up pace again in March and April 2012. This pattern has repeated itself again this year (2013), having abated in the fall of 2012 and recurred in this past month. The disease seems to have relapsed in several patients whose disease remitted last year. The numbers of patients affected and the death toll has varied in the news reports, but one of the news reports above says that the disease has caused 24 deaths since beginning in 2011.
Pictures of the rash on the hands and feet of the affected Vietnamese villagers are available at the source URL above and at
http://www.saigon-gpdaily.com.vn/Health/2012/4/100698 and
http://www.eyedrd.org/2012/04/break...-has-claimed-27-lives-in-central-vietnam.html.
Prior reports say that WHO and the US-based Centers for Disease Control and Prevention (CDC) experts have failed to find a cause for this outbreak, but the disease seems to follow a seasonal pattern and recurred after resumption of eating moldy rice.
Quang Ngai is a Vietnamese province located in the South Central Coastal region along the South China Sea, 883 km (549 mi) south of Hanoi and 838 km (521 mi) north of Ho Chi Minh City (
http://en.wikipedia.org/wiki/Quang_Ngai_province). The province has a large plain along the coast and in the center of the province and has mountains and hills in the west. Son Ha is a rural district of Quang Ngai province with a population of 64 398 in 2003 (
http://en.wikipedia.org/wiki/Son_Ha_District). Ba To is a rural district of Quang Ngai province with a population of 47 268 in 2003 (
http://en.wikipedia.org/wiki/Ba_To_District).
tiphat: alert - Ro) out of 240 who contracted it in Ba To and Son Ha districts since it was first detected in 2011. 