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Viral disease breaks out in Rajouri -12 dead in 15 days

Shiloh

Editor, Senior Moderator
Source: http://www.risingkashmir.com/index.php?option=com_content&task=view&id=16964&Itemid=1

Viral disease breaks out in Rajouri

12 die in 15 days, 78 hospitalized in 24 hours
Virus spreading but CMO says no need to worry
Shaheen Khan
Nowshera LoC (Rajouri), Sep 19: At least 78 people have been admitted in different hospitals and dispensaries here during past 24 hours in connection with Pyraxia of Unknown Origin (PUO) disease, hospital authorities said Saturday.
Panic gripped the border belt of the Rajouri district following reports of 12 deaths during past 15 days due to PUO disease.
Though medical teams have been deputed to various areas, the disease is spreading in other areas of the district which has made doctors panicky.
However, Chief Medical Officer Vaid Sharma said the situation was under control.
The disease (still not diagnosed) spread in Bhawani, Nonial, Jhangar, Chowki, Langar and Ganiya areas of Nowshera tehsil few days ago and is continuously spreading further.
According to reports, at least 12 persons have lost their life during the past 15 days due to the strange disease.
They include a couple Sayta Devi and her husband Dalip Kumar of Ganiya village, Dev Raj son of Dewan Chand, Yog Raj son of Gopi Nath of village Nonial, 12th standard student Naresh Kumar son of Romesh Chander of Langar village and Kanchan Devi wife of Raj Kumar of the same area besides some others.
Block Medical Officer Nowshera, Dr Rajinder Singh Sambyal confirmed the deaths.
However, he said it is just a viral fever and most patients were reporting with high fever and ailments of jaundice.

Following the outbreak on this strange disease, panic gripped the entire area while the number of infected patients is increasing.
Block Medical Officer, Dr Rajinder Singh Sambyal said around one dozen persons were infected last week adding 26 patients were admitted on Friday alone while 40 on Saturday.
He said some patients in critical condition had been referred to Government Medical College Jammu. He said a patient Shahida Begum wife of Abdur Rashid of Garn village was referred to GMC in a critical condition today.
Though BMO said the disease is Pyraxia of Unknown Origin, it is yet to be confirmed. However, he categorically refuted any possibility of Swine Flu.

According to reports, four cases were reported from Sunderbani and five from Kalakote blocks.
District Health Officer Sadid Khan admitted that some cases had been reported from Kalakote and Sunderbani area.
He said some people were found infected with POU in Kharau Panja area on Saturday. ?Our department has launched Household Survey in the Nowshera and other infected areas and the report is expected to come within a few days.?
Meanwhile, health department has constituted teams of doctors and deputed them in various areas.
Chief Medical Officer Rajouri, Dr Vaid Sharma said ?There is no need to panic. The situation is under control.?
However he admitted that number of infected patients was increasing.
?We examined residents of Gania and Janghar area on Friday and deputed more teams to Vishu Dhar areas today,? he said. ?A team under the supervision of Deputy Director Health has taken stock of the situation. They have collected water samples from the area, which have been sent to Microbiology department of GMC for analysis.
The Health department has also deputed some doctors in Rajouri to GMC to know about the disease. ?These doctors are camped at GMC for the past two days. Dr. Neeru Khajuria has been deputed to GMC to know about the diseases and report back to Rajouri,? the BMO Nowshera said. ?Still the disease is unknown. Anything regarding it can be said as and when we get report from GMC.?
 
Re: Viral disease breaks out in Rajouri -12 dead in 15 days

OK. Several things worth pointing out. "Pyraxia" should probably be "pyrexia", which is just another word for fever:

http://en.wikipedia.org/wiki/Fever

Fever (also known as pyrexia, from the Greek pyretos meaning fire, or a febrile response).

Now PUO (which we would describe as FUO - Fever of Undetermined Origin) is not a diagnosis, even in parts of the world where "viral fever" is.

The article also seems to have a counting error, as it mentions a dozen patients admitted in one week, but says that 40 and 26 of them occurred on Friday and Saturday. It then further compounds the confusion by mentioning 78 (12+26+40) cases in 24 hours. It is not clear exactly how many are ill, but it is likely in the hundreds, at least.

This article falls under the category of their definitely being an outbreak of some kind there, but the disease and number of cases and deaths are extremely unclear. This is not a source I've ever dealt with before.

But with jaundice as a symptom, H1N1 is EXTREMELY unlikely, but hepatitis is likely, and leptospirosis is also possible. Someone should send the article to ProMed for an RFI.
 
Re: Viral disease breaks out in Rajouri -12 dead in 15 days

Or maybe not. I kind of suspected this. That first article contained enough errors, that this doesn't surprise me one bit. Of note is that this article was published BEFORE the one that started this thread, but already refers to the information in the first article. It is likely, IMO, that the first article is a reprint of some local story that did not make the internet. There are also some serious timing issues here: That first article was published around 4am Sunday morning (local time there) and refers to incidents on "Friday and Saturday" (unless Friday and Saturday is the 12th and 13th?). But this article was published on Thursday and is already refuting the first article.

http://www.thenorthlines.com/newsdet.aspx?q=24349

Fever takes 6 lives in Nowshera
Health Services refutes reports of mystery fever
9/18/2009 1:18:44 AM

NL Correspondent
Jammu, Sept 17 :The Director Health Services, Jammu has refuted the news item carried by some sections of media about dozen mysterious fever deaths in border belt of Nowshera as totally baseless.
To verify the factual position, the Chief Medical Officer, Rajouri was despatched to the border areas of Nowshera who after verification reported that six deaths had occurred in Nowshera due to different ailments. The CMO has already deputed a team of doctors along with medicines to the concerned area.
However, a high-level team of doctors comprising of Deputy Director, Health Services Dr. Vijay Gupta and Divisional Nutrition Officer Dr. Sham Gopal along with sufficient medicines have already proceeded to Nowshera for on-the-spot enquiry surveillance and assessment of the gravity of the situation.
 
Re: Viral disease breaks out in Rajouri -12 dead in 15 days

Looks like there might really be an outbreak of some kind here. Someone should send this to ProMed now. This is confirmation from a second source. I'm not sure why the denial above was issued.

http://www.kashmirwatch.com/showhea...chive=&start_from=&ucat=1&var0news=value0news

Mysterious fever’ kills 13 in Rajouri




Srinagar: Panic has gripped the entire belt of Nowshera sector in Jammu & Kashmir's Rajouri district after 13 people fell victim to a mysterious fever that has caught the health officials totally unaware.

Reports reaching Press Bureau of India said that the mysterious fever has gripped the villages close to Line of Control (LoC) in Nowshera sector of Rajouri district.

On Saturday the toll rose to 13 after Surinder Devi (37) wife of Pashori Lal of Simbal Seri village in the district, died at the Government Medical College and Hospital (GMCH) Jammu.


''Symptoms indicate it to be a viral disease,'' a spokesman of the health department said. He said that other things cannot be ruled out as reports of the samples taken from affected people are yet come.

Nearly 80 people of half-a-dozen bordering villages, including Nonial, Bhawani, Sher Makri, Jhangar and Choki, were affected by the disease.


Sources said that the mysterious disease spread eight days back. Victims of the disease suffer from high fever, followed by jaundice and vomiting. Sources said that 40 patients suffering from the disease are reported to treated in the Sub-District Hospital, Sunderbani, followed by 28 in Nowshera hospital.

Meanwhile, a special team of health officials led by Dr Vijay Gupta, Deputy Director, visited the effected areas of Sunderbani and Nowshera areas and collected samples from the patients.

The health authorities, on the other hand, accused Public Health Engineering (PHE) officials for not ensuring potable drinking water, the major cause behind jaundice problem.

CMO Rajouri Dr V P Sharma said that he was closely monitoring the situation. He said there is no need to be panic.

“Teams have been pressed into service. People are being given advice to consume boiled water and take all other precautions.” He said that 28 patients have reported to Nowshera hospital, 40 at Sunderbani so far and serious patients were sent to Jammu. (PBI)
 
Re: Viral disease breaks out in Rajouri -12 dead in 15 days

HHMM, Jaundice. This could be a type of hepatitis.
 
Re: Viral disease breaks out in Rajouri -12 dead in 15 days

HHMM, Jaundice. This could be a type of hepatitis.

Hepatitis is possible (likely Hepatitis E if so), as is Leptospirosis. Either one could be the result of bad/polluted water.
 
Re: Viral disease breaks out in Rajouri -12 dead in 15 days

Not the same outbreak, but rapid onset, yellowing skin, but with associated diarrhea occurring 1,000 miles away.

Mysterious disease kills primitive tribals

Latehar (Jharkhand), Sep 20 (PTI) Eleven tribals have died of a mysterious disease in one month in Jharkhand's Latehar district, health officials said.

The toll reached 11 with two fresh deaths being reported from Champa village in Mahuadand in the district today, civil surgeon of the district, Aron Tigga said.

Pradip Waski, an official of disease surveillance programme, told reporters that they were trying to know more about the mysterious disease and would take preventive measures after a surveillance team would examine the affected persons of the tribe and those living in the nearby areas.

The civil surgeon said the district administration would taken the help of Centre if the situation demands.

Giving details of the symptoms of the disease, he said the affected persons took ill suddenly, suffered stomach problems and the skin turn yellow.
http://ptinews.com/news/292186_Mysterious-disease-kills-primitive-tribals
 
Re: Viral disease breaks out in Rajouri -12 dead in 15 days

Increase to 15 deaths in the second outbreak. Kind of sounds like leptospirosis, especially with the mention of the distended stomach.

http://www.zeenews.com/news565160.html

Mysterious disease kills primitive tribespersons
Updated on Sunday, September 20, 2009, 19:33 IST Tags:Latehar, Jharkhand, Tribal
Latehar (Jharkhand): Fifteen persons belonging to a primitive tribe died of a mysterious disease in the past one month in Jharkhand's Latehar district.

The deaths included two persons, who died of the disease at Champa village in Mahuadand in Latehar district today.


Pradip Waski, an official of disease surveillance programme, told newsmen that currently they were gathering information about the disease and taking action after examining the affected persons.

Official sources confirmed eleven deaths due to the disease during the period.

Waski said a disease surveillance programme team from Ranchi would visit the affected areas tomorrow to take stock of the situation.

Sources said the affected persons including women and children were being treated.

The civil surgeon of the district, Aron Tigga said the district administration would take the help of Centre, if the situation demands.

Referring the disease, he said the affected persons fell sick suddenly, suffer distended stomach and the skin turn yellow.

Bureau Report
 
Re: Viral disease breaks out in Rajouri -12 dead in 15 days

Not the same outbreak, but rapid onset, yellowing skin, but with associated diarrhea occurring 1,000 miles away.

...

Giving details of the symptoms of the disease, he said the affected persons took ill suddenly, suffered stomach problems and the skin turn yellow.
http://ptinews.com/news/292186_Mysterious-disease-kills-primitive-tribals

I'm not sure that "stomach problems" refers to diarrhea here, especially with the mention in the second article of distended stomach (and not diarrhea or vomitting).

Either way, someone needs to send these articles to ProMed.
 
Re: Viral disease breaks out in Rajouri -12 dead in 15 days

Alert, You are correct. I think I read diarrhea in an unrelated article and got jumbled.
 
Re: Viral disease breaks out in Rajouri -12 dead in 15 days

All that is clear from the symptomatic description is that this disease affects the liver. Without knowing what has been ruled in or out, it is difficult to speculate on what this might be. Possible diagnoses included hepatitis (D? E? Mutant B from Modasa?), leptospirosis, and various parasitic infections. Both outbreaks seem to have sporadic distribution that seems inconsistent with person-to-person spread, and is more consistent with a vector-borne or water-borne disease.

If there is a proper exposure history (exposure to contaminated blood - bad injections?), that strain of hepatitis B from Modasa should also be considered.
 
Re: Viral disease breaks out in Rajouri -12 dead in 15 days

Yikes. This is apparently right across the border in Pakistan. 42 deaths due to hepatitis in one week. And it's re-used syringes again. That Modasa hepatitis B strain is quite possible now.

http://www.promedmail.org/pls/otn/f..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,79313

HEPATITIS, VIRAL - PAKISTAN (03): SYRINGE REUSE
***********************************************
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: Sat 19 Sep 2009
Source: Online News [edited]
<http://www.onlinenews.com.pk/details.php?id152166>
[This page is now blank, and an archive search does not locate it. - ProMED]


At least 16 patients undergoing treatment for hepatitis B and C
infections in various hospitals of South Punjab have died, while
several others are under treatment.

According to media reports, in the last 24 hours, 16 patients
diagnosed with hepatitis B and C and undergoing treatment in various
hospitals in Vehari, Burewal, Gago Mandi, Khanewal, Kabir Wala and
Mian Channu have died. Most deaths occurred in Vehari, where 7 people
died. Another 9 patients died of hepatitis in other local hospitals.

The reports said that hepatitis is spreading very fast, and the major
cause of spreading of the disease is use of a syringe more than once.
The death toll has risen to 42 during a single week.


In an interview with a private TV channel, director general Aslam
Chaudhry said steps are being taken to control the disease, and
vaccinations [against hepatitis B? - Mod.CP] are being given to
children under one year of age.

--
Communicated by:
ProMED-mail Rapporteur Brent Barrett

[If medical malpractice has been responsible for this outbreak of
disease, the medical authorities in Pakistan should reveal immediately
what measures are now in place to avoid a recurrence of such an
unfortunate incident.


The HealthMap/ProMED-mail interactive map of Punjab, Pakistan can be
accessed at: <http://healthmap.org/r/008Q>. - Mod.CP]

[see also:
Hepatitis, viral - Pakistan (02): prevalence 20090610.2141
Hepatitis, viral - Pakistan: (SD) fatal 20090609.2125
2008
----
Hepatitis B & C - Pakistan (02): (SD) 20081203.3804
Hepatitis B & C - Pakistan: (SD) 20081201.3773
2007
----
HIV/AIDS & hepatitis, barbers - Pakistan (Islamabad) 20070521.1630
Hepatitis, viral - Pakistan 20070306.0796
2006
----
Hepatitis B and C, barbers - Pakistan (Islamabad) (02) 20061216.3536
Hepatitis B and C, barbers - Pakistan (Islamabad) 20061215.3529
2004
----
Hepatitis - Pakistan (Punjab): RFI 20040609.1546]
.............................................cp/msp/jw
*##########################################################*
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are posted, but the accuracy and completeness of the
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thereon, are not guaranteed. The reader assumes all risks in
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and its associated service providers shall not be held
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Re: Viral disease breaks out in Rajouri -12 dead in 15 days

Not exactly a local source, but this one is reporting six deaths due to a mystery disease, which seems to be a hybrid of posts #1 and #3. The mention of many patients needing only outpatient treatment means that hepatitis A should also be considered.

http://www.thaindian.com/newsportal...ms-six-lives-jammu-and-kashmir_100250528.html


Mysterious fever claims six lives Jammu and Kashmir
September 21st, 2009 - 10:58 pm ICT by ANI -
Rajouri (Jammu and Kashmir), Sep 21(ANI): Panic has gripped Nowshera and Sunderbani belt of Jammu and Kashmir’s Rajouri district after a mysterious fever reportedly killed six people.

The mystifying fever has put the State health authorities in confusion, as Doctors are unable to diagnose the cause of the fever.

The fever, first reported from Nowshera belt, is believed to be continuously spreading to neighbouring localities.

Victims of the disease suffer from high fever, followed by jaundice and vomiting.

“Children and elderly people are running high fever. Many patients are coming to the OPD (Out Patient Department), while many have been admitted. Some patients have been sent to Jammu Medical College and right now also we have many patients with us,” said Swatanter Singh, a paediatrician with a local hospital.

Meanwhile, several local residents criticised the State government for its laid-back attitude towards the matter.

“There should be a primary health centre in this border area. A team of doctors should have been here especially after the fever killed many people. The Government should give directions to the doctors to find out the exact cause of this mysterious fever and the PHE (Public Health Engineering) department should be told to put medicines in the water supplied to various areas,” said Mahinder Lal, a local resident.

The mysterious fever in Rajouri district has came at a time when the country is battling with the deadly swine flu, which has killed 247 and infected 8,153 people. (ANI)
 
Re: Viral disease breaks out in Rajouri -12 dead in 15 days

And a ProMed posting on the second outbreak, the one in Latehar. Combining the bold text with the other article that mentions fever, and malaria is also possible, in addition to hepatitis (A? B? E?) and leptospirosis.

http://www.promedmail.org/pls/otn/f..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,79338

Archive Number 20090921.3323
Published Date 21-SEP-2009
Subject PRO/EDR> Undiagnosed illness - India (03): (JH), RFI

UNDIAGNOSED ILLNESS - INDIA (03): (JHARKHAN), 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>

Date: Sun 20 Sep 2009
Source: PTI News [edited]
<http://ptinews.com/news/292186_Mysterious-disease-kills-primitive-tribals>


11 tribals have died of a mysterious disease in one month in
Jharkhand's Latehar district, health officials said.

The toll reached 11 with 2 fresh deaths being reported from Champa
village in Mahuadand in the district today [20 Sep 2009], civil
surgeon of the district, Aron Tigga said.

Pradip Waski, an official of the disease surveillance programme, told
reporters that they were trying to learn more about the mysterious
disease and would take preventive measures after a surveillance team
examines the affected persons of the tribe and those living in the
nearby areas.

The civil surgeon said the district administration would accept the
help of the Centre if the situation demands it.

Giving details of the symptoms of the disease, he said the affected
persons took ill suddenly, suffered stomach problems, and the skin
turn yellow.

--
Communicated by:
ProMED-mail <promed@promedmail.org>

[The information is very scarce, but diarrhea and jaundice could be
signs of hepatitis A or leptospirosis among the most likely
diagnoses. If fever was present, malaria is another possibility.
Laboratory tests and more clinical information should solve the
puzzle.


More information on Latehar (Jharkhand) can be found at
<http://en.wikipedia.org/wiki/Latehar>. - Mod.EP]

[see also:
Undiagnosed illness - India (02): (GA) RFI 20090722.2594
Undiagnosed illness - India: (Manipur), RFI 20090109.0088
2008
----
Undiagnosed disease - India: (Manipur), RFI 20080209.0535
2007
----
Undiagnosed disease - India (Manipur): RFI 20071009.3318
2004
----
Undiagnosed illness - India (Manipur): RFI 20040721.1980]
...................................................ep/msp/lm
 
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