Re: Woman dies of mystery hemorrhagic illness in Nairobi - Tests negative for Ebola and other hemorrhagic fever viruses - gastrointestinal hemorrhage suspected
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Published Date: 2011-12-23 16:45:58
Subject: PRO/EDR> Undiagnosed illness - Kenya: (Nairobi) Ebola NOT
Archive Number: 20111223.3663
UNDIAGNOSED ILLNESS - KENYA: (NAIROBI) EBOLA NOT
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[1]Date: Fri 23 Dec 2011Source: Daily Nation [edited]http://www.nation.co.ke/News/Ministry+allays+fears+of+Ebola+outbreak+/-/1056/1294366/-/78bu67z/-/index.html
The Ministry of Health has allayed fears of an Ebola [haemorrhagic
fever] outbreak following the death of a woman at Kenyatta National
Hospital (KNH). At the same time, KNH Friday [23 Dec 2011] discharged
3 people who had been quarantined for being in contact with the
patient who died from excessive bleeding.
Findings by scientists from the Kenya Medical Research Institute
(KEMRI) and the Centres for Disease Control and Prevention (CDC)
showed that there were no traces of ebola[virus] or any other related
infectious [agent] in the blood samples taken from the body of the
woman. Blood from the patient was analysed in both KEMRI and CDC
laboratories and is negative for all viral hemorrhagic fever viruses
tested, including [ebolavirus] said the Director of Public Health
Sharif Shanaaz.
Viral haemorrhaic fever is characterised by fever and bleeding, which
can lead to shock and death in most cases. The viral haemorrhagic
fevers include Ebola, yellow fever, Marburg fever, and Rift Valley
fever among others. In the case of ebolavirus fever normally the early
signs of this infection start with tiredness, headache, sore throat,
then high fever before bleeding sets in from any body opening like the
mouth, nose, vaginal opening, or the anus.
Dr Shanaaz told reporters in Nairobi that the 29-year-old woman, who
was a restaurant attendant, might have died from bleeding possibly
caused by stomach ulcer or a related ailment. Tests showed that the
woman was not suffering from any infectious disease, but she was
vomiting blood, an indication that she might have had an ulcer.
On Thursday [22 Dec 2011], medics at the KNH Casualty department
received the patient in a state of heavy bleeding. Early suspicions
were that the woman who died immediately on arrival [might have been a
victim of Ebola haemorrhagic fever since her clothes were soaked with
blood. The 3 other people who had taken the woman to the hospital --
her father, another relative, and the taxi driver, were isolated in a
special ward until the tests on the deceased patient had been
conducted.]
According to a report in 2000 by the American Society of Tropical
Medicine and Hygiene, most viral haemorrhagic fevers are rare and
unpredictable epidemics. Rodents like rats and mice, and arthropods
such as certain insects are the main reservoirs for this type of
virus. [Bats are also likely vectors]. Dr Shanaaz said medics have yet
to find a cure for these diseases because of their unpredictable
nature, which makes it difficult to conduct experimental studies.
The Ministry's Head of the Division of Disease Surveillance and
Response Daniel Langat said that despite the results showing no traces
of the dreaded Ebola haemorrhagic fever, the government would continue
to monitor the situation. "Quarantine facilities will be retained, but
we would like to assure Kenyans and the entire public that we are all
safe."
In Africa, Ebolavirus was first associated with an outbreak of 318
cases of a haemorrhagic disease the Democratic Republic of Congo in
1976. Similar outbreaks have since been reported in Northern Uganda,
Democratic Republic of Congo and even South Sudan. In Kenya, there is
yet to be any officially confirmed case.
[Byline: Aggrey Mutambo]
--
Communicated by:
ProMED-mail
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******
[2]
Date: Fri 23 Dec 2011
From: SK Sharif [edited]
A 29-year-old female was brought to Kenyatta National Hospital on 22
Dec 2011. She was pronounced dead on arrival at the casualty. She had
been alright until 9 in the morning when she started vomiting blood.
There was no bleeding from other body orifices. There was no history
of travel outside Nairobi in the last 3 weeks. The hospital doctors
suspected viral hemorrhagic fever and wanted to rule out
[ebolavirus].
Blood samples were taken by CDC and KEMRI staff for testing. The tests
were negative for Ebola, Marburg, CCHF, yellow fever, and dengue by
RT-PCR. The tests were negative for Ebola and Marburg by antigen
capture ELISA tests. The samples were also negative for IgM antibody
ELISA for Ebola, Marburg, Lassa, yellow fever, dengue, chikungunya,
CCHF, and Rift Valley fever.
The diagnosis of Ebola [hemorrhagic fever] was most unlikely in this
case because of a very short history of illness and no history of
travel outside Nairobi in the preceding weeks. The profuse hematemesis
covered the patient and her clothes with blood and lead the clinicians
to believe that she was bleeding from the nose, ears, and skin. It
shows how important it is to get a proper history and examination
before making a diagnosis of a viral hemorrhagic fever.--
Dr SK Sharif MBS, MMed, MSc
Director of Public Health and Sanitation
Ministry of Public Health and Sanitation
PO Box 30016-00100
Nairobi Kenya
via
ProMED-EAFR
<promed-eafr@promedmail.org>
[ProMED-EAFR would like to thank Dr Sharif for his rapid sharing of
the detailed information above on the official results of the rapid
investigation and laboratory findings on the case/patient. The
observation of the importance of a thorough history and physical
examination at the entry point is notable. - Mod.MPP]
[
It is likely that infectious disease was not responsible for the
death of the patient. It remains true that up to the present there
have been no confirmed cases of Ebola haemorrhagic fever in Kenya.
The HealthMap/ProMED-mail interactive map of Kenya, showing the
location of Nairobi, can be accessed at
http://healthmap.org/r/1zkN.
- Mod.CP]
