Zamboanga, Philippines: Four die, 16 others ill with unknown illness - leptospirosis identified

[alert]

Given the mention of fishing, tetrodotoxin might be likely...

http://www.abs-cbnnews.com/nation/regions/07/01/11/mystery-illness-kills-4-downs-16-others-ph

Mystery illness kills 4, downs 16 others in PH
by Queenie Casimiro, ABS CBN News Zamboanga
Posted at 07/01/2011 8:10 PM | Updated as of 07/01/2011 8:10 PM


ZAMBOANGA DEL NORTE, Philippines - Four people died while 16 others were hospitalized in Zamboanga del Norte because of a mysterious illness, health officials said Friday.

The victims, who all live in Barangay Mantebo, Sibuco town in Zamboanga del Norte, complained of pain and numbness in their lower extremities.

Pantera Nadjal, one of the patients said she started feeling numbness and a tingling sensation in her feet and legs starting last May.

"Parang hangin dito sa paa nagsimula tapos umakyat hanggang sa tyan," Nadjal said.

Fifteen other villagers who experienced the same sysmptoms have been admitted at the Zamboanga City Medical Center (ZCMC).

Dr. Saibzur Edding, Sibuco hospital chief, said other residents of Mantebo were admitted to the hospital.

Four have died due to the unidentified infection.

Edding said there is no mining activity in or near Mantebo. Fishermen also do not use either dynamite or cyanide when fishing.

Dr. Maribel Felisario, ZCMC information officer, said they sent samples of the patients' urine and blood to the Department of Health in Manila for testing.

They have also gathered samples from the village including water, fish, and seaweeds that are reportedly part of the patients' diet.

Felisario said they have encountered similar cases before but "this one is different since the patients come from one area."

 

[fredvries]

Re: Zamboanga, Philippines: Four die, 16 others ill with unknown illness

Re: Zamboanga, Philippines: Four die, 16 others ill with unknown illness

Probably not true but numbness starting in the lower extremities does remind me of the forced suicide of Socrates. He took a potion that contained Conium maculatum or poison hemlock.

Plato describes it as:
The man...laid his hands on him and after a while examined his feet and legs, then pinched his foot hard and asked if he felt it. He said "No"; then after that, his thighs; and passing upwards in this way he showed us that he was growing cold and rigid. And then again he touched him and said that when it reached his heart, he would be gone. The chill had now reached the region about the groin...

Does it grow in The Philippines?
Conium maculatum is native in temperate regions of Europe, West Asia, as well as North Africa. It has been introduced and naturalised in many other areas, including Asia, North America, Australia, and New Zealand.

 

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Re: Zamboanga, Philippines: Four die, 16 others ill with unknown illness

Re: Zamboanga, Philippines: Four die, 16 others ill with unknown illness

I believe that particular symptom is the result of the destruction of the myelin in the nervous system. There are a wide variety of things that could produce such damage, from infections (such as polio, typhus, and WNV), to auto-immune conditions (such as Guillain-Barre and ODS) to toxins (such as the one you mention).

The rest of the symptomatic description is too crude to guess which one is in play here, but the lack of fever as a reported symptom tends to suggest something toxic.

 

[alert]

Re: Zamboanga, Philippines: Four die, 16 others ill with unknown illness

Re: Zamboanga, Philippines: Four die, 16 others ill with unknown illness

This is a markedly different description than the original post, indicating swelling, pain, and vomiting, among other symptoms. The above explanations are likely thus incorrect.

http://www.sunstar.com.ph/zamboanga...2/illness-kills-4-downs-19-zambo-norte-164626

Illness kills 4, downs 19 in Zambo Norte

By Bong Garcia

Saturday, July 2, 2011

ZAMBOANGA CITY -- Health authorities are baffled by an unknown sickness that hit a coastal village in Zamboanga del Norte province that has already killed four people and hospitalized 19 others.


The 19 people are all residents of Mantibo village in Sibuco town and are admitted at the Zamboanga City Medical Center.

The 19 patients suffered swollen lower limbs but doctors could not give any diagnoses yet as of this posting.


The patients complained of pain and numbness in their lower extremities, cramps, loss of appetite and vomiting.


Sibuco town Mayor Bong Edding has recommended the conduct of laboratory test to determine what disease struck the village.


Hospital authorities could not exactly diagnose the kind of ailment the villagers are suffering pending the conduct of laboratory analysis.


Health officials said there had been similar cases in the past but patients came from different places, not like the case of Sibuco town where all the patients are from Mantibo village.


Edding ordered the municipal health officer to check if there are still residents in Mantibo who are suffering the same kind of ailment but were not brought to the hospital.


Edding described Mantibo, which is a coastal village, as a typical normal village where there are not many activities like mining and other that may cause the sickness.


The village of Mantibo has close to a thousand residents, Edding said.(Sunnex)

 

[alert]

Re: Zamboanga, Philippines: Four die, 19 others ill with unknown illness

Re: Zamboanga, Philippines: Four die, 19 others ill with unknown illness

http://www.mb.com.ph/articles/325244/mystery-ailment-kills-4-downs-19-zamboanga-del-norte

Mystery ailment kills 4, downs 19 in Zamboanga del NorteJuly 3, 2011, 7:47pmZAMBOANGA CITY, Philippines (PNA) ? Health authorities are baffled by a mysterious disease that has so far killed four people and hospitalized 19 others who are all residents of a coastal barangay in Zamboanga del Norte.

The 19 people, all residents of Barangay Mantibo, Sibuco municipality, have been affected by the unknown disease and are now confined at the government-run Zamboanga City Medical Center (ZCMC).

The lower limbs of the 19 patients are swollen but physicians could not exactly diagnose the kind of ailment that struck them.

The patients complained of cramps, loss of appetite, and vomiting.

Sibuco Mayor Bong Edding recommended the conduct of laboratory tests to determine the disease.

Officials at the ZCMC have not issued any statement yet since they have to conduct laboratory analysis first.

Edding said he ordered his municipal health officer to check if there are still residents in Mantibo who are afflicted with the same ailment but were not brought to the hospital.

Edding described Mantibo as a coastal barangay, a typical village where there is not much activity that may bring any diseases.

The barangay of Manbito has close to a thousand residents, Edding said.

 

[alert]

Re: Zamboanga, Philippines: Four die, 19 others ill with unknown illness

Re: Zamboanga, Philippines: Four die, 19 others ill with unknown illness

In response to the moderator's questions below, other articles seem to indicate that swelling is present, as is pain.

http://www.promedmail.org/pls/apex/..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,89184

Archive Number 20110703.2021
Published Date 03-JUL-2011
Subject PRO/EDR> Undiagnosed disease, fatal - Philippines: (ZN)

UNDIAGNOSED DISEASE, FATAL - PHILIPPINES: (ZAMBOANGA DEL NORTE)
***************************************************************
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: 1 Jul 2011
Source: ABS CBN News Zamboanga [edited]
<http://www.abs-cbnnews.com/nation/regions/07/01/11/mystery-illness-kills-4-downs-16-others-ph>


4 people died, while 16 others were hospitalized in Zamboanga del
Norte because of a mysterious illness, health officials said Friday [1
Jul 2011].

The victims, who all live in Barangay Mantebo, Sibuco town in
Zamboanga del Norte, complained of pain and numbness in their lower
extremities. One of the patients said she started feeling numbness and
a tingling sensation in her feet and legs starting last May [2011]; 15
other villagers who experienced the same symptoms have been admitted
at the Zamboanga City Medical Center (ZCMC).

Dr. Saibzur Edding, Sibuco hospital chief, said other residents of
Mantebo were admitted to the hospital; 4 have died due to the
unidentified infection. Edding said there is no mining activity in or
near Mantebo. Fishermen also do not use either dynamite or cyanide
when fishing [thus excluding toxic chemicals used in those activities
- Mod.JW].

Dr. Maribel Felisario, ZCMC information officer, said they sent
samples of the patients' urine and blood to the Department of Health
in Manila for testing. They have also gathered samples from the
village, including water, fish and seaweeds that are reportedly part
of the patients' diet. Felisario said they have encountered similar
cases before, but "this one is different, since the patients come from
one area."

[Byline: Queenie Casimiro]

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

[If this is a toxin, more information regarding what these people are
eating would be nice to have. It sounds a little bit like cassava root
poisoning. However, there are other things that may cause neurological
complications and produce tingling. I don't know whether this is just
a sensory tingling, as when the blood supply is compromised, or
whether this is painful in some way. - Mod.TG]

[I agree, it sounds toxic. - Mod.LM]

[The HealthMap/ProMED interactive map showing Sibuco town is at:
<http://healthmap.org/r/0*XI>
- Mod.JW]

 

[alert]

Re: Zamboanga, Philippines: Four die, 19 others ill with unknown illness

Re: Zamboanga, Philippines: Four die, 19 others ill with unknown illness

http://e-dyario.com/actualidad/2011...iosa-enfermedad-con-5-muertes-y-20-afectados/

Spanish to English translation

Zamboanga health authorities investigate mysterious disease with 5 deaths and 20 affected
Published on July 4, 2011 by Newel Carlet
Share. Health officials are investigating the cause of death of five people because of an unknown disease that has affected 20 other people in the town of Sibuco in Zamboanga del Norte province and about 820 kilometers south of Manila.


Sibuco Township, in southwestern Mindanao
The affected residents in the neighborhood of Mantibo and were admitted to the Zamboanga Medical Center with inflammation in the lower limbs, and suffer from leg cramps, loss of appetite and vomiting.

Sibuco Mayor, Bong Edding, ordered the investigation to the many people affected appeared since earlier this month it will increase surveillance if more patients in the neighborhood, which has about a thousand residents, mostly Muslims involved in mining and other agricultural activities.

Edding said that so far has not been informed of contamination in the food chain in the affected village, where in addition to agriculture fishing is also exercised.

 

[alert]

Re: Zamboanga, Philippines: Four die, 19 others ill with unknown illness

Re: Zamboanga, Philippines: Four die, 19 others ill with unknown illness

http://www.philstar.com/nation/article.aspx?publicationSubCategoryId=67&articleId=702371

Mysterious disease kills 5, downs 20 in Zambo
By J. Antonio Rimando The Philippine Star Updated July 04, 2011 12:00 AM 0 comment to this post


Zoom
DIPOLOG CITY, Zamboanga del Norte, Philippines ? At least five persons have succumbed to an unknown disease which also hit 20 others for the past three days in a mountain village of Sibuco town in this province.

Reports from Sibuco town mayor Erbie ?Bong? Edding said some of the afflicted victims were taken to the Zamboanga del Norte Medical Center, Siocon District Hospital and several other hospitals in Zamboanga City.

The patients were said to have suffered from swollen lower limbs and complained of severe leg cramps followed by loss of appetite and vomiting.

Edding was quoted as saying that the community which has 1,000 residents and mostly Muslims, was a typical village and some of the villagers engaged in mining activities in the upper portion of the barangay. He said a portion of the mountain town is rich in mineral deposits which are being excavated by a Canadian-based mining company.

But he assured that that there so far has been no reported food contamination in the community as most of the villagers engage in farming, gardening and fishing.

Edding also recommended laboratory examination for the affected patients to pinpoint the actual cause of their mysterious ailment which, he feared, could affect later other residents.

 

[alert]

Re: Zamboanga, Philippines: Five die, 20 others ill with unknown illness

Re: Zamboanga, Philippines: Five die, 20 others ill with unknown illness

http://www.zamboangatoday.ph/index....se-of-patients-at-zcmc-remains-a-mystery.html

Disease of patients at ZCMC remains a mystery
Tuesday, 05 July 2011 11:21

Doctors at the Zamboanga City Medical Center remain uncertain as to the true cause of the disease that has afflicted sixteen residents from barangay Mantibu, Sibuco Zamboanga del Norte who are now confined in this medical facility.

Hospital PIO Dr. Maribel O. Felisario disclosed there are four females and 12 males, 19 years old is the youngest and 49 is the oldest who have been confined in the said hospital since last week.

Felisario said the primary consideration is that the victims could have been exposed to something such as toxins from marine food, sea weeds, water, heavy metal poisoning. But they cannot give the exact findings until the laboratory test results from Manila will arrive.

The common complaints of the victims are numbness in the lower extremities like the legs, swollen of the feet, sensory deficit in the feet, weakness to stand on two feet and other symptoms, all in the lower extremities.

Toxicologist Dr. Aeesha Pingli said she really has to rely on the results of laboratory tests from the blood, urine, feces samples including the food taken by the victims to be able to identify the cause of the disease.

?So far many of them are recuperating from the medicines we have administered,? Pingli said.

Meanwhile, Sibuco Municipal Mayor Norbi Edding Jr. confirmed four residents in the said barrio have already died.

?Two females, one male and a minor have already died, but I do not know if the cause of their death is related to this incident,? Edding said.

He said it was through his Municipal Health Office that he knew about the incident and immediately rushed the victims to Zamboanga City for treatment.
According to Edding, medical expenses incurred by the victims will be shouldered by the local government.

He has coordinated with the Department of Health for the conduct of medical mission in the said community within the week.

One of the patients, Pantera Najal, 42, confirmed a certain Hajiban Abdurahman, her neighbor, died due to the disease.

 

[alert]

Re: Zamboanga, Philippines: Five die, 20 others ill with unknown illness

Re: Zamboanga, Philippines: Five die, 20 others ill with unknown illness

This is not good at all. This sounds almost nothing like the other articles in this thread.

http://newsinfo.inquirer.net/21500/mystery-disease-afflicts-zamboanga-del-norte-village

Mystery disease afflicts Zamboanga del Norte village
By Julie S. Alipala
Inquirer Mindanao
8:33 pm | Tuesday, July 5th, 2011 0share21 21ZAMBOANGA CITY, Philippines—Health officials in Western Mindanao are in a quandary as to what has killed at least four people and downed more than two dozen other people in a fishing village in Sibuco, Zamboanga del Norte, since late April.

Dr. Aristides Tan, director of the Department of Health in Western Mindanao, said they have been searching for answers to the mystery.

“We are very puzzled. Even our toxicologists are wondering what this disease is,” he said.

Tan said laboratory samples from the victims and the village’s surroundings had been gathered and sent to Manila for analysis.

Dr. Romeo Ong, director of the Zamboanga City Medical Center where at least 16 residents of Mantebo village have been admitted since May, said they were expecting the results from Manila to come in next week.

Ong said the patients showed the same symptoms, such as coughing, fever and mild paralysis of the lower body.

Those who succumbed to the mysterious illness died within a short period after being hospitalized, Sibuco health chief Derileen Edding said.

She cited the case of Hadjiban Abdurahman, 23, who died 18 hours after being hospitalized on June 11.

“All the patients, according to their relatives, complained of cough, fever then numbness of the lower parts of their bodies,” Edding said. “The illness progresses so fast.”

Tan said they had initially suspected, based on the symptoms manifested by the patients, that it the ailment could have been caused by be some kind of marine toxin.

But then the manifestations were also symptoms of heavy metal poisoning and Guillain-Barre Syndrome. The latter is a serious disorder that occurs when the body’s immune system attacks parts of the nervous system. This would result in nerve inflammation and causes muscle weakness, Tan said.

“That is why we need to determine first what is causing the problem so we can address it,” Tan said, adding that the samples extracted from patients for laboratory analysis included spinal fluids.

Sibuco Mayor Norbideiri Edding said health experts were expected to go to Mantebo on July 7 to conduct further investigation.

He said the local government was informed that at least 20 more patients were being treated by relatives at home.

Mantebo is a remote village in Sibuco and residents travel by sea because the road that leads to it from the town’s center was so dilapidated nobody uses it.

 

[alert]

Re: Zamboanga, Philippines: Five die, 20 others ill with unknown illness

Re: Zamboanga, Philippines: Five die, 20 others ill with unknown illness

Guillain-Barre would not cause swelling of the legs, so if the reports of swelling are correct, GBS should be excluded.

http://zamboangatimes.ph/top-news/1...-disease-discharged-from-zambo-hospital-.html

10 victims of mysterious disease discharged from Zambo hospital
Tuesday, 05 July 2011 16:47
Government physicians has discharged from the hospital 10 patients from Sibuco, Zamboanga del Norte who were struck by a mysterious disease that has killed four people and hospitalized 16 others on Sunday

Sibuco Mayor Bong Edding said doctors at the Zamboanga City Medical Center has discharged 10 of their patients suffering from an unknown disease. Six others were placed under further observation.

Edding said medical and laboratory tests conducted on the 20 patients were also sent to Manila for further analysis to determine the kind of disease that have struck the coastal Barangay of Montebo in Sibuco last week.

Medical experts at the government hospital suspect the victims may have suffered from the ?Guillain Barre Syndrome,? since the patients? lower limbs are swollen and they complained of cramps, loss of appetite and vomiting, Edding said.

Edding who personally attended to the needs of the patients said his administration will shoulder the medical expenses of the victims.
He said that food and medicines and financial assistance were also extended by him to the relatives of the victims who are in this city taking care of the patients.

On Sunday, physicians in this city were baffled by a mysterious disease that has struck 20 people from Sibuco.
Four of the patients affected by the unknown disease died at the hospital while 16 others were placed under medication.
Hospital officials said there had been similar cases in the past in which the patients came from different places. But this time, they are puzzled because all the 19 patients come from one place ? Sibuco. ? Nonoy E. Lacson

 

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Re: Zamboanga, Philippines: Five die, 20 others ill with unknown illness

Re: Zamboanga, Philippines: Five die, 20 others ill with unknown illness

http://www.zambotimes.com/archives/...s-disease-discharged-from-Zambo-hospital.html

Wednesday, July 6. 2011
10 of 16 patients with mysterious disease discharged from Zambo hospital
by Teofilo P. Garcia


ZAMBOANGA CITY ? The government physicians have discharged 10 of the 16 (not 19 as earlier reported) patients who have recuperated after suffering from a still unknown disease, officials said.

The patients, all residents of the coastal Barangay Mantibo in the town of Sibuco, Zamboanga del Norte, were rushed last week to the government-run Zamboanga City Medical Center here after they fell ill from the mysterious disease.

The patients, whose lower limbs were swollen, complained of cramps, loss of appetite and vomiting.

Sibuco Mayor Bong Edding said the remaining six patients were placed under further observation as the attending physicians have yet to wait for the results of the laboratory analysis to determine what disease they are suffering from.

Edding said some health officials suspects the victims may have suffered from the Guillain Barre Syndrome since the patients' lower limbs are swollen and complained of cramps, appetite loss and vomiting.

Guillain-Barre Syndrome, as stated at Yahoo Health, is a serious disorder that occurs when the body's defense (immune) system mistakenly attacks part of the nervous system that leads to nerve inflammation that causes muscle weakness.

The YahooHealth said the symptoms of Guillain-Barre can get worse very quickly since it may take only a few hours to reach the most severe symptoms, but weakness increasing over several days is also common.

"Muscle weakness or the loss of muscle function (paralysis) affects both sides of the body. In most cases, the muscle weakness starts from the legs and then spreads to the arms. This is called ascending paralysis," Yahoo Health stated.

"Patients may notice tingling, foot or hand pain, and clumsiness. If the inflammation affects the nerves to the diaphragm, and there is weakness in those muscles, the person may need breathing assistance," Yahoo Health added.
However, ZCMC Toxicologist Dr. Aeesha Pingli said she really has to rely on the results of the laboratory tests to determine what disease struck the patients.

Samples of blood, urine and feces were taken and sent to Manila for laboratory analysis.

Of the 16 patients taken to the ZCMC, 12 are males and four are females aged between 19 to 49 years old.

Edding confirmed that, so far, four residents of Barangay Mantibo have already died after they fell ill from the mysterious disease.

Edding said he coordinated with the Department of Health (DOH) regional office for the conduct of medical mission in Mantibo the soonest possible time.

Edding described Mantibo, which is a coastal barangay, as a typical normal village where there is not much activities like mining and others that may bring disease.

The barangay has close to a thousand residents, Edding said. (PNA)

 

[alert]

Re: Zamboanga, Philippines: Five die, 20 others ill with unknown illness

Re: Zamboanga, Philippines: Five die, 20 others ill with unknown illness

The reporting is all over the place here. Some of the reports indicate a paralytic illness with perhaps a gastrointestinal component. Others seem to indicate primarily swelling and pain, and not paralysis, sounding perhaps like an ingested parasite. And one article above describes the illness as almost flu-like, with symptoms of cough and fever. The attack rate in the village seems to be about 3-5% which would be an incredible rate for GBS (and probably too many paralytic cases to consider polio). The number of cases ranges from 20 in some reports to more than 40 in the flu-like report. And curiously, few if any of the cases appear to be children.

The counts are equally all over the place, as it the time period, but it seems this outbreak has been going on for at least two months. There are conflicting reports as to whether mining is ongoing in the village.

And contagion appears unlikely, as some of the cases were in the hospital (which is not in the village) as early as May, and there is no evidence of spread in the hospital, and no evidence of family clustering of cases.

 

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Re: Zamboanga, Philippines: Five die, 20 others ill with unknown illness

Re: Zamboanga, Philippines: Five die, 20 others ill with unknown illness

http://www.sunstar.com.ph/zamboanga...arges-10-patients-mysterious-illnesses-165291

Hospital discharges 10 patients with mysterious illnesses
By Bong Garcia

Wednesday, July 6, 2011

A GOVERNMENT-RUN hospital in Zamboanga City discharged 10 people who suffered from an unknown disease after they showed signs of recovery from the illness.

Six others suffering from same illness are still in the hospital. Four people in same village have reportedly died of the disease in the village of Mantibo, said Sibuco town Mayor Bong Edding.

The patients, all from the coastal village of Mantibo in the town of Sibuco, Zamboanga del Norte, were brought to Zamboanga City Medical Center after they have fallen ill from the mysterious disease.


They all suffered from swollen lower limbs, cramps, loss of appetite, and vomiting.


Mayor Edding said the six remaining patients have been were placed under further observation as doctors are still waiting for results of their laboratory analysis to determine what type of disease they suffer from.


Edding said some health officials in the city suspect the victims may have suffered from the Guillain Barre Syndrome.


Guillain Barre Syndrome is a rare and severe disease, which affects the peripheral nervous system.


However, ZCMC Toxicologist Dr. Aeesha Pingli said she has to rely on the results of the laboratory tests to determine what disease struck the patients.


Samples of blood, urine and feces were taken from the patients and sent to Manila for laboratory analysis.


Of the 16 patients taken to the ZCMC, 12 are males and four are females. The youngest in the group is 19 years old and the oldest is 49 years old.


Edding said he has coordinated with the Department of Health in the region for the conduct of medical mission in Mantibo village.

 

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Re: Zamboanga, Philippines: Five die, 20 others ill with unknown illness

Re: Zamboanga, Philippines: Five die, 20 others ill with unknown illness

http://news.xinhuanet.com/english2010/health/2011-07/06/c_13969470.htm

Mysterious disease kills 4, hospitalizes 19 in S Philippines

English.news.cn 2011-07-06 19:04:27 FeedbackPrintRSS

ZAMBOANGA CITY, the Philippines, July 6 (Xinhua) -- A mysterious disease has claimed at least four lives and sent 19 villagers from a coastal town in southern Philippines, health officials said Wednesday.

The patients, aged 19 to 49 years old, all native of Mantebo, a coastal village of Sibuco town, Zamboanga del Norte province, were brought to Zamboanga City Medical Center last week after the local town officials were alarmed of the disease that have stricken the village.

Dr. Maribel Felisario, public information officer of the medical center, said the patients complained of cramps, swollen lower limps, and experienced loss of appetite and vomiting.

At least four people have died but Sibuco Mayor Norbie Bong Edding said they were investigating if the death of the victims were related to the disease that have stricken the village.

Although the hospital initially believed the victims might have been exposed to toxin of marine products, doctors have to rely on the laboratory test to determine the cause of the disease, said Felisario.

"Until now we are still waiting for the result of the laboratory testing that was conducted in Manila to really determine the cause," Felisario said.

Edding said exposure to mining was unlikely, noting that there is no tributary that connects to his town from the mining site that is based in the hinterland of Siocon town, which is a town away from his place.

The Department of Health has sent its experts to investigate, and examination will be processed in Manila, according to Edding.

 

[alert]

Re: Zamboanga, Philippines: Five die, 20 others ill with unknown illness

Re: Zamboanga, Philippines: Five die, 20 others ill with unknown illness

The article ProMED has chosen here is one of the more unusual in this thread as to the symptoms described; I am not sure that this is the correct description.

http://www.promedmail.org/pls/apex/..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,89223

Archive Number 20110707.2053
Published Date 07-JUL-2011
Subject PRO/EDR> Undiagnosed disease, fatal - Philippines (02): (ZN)

UNDIAGNOSED DISEASE, FATAL - PHILIPPINES: (02) (ZAMBOANGA DEL NORTE)
********************************************************************
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: Tue 5 Jul 2011
Source: Inquirer News [edited]
<http://newsinfo.inquirer.net/21500/mystery-disease-afflicts-zamboanga-del-norte-village>


Mystery disease afflicts Zamboanga del Norte village
----------------------------------------------------
Health officials in Western Mindanao are in a quandary as to what has
killed at least 4 people and downed more than 2 dozen other people in
a fishing village in Sibuco, Zamboanga del Norte, since late April
[2011].

Dr Aristides Tan, director of the Department of Health in Western
Mindanao, said they have been searching for answers to the mystery.
"We are very puzzled. Even our toxicologists are wondering what this
disease is," he said.

Tan said laboratory samples from the victims and the village's
surroundings had been gathered and sent to Manila for analysis.

Dr Romeo Ong, director of the Zamboanga City Medical Center where at
least 16 residents of Mantebo village have been admitted since May
[2011], said they were expecting the results from Manila to come in
next week [week of 11 Jul 2011].

Ong said the patients showed the same symptoms, such as coughing,
fever, and mild paralysis of the lower body.

Those who succumbed to the mysterious illness died within a short
period after being hospitalized, Sibuco health chief Derileen Edding
said. She cited the case of a 23 year old victim who died 18 hours
after being hospitalized on 11 Jun 2011.

"All the patients, according to their relatives, complained of cough,
fever, then numbness of the lower parts of their bodies," Edding said.
"The illness progresses so fast."

Tan said they had initially suspected, based on the symptoms
manifested by the patients, that it the ailment could have been caused
by be some kind of marine toxin.

But then the manifestations were also symptoms of heavy metal
poisoning and Guillain-Barre syndrome. The latter is a serious
disorder that occurs when the body's immune system attacks parts of
the nervous system. This would result in nerve inflammation and causes
muscle weakness, Tan said.

"That is why we need to determine first what is causing the problem
so we can address it," Tan said, adding that the samples extracted
from patients for laboratory analysis included spinal fluids.

Sibuco mayor Norbideiri Edding said health experts were expected to
go to Mantebo on 7 Jul 2011 to conduct further investigation. He said
the local government was informed that at least 20 more patients were
being treated by relatives at home.

Mantebo is a remote village in Sibuco and residents travel by sea
because the road that leads to it from the town's center was so
dilapidated nobody uses it.

[byline: Julie S Alipala]

--
communicated by:
HealthMap Alerts via ProMED-mail
<promed@promedmail.org>

[This mysterious disease seems not to have abated, so it is likely
that the source has not been identified. However, this article gives
us little information aside from a few additional clinical signs. We
know it produces fever, coughing, and numbness in the lower portion of
the body.

In the previous positing I suggested cassava root as a toxic cause.
However, I do not know of cassava root causing fever and coughing.
Lathyrus poisoning also comes to mind but likewise, I do not know of
it causing fever and coughing.

It would be useful to have a description of which foods had been
consumed, what the quality of the water is, to receive some
inforamtion about the sources of the food and water. We hope to have
some results soon. - Mod.TG

The HealthMap/ProMED-mail interactive map of the Philippines can be
seen at <http://healthmap.org/r/10XR>. - Sr.Tech.Ed.MJ]

 

[alert]

Re: Zamboanga, Philippines: Five die, 20 others ill with unknown illness

Re: Zamboanga, Philippines: Five die, 20 others ill with unknown illness

This appears to be an official release from the government, and suspects a marine toxin (and contains the lower case counts).

http://www.pia.gov.ph/?m=7&r=r09&id=42511

Filipino to English translation

PIA Press Release
Friday, July 08, 2011
Cebuano News: reportedly victims of marine toxin poisoning in Sibuco, escaped to the hospital
by Alfonso T. Ruda

Dipolog City, July 8 (PIA) - escaped the hospital residents in the village Mantibo, Sibuco, Zamboanga del Norte that reportedly brought to the hospital early wealth from the marine toxin poisoning.


In the interview to Sibuco Municipal Health Officer, that Dr. Derileen edding, he said that aside from the 1 you just victim remains in hospital should be made wealth from other examinations, which escaped from the Zamboanga City Medical Center 15 victims in the hospital that first brought wealth from the alleged marine toxin poisoning.


The 15 residents Mantibo, today kasamtangan nanimuyo the house of captain Mantibo in Labuan, Zamboanga City while still expected results was made a laboratory test water samples from Mantibo and sample the fish sent to kaulohang-Manila.


National and yet Dr.. Edding, yet they are waiting on laboratory test results to masuta mitakboy that the cause of sickness to the victims.


Love it, knowing that 4 You are resident in the village Mantibo died last month from May wealth from non-sensible sickness.


Gireklamo the victims pagpanguhubag their feet, loss of appetite and vomiting, food and vomit.


Following this, gimando of Zamboanga del Norte Provincial Health Officer, Dr. Eduardo Luayon delivering and medical teams in the area to probe the status of residents in nasangpit barangays.


The village Mantibo was a coastal village in the city Sibuco in the third district of the province that reach only by pumpboat within an hour if not maot timing. (JPA/ATR/PIA9-Zambo Norte)

 

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Re: Zamboanga, Philippines: Four die, 16 others ill with unknown illness - marine toxin suspected

Re: Zamboanga, Philippines: Four die, 16 others ill with unknown illness - marine toxin suspected

Two new clues here. First, although the onset dates seem to be scattered over the past three months (at least according to some reports), all the hospitalizations occurred at the same time. Secondly, all surviving cases have been discharged.

http://www.zamboangatoday.ph/index....ess-remain-in-city-awaiting-test-results.html

Victims of mystery illness remain in city awaiting test results
Wednesday, 13 July 2011 12:22

The Zamboanga City Medical Center (ZCMC) already discharged on Wednesday the 16 patients afflicted with a mysterious illness from Sibuco, Zamboanga del Norte.

ZCMC Information Officer, Dra. Maribel Felisario confirmed that the 16 patients, composed of four females and 12 males, were discharged from the hospital already in good condition.

Some of the patients according to Felisario are staying in Barangay Labuan awaiting for their test results.

Four of the patients were admitted at ZCMC last June 28 while the other 12 were admitted last June 29.

The patients complained of weakness, numbness and tingling sensation in the feet and difficulty in standing and walking.

Felisario assured that they will reveal the result of the tests, as well as the official diagnoses, once all the test results and the investigation results come out.

Some of the tests were done at the Department of Health (DOH) Research Institute for Tropical Medicine (RITM), UP Marine Science Laboratory and Chempro Laboratory.

According to Felisario, the DOH National Epidemiology Center already sent a team of doctors to Zamboanga del Norte to look into the matter.

As of now, the type of illness that hit the 16 patients remains to be a mystery.

 

[Ronan Kelly]

Re: Zamboanga, Philippines: Four die, 16 others ill with unknown illness - marine toxin suspected

Re: Zamboanga, Philippines: Four die, 16 others ill with unknown illness - marine toxin suspected

?Mystery? disease in Zamboanga del Norte identified as leptospirosis
By Jocelyn R. Uy
Philippine Daily Inquirer
6:45 pm | Friday, July 15th, 2011 0shareNew 0MANILA, Philippines?Health officials have finally identified what was earlier thought to be a mysterious disease that killed at least four people in a fishing village in Sibuco, Zamboanga del Norte over the last few months.

In a press conference Friday, Health Secretary Enrique Ona announced that it was a ?variant of leptospirosis,? which had symptoms different from those normally associated with the disease.

Most of the patients stricken ill by the supposed ?mysterious disease? showed symptoms of coughing, fever, blurring of vision, headache, stomach pains and mild paralysis of the lower extremities.

The usual symptoms of leptospirosis, commonly transmitted to humans from water contaminated by animal urine, include fever, chills and intense headache.

In extreme cases, complications like meningitis, renal failure and respiratory distress may arise and lead to death, according to the Department of Health.

The Research Institute for Topical Medicine on Friday confirmed that at least 10 blood samples taken from the patients afflicted by the so-called mystery disease were positive for leptospirosis, said Assistant Health Secretary Dr. Eric Tayag, also head of the National Epidemiology Center.

?So it?s not a mystery anymore,? Tayag told reporters after receiving a call from the RITM on Friday.

Preliminary reports reaching the DOH showed that the fishing village had experienced regular rains over the past few months, which could have possibly caused the spread of leptospirosis in the area, said Tayag.

?There are also many animals, including rats, in the area, which explains why there were residents infected by leptospirosis,? added the health official.

http://newsinfo.inquirer.net/24327/...mboanga-del-norte-identified-as-leptospirosis

 

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Re: Zamboanga, Philippines: Four die, 16 others ill with unknown illness - leptospirosis identified

http://www.mb.com.ph/articles/326945/new-cases-lepto-confirmed

New cases of Lepto confirmed By JENNY F. MANONGDOJuly 15, 2011, 6:50pmMANILA, Philippines ? Health authorities Friday confirmed that Leptospirosis caused the deaths of four people and hospitalization of 16 others in Barangay Mantibo in Sibuco, Zamboanga City.

Based on laboratory results from the Research Institute for Tropical Medicine (RITM), 10 out of the 20 patients were inflicted with Leptospirosis, a disease transmitted through water contaminated by animal urine, usually from rats. It can be ingested through contaminated food and water or through floodwater.

Earlier, authorities were puzzled about the cause of disease that started affecting the residents since May. Chemical and marine products poisoning were earlier thought to have caused the sickness and deaths of the affected residents. Specimens were gathered from the residents and were sent to RITM for laboratory testing.

?Laboratory tests showed they are negative for arsenic, lead and mercury? There were three people who were positive for mercury but they are on safe levels, so it is not mercury poisoning,? DoH Assistant Secretary Dr. Eric Tayag said.

Doctors also noted that the patients manifested symptoms that were unusual from the common symptoms seen among Leptospirosis such as fever, chills and intense headache.

?The presentation of patients was mostly neurological, they became paralyzed and their lower extremities became numb and they also suffered from stomach pain,? DoH Secretary Enrique T. Ona said.

The patients were also suspected to have suffered from vitamin B1 deficiency or Beri Beri due to their diet which is mostly seafood.

According to Tayag, local authorities reported heavy rains in Simbuco recently. ?There are many animals in the area including rats.?

According to experts, the Leptospira bacteria can enter a person?s body through the eyes and nose and through breaks in the skin.

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