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Two Johannesburg brothers were admitted to Olivedale Clinic because of a mystery illness. Both of them lost their lives. One brother died on Saturday and the other one passed away on Sunday night, exactly 24 hours after the former?s death. Hospital officials have no clue of their mysterious death. Martina Nicholson, who is the Spokesperson of the hospital, said the case will be investigated properly by the National Institute for Communicable Diseases. She further added that the result of the cause of death is slated to come up in the coming week. It is said that the brothers didn?t go outside the country, but were in constant touch with flora and fauna. The different tests that were conducted on them proved negative, but it was assumed that they might be suffering from hemorrhagic fever. Two nurses who were in close proximity with the brothers were also thoroughly checked, but were found to be ok. Hospital authorities have commiserated with the family members and urged people to respect their privacy. It is worth noting that two years ago at least three people died, when they came in contact with the arena virus strain that spread quickly from the Morningside Clinic in Sandton. The hospital is taking all the necessary precautionary measures and so far nobody is in quarantine and no more cases have been registered as well.
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Two Johannesburg brothers were admitted to Olivedale Clinic because of a mystery illness. Both of them lost their lives. One brother died on Saturday and the other one passed away on Sunday night, exactly 24 hours after the former?s death. Hospital officials have no clue of their mysterious death. Martina Nicholson, who is the Spokesperson of the hospital, said the case will be investigated properly by the National Institute for Communicable Diseases. She further added that the result of the cause of death is slated to come up in the coming week. It is said that the brothers didn?t go outside the country, but were in constant touch with flora and fauna. The different tests that were conducted on them proved negative, but it was assumed that they might be suffering from hemorrhagic fever. Two nurses who were in close proximity with the brothers were also thoroughly checked, but were found to be ok. Hospital authorities have commiserated with the family members and urged people to respect their privacy. It is worth noting that two years ago at least three people died, when they came in contact with the arena virus strain that spread quickly from the Morningside Clinic in Sandton. The hospital is taking all the necessary precautionary measures and so far nobody is in quarantine and no more cases have been registered as well. -
Re: Possible hemorragic fever outbreak in Johannesburg - at least two dead
Local News | Johannesburg
Olivedale Clinic still in the dark over ?mystery? deaths
Gia Nicolaides | 11 Hours Ago
The Olivedale Clinic on Tuesday assured patients that there had been no new cases of the mystery illness that killed two brothers.
The two young men died within 24 hours of each other over the weekend at the Olivedale Clinic. The illness was suspected to be haemorrhagic fever but all tests so far have come back negative.
Two nurses who had high fever on Monday night were thoroughly examined and their ailments were found to be unrelated to the disease.
The National Institute for Communicable Diseases said it was still conducting tests.
Two years ago, three people were killed when a strain of the arena virus spread rapidly from the Morningside Clinic in Sandton. -
Re: Possible hemorragic fever outbreak in Johannesburg - at least two dead
Hospital to probe brothers' deaths
September 08 2010 at 11:57AM Get IOL on your
mobile at m.iol.co.za
Johannesburg - Olivedale Hospital was still trying to find out what caused the deaths of two brothers at the facility a few days ago, it said on Wednesday.
"It is possible that both young people acquired their illness from a common source that may render the transmission to others less likely," the hospital's general manager Robert Jordaan said in a statement.
"However, precautionary measures will remain in place and the monitoring of close contacts and medical personnel will continue."
No new cases had been reported and people who had been in close personal contact wit the brothers remained in good health.
Close personal contact is defined as contact with a patient's blood or body fluids.
A key feature of the illness included fevers and liver failure.
The hospital said it was working with the National Institute of Communicable Diseases and the department of health on the matter.
The Star reported that Ioannis and Giorgio Avgousti died at the weekend after a sudden onset of illness.
Sunday would have been Ioannis's 21st birthday. - SapaComment
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Re: Possible hemorragic fever outbreak in Johannesburg - at least two dead
This is the thread from the Lujo arenavirus outbreak two years ago.
Notably, the index case in that outbreak died on September 14, roughly the same time of year. Also, that outbreak is presumed to have originated in Zambia, not South Africa, although the index case did travel extensively before taking ill. Also, that arenavirus had a fairly long incubation period (2-3 weeks), so if it is responsible for the current outbreak, both brothers would likely have been infected by a common source. That virus was isolated from all five suspected cases in that outbreak, but not from any other sources anywhere, including any animals. Despite the current articles, there were four fatalities, not three, in that outbreak.
This one will be worth watching closely, as it may re-write the history of that outbreak.
A wide variety of agents endemic to South Africa might also be responsible for the current outbreak, including RVF, CCHF, rickettsiosis, and leptospirosis, all of which would be more likely given the contact with animals mentioned above. Ebola and Marburg are also symptomatically consistent, but neither is endemic to South Africa, and neither has been reported anywhere in the world in over 20 months.Comment
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Re: Possible hemorragic fever outbreak in Johannesburg - at least two dead
Sent to ProMed.Comment
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Re: Possible hemorragic fever outbreak in Johannesburg - at least two dead
Thank you, Sharon, as always.Originally posted by sharon sanders View PostComment
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Re: Possible hemorragic fever outbreak in Johannesburg - at least two dead
It would be nice to know which hemorrhagic fever agents have been excluded, in particular, whether CCHF and Lujo have been excluded. The likelihood that this is yet another novel agent is very low.
Fear mounts as Olivedale clinic illness remains a mystery
Gia Nicolaides | 8 Hours Ago
Patients who were admitted to Olivedale Clinic at the same time as two brothers who died from a mystery illness on Wednesday said they were worried they will contract the disease.
Ioannis and Giorgio Avgousti died within 24 hours of each other over the weekend. It was initially believed that they died of haemorrhagic fever but all tests so far had come back negative.
A Johannesburg man said his son was admitted to the paediatrics ward and was moved because the area had to be isolated.
He said if the mystery illness which killed the brothers is contagious he is worried that his family is at risk.
?One could have contracted it by just being at the hospital and I think the sooner one can do something about it the better because not knowing is my biggest fear,? he said.
The brothers apparently did not leave the country recently but had been in contact with wildlife.
Doctors said it was possible that the siblings contracted the illness from a common source making the risk of infection less likely.Comment
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Re: Possible hemorragic fever outbreak in Johannesburg - at least two dead
This is the facebook page of one of the deceased brothers. Posting seems to have stopped around August 25th, with no mention of illness.
Comment
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NO Hemorrhagic fever outbreak in Johannesburg; two brothers die of Epstein-Barr virus (and Duncan syndrome?)
Mystery illness identified
Sep 10, 2010 1:27 PM | By Sapa
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A syndrome associated with the Epstein Barr virus has been identified as the cause of the death of two brothers who died at the Olivedale Hospital recently, the hospital said on Friday
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Epstein Barr Virus
Photograph by: http://www.roche.de/
"The illness that took the lives of two young men who were hospitalised and later died at Netcare Olivedale Hospital a number of days ago has been positively diagnosed," said Robert Jordaan, general manager of the hospital north of Johannesburg.
He quoted National Institute for Communicable Diseases' Professor Lucille Blumberg as saying: "As many people know the Epstein Barr virus (causing glandular fever) is a very common illness that affects 95 percent of people by early adulthood.
"Typically, it is a mild, self-limiting illness with no adverse outcome. People generally recover completely. In highly exceptional circumstances, in a very small number of people, this leads to a syndrome resulting in a massively disproportionate immune response to the presence of the Epstein Barr virus resulting in organ failure."
The syndrome affects less than one million individuals with the Epstein Barr virus infection.
People who had had contact with the brothers were in no danger and contact monitoring had stopped.
Ioannis and Giorgio Avgousti died at the weekend after a sudden onset of illness.Comment
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NO Hemorrhagic fever outbreak in Johannesburg; two brothers die of Epstein-Barr virus (and Duncan syndrome?)
Sept. 10 (Bloomberg) -- Netcare Ltd., the largest private hospital owner in South Africa, said two brothers who died at its Olivedale Hospital in Johannesburg had been diagnosed as having a rare syndrome associated with the Epstein Barr virus.
Epstein Barr, which typically gives rise to symptoms such a fever, sore throat, and swollen lymph glands, is one of the most common human viruses, with as many as 95 percent of people infected by the time they reach the age of 40, according to the U.S. Centers for Disease Control and Prevention. Most recover completely.
"In a very small number of people, this leads to a syndrome resulting in a massively disproportionate immune response to the presence of the Epstein Barr virus resulting in organ failure," Lucille Blumberg, head of the National Institute for Communicable Diseases' epidemiology unit, said in the Netcare statement. "This syndrome affects less than one in a million individuals with Epstein Barr virus infection."
The two brothers were originally suspected of having a hemorrhagic fever, Johannesburg's Star newspaper reported on Sept. 7, citing a nurse at the Olivedale hospital who spoke on condition of anonymity. There are several types of hemorrhagic fever syndromes found in Africa, including Ebola, Marburg and a form of dengue fever.
"All viral hemorrhagic fevers and other epidemic-prone diseases have been totally excluded," Robert Jordaan, the hospital's general manager, said in the statement.
--Editors: Phil Serafino, Kristen Hallam
Read more: http://www.sfgate.com/cgi-bin/articl...#ixzz0z8ZhEDflComment
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NO hemorragic fever outbreak in Johannesburg - two brothers die of Epstein-Barr virus infection
In hindsight, the refusal to state specifically what the animal exposure was might have been a sign that something exotic was less likely; the whole report is reminiscent of the reports that Matt and Mindy McIntosh contracted something in a barn.
Obviously, the strong response was the result of lessons learned from the actual VHF outbreak two years ago, of which there is still a lot we do not know.Comment
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NO hemorrhagic fever outbreak in Johannesburg - at least two dead - Epstein Barr syndrome named
Nothing in any of the previous articles indicated that the two fatalities were twins. Obviously, if they were identical twins, that would explain why they both had the genetic defect that caused this reaction.
Date:Friday, 10th September 2010
Twins died of very rare syndrome
Friday, 10 September 2010 21:04
?GEN VOS
JOHANNESBURG - The Avgousti brothers had less than a one-in-a-million chance of dying from the rare syndrome that tragically claimed their lives last week. But doctors say there is no danger of further fatalities from the exotic illness.
Twin brothers Giorgio and Ioannis, who would have turned 21 on Sunday, died within 24 hours of each other after they were admitted to the Netcare Olivedale hospital last weekend.
Doctors were at first uncertain of what had caused their untimely deaths, prompting medical staff to call in assistance from the National Institute of Communicable Diseases (NICD). They also kept tabs on those who had been in close contact with the brothers, amid fears of an outbreak of a mystery illness.
Professor Lucille Blumberg from the NICD yesterday identified the cause of death as an ?extremely rare syndrome?, associated with the common Epstein Barr virus (EBV) which causes glandular fever.
According to Blumberg, EBV affects up to 95% of people by early adulthood and those affected typically recover without any adverse effects. The virus can, however, result in a ?massively disproportionate immune response? and result in organ failure ? but this only happens ?in highly exceptional circumstances, in a very small number of people?.
Blumberg said the syndrome that killed the Avgoustis typically affected ?less than one in a million? people who contract EBV.
There was no danger of the disease affecting those who had come into contact with the Avgoustises, but additional scientific investigations would be conducted to understand why these two brothers had both developed the killer syndrome.
Doctors earlier suspected that the disease might have been a form of haemorrhagic fever which they picked up from a common source, but this hypothesis has been ?totally excluded? by the scientific tests conducted over the past few days.
Medical encyclopaedia site RightHealth.com notes that EBV is one of the most common viruses and that most people around the world become infected with it sometime during their lives.
Infants become susceptible to EBV when the maternal antibody protection present at birth disappears, but infections in children are usually indistinguishable from other mild childhood illnesses.
In 35% to 50% of infections during adolescence or young adulthood, EBV will cause symptoms like fever, sore throat and swollen lymph glands, but these symptoms usually clear up within a month or two.
There is no specific treatment for the infectious brand of EBV and there are no antiviral drugs or vaccines to combat the disease.Comment
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Re: NO hemorragic fever outbreak in Johannesburg - two dead of Epstein Barr syndrome named
Genetic clues in baffling death of brothers infected by common virus
Sep 19, 2010 12:00 AM | By SUBASHNI NAIDOO
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Medical detectives are investigating whether the genetic make-up of two brothers resulted in them dying of a common virus.
Ioannis and Giorgio Avgousti of Benoni - believed to be in their 20s - died in the Olivedale Clinic in Johannesburg within 24 hours of each other last week.
The National Institute of Communicable Diseases (NICD) this week revealed that the brothers had a "very severe response" to Epstein-Barr virus (EBV), which typically gives rise to mild symptoms such as fever, sore throat and swollen lymph glands. It is one of the most common human viruses.
The NICD said that up to 95% of people can be infected by the virus by the age of 40.
"Unfortunately, in this case, it resulted in a number of organs being severely affected. Liver failure was a particular problem," said Dr Lucille Blumberg, head of the NICD's epidemiology unit. "Very rarely would EBV cause an illness such as seen in these brothers, with very severe disease and a fatal outcome.
"This has been documented to date in people with specific underlying genetic immunity problems that resulted in an inability to respond to infection with EBV."
Specialist virologist Dr Terry Marshall, who assisted the NICD, said a team of experts were often brought in when clinicians needed assistance with a particular diagnosis.Comment
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Re: NO hemorragic fever outbreak in Johannesburg - two dead from Epstein Barr syndrome named
Presumably, this is the genetic defect involved.
[snip]
Presentation
Strangely, in boys with X-linked lymphoproliferative disorder there is an inability to mount an immune response to the Epstein-Barr virus (EBV)[5], which often leads to death from bone marrow failure, irreversible hepatitis, and malignant lymphoma. However, the connection between EBV and X-linked lymphoproliferative disorder is yet to be determinedComment
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Re: NO hemorragic fever outbreak in Johannesburg - two dead from Epstein Barr syndrome named
Originally posted by alert View PostPresumably, this is the genetic defect involved.
[snip]
Presentation
Strangely, in boys with X-linked lymphoproliferative disorder there is an inability to mount an immune response to the Epstein-Barr virus (EBV)[5], which often leads to death from bone marrow failure, irreversible hepatitis, and malignant lymphoma. However, the connection between EBV and X-linked lymphoproliferative disorder is yet to be determined
Also, From Merck Manual: http://www.merck.com/mmpe/sec13/ch16...164-ch164p-230
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X-linked Lymphoproliferative Syndrome (Duncan's Syndrome)
X-linked lymphoproliferative syndrome results from a T-cell and natural killer cell defect and is characterized by an abnormal response to Epstein-Barr virus infection, leading to liver failure, immunodeficiency, lymphoma, fatal lymphoproliferative disease, or bone marrow aplasia.
X-linked lymphoproliferative syndrome is caused by mutations in a gene on the X chromosome that encodes a T and natural killer (NK) cell?specific protein called SAP. Without SAP, lymphocytes proliferate unchecked in response to Epstein-Barr virus (EBV) infection, and NK cells do not function.
The syndrome is usually asymptomatic until EBV infection develops. Then, most patients develop fulminating or fatal infectious mononucleosis with liver failure (caused by cytotoxic T cells that react to EBV-infected B or other tissue cells); survivors of initial infection develop B-cell lymphomas, aplastic anemia, hypogammaglobulinemia (resembling that in common variable immunodeficiency), or a combination
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