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UNDIAGNOSED FATALITIES - MALAWI, MOZAMBIQUE: 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: 11 Jul 2009
Source: Nation Online, Window on Malawi [edited]
<http://www.nationmw.net/newsdetail.asp?article_id=3384>
Strange disease hits Neno
-------------------------
An unknown disease has killed 15 people out of 103 patients since May
this year [2009] in 2 bordering villages of Mtemankhawa and Datson in
Malawi and Mozambique, respectively. Mtemankhawa Village, with a
total population of 753, is in the area of TA Dambe in Neno while
Datson Village, in the area of Chief Tsangano in Mozambique, has a
population of 329.
Traditional leaders in the area and Secretary for Health Chris
Kang'ombe have confirmed the occurrence of the unknown disease and
the deaths. "It is true that 15 people out of 103 cases have died so
far. 8 are from the Malawi side while 7 from Mozambique side. 5 are
admitted to Neno District Hospital," said Kang'ombe in an interview
yesterday. He described the disease as "not well known".
The PS said the ministry has already sent laboratory samples to South
Africa for analysis. The symptoms of the disease, according to
Kang'ombe, include stiff neck, dehydration, fever, headache, joint
pain, discomfort in abdomen and loss of voice. He ruled out meningitis.
While waiting for the results of the samples, he said, the ministry
is treating some patients with antibiotics and has supplied the
people with Chlorine because "they use unprotected wells for water."
He said the area is "very cold" and some people are forced not to
bathe for many days. He said some live together with animals in their
round grass-thatched houses which have no windows. "These could be
some contributing factors but it is yet to be seen," said Kang'ombe.
He said the ministry has also set up a treatment camp in the area to
handle minor cases.
Group Village Headman Chakulembera, who oversees Mtemankhawa Village,
said in an interview on Wednesday [8 Jul 2009] in Mwanza that those
affected by the disease develop stiff jaws, neck and have abdominal
pains. "It makes it difficult for them to eat," he said.
Chakulembera, who was flanked by village headman Mtemankhawa and T/A
Dambe's envoy MacDonald Chindimwe, said among those killed include 5
pupils, 3 from Chawe Primary School.
"On average, we have 3 or 4 deaths per week. People are worried about
the development because they cannot work in their wheat and Irish
potato gardens," said Chakulembera, who was supported by Mtemankhawa
who said: "The latest death was on Monday this week, 6 Jul 2009."
The group village headman said the disease has affected almost every
family, with some having more than one patient. Chakulembera said
some patients died at Neno District Hospital but the majority
succumbed at their homes. "We are living in fear. When one is
attacked, we know he or she is going to die," he said.
Chakulembera said health officials from both Malawi and Mozambique
have been visiting the area "frequently" to monitor the situation.
"The Ministry of Health supplied us with Chlorine to add to the water
we use," confirmed Chakulembera. There is no piped water or
boreholes. Most of the houses are old round grass-thatched ones and
have no windows. People sleep together with animals in such houses,"
he said when asked to explain the living conditions of the people in
the affected area.
On another note, Mtemankhawa said he is living in fear for his life
after some of his villagers warned they would "deal with him. They
accuse me of being a wizard and that I am behind the deaths. They
make such allegations because they say I do not provide a solution.
But it is not true," he said.
He said villagers have since agitated for a witchdoctor to come to
the village to find the cause of the mysterious disease. He also said
grave-diggers have threatened to abandon their work, arguing they are
fed up with the frequent deaths. Dambe's advisor said the chief
advised fellow traditional leaders to tell people to stop sleeping in
the same house with animals and ensure that all dwelling units have
windows and pit latrines as preventive measures.
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[The above newswire describes a clinical picture that is difficult to
come to diagnostic conclusions on. Some of the symptoms might lead
one to think meningitis was the etiology, but the newswire mentions
that meningitis has been ruled out. Other symptoms might be
compatible with the more severe form of leptospirosis, although
arthralgias are described rather than myalgias, and jaundice is not
mentioned where it tends to be a predominant presenting symptom with
severe leptospirosis. According to the article, since the beginning
of May 2009, the overall attack rate has been 9.5 percent (103 cases
out of a total population of 1082) with a case fatality rate of 14.6
percent. Oftentimes when one reads newswires, the presumed risk
factors of disease mentioned helps to narrow down the etiologic
agent. In the above newswire this isn't really the case as it
mentions poor water and sanitation, and close proximity to animals,
risk factors for a large spectrum of microbial agents includi!
ng bacterial and viral agents. Note, that while this moderator is
mentioning microbial agents, the possibility of exposure to
environmental toxins has not been ruled out as yet either.
More information from knowledgeable sources in the region would be
greatly appreciated.
For a map of the Neno district of Malawi, see
<http://www.maplandia.com/malawi/southern/neno/>. For a map of the
Tsangano district of Mozambique, see
<http://www.maplandia.com/mozambique/tete/tsangano/>. If one zooms
out, one sees that the 2 districts are to the south of Lake Nyasa.
For the interactive HealthMap/ProMED map of Neno, Malawi, see
<http://healthmap.org/r/00Aa>, and for Tsangano Mozambique, see
<http://healthmap.org/r/00Ab>. - Mod.MPP]
..............................mpp/ejp/dk
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using information posted or archived by ProMED-mail. ISID
and its associated service providers shall not be held
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UNDIAGNOSED FATALITIES - MALAWI, MOZAMBIQUE: 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: 11 Jul 2009
Source: Nation Online, Window on Malawi [edited]
<http://www.nationmw.net/newsdetail.asp?article_id=3384>
Strange disease hits Neno
-------------------------
An unknown disease has killed 15 people out of 103 patients since May
this year [2009] in 2 bordering villages of Mtemankhawa and Datson in
Malawi and Mozambique, respectively. Mtemankhawa Village, with a
total population of 753, is in the area of TA Dambe in Neno while
Datson Village, in the area of Chief Tsangano in Mozambique, has a
population of 329.
Traditional leaders in the area and Secretary for Health Chris
Kang'ombe have confirmed the occurrence of the unknown disease and
the deaths. "It is true that 15 people out of 103 cases have died so
far. 8 are from the Malawi side while 7 from Mozambique side. 5 are
admitted to Neno District Hospital," said Kang'ombe in an interview
yesterday. He described the disease as "not well known".
The PS said the ministry has already sent laboratory samples to South
Africa for analysis. The symptoms of the disease, according to
Kang'ombe, include stiff neck, dehydration, fever, headache, joint
pain, discomfort in abdomen and loss of voice. He ruled out meningitis.
While waiting for the results of the samples, he said, the ministry
is treating some patients with antibiotics and has supplied the
people with Chlorine because "they use unprotected wells for water."
He said the area is "very cold" and some people are forced not to
bathe for many days. He said some live together with animals in their
round grass-thatched houses which have no windows. "These could be
some contributing factors but it is yet to be seen," said Kang'ombe.
He said the ministry has also set up a treatment camp in the area to
handle minor cases.
Group Village Headman Chakulembera, who oversees Mtemankhawa Village,
said in an interview on Wednesday [8 Jul 2009] in Mwanza that those
affected by the disease develop stiff jaws, neck and have abdominal
pains. "It makes it difficult for them to eat," he said.
Chakulembera, who was flanked by village headman Mtemankhawa and T/A
Dambe's envoy MacDonald Chindimwe, said among those killed include 5
pupils, 3 from Chawe Primary School.
"On average, we have 3 or 4 deaths per week. People are worried about
the development because they cannot work in their wheat and Irish
potato gardens," said Chakulembera, who was supported by Mtemankhawa
who said: "The latest death was on Monday this week, 6 Jul 2009."
The group village headman said the disease has affected almost every
family, with some having more than one patient. Chakulembera said
some patients died at Neno District Hospital but the majority
succumbed at their homes. "We are living in fear. When one is
attacked, we know he or she is going to die," he said.
Chakulembera said health officials from both Malawi and Mozambique
have been visiting the area "frequently" to monitor the situation.
"The Ministry of Health supplied us with Chlorine to add to the water
we use," confirmed Chakulembera. There is no piped water or
boreholes. Most of the houses are old round grass-thatched ones and
have no windows. People sleep together with animals in such houses,"
he said when asked to explain the living conditions of the people in
the affected area.
On another note, Mtemankhawa said he is living in fear for his life
after some of his villagers warned they would "deal with him. They
accuse me of being a wizard and that I am behind the deaths. They
make such allegations because they say I do not provide a solution.
But it is not true," he said.
He said villagers have since agitated for a witchdoctor to come to
the village to find the cause of the mysterious disease. He also said
grave-diggers have threatened to abandon their work, arguing they are
fed up with the frequent deaths. Dambe's advisor said the chief
advised fellow traditional leaders to tell people to stop sleeping in
the same house with animals and ensure that all dwelling units have
windows and pit latrines as preventive measures.
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[The above newswire describes a clinical picture that is difficult to
come to diagnostic conclusions on. Some of the symptoms might lead
one to think meningitis was the etiology, but the newswire mentions
that meningitis has been ruled out. Other symptoms might be
compatible with the more severe form of leptospirosis, although
arthralgias are described rather than myalgias, and jaundice is not
mentioned where it tends to be a predominant presenting symptom with
severe leptospirosis. According to the article, since the beginning
of May 2009, the overall attack rate has been 9.5 percent (103 cases
out of a total population of 1082) with a case fatality rate of 14.6
percent. Oftentimes when one reads newswires, the presumed risk
factors of disease mentioned helps to narrow down the etiologic
agent. In the above newswire this isn't really the case as it
mentions poor water and sanitation, and close proximity to animals,
risk factors for a large spectrum of microbial agents includi!
ng bacterial and viral agents. Note, that while this moderator is
mentioning microbial agents, the possibility of exposure to
environmental toxins has not been ruled out as yet either.
More information from knowledgeable sources in the region would be
greatly appreciated.
For a map of the Neno district of Malawi, see
<http://www.maplandia.com/malawi/southern/neno/>. For a map of the
Tsangano district of Mozambique, see
<http://www.maplandia.com/mozambique/tete/tsangano/>. If one zooms
out, one sees that the 2 districts are to the south of Lake Nyasa.
For the interactive HealthMap/ProMED map of Neno, Malawi, see
<http://healthmap.org/r/00Aa>, and for Tsangano Mozambique, see
<http://healthmap.org/r/00Ab>. - Mod.MPP]
..............................mpp/ejp/dk
*################################################# #########*
************************************************** **********
ProMED-mail makes every effort to verify the reports that
are posted, but the accuracy and completeness of the
information, and of any statements or opinions based
thereon, are not guaranteed. The reader assumes all risks in
using information posted or archived by ProMED-mail. ISID
and its associated service providers shall not be held
responsible for errors or omissions or held liable for any
damages incurred as a result of use or reliance upon posted
or archived material.
************************************************** **********
Become a ProMED-mail Premium Subscriber at
<http://www.isid.org/ProMEDMail_Premium.shtml>
************************************************** **********
Visit ProMED-mail's web site at <http://www.promedmail.org>.
Send all items for posting to: promed@promedmail.org
(NOT to an individual moderator). If you do not give your
full name and affiliation, it may not be posted. Send
commands to subscribe/unsubscribe, get archives, help,
etc. to: majordomo@promedmail.org. For assistance from a
human being send mail to: owner-promed@promedmail.org.
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