Cholera Outbreak in Papua New Guinea?s Morobe Province

[Sally Furniss]

Re: 70 dead, 800+ hundred affected by mystery illness in Papua New Guinea?s Morobe Province

Re: 70 dead, 800+ hundred affected by mystery illness in Papua New Guinea?s Morobe Province

Date of article 25 June 2008

Health services in big trouble

TWELVE aid posts in Menyamya district, Morobe Province, are closed and the Menyamya Health Centre faces imminent closure.

The Post-Courier was told that only 13 of the 25 aid posts remain open but are running out of medicines while an old, rusted and leaking water tank is posing a health risk to the patients and the staff at the health centre.

This reporter was taken on a guided tour of the district and told that the health facilities were providing health care to more than 19,000 people who produce 60 per cent of PNG’s organic coffee.

The water tank could not supply the labour ward, outpatient and the entire operation of Menyamya health centre.

Five aid posts out of 10 in Wapi local level council were closed while seven out of 15 in Kome local level government area were also closed.

Kome LLG aid post supervisor Isa Elizah revealed that under tghe national health policy, water is the key element to providing a better health service.
“As health staff, hygiene is crucial in performing health activities. But it is not the case here at Menyamya and this is beyond the Health Department’s workplace policy, which is posing a big health risk to the patients,” he said.

Mr Elizah, who is also the Menyamya high school board chairman, said that government health facilities in the district were running into problems and this was putting lives of more than 29,000 people at risk.

He said the Menyamya health centre was conducting only curative services at the outpatient section and it could not perform any other duties.

“Immunisation and MCH patrols have not been conducted since 2003. There are no fridges to keep vaccines and vehicles to travel to conduct the mobile clinics throughout the district,” he said.

“Basic medication like antibiotics are not available and the shelves are collecting dust,” he added.

He said that diseases like typhoid were already affecting lives, while cases for tuberculosis were not treated because of the lack of medicines.
He said that malaria was picking up while Sexually Transmitted Disease (STI) cases were increasing at an alarming rate.

Major emergency delivery and accident cases that required immediate referrals to Angau hospital were treated with tablets and patients were referred back to the villages, he said.

http://www.postcourier.com.pg/20080625/news03.htm

 

[alert]

Re: 70 dead, 800+ hundred affected by mystery illness in Papua New Guinea?s Morobe Province

Re: 70 dead, 800+ hundred affected by mystery illness in Papua New Guinea?s Morobe Province

Weclome to ProMed posting #2. This is a combination of several reports already available elsewhere on FT, but the moderator's comment is new. Personally, I doubt influenza is involved in this outbreak, but we must await further investigations.

http://www.promedmail.org/pls/otn/f..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,79003

Archive Number 20090830.3049
Published Date 30-AUG-2009
Subject PRO/EDR> Undiagnosed disease - Papua New Guinea (02): (MR)


UNDIAGNOSED DISEASE - PAPUA NEW GUINEA (02): (MOROBE)
*****************************************************
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: Mon 24 Aug 2009
Source: PLoS currents - influenza [edited]
<http://knol.google.com/k/antoine-flahault/first-estimation-of-direct-h1n1pdm/2nsp4xxomyqub/1?collectionId=28qm4w0q65e4w.1&positi>


[In response to the request for information entitled "Undiagnosed disease -
Papua New Guinea (MR), RFI 20090828.3033", a correspondent has written in
favour of the suggestion that the undiagnosed disease currently afflicting
villagers in Papua New Guinea could well be influenza pandemic H1N1 2009
virus infection, since reports from New Zealand and Australia indicate
significantly higher levels of mortality among indigenous peoples (see:
Influenza pandemic (H1N1) 2009 (35): NZ surveillance 20090827.3022).

New Caledonia is a small Pacific island located near New Guinea, and severe
disease has been reported from inhabitants there. The correspondent has
drawn attention to another report suggesting greater lethality of the
pandemic H1N1 2009 virus versus seasonal influenza and enhanced
vulnerability of indigenous peoples. Extracts from this analysis are posted
below. - Mod.CP]

1st estimation of direct H1N1 2009 pandemic virus
-------------------------------------------------
"We provide rough estimates of direct lethality from ARDS [acute
respiratory distress syndrome] due to the pandemic H1N1 2009 virus from 2
independent sources of data, one from New Caledonia, where 30 000
infections are assumed to have occurred and 3 deaths reported to be
attributable directly to the pandemic virus. Another source is Mauritius,
where 70 000 infections are estimated to have occurred and 7 reported
deaths from ARDS (5 of them are currently confirmed). These surveillance
data allow for 1st estimation of direct lethality due to the pandemic H1N1
2009 virus to be one per 10 000 infections, about 100 times more than
regular seasonal influenza.

"Influenza lethality is due to 3 main causes: 1st, direct viral origin
leading to viral pneumonia of high severity, with an acute respiratory
distress syndrome (ARDS) associated with 30 to 50 per cent lethality in
intensive care units (ICUs) [1 - this and other references are shown at the
above URL]; 2nd, bacterial super-infection due to pneumococcal,
staphylococcal, streptococcal, or meningococcal pneumonia, usually curable
with appropriate antibiotics, provided they are administered early enough;
and 3rd, decompensation of severe underlying conditions, often in elderly
people or in vulnerable chronic patients. The last is the predominant cause
of death attributable to seasonal influenza in developed countries and has
reached, for years now -- despite of the use of mass immunization in the
elderly -- a level of around one death per 1000 infections. This cause of
lethality is rarely reported as attributed to influenza in death
certificates, and therefore is not easily assessable during outbreaks, and
is usually measured as excess mortality when time series of mortality
become available, sometimes in real time, most often several months after
the season [2]. The 2nd cause, that is, bacterial super-infection, is much
less seen in developed countries due to antibiotic availability. However,
in the developing world, it may still be a cause of concern, since
bacterial pneumonia may rapidly become lethal if treatment is not given
appropriately in time. The direct lethality due to viral pneumonia gives
probably the best estimate of influenza strains' virulence, since it may
vary from strain to strain and is not due to the level of health
development of a country. Furthermore, ARDS always leads to ICU and is easy
enough to diagnose and to report.

Death from ARDS due to seasonal influenza
-----------------------------------------
"There are not many assessments available with regards to the incidence of
death from ARDS due to seasonal influenza in the literature. Empirical
evidence suggests that in France less than 5 to 10 of such cases are
identified each year, when an average of 6 million seasonal infections are
estimated from the French sentinel system [3]. We may, therefore, assume,
waiting for better estimates in the future, that deaths from ARDS due to
seasonal influenza are an exceptional event occurring once every million
infected patients.

Death from ARDS due to H1N1 pdm
-------------------------------
"It is too early to provide precise figures of deaths of ARDS due to the
new strain of pandemic influenza. In the USA, there is too large an
uncertainty reported regarding the denominator (i.e. number of influenza
infections), as is true of the UK and Argentina as well. In smaller areas,
and in particular in islands such as French New Caledonia or Mauritius, we
may have first rough estimates which may be more relevant and easier to catch.

"The French government estimated last week that 20 000 cases of influenza
had occurred in New Caledonia in the emerging outbreak, leading to a rough
estimate of 30 000 infections, and by 21 Aug 2009, 3 deaths of confirmed
cases were reported in patients aged 8, 27, and 58 years [4].

"The government of Mauritius estimated last week that 15 000 cases of
influenza had occurred in the last 2 weeks in Mauritius; however, some
reports from the media and recent personal communications from local
doctors lead me to estimate that about 50 000 cases actually occurred, and,
therefore, about 70 000 infections, taking into account mild illnesses. By
19 Aug 2009, 7 deaths had occurred; 5 of them were already virologically
confirmed in patients aged 4, 6, 28, 46, and 53 years [5].

"The New Caledonia and Mauritius figures are consistent with a rough
estimate of about one death from ARDS due to pandemic H1N1 2009 virus
infection per 10 000 infections, i.e. a virulence of 100 times that
observed for seasonal strains.

"We acknowledge that we are producing very rough estimates of direct
lethality associated with H1N1 2009 pandemic virus. However, it may be
useful to deliver such estimates as early as possible in the course of this
pandemic with the purpose of helping health authorities to check
availability of ICUs and artificial ventilation devices in their countries,
in case of a wave of similar virulence this fall [2009] in the northern
hemisphere. When assuming that half of ARDS are of lethal outcome, we may
assume that H1N1 2009 pandemic virus may generate one case of ARDS every
5000 infections. ARDS is always treated in ICUs, and 3 weeks of treatment
is probably an average period. In case of attack rates of 30 to 50 per cent
this fall and winter in the northern hemisphere [6], these figures may help
refine preparedness."

[byline: Antoine Flahault, EHESP School of Public Health, Rennes, France]

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

[It remains possible, as acknowledged in the New Zealand study, that the
enhanced lethality of the pandemic (H1N1) 2009 virus in indigenous
populations may be a consequence of underlying health and other
inequalities. Further information on the outcome of the investigation of
undiagnosed disease in Papua New Guinea is awaited.

The full content and references of the above report can be found at:
<http://knol.google.com/k/antoine-flahault/first-estimation-of-direct-h1n1pdm/2nsp4xxomyqub/1?collectionId=28qm4w0q65e4w.1&positi>.
- Mod.CP]

[see also:
Undiagnosed disease - Papua New Guinea (MR), RFI 20090828.3033]

....................cp/msp/sh

 

[alert]

Re: 70 dead, 800+ hundred affected by mystery illness in Papua New Guinea?s Morobe Province

Re: 70 dead, 800+ hundred affected by mystery illness in Papua New Guinea?s Morobe Province

http://tvnz.co.nz/health-news/png-cholera-outbreak-kills-over-40-2957736

PNG cholera outbreak kills over 40 Published: 11:52AM Monday August 31, 2009

Source: AAP
Read

Papua New Guinea map (ONE News)
Papua New Guinea is suffering its first known cholera outbreak with 41 villagers reportedly dead in remote parts of the country.


PNG's Health Minister Sasa Zibe has confirmed the cholera outbreak and directed health officials to immediately contain its spread.


World Health Organisation (WHO) representatives based in PNG sent an investigation team to Finschhafen District, Morobe Province in PNG's northwest coast late last week after a mysterious illness ripped through the area.


They have since confirmed the incidence of cholera.

"As this is the first reported case, the government will now be reporting this to the WHO as part of the requirement under the international health regulation," Mr Zibe said in a statement.


He urged villagers with cholera's diarrhoea-like symptoms or severe dehydration to report immediately to rural health facilities.


"If allowed to spread the disease will add further burden to our fragile health system," Mr Zibe said.


According to the WHO, cholera is mainly transmitted through contaminated water and food and is closely linked to inadequate environmental management.

 

[alert]

Re: 70 dead, 800+ hundred affected by Cholera in Papua New Guinea?s Morobe Province

Re: 70 dead, 800+ hundred affected by Cholera in Papua New Guinea?s Morobe Province

That was my first guess after reading the articles - confirmed cholera, not flu at all.

 

[Rwilmer]

Re: 70 dead, 800+ hundred affected by mystery illness in Papua New Guinea?s Morobe Province

Re: 70 dead, 800+ hundred affected by mystery illness in Papua New Guinea?s Morobe Province

There we go. Cholera.

 

[JetStuuby]

Re: 70 dead, 800+ hundred affected by mystery illness in Papua New Guinea?s Morobe Province

Re: 70 dead, 800+ hundred affected by mystery illness in Papua New Guinea?s Morobe Province

What about the......

QUOTE: "The officer in charge of the Menyamya health centres, Sr Bina David, described the situation as ?an epidemic?.
She said they were still unable to confirm the disease because of the unstable symptoms.
She could not even say whether it was a viral or bacterial infection.
?Some patients had red eyes, severe headache, high fever, dysentery, upset stomach, sore throat and coughing."

Those symptoms don't match with cholera.......

Specific symptoms of this condition can include:

Sudden onset and large amounts of watery diarrhea. Diarrhea is usually painless.

Vomiting.

Muscle cramps.

Stool that has a characteristic "rice-water" appearance -- grey, slightly cloudy with flecks of mucus, and a slightly sweaty odor (see Pictures of Cholera).

As fluid is lost, other symptoms can occur, including:

Thirst
Weakness
Increased heart rate
Reduced urine production
Coma
Death.

Fever is not a symptom of cholera.


from http://diarrhea.emedtv.com/cholera/cholera-symptoms.html

 

[alert]

Re: 70 dead, 800+ hundred affected by mystery illness in Papua New Guinea?s Morobe Province

Re: 70 dead, 800+ hundred affected by mystery illness in Papua New Guinea?s Morobe Province

And there is the lesson on the effect of the H1N1 pandemic on undiagnosed illnesses. When the reports seem to mention things like "we can only treat normal flu", or when deadly outbreaks occur and the symptoms given are things like runny nose and sore throat, the idea of H1N1 is contaminating the reports, even when the virus is not.

Bungoma, Kenya had a cholera outbreak in early May that the locals got spooked and screamed H1N1 as well. Not the first outbreak to get improperly blamed on flu, and likely not the last.

And we should send this last article to ProMed so everyone can stop worrying about a 10% CFR flu.

 

[alert]

Re: 70 dead, 800+ hundred affected by mystery illness in Papua New Guinea?s Morobe Province

Re: 70 dead, 800+ hundred affected by mystery illness in Papua New Guinea?s Morobe Province

Those symptoms don't match with cholera.......

Specific symptoms of this condition can include:

Sudden onset and large amounts of watery diarrhea. Diarrhea is usually painless.

Vomiting.

Muscle cramps.

Stool that has a characteristic "rice-water" appearance -- grey, slightly cloudy with flecks of mucus, and a slightly sweaty odor (see Pictures of Cholera).

As fluid is lost, other symptoms can occur, including:

Thirst
Weakness
Increased heart rate
Reduced urine production
Coma
Death.

Fever is not a symptom of cholera.


from http://diarrhea.emedtv.com/cholera/cholera-symptoms.html

We got bad reports of symptoms. People freaked out because they were sure it was H1N1, and reported H1N1 symptoms where they weren't. In remote areas like this, the reports of symptoms are not often accurate. The "red eyes" now almost looks like a bogus (nonsense) symptom as well. And in areas where remote areas may have really poor health infrastrucutre, the local government often prefers to blame outbreaks on bizarre causes to avoid blame.

The red flag to me on this one was that no "terminal symptom" of H1N1 was being reported. There were no reports of pneumonia, or difficulty breathing, or even neurological involvement. The description was of people who had flu symptoms, and just died. That's not the way flu kills.

Do we really belive the Nepal has been reporting hemorrhagic illness for the past 10 years? Of course not. It is the same way with this.

 

[JetStuuby]

Re: 70 dead, 800+ hundred affected by mystery illness in Papua New Guinea?s Morobe Province

Re: 70 dead, 800+ hundred affected by mystery illness in Papua New Guinea?s Morobe Province

Yet the initial reports speak of 21 being dead from influenza and 20 from dysentery. Seeming to indicate that there were two groups of ill, perhaps afflicted by two different agents.

And the symptoms being influenza like was reported a number of times, including fever which is not a symptom of cholera.

What makes you so sure all of these deaths are due to cholera?

 

[Treyfish]

Re: 70 dead, 800+ hundred affected by mystery illness in Papua New Guinea?s Morobe Province

Re: 70 dead, 800+ hundred affected by mystery illness in Papua New Guinea?s Morobe Province

first known case?

Cholera Deaths - Worldmapper: The world as you've never seen it before<BUTTON class=w10 type=submit></BUTTON><BUTTON class=w20 type=submit></BUTTON>
In 1962, in Papua New Guinea, 36% of cholera cases, which was 464 people, died:tiphat:http://www.worldmapper.org/posters/worldmapper_map232_ver5.pdf

 

[alert]

Re: 70 dead, 800+ hundred affected by mystery illness in Papua New Guinea?s Morobe Province

Re: 70 dead, 800+ hundred affected by mystery illness in Papua New Guinea?s Morobe Province

First, two separate outbreaks ofthe same high mortality in the same region is very unlikely (the same probablility of one outbreak landing in your neighborhood) statistically. The CFR was inconsistent with H1N1 (or H5N1 for that matter). There were just too many red flags. We'll keep an eye on this outbreak (as even 41 cholera deaths is newsworthy), and see if anything else develops, but I don't think there was any flu there.

The timing was also wrong for flu. With all the global H1N1 coverage, it wouldn't take 41 (or even 21) deaths to send out an H1N1 alarm. But cholera from contamined water will sicken everyone at once, leading to this kind of report.

Also keep in mind that in addition to being wrong about symptoms, the reports were conflicting about how many were ill. We had reports of 700 illnesses in a village of 258 people.

 

[Rwilmer]

Re: 70 dead, 800+ hundred affected by mystery illness in Papua New Guinea?s Morobe Province

Re: 70 dead, 800+ hundred affected by mystery illness in Papua New Guinea?s Morobe Province

Yet the initial reports speak of 21 being dead from influenza and 20 from dysentery. Seeming to indicate that there were two groups of ill, perhaps afflicted by two different agents.

And the symptoms being influenza like was reported a number of times, including fever which is not a symptom of cholera.

What makes you so sure all of these deaths are due to cholera?

Only about one in 10 infected people develops the typical signs and symptoms of cholera, which include:

■Severe, watery diarrhea. The incubation time for cholera is brief — usually one to five days after infection. Diarrhea comes on suddenly. Diarrhea due to cholera is often voluminous, flecked with mucus and dead cells, and has a pale, milky appearance that resembles water in which rice has been rinsed (rice-water stool). What makes cholera diarrhea so deadly is the loss of large amounts of fluids in a short time — as much as a quart (.95 liters) an hour.
■Nausea and vomiting. Occurring in both the early and later stages of cholera, vomiting may persist for hours at a time.
■Muscle cramps. These result from the rapid loss of salts such as sodium, chloride and potassium.
■Dehydration. This can develop within hours after the onset of cholera symptoms — far more quickly than in other diarrheal diseases. Depending on how much body fluids have been lost, dehydration can range from mild to severe. A loss of 10 percent or more of total body weight indicates severe dehydration. Signs and symptoms of cholera dehydration include irritability, lethargy, sunken eyes, a dry mouth, extreme thirst, dry, shriveled skin that's slow to bounce back when pinched into a fold, little or no urine output, low blood pressure, and an irregular heartbeat (arrhythmia).
■Shock. Hypovolemic shock is one of the most serious complications of cholera dehydration. It occurs when low blood volume causes a drop in blood pressure and a corresponding reduction in the amount of oxygen reaching your tissues. If untreated, severe hypovolemic shock can cause death in a matter of minutes.
Signs and symptoms of cholera in children
In general, children with cholera have the same signs and symptoms adults do, but they may also experience:

■Extreme drowsiness or even coma
■Fever
■Convulsions

My comment: Fever is a symptom of cholera.

http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms

 

[JetStuuby]

Re: 70 dead, 800+ hundred affected by mystery illness in Papua New Guinea?s Morobe Province

Re: 70 dead, 800+ hundred affected by mystery illness in Papua New Guinea?s Morobe Province

I think keeping an eye on it is wise.

It seems odd that a Doctor would announce two pathogens and specifically mention flu like symptoms, especially ones that do not occur with cholera as afflicting the sick if that were not the case.

 

[alert]

Re: 70 dead, 800+ hundred affected by mystery illness in Papua New Guinea?s Morobe Province

Re: 70 dead, 800+ hundred affected by mystery illness in Papua New Guinea?s Morobe Province

I've seen plenty of wrong symptoms and nonsense symptoms before. This isn't even close to the worst "wrong symptom" violation - read the cholera in Bungoma in Kenya ProMed post (around May 3) for an even more alarming example - it seems to indicate a disease that is a hybrid of VHF and H1N1.

And as far as fever goes, if there are not medical facilities in the area, how do you think they even determine if someone has a fever? There may not be thermometers in the villagers. Fever is often reported as a symptom to mean generally not feeling well.

 

[JetStuuby]

Re: 70 dead, 800+ hundred affected by mystery illness in Papua New Guinea?s Morobe Province

Re: 70 dead, 800+ hundred affected by mystery illness in Papua New Guinea?s Morobe Province

There are some subtle differences between the Kenya Promed case and this one.

In Kenya it was residents claiming the symptoms. In Papua it is the Medical Officer and a Doctor claiming influenza like symptoms.

In Kenya there was no mention of fever or coughing (both symptoms of influenza), yet in Papua there was mention of these symptoms (neither of which symptoms of Cholera).

I think it bears watching as there is evidence pointing to a second agent at work here, not solely cholera.

 

[Rwilmer]

Re: 70 dead, 800+ hundred affected by mystery illness in Papua New Guinea?s Morobe Province

Re: 70 dead, 800+ hundred affected by mystery illness in Papua New Guinea?s Morobe Province

Only about one in 10 infected people develops the typical signs and symptoms of cholera, which include:

■Severe, watery diarrhea. The incubation time for cholera is brief ? usually one to five days after infection. Diarrhea comes on suddenly. Diarrhea due to cholera is often voluminous, flecked with mucus and dead cells, and has a pale, milky appearance that resembles water in which rice has been rinsed (rice-water stool). What makes cholera diarrhea so deadly is the loss of large amounts of fluids in a short time ? as much as a quart (.95 liters) an hour.
■Nausea and vomiting. Occurring in both the early and later stages of cholera, vomiting may persist for hours at a time.
■Muscle cramps. These result from the rapid loss of salts such as sodium, chloride and potassium.
■Dehydration. This can develop within hours after the onset of cholera symptoms ? far more quickly than in other diarrheal diseases. Depending on how much body fluids have been lost, dehydration can range from mild to severe. A loss of 10 percent or more of total body weight indicates severe dehydration. Signs and symptoms of cholera dehydration include irritability, lethargy, sunken eyes, a dry mouth, extreme thirst, dry, shriveled skin that's slow to bounce back when pinched into a fold, little or no urine output, low blood pressure, and an irregular heartbeat (arrhythmia).
■Shock. Hypovolemic shock is one of the most serious complications of cholera dehydration. It occurs when low blood volume causes a drop in blood pressure and a corresponding reduction in the amount of oxygen reaching your tissues. If untreated, severe hypovolemic shock can cause death in a matter of minutes.
Signs and symptoms of cholera in children
In general, children with cholera have the same signs and symptoms adults do, but they may also experience:

■Extreme drowsiness or even coma
■Fever
■Convulsions

My comment: Fever is a symptom of cholera.

http://www.mayoclinic.com/health/cholera/DS00579/DSECTION=symptoms

Fever is a symptom of cholera in children. Most of these deaths are children.

 

[Treyfish]

Re: 70 dead, 800+ hundred affected by mystery illness in Papua New Guinea?s Morobe Province

Re: 70 dead, 800+ hundred affected by mystery illness in Papua New Guinea?s Morobe Province

<TABLE border=0 cellSpacing=0 cellPadding=0 width=560><TBODY><TR><TD vAlign=top width=550 colSpan=2>:tiphat:H1N1 has been there in that area for a couple months at least.

Papua New Guinea announces first H1N1 flu case <!-- TITLE : end--><!--
Patient was tested positive after flying in from hard-hit Australia. -AFP -->

</TD></TR><TR>

</TR><TR><TD vAlign=top width=550 colSpan=2 align=left><TABLE><TBODY><TR><TD><TABLE><TBODY><TR><TD>

</TD></TR><TR><TD class=content_subtitle align=left>Fri, Jun 19, 2009
AFP
</TD></TR></TBODY></TABLE></TD><TD width=400 align=right><TABLE border=0 cellSpacing=0 cellPadding=0><TBODY><TR><TD vAlign=top align=right></TD><TD height=15>

</TD><TD vAlign=top align=right><FORM method=post name=emailToFriendForm action=emailToFriend.jsp></FORM><SCRIPT> function openEmailA1AdminWindow(emailToFriendForm) { var emailToFriendPageURL = emailToFriendForm.emailToFriendPageURL.value; emailToFriendForm.action = emailToFriendPageURL; emailToFriendForm.target="_blank"; emailToFriendForm.submit(); } </SCRIPT></TD></TR></TBODY></TABLE><TD></TD></TR></TBODY></TABLE></TD></TR><!-- Story Without Image / With eXtra Large Image End --><TR><TD class=bodytext_10pt colSpan=3><!-- CONTENT : start -->PORT MORESBY - Papua New Guinea has urged the public not to panic after recording its first swine flu case, a report said on Friday.
Authorities were trying to contact the victim, who tested positive after flying in from hard-hit Australia last weekend, The National newspaper said.
"We will find out the flight the person came in and contact the airline for the passenger manifest," said Health Secretary Clement Malau.
<TABLE border=0 cellSpacing=2 cellPadding=2 width=300 align=right><TBODY><TR><TD><SCRIPT language=JavaScript src="/static/ads/scripts/adsimu.js"></SCRIPT></TD></TR></TBODY></TABLE>"We would like to identify the passengers who sat at least two rows to the front and back of this person ... the contact tracing effort is a massive exercise and is under way right now."
The passenger, who showed flu symptoms, reportedly lives in Port Moresby and had been told to stay at home and avoid contact with other people.
Health officials were not immediately available to confirm the report.
Swine flu has infected nearly 40,000 people around the world in 89 countries and territories, causing 167 deaths since late March, World Health Organization figures show.:tiphat:http://www.asiaone.com/Health/News/Story/A1Story20090619-149709.html

</TD></TR></TBODY></TABLE>

 

[Flufreak]

Re: 70 dead, 800+ hundred affected by mystery illness in Papua New Guinea?s Morobe Province

Re: 70 dead, 800+ hundred affected by mystery illness in Papua New Guinea?s Morobe Province

The mere fact that you are sick with one thing certainly does not preclude another, usually makes it even more likely.

 

[JetStuuby]

Re: 70 dead, 800+ hundred affected by mystery illness in Papua New Guinea?s Morobe Province

Re: 70 dead, 800+ hundred affected by mystery illness in Papua New Guinea?s Morobe Province

A lot of mining occurs in Papua. There are thousands of Australians working/living and travelling to Papua each week.

H1N1 has been there since April.

 

[Treyfish]

Re: 70 dead, 800+ hundred affected by mystery illness in Papua New Guinea?s Morobe Province

Re: 70 dead, 800+ hundred affected by mystery illness in Papua New Guinea?s Morobe Province

"While local media reports say 70 people have died from the mysterious disease, the Morobe Provincial Health Office has denied that. The Health Advisor Dr Theo Likei says that 20 people died of dysentery in the remote Menyamya District last week, and 21 died of a mysterious influenza-like disease. He says more than 800 people have been affected from nearly 10 villages. He says the worst affected are children and pregnant women."