Undiagnosed case of viral haemorrhagic fever in Mumbai - not CCHF

[Ronan Kelly]

First case of viral haemorrhagic fever in Mumbai
Published: Saturday, Jan 22, 2011, 1:30 IST
By Menaka Rao | Place: Mumbai | Agency: DNA

Days after three cases of Crimean-Congo hemorrhagic fever (CCHF) were detected in Ahmedabad, a 48-year-old resident of Thane has shown clinical symptoms of the viral haemorrhagic fever and is critical.

Doctors at Jaslok Hospital where Sampat Jain was referred to earlier transferred him to the BMC-run Kasturba hospital on Friday morning.

The disease, also known as Congo fever, has so far claimed three lives in Ahmedabad in the last few days and has resulted in health authorities screening thousands of people. The mortality rate from CCHF is approximately 90%, say doctors, with death occuring in the second week of illiness.

Consulting physician at Jaslok, Dr Pratik Samdhani told DNA, ?Sampat was referred to me last night. He had high fever and was disoriented. He was not responding to the treatment given by the local physician for 6-7 days. His MRI scan revealed that he was bleeding in the brain. Besides, he has a low blood platelets count. His kidney and liver were deranged.?

Jain, whose dengue, malaria and leptospirosis tests were negative, is on ventilator.

?Since patients with CCHF have already been detected in Ahmedabad and the disease is infectious, Jain needed to be kept under fourth degree of isolation. Since Jaslok does not have this facility, we decided to shift him to Kasturba Hospital,? explained Samdhani. ?There is no improvement in his condition.?

Jain is a vegetarian and had no contact with livestock. His last visit outside the city was to Shirdi some days ago. ?We have recommended Kasturba to give him Ribavarine,? Samdhani said.

Jaslok Hospital also gave the medication to 47 of its employees, including Dr Samdhani, as a precautionarymeasure. The move has cost the hospital around Rs1.5 lakh.

?Jaslok has also instructed Kasturba Hospital to send secretion samples to the National Institute of Virology (NIV). This includes nasal swab and sputum,? said Dr Samdhani. Samdhani said the the viral infection could either be arboviral or adenoviral.

....

http://www.dnaindia.com/mumbai/report_first-case-of-viral-haemorrhagic-fever-in-mumbai_1497552

 

[alert]

Re: First case of viral haemorrhagic fever in Mumbai

Re: First case of viral haemorrhagic fever in Mumbai

The CCHF outbreak thread for Ahmedabad is below. The article above is mildly confusing; as indicated in post #32 in the thread below, ribavirin is toxic. Even if this case were confirmed as CCHF (which seems unlikely given his lack of exposure history), giving ribavirin to his contacts is ill-advised and will likely produce more illness than it prevents.

Results of NIV testing for CCHF will likely be announced soon.

http://www.flutrackers.com/forum/showthread.php?p=388505#post388505

 

[alert]

Re: First case of viral haemorrhagic fever in Mumbai

Re: First case of viral haemorrhagic fever in Mumbai

http://www.promedmail.org/pls/apex/..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,86769

Archive Number 20110122.0263
Published Date 22-JAN-2011
Subject PRO/AH/EDR> Undiagnosed hemorrhagic fever - India: (MA)


UNDIAGNOSED HEMORRHAGIC FEVER - INDIA: (MAHARASHTRA)
****************************************************
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: Sat 22 Jan 2011
Source: DNA (Daily News Analysis) [edited]
<http://www.dnaindia.com/mumbai/report_first-case-of-viral-haemorrhagic-fever-in-mumbai_1497552>


Viral haemorrhagic fever in Mumbai
----------------------------------
Days after 3 cases of Crimean-Congo hemorrhagic fever (CCHF) were
detected in Ahmedabad, a 48-year-old resident of Thane [a city to the
north of Mumbai] has shown clinical symptoms of [a] viral
haemorrhagic fever and is critical. Doctors at Jaslok Hospital where
the patient was referred to earlier transferred him to the BMC
[Brihanmumbai Municipal Corporation]-run Kasturba hospital on Friday
morning [21 Jan 2011].

The disease has so far claimed 3 lives in Ahmedabad in the last few
days and has resulted in health authorities screening thousands of
people. The mortality rate from CCHF is approximately 90 percent, say
doctors, with death occurring in the 2nd week of illness.

Consulting physician at Jaslok, Dr Pratik Samdhani told DNA, "Sampat
was referred to me last night. He had high fever and was disoriented.
He was not responding to the treatment given by the local physician
for 6-7 days. His MRI scan revealed that he was bleeding in the
brain. Besides, he has a low blood platelets count. His kidney and
liver were deranged." The patient, whose dengue, malaria and
leptospirosis tests were negative, is on ventilator.

"Since patients with CCHF have already been detected in Ahmedabad and
the disease is infectious, the patient needed to be kept under 4th
degree of isolation. Since Jaslok [hospital] does not have this
facility, we decided to shift him to Kasturba Hospital," explained
Samdhani. "There is no improvement in his condition."

The patient is a vegetarian and had no contact with livestock. His
last visit outside the city was to Shirdi some days ago. "We have
recommended Kasturba to give him Ribavirine," Samdhani said.

Jaslok Hospital also gave the medication to 47 of its employees,
including Dr Samdhani, as a precautionary measure.

"Jaslok has also instructed Kasturba Hospital to send secretion
samples to the National Institute of Virology (NIV). This includes
nasal swab and sputum," said Dr Samdhani. Samdhani said the the viral
infection could either be arboviral or adenoviral [i.e., presumably
insect or aerosol aerosol transmitted, as opposed to tick-transmitted?].

Dr GT Ambe, executive health officer, BMC, said he is not aware about
the development. Doctors say that the disease is fatal. Unless it is
detected at an early stage, and treated aggressively, the patient
dies immediately after.

CCHF was successfully identified by the NIV few days ago. The disease
is endemic in many countries in Africa, Europe and Asia. In 2001,
cases or outbreaks were recorded in Kosovo, Albania, Iran, Pakistan,
and South Africa, according to WHO.

Doctors said after the virus strikes the patient, there is a
breakdown of blood and blood products. The tissues get damaged.
Thereafter one gets fever and develops a rash that leads to bleeding.
It can rapidly deteriorate to headaches, seizures, convulsions and
eventually lead to coma. The patient may also experience
irritability, and photophobia (irritation to light).

[Byline: Menaka Rao]

--
Communicated by:
Ronan Kelly
<ronankelly@comcast.net>

[Crimean-Congo haemorrhagic fever (CCHF) is primarily a zoonosis.
Sporadic cases and outbreaks of CCHF affecting humans do occur.
Humans who become infected with CCHF acquire the virus from direct
contact with blood or other infected tissues from livestock during
this time, or they may become infected from a tick bite. The majority
of cases have occurred in those involved with the livestock industry,
such as agricultural workers, slaughterhouse workers and
veterinarians. A detailed account of CCHF can found at the WHO website:
<http://www.who.int/mediacentre/factsheets/fs208/en/index.html>).

In the case of the patient in a Mumbai hospital the diagnosis has
been made mainly by association with a confirmed outbreak of CCHF in
Ahmedabad (in the state of Gujarat), far to the north of Mumbai (in
the state of Maharashtra). The observation that the patient is a city
dweller and a vegetarian is not compatible with the diagnosis of
CCHF. No positive diagnosis of the etiologic agent is reported but
dengue, malaria and leptospirosis infections have been excluded.
Curiously arboviral or adenoviral infection are being considered as
alternative diagnoses.

The results of the tests at the National Institute of Virology in
Pune (Maharashtra) are awaited.

 

[Ronan Kelly]

Re: First case of viral haemorrhagic fever in Mumbai

Re: First case of viral haemorrhagic fever in Mumbai

Mumabi Congo fever victim?s samples sent to National Institute of Virology
Published: Saturday, Jan 22, 2011, 22:32 IST | Updated: Saturday, Jan 22, 2011, 22:34 IST
By Somita Pal & Nozia Sayyed | Place: Mumbai | Agency: DNA

With no significant development in Sampatraj Jain?s condition, the National Institute of Virology (NIV) is going to test the samples sent by Kasturba Hospital for 7-8 viruses causing viral haemorrhagic fever.

The 48-year-old Bhiwandi resident was shifted from Jaslok Hospital to Kasturba Hospital on Friday morning after doctors found that the clinical symptoms indicated viral haemorrhagic fever.

Dr Om Shrivastav, infectious diseases consultant, Jaslok Hospital, said, ?There is no doubt that he has viral haemorrhagic fever. The virus can be the Congo virus, as in the cases detected in Ahmedabad. But chances of it being hanta virus, which spreads through rodents, are more as it affects the kidney and liver.?

...

http://www.dnaindia.com/mumbai/repo...ent-to-national-institute-of-virology_1497955

 

[alert]

Re: First case of viral haemorrhagic fever in Mumbai

Re: First case of viral haemorrhagic fever in Mumbai

It seems very unlikely that this individual has CCHF. It might be a dengue hemorrhagic fever case, and perhaps the tests at the hospital were not good enough to detect it. As indicated above, perhaps a hantavirus is also suspect. The fact that his son recently had mild fever might be an important clue.

Google maps tells me that Gujarat lies between Rajasthan and Mumbai, so it is possible, although very unlikely, that he could have had contact with a previously unrecognized human CCHF case in Gujarat.

http://www.dnaindia.com/mumbai/report_mystery-fever-leaves-bhiwandi-residents-jittery_1497967

Mystery fever leaves Bhiwandi residents jittery
Published: Saturday, Jan 22, 2011, 22:45 IST
By Devendra T Goregaonkar, Shubhangi Ghadi & Deepa Sarna | Place: Mumbai | Agency: DNA

A day after 48-year-old Sampat Jain, a Bhiwandi resident, showed clinical symptoms of the rare and fatal Crimean-Congo Haemorrhagic Fever (CCHF), health authorities from theBhiwandi-Nizampur Municipal Corporation (BNMC) are gearing up to restrict the spread of the deadly fever.

Dr AB Nandapurkar, residential district health officer, Thane District, said that there will be a district-wide survey of livestock to identify those infected by ticks. Another survey will identify people suffering from fever and showing symptoms of CCHF.

Meanwhile, Jain’s illness has left the residents of Bhiwandi’s Gokulnagar grappling to come to grips with the mystery fever, and clueless about how to go about getting a treatment if they come down with it.

Strangely enough, the doctor who treated Jain and suggested that he should shift to a Mumbai hospital did not inform the local civic authorities.

Jain stays on the first floor of Nalanda Housing Society, a two-building complex which has around 32 flats.

The news of Jain’s ailment spread like wild fire in the entire Gokulnagar area, which houses nearly 15,000 residents staying in 25 buildings. Most of the residents, who are confused about the symptoms of CCHF, have decided to approach civic hospitals even in the case of a minor fever.

Geeta Sharda, a senior citizen from Nalanda Society, said, “We came to know about Jain’s illness through children who heard about it in their tuition classes. But we still don’t know what to do if anyone suffers from the fever.”

Alpesh Jain, Sampat Jain’s son, said, “My father is under observation and we are waiting for the doctor’s final report.

Though no one in the family is now suffering from fever or any other symptoms, I suffered from fever a few days ago but I am completely fine now.”

The Jains had recently visited Rajasthan but did not halt at any city in Gujarat, where three cases of CCHF have been reported.

“No government or civic hospital has Jain’s health records as he directly went to Jaslok Hospital after receiving treatment from a local physician. Now we have appealed to all the private doctors as well as the citizens to inform local bodies if similar cases are observed by them,” said Dr KR Kharat, chief medical officer, Bhiwandi-Nizampur Municipal Corporation said,

He added that the state government had not informed the municipal corporation about the patient suspected of CCHF.

“However, we have started taking measures to restrict the spread of the fever. If people suspect any cases of CCHF in their neighbourhood, they should inform the municipal doctors,” he said. Precautionary measures are also being taken in Thane city.

Precautions that individuals can take to avoid the deadly fever include, wearing gloves, aprons, goggles and closed footwear, like gumboots while handling live or dead cattle. Disinfecting the dead animals before disposal is another requirement to prevent the spread of the ticks.

The deadly disease has already killed three from Ahmedabad, with the first death occurring in the first week of January 2011. The dead included a 30-year-old woman, the doctor who was treating her, and the nurse who was assisting in her treatment.

What is CCHF?
•Crimean-Congo Hemorrhagic Fever (CCHF), also known as Congo fever, is a tick-borne viral disease. It spreads from animals to humans either by tick bites or through contact with infected animal tissue during or immediately after slaughter. While the spread from animals to humans is rare, the disease is severe in infected human beings, with a mortality rate of 30 percent.
•Symptoms of CCHF include high fever, vomiting and abdominal pain. As the disease progresses, bruising and severe nosebleeds are also common.
•The disease first came to notice in the Crimea in 1944, and was given the name Crimean hemorrhagic fever.

 

[Ronan Kelly]

Re: First case of viral haemorrhagic fever in Mumbai

Re: First case of viral haemorrhagic fever in Mumbai

...


Meanwhile, the state government has called a meeting of all health and animal husbandry department officials on Monday morning. "We will have the NIV report by then and can decide the further course of action,'' said minister Shetty.

Read more: 'There is no reason for Mumbaikars to panic' - The Times of India http://timesofindia.indiatimes.com/...o-panic/articleshow/7344342.cms#ixzz1BnSn7qHi

 

[alert]

Re: First case of viral haemorrhagic fever in Mumbai

Re: First case of viral haemorrhagic fever in Mumbai

And now suggestion that the family did visit Ahmedabad.

Still, it would be very unlikely that this case did have contact with the known CCHF cases, but it gets closer...

http://timesofindia.indiatimes.com/...h-to-Jains-neighbours/articleshow/7344461.cms


Officials give clean bill of health to Jain's neighbours
TNN, Jan 23, 2011, 01.46am IST

Tags:National Institute of Virology|hemorrhagic fever|Bhiwandi-Nijampur Municipal Corporation MUMBAI: Around half a dozen members of Bhiwandi resident Sampat Jain's family stood outside ward no 14 at Kasturba Hospital near Chinchpokli. "We don't want to talk to anyone until we get the test report from National Institute of Virology,'' said his son Kiran.

Kiran said he hadn't seen his father in the last 24 hours and was unaware if he was on ventilator support. "He will come through and I am sure we will be able to leave in a day or two.''

All members of the Jain family have been given a preventive course of Ribavirin as a precautionary measure, he added.

Unlike the peace in Kasturba's green campus, the lane in which the Jains live in Bhiwandi was a hive of activity on Saturday. As news about the 48-year-old Jain suffering from a hemorrhagic fever spread, doctors from the Bhiwandi-Nijampur Municipal Corporation's (BNHC) health department visited the Gokul Nagar area. Health officials surveyed around 200 families, checking people for symptoms.

BNMC's health officer K R Kharat said, "We spent the entire day carrying out a survey in the Gokul Nagar area, and checked around a thousand residents." The authorities found no one with symptoms similar to Crimean Congo Hemorrhagic Fever (CCHF). The only spot of worry was the statement given by a neighbour. "The patient's neighbour told us that the family visited Rajasthan 15 days ago and had stopped at Ahmedabad on the return journey,'' he said. Ahmedabad district witnessed three deaths due to the CCHF in the last two weeks.

The Bhiwandi doctors also discovered that on his return, Sampat Jain had taken ill and was receiving treatment at a local hospital before he was moved to Bhatia Hospital in Mumbai. He was then admitted to Jaslok Hospital before the doctors there transferred him to Kasturba.

Dr Pratik Samdhani from Jaslok Hospital said: "The patient had a brain hemorrhage along with renal failure. And because we could not collect the blood samples in complete isolation as required when a person is suffering from an infectious disease, we had to send him to Kasturba."



Read more: Officials give clean bill of health to Jain's neighbours - The Times of India http://timesofindia.indiatimes.com/...ghbours/articleshow/7344461.cms#ixzz1BnotG3BN

 

[Ronan Kelly]

Re: First case of viral haemorrhagic fever in Mumbai

Re: First case of viral haemorrhagic fever in Mumbai

Mumbai sample tests negative for Congo fever, one result awaited
TNN, Jan 23, 2011, 12.53am IST
MUMBAI: The city may not need to worry about the Crimean-Congo Haemorrhagic Fever just yet.

The Pune-based National Institute of Virology said on Saturday one of two samples sent from Mumbai had tested negative. The other sample was sent by BMC officials on Saturday morning and results will be known on Sunday, said NIV director A C Mishra. It belongs to 48-year-old Sampat Jain.

A senior doctor of Kasturba Hospital who examined Jain said his brain scan had shown a mid-brain haemorrhage but there could be various causes. "It definitely did not look like a case of Congo fever. He doesn't have any fever or rash that is associated with haemorrhagic fever. He has a brain haemorrhage and had bled through the nose and mouth," the doctor said, adding that these didn't add up to a classical haemorrhagic fever.

....


Read more: Mumbai sample tests negative for Congo fever, one result awaited - The Times of India http://timesofindia.indiatimes.com/...awaited/articleshow/7344335.cms#ixzz1Bo3zlPS8

 

[Ronan Kelly]

Re: First case of viral haemorrhagic fever in Mumbai

Re: First case of viral haemorrhagic fever in Mumbai

From the above story;


Both BMC and NIV officials refused to divulge the source of the first sample that tested negative on Saturday

Read more: Mumbai sample tests negative for Congo fever, one result awaited - The Times of India http://timesofindia.indiatimes.com/...awaited/articleshow/7344335.cms#ixzz1Bo4QKGD2

 

[alert]

Re: First case of viral haemorrhagic fever in Mumbai

Re: First case of viral haemorrhagic fever in Mumbai

No fever implies no hemorrhagic fever.

There are a variety of non-infectious conditions that can produce hemorrhage, including anything that reduces platlet count.

 

[Ronan Kelly]

Re: First case of viral haemorrhagic fever in Mumbai

Re: First case of viral haemorrhagic fever in Mumbai

and then there's this - ignore the speculative title - says he was suffering from fever for 10 days.


First case of suspected Congo fever in Bhiwandi
Hindustan Times
Mumbai, January 23, 2011

...
A hospital source said Jain, who is suffering from renal failure, is critical and on ventilator. He is on anti-viral drugs. Doctors said Jain was suffering from fever, body ache and headache for the last 10 days.
Jain first took treatment for fever from a general practitioner for few days, and then was shifted to a nursing home. ?When his condition deteriorated, he was taken to Bhatia Hospital. As all the intensive care beds there were full, he was shifted to Jaslok,? said Dr Pratit Samdani, a consulting physician at Jaslok.

Jain had travelled to Shirdi and Nashik 15 days ago. ?When we did his MRI, it showed blood in the brain. The symptoms were similar to viral hemorrhage fever,? said Dr Samdani. Jain?s platelet count was only 35,000, which is very low.
http://www.hindustantimes.com/First-case-of-suspected-Congo-fever-in-Bhiwandi/Article1-653610.aspx

 

[Ronan Kelly]

Re: First case of viral haemorrhagic fever in Mumbai

Re: First case of viral haemorrhagic fever in Mumbai

DNA's reporting on this outbreak has at times been questionable, I'm still waiting on a second source that both samples tested negative.

No need to press panic button: National Institute of Virology
Published: Sunday, Jan 23, 2011, 13:03 IST
By Nozia Sayyed | Place: Pune | Agency: DNA

The National Institute of Virology (NIV) in Pune, flooded with serum samples from across states after the outbreak of Crimean Congo hemorrhagic fever (CCHF) in Gujarat, said there is no need to panic as all the samples have tested negative.

The serum and nasal sample that was received from Jaslok Hospital in Mumbai, of a 48-year-old resident of Thane, who is currently under treatment there, also tested negative, the NIV stated on Saturday. The patient has clinical symptoms similar to that of CCHF and is critical.



...

http://www.dnaindia.com/mumbai/repo...button-national-institute-of-virology_1498084

 

[Ronan Kelly]

Re: First case of viral haemorrhagic fever in Mumbai

Re: First case of viral haemorrhagic fever in Mumbai

Bhiwandi man has no Congo fever
TNN, Jan 24, 2011, 12.08am IST
MUMBAI: The blood sample of Bhiwandi resident Sampat Jain, who has been down with a mystery fever, tested negative for the Crimean-Congo Haemorrhagic Fever on Sunday.

"Jain tested negative for CCHF and we have no other suspected case," said BMC executive health officer Dr G T Ambe.

Jain, who was admitted to Jaslok Hospital, was shifted to BMC's Kasturba Infectious Disease Hospital on Friday on the suspicion that he had CCHF. His blood and fluid samples were sent to the National Institute of Virology (NIV) for tests on Saturday. "His condition is critical and he is still on ventilator," said Dr Om Shrivastava. "I haven't yet seen the reports, but I have been told that he tested negative for CCHF. Even so, it is a case of viral haemorrhagic fever." and we will have to treat him accordingly."

...

The institute director, A C Misra, told TOI that samples of two patients from Mumbai had tested negative. While the BMC sent the second sample, NIV did not reveal the name of the private hospital that sent the first sample for testing.



...

Read more: Bhiwandi man has no Congo fever - The Times of India http://timesofindia.indiatimes.com/...o-fever/articleshow/7349699.cms#ixzz1Bubz5Joe

 

[alert]

Re: Undiagnosed case of viral haemorrhagic fever in Mumbai - not CCHF

With CCHF excluded, it is unlikely we will hear the actual cause of the individual's illness. edit.

IMO, the speculation of a cerebral hemorrhage or hemorrhagic stroke, which would explain the bleeding in the brain and out the mouth and nose, is not sufficient alone to fully explain this man's condition, as it would not explain his low platelet count.

http://www.promedmail.org/pls/apex/..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,86797

Archive Number 20110123.0284
Published Date 23-JAN-2011
Subject PRO/AH/EDR> Undiagnosed hemorrhagic fever - India (02): (MA)


UNDIAGNOSED HEMORRHAGIC FEVER - INDIA (02): (MAHARASHTRA)
***********************************************
A ProMED-mail post
<http: www.promedmail.org="">
ProMED-mail is a program of the
International Society for Infectious Diseases
<http: www.isid.org="">

[1]
Date: Sun 23 Jan 2011
Source: The Times of India [edited]
<http: timesofindia.indiatimes.com="" city="" mumbai="" officials-give-clean-bill-of-healthto-jainsneighbours="" articleshow="" 7344461.cms#ixzz1boacndyu="">


Around half a dozen family members of a Bhiwandi resident stood
outside ward no. 14 at Kasturba Hospital near Chinchpokli. "We don't
want to talk to anyone until we get the test report from the National
Institute of Virology," said the patient's son. He said he hadn't
seen his father in the last 24 hours and was unaware whether he was
on ventilator support. "He will come through this, and I am sure we
will be able to leave in a day or 2." All members of the family have
been given a preventive course of Ribavirin as a precautionary
measure, he added.

As news about the 48-year-old father suffering from a haemorrhagic
fever spread, doctors from the Bhiwandi-Nijampur Municipal
Corporation's (BNHC) Health Department visited the Gokul Nagar area.
Health officials surveyed around 200 families, checking people for symptoms.

BNMC's health officer K R Kharat said: "We spent the entire day
carrying out a survey in the Gokul Nagar area and checked around a
thousand residents." The authorities found no one with symptoms
similar to Crimean-Congo haemorrhagic fever (CCHF). The only spot of
worry was the statement given by a neighbour. "The patient's
neighbour told us that the family visited Rajasthan 15 days ago and
had stopped at Ahmedabad [in Gujarat state] on the return journey,''
he said. Ahmedabad district has witnessed 3 deaths due to the CCHF in
the last 2 weeks. The Bhiwandi doctors also discovered that on his
return, the patient had taken ill and was receiving treatment at a
local hospital before he was moved to Bhatia Hospital in Mumbai. He
was then admitted to Jaslok Hospital before the doctors there
transferred him to Kasturba.

Dr Pratik Samdhani from Jaslok Hospital said: "The patient had a
brain haemorrhage along with renal failure. And because we could not
collect the blood samples in complete isolation as required when a
person is suffering from an infectious disease, we had to send him to
Kasturba."

--
Communicated by:
ProMED-mail


******
[2]
Date: Sun 23 Jan 2011
Source: The Times of India [edited]
<http: timesofindia.indiatimes.com="" city="" mumbai="" mumbai-sample-tests-negative-for-congo-fever-one-result-awaited="" articleshow="" 7344335.cms="">


The city may not need to worry about a Crimean-Congo haemorrhagic
fever [CCHF] outbreak just yet. The Pune-based National Institute of
Virology [NIV] said on Saturday [22 Jan 2011] that one of 2 samples
sent from Mumbai had tested negative. The other sample had been sent
by BMC [Brihanmumbai Municipal Corporation] officials on Saturday
morning and results will be known on Sunday [23 Jan 2011], said NIV
director A C Mishra.

A senior doctor of Kasturba Hospital who examined the patient said
his brain scan had shown a mid-brain haemorrhage, but there could be
various causes. "It definitely did not look like a case of CCHF
fever. He doesn't have any fever or rash that is associated with
haemorrhagic fever. He has a brain haemorrhage and had bled through
the nose and mouth," the doctor said, adding that these didn't add up
to a classical haemorrhagic fever.

The patient, a resident of Bhiwandi, was shifted from 3 private
hospitals before being admitted in a serious condition to civic-run
Kasturba Hospital in Chinchpokli on Friday [21 Jan 2011] evening.

Public health minister Suresh Shetty told the Times of India that
there should be no reason to panic. Viral haemorrhagic fevers are
caused by viruses that live on animals and can spread from person to
person only after direct contact of blood or body fluids. "Let's wait
for the NIV results. If the result is positive, we will have to get
the animal husbandry department to check cattle, as they are carriers
of this disease," he added.

Additional municipal commissioner Manisha Mhaiskar said it would be
premature to label him as a patient with haemorrhagic fever. "We need
a positive report to say such things," she said, adding that there
was no suspected patient at present. Both BMC and NIV officials
refused to divulge the source of the 1st sample that tested negative
on Saturday [22 Jan 2011].

The man's sample will be tested along with hundreds rushed from
Ahmedabad, where 3 people have died because of the Crimean Congo
Hemorrhagic Fever in the last fortnight. The Mumbai patient is under
the care of infectious diseases specialist Dr Om Shrivastava who told
the Times of India that it had looked like a case of viral
haemorrhagic fever on clinical examination. "But, rather than
speculating, we should wait for the reports," said Dr Srivastava, who
also consults at Jaslok Hospital which transferred the man to
Kasturba Hospital.

Dr Abhay Chowdhary of Haffkine Institute in Parel said that CCHF
doesn't spread through droplets or air. "It spreads only through
contact with blood or fluids of an infected person. So it is a
healthcare worker who doesn't observe all safety precautions who is
at high risk,'' he said. The main task is to establish whether cattle
in the state are carrying ticks that are infected with the virus. "If
one tick is infected, it will spread the virus to other ticks all
over the state. Each tick produces 10 000 eggs, and they transmit the
virus to eggs as well. So, we need to take care of our livestock,"
said Dr Chowdhury.

The state government has called a meeting of all health and animal
husbandry department officials for Monday [24 Jan 2011] morning. "We
will have the NIV report by then and can decide the further course of
action,'' said minister Shetty.

--
Communicated by:
Ronan Kelly <ronankelly@comcast.net>

[These 2 reports justify the skepticism expressed previously
regarding the preliminary diagnosis of CCHF, which now appears to
have been proposed on the basis of the patient's travel through
Ahmedabad (Gujarat state) earlier, where 3 cases of CCHF have been
confirmed. It is likely that the Mumbai patient's condition is the
result of a brain haemorrhage and may not be a consequence of an
infection. Results from the analysis of a 2nd sample of unspecified
clinical material submitted to the NIV are awaited.</ronankelly@comcast.net></http:></promed@promedmail.org></http:></http:></http:>

 

[Ronan Kelly]

Re: Undiagnosed case of viral haemorrhagic fever in Mumbai - not CCHF

Viral haemorrhagic fever patient sent back to Jaslok hospital
Published: Monday, Jan 24, 2011, 23:30 IST
By Menaka Rao | Place: Mumbai | Agency: DNA

Sampat Jain, 48, who was detected with viral haemorrhagic fever, was transferred back to Jaslok hospital, on Monday.
...

?Jain is not showing any signs of active viral infection. He will be kept under isolation,? said Dr Om Shrivastav.Jain, however, is still critical and on ventilator.

http://www.dnaindia.com/mumbai/repo...-patient-sent-back-to-jaslok-hospital_1498779

 

[alert]

Re: Undiagnosed case of viral haemorrhagic fever in Mumbai - not CCHF

Apparently, they are still testing.

In addition to testing for more unusual viruses, they may also be testing for common viruses that might just present like this in a rare severe case.

It is also possible that whatever agent caused the illness is long gone, and that's why the tests are coming back negative. Apparently this man has been ill for more than 2 weeks.

http://www.hindustantimes.com/Bhiwandi-resident-tests-negative-for-Congo-fever/Article1-654317.aspx

Bhiwandi resident tests negative for Congo fever
HT Correspondent, Hindustan Times
Mumbai, January 25, 2011 Email to Author

First Published: 02:42 IST(25/1/2011)
Last Updated: 02:44 IST(25/1/2011)Share more...0 Comments Email print

The blood samples of the second suspected case of the Crimean Congo Haemorrhagic Fever (CCHF), more commonly known as Congo fever, from the city has tested negative for the disease. The samples were sent to the National Institute of Virology (NIV), Pune. While the result of the first case was known on Saturday, the test report for Bhiwandi resident Sampat Jain, 48, was declared as negative for the virus on Sunday.

However, with the haemorrhagic fever already claiming three lives in Gujarat, state health officials will hold a meeting on Monday to decide if the authorities need to gear up to combat the disease.

Dr GT Ambe, executive health officer of the Brihanmumbai Municipal Corporation (BMC), confirmed that Jain’s reports were negative. However, Jain continues to be critical and is under observation at Kasturba Hospital, Chinchpokli.

Dr Pratik Samdhani of Jaslok Hospital where Jain was treated before being taken to Kasturba Hospital said the patient had tested negative for common illnesses such malaria, jaundice and dengue. “We thus suspected that he could be suffering from Congo fever and transferred him to Kasturba Hospital,” he said.

“Since Jain is still critical, NIV will carry out tests for other less-common viruses too. One of Jain’s relatives had suffered from fever. But now, he is fine,” Samdhani said.

With no confirmed cases of Congo fever, caused by close contact to livestock, in the city, health officials said there was no need to hit the panic button yet.

“We don’t feel any requirement to take any measures right away. For basics, we already have an isolation ward at Kasturba Hospital set up for swine flu patients. If there are any cases of Congo fever, we can isolate them there,” said Dr Ambe.

“On Monday, the officials may decide on whether we should take steps in the city against the virus,” said Bhushan Gagrani, secretary, public health department.

The civic body has already has sent out an advisory to all civic hospitals, to take adequate measures to check the spread of the fever.

The virus can be transmitted from animals to humans and has an incubation period of one to three days and a maximum of nine days.

 

[alert]

Re: Undiagnosed case of viral haemorrhagic fever in Mumbai - not CCHF

I believe this post is in error; I don't think there are two cases in this thread. I think the reference is to two samples taken from the same case.

http://www.promedmail.org/pls/apex/..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,86824


Archive Number 20110125.0305
Published Date 25-JAN-2011
Subject PRO/EDR> Undiagnosed hemorrhagic fever - India (03): (MA), RFI


UNDIAGNOSED HEMORRHAGIC FEVER - INDIA (03): (MAHARASHTRA), 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: Mon 24 Jan 2011
Source: TopNews New Zealand [edited]
<http://topnews.net.nz/content/211408-congo-fever-suspect-tested-negative>


Crimean-Congo hemorrhagic fever suspect tested negative
--------------------------------------------------------
A resident of Bhiwandi has tested negative for Crimean-Congo
haemorrhagic fever (CCHF) virus infection, much to the relief of his
doctors and his family. The patient has been treated at BMC's
[Bhiwandi-Nijampur Municipal Corporation] Kasturba Infectious Disease
Hospital since Friday [21 Jan 2011], after the fever scare was
strongly suspected. But when his urine and blood samples were sent to
the National Institute of Virology (NIV), they tested negative for
CCHF virus infection. With the earlier reports of CCHF claiming the
lives of 3 in Ahmedabad, this [negative test result] came as a
pleasant surprise for the clinicians.

Dr Om Shrivastava said: "[The patient's] condition is critical and he
is still on a ventilator. Even if he has tested negative for the CCHF,
it is a case of viral haemorrhagic fever and we will have to treat him
accordingly."

[In view of the CCHF risk] the Health Departments have issued
guidelines to send the samples from suspected cases of CCHF to the NIV
for thorough [laboratory] examination. CCHF is a widely-spread viral
disease, and is carried by wild as well as domestic animals. It has a
whopping 30 percent mortality rate in infected humans. This disease is
commonly characterized by nosebleeds, bloody urine, vomiting and black
stools.

[Byline: Neeraj Shahane]

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

[Bhiwandi is a city in the district of Thane, in the Indian state of
Maharashtra, located 20 km to the north-east of Mumbai and 15 km to
the north-east of Thane city. Thus the patient who is now being
treated in Kasturba Infectious Disease Hospital comes from the same
district of Maharashtra as the 1st suspected case of CCHF. Fortunately
clinical samples from both patients have tested negative for CCHF virus.

The illness of the 1st case is thought now not to have had an
infectious cause. The 2nd case, described above, is still considered
to be suffering from a so far unidentified viral haemorrhagic fever.
Further information on the cause of this patient's illness is awaited.

 

[Ronan Kelly]

Re: Undiagnosed case of viral haemorrhagic fever in Mumbai - not CCHF

I'm not so sure alert. Looking at posts 8,9 and 13 above it seems that the first sample originated in a private hospital from an unidentified individual. BMC
has been very open about the (second) sample from Sampat Jain, but has not offered any information on the first.