- PANAMA CITY (Reuters)
-- The death toll from a mystery illness in Panama has risen to at least
17, with 10 others still suffering but recovering from fever, diarrhea
and partial paralysis, the Health Ministry said on Wednesday.
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- Doctors do not know the cause but say the disease progresses
rapidly to the renal system and causes neurological damage.
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- Two more people suffering from the unidentified illness
died on Wednesday, health minister Camilo Alleyne told reporters. He also
bumped up the number of people fighting the mystery disease to 10 from
seven. Up to Tuesday the disease had killed 15 over the last month, the
ministry said.
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- The ministry declared a national epidemic alert on Tuesday.
The dead were all over 60 years of age and most were already suffering
from high blood pressure, diabetes and kidney problems. The illness does
not seem to be contagious and dengue fever, influenza, West Nile virus
and other illnesses have been ruled out.
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- UNDIAGNOSED DEATHS - PANAMA - REQUEST FOR INFORMATION
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- A ProMED-mail post ProMED-mail is a program of the International
Society for Infectious Diseases
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- By Ana Teresa Benjamin La Prensa 10-3-6
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- While the Ministry confirmed 6 deaths, medical sources
are speaking of 17 deaths
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- Authorities have not been able to identify the cause
of a syndrome that has already affected 22 persons. There is no evidence
of direct contagion with this syndrome, which begins with severe diarrhea.
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- An "epidemiologic alert" has been issued by
the Ministry of Health. The cause is an "aggressive, acute syndrome,
whose origin is unknown, that has led to the deaths of at least 7 of the
22 [persons] who were treated in the Dr. Arnulfo Arias Madrid Hospital
Complex of Social Security (CSS) and in the Santo Tomas Hospital.
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- The patients presented with a clinical picture that,
in the lethal cases, developed over the course of one week, beginning with
fever and severe diarrhea and progressed to renal failure and neurological
deficits in the extremities.
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- The Minister of Health, Camilo Alleyne, reported last
night [2 Oct 2006] the deaths of 6 people by cardio-respiratory arrest,
but medical sources said that there were already 17 fatalities in the complex.
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- The problem began one and a half months ago, although
it wasn't until the end of September [2006] that the authorities considered
it to be an "unusual" occurrence.
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- In the CSS Complex, for example, the Department of Epidemiology
issued a memorandum on 27 Sep [2006] in which it requested that all medical
personnel give notification immediately of any "renal syndrome with
neurologic manifestations."
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- In addition, it was known that the Minister and the Director
General of Health, Cirilo Lawson, had met various times with investigators
of the Gorgas Institute and medical specialists to study the medical records
of the deceased patients in order to rule out possible causes.
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- In fact, the Gorgas Institute conducted studies in order
to determine the causes and also sent specimens from the deceased to the
Center for Disease Control and Prevention in the United States.
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- Alleyne explained that "there [was] no evidence
encountered of direct contagion," and that all of the patients were
persons greater than 60 years of age, with predisposing diabetes, renal
disease or hypertension. Nevertheless, medical sources reported that the
patients were between 40 and 80 years of age. The cases presented in the
metropolitan area, west Panama, San Miguelito and Cocle Province.
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- ProMED mail
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- >From the description given in the article from the
local press in Panama, there appears to be "confidence" on the
part of the Ministry that the outbreak does not appear to be "contagious,"
so that person-to-person transmission seems to be ruled out by the epidemiologic
studies. Obvious questions include what is the common exposure on the part
of the patients; the mention that they are all older individuals with pre-existing
medical problems could be an indication of an exposure that, in most cases,
is relatively benign, but when a compromised individual is exposed, then
problems are seen. Or it may be an indication of an exposure that is occurring
in the health care environment where these individuals may have a common
exposure. And a key question is whether this exposure is to an infectious
agent or a toxin.
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- Clearly, more information on the epidemiologic studies
conducted on this outbreak would be very much appreciated. - Mod.MPP .......mpp/msp/dk
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- Patricia A. Doyle DVM, PhD
- Bus Admin, Tropical Agricultural Economics
- Univ of West Indies
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- Please visit my "Emerging Diseases" message
board at:
- http://www.emergingdisease.org/phpbb/index.php
- Also my new website:
- http://drpdoyle.tripod.com/
- Zhan le Devlesa tai sastimasa
- Go with God and in Good Health
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