Published Date: 2013-02-23 23:58:13
Subject: PRO/EDR> Undiagnosed syndrome - Ghana: human
Archive Number: 20130223.1556017
UNDIAGNOSED SYNDROME - GHANA: HUMAN
A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases
Date: Sat 22 Feb 2013
Source: World health Organization Africa [edited]
Outbreak of a "strange" phenomenon reported in Ghana
On 8 Feb 2013, health authorities in Ghana received reports of the sudden outbreak of a "strange" phenomenon affecting people along the coastline of Aflao, near the country's boarder with Togo.
Affected patients reported acute onset of cough, sneezing and chest pain. About 28 persons reported that they had experienced these symptoms which resolved on self-medication and/or when they left the coastline. No severe cases or deaths have been reported.
Unconfirmed reports also have it that the phenomenon was widespread along the immediate coastline of Togo, affecting mostly fishermen. Similar reports point to possibility of chemical waste dumped into the sea being the cause of the symptoms.
Health authorities in Ghana are investigating the "strange" phenomenon and have directed that all patients reporting to the health facilities in the affected areas with sneezing, coughing and running nose be thoroughly investigated.
Radio announcements are on-going for people with symptoms of the "strange" phenomenon to report at the Municipal Hospital for management and investigation. All health facilities in the district have been requested to record and report cases with the symptoms to the district authorities. Health staff at the Aflao port have been sensitized on the symptoms and advised to report suspected cases. Since that day and as at 19 Feb 2013 no other cases have been reported.
The WHO Country Office in Ghana is liaising closely with the Ministry of Health in the investigation and follow up. It is also sharing investigation findings with the WHO Regional Office for Africa (AFRO) so that appropriate support can be provided.
AFRO is liaising with the WHO Inter-country support team for West Africa and WCO/Ghana, both of which are closely monitoring the situation.
[This sounds like "red tide."
Red tide is caused by several toxic algae. Depending upon the toxin, it is also known as paralytic shellfish poisoning (PSP), because it causes shellfish to be toxic for consumption.
The _Alexandrium_ genus is found in coastal waters high in nitrogen content. These organisms produce a neurotoxin, like many of the organisms capable of causing paralytic shellfish poisoning (PSP). The neurotoxin is potentially fatal for humans consuming contaminated shellfish and may be dangerous to humans and animals who swim in waters that are "blooming" with the organisms. Ocean spray containing the organisms may also cause illnesses, including rashes and eye irritation in people. Some species of this genus are capable of causing "red tide" that may be visible for long distances along a coastline.
PSP is a significant problem in several geographic areas, especially on both the east and west coasts of the USA. Produced by several closely related species in the genus _Alexandrium_, PSP toxins are responsible for persistent problems due to their accumulation in filter-feeding shellfish, but they also move through the food chain, affecting zooplankton, fish larvae, adult fish, and even birds and marine mammals.
Alexandrium blooms generally do not involve large-cell accumulations that discolor the water and may instead be invisible below the water surface. Low-density populations can cause severe problems due to the high potency of the toxins produced. Furthermore, _Alexandrium_ spp. can grow in relatively pristine waters, and it is difficult to argue that anthropogenic nutrient inputs are stimulating the blooms. These characteristics are important when considering mitigation and control strategies.
Often PSP is associated with red tides or algal blooms. Red tide is caused by an organism called _Karenia brevis_, which in high concentration can make the water look red. The organism releases a toxin that paralyzes the respiratory system of fish and other marine life.
Airborne toxins, water spray, and splashes in an outbreak have kept people from beaches while leaving others with irritated eyes and throats. Red tide irritates the skin of people exposed to it and can cause itchy eyes, scratchy throats, and coughs. Harvesting from affected areas for personal consumption is discouraged. Red tide poisoning symptoms include nausea and dizziness and may last for several days.
Previously, the one of the organism causing red tide was known as _Gymnodinium breve_, but it has been reclassified in the taxonomy of dinoflagellates. Its new name -- _Karenia brevis_, or _K. brevis_ -- was chosen in honor of Dr Karen Steidinger, a prominent red tide scientist from the Florida Marine Research Institute in St. Petersburg, Florida (http://www.mote.org/index.php?src=gendocs&ref=%28renamed%29%20Red%20Tide%20Update_608&category=Ecotoxicology).
Shellfish that have caused this disease include mussels, cockles, clams, scallops, oysters, crabs, and lobsters. Symptoms begin anywhere from 15 minutes to 10 hours after eating the contaminated shellfish, although usually within 2 hours. Symptoms are generally mild, and begin with numbness or tingling of the face, arms, and legs. This is followed by headache, dizziness, nausea, and muscular incoordination. Patients sometimes describe a floating sensation. In cases of severe poisoning, muscle paralysis and respiratory failure occur, and in these cases death may occur in 2 to 25 hours.
Ghana may be found on the HealthMap/ProMED-mail interactive map at: http://healthmap.org/r/1jUt - Mod.TG]