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UNDIAGNOSED DEATHS - ZAMBIA: REQUEST FOR INFORMATION
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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: Wed 28 Nov 2007
Source: Agence France-Presse (AFP) [edited]
<http://afp.google.com/article/ALeqM5hiW3QSgNrv0Y97qsQ4YpznJ7x7tw>
The health minister [Brian Chituwo] announced Tuesday [27 Nov 2007]
that 4 people have died and 20 others were put under quarantine
following the outbreak of an unknown disease in southern Zambia.
Brian Chituwo said the government has dispatched medical experts to
investigate the cause of the disease and assess the situation in
Namwala, a small town in the southern province of Zambia.
"The 4 died before the medical team arrived in the area," Chituwo
said. The 20 patients have been quarantined in an effort to contain
the spread of the disease, which has symptoms of vomiting and
backache, the minister said.
Chituwo said the disease was detected last Sunday [?25 Nov 2007] by
local medical practitioners following the death of the 4 patients.
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[Speculation on a differential diagnosis with the symptoms given
above -- vomiting and backache -- is a "fun" challenge. Checking the
possible list of infectious agents that would produce the clinical
spectrum of a cluster of severe, fatal infections associated with
vomiting and backache in Zambia using the GIDEON (Global infectious
disease and epidemiology network) database
(<http://www.gideononline.com>), comes up with a list of the
following possible diagnoses (and probability of occurrence) -- which
includes viral, bacterial, and parasitic diseases:
Rift Valley fever (30.8 percent probability), leptospirosis (27.5
percent), influenza (2.4 percent), malaria (11.5 percent), meningitis
-- bacterial (9.2 percent), relapsing fever (3.2 percent), septicemia
--bacterial (1.8 percent), legionellosis (1.4 percent). Other
diseases mentioned with a less than one percent probability include:
typhoid and enteric fever, _Bunyaviridae_ infections -- misc.,
rabies, tuberculosis, typhus -- endemic, _Streptococcus suis_
infection, yellow fever, trypanosomiasis -- African, Q-fever,
brucellosis, yersiniosis, ornithosis, trichinosis, infectious
mononucleosis or EBV (Epstein-Barr virus) infection, poliomyelitis,
toxoplasmosis.
Even more fun is the possible list of other diseases that might
produce the same type of cluster, but anywhere in the world (not
necessarily seen in Zambia at present). This list (according to the
GIDEON network would include: hantavirus infections -- Old World,
Ebola, Lassa fever, typhus -- scrub, dengue, hantavirus pulmonary
syndrome, and Crimean-Congo hemorrhagic fever to mention a few.
In the see also section below one can find a listing of prior
disease/outbreak related ProMED-mail postings from Zambia, going back
to 1995. Human and zoonotic diseases reported on ProMED-mail in this
period include: anthrax, cholera, rabies, plague, suspected Ebola
virus infection (a cluster of 3 suspected cases that were ultimately
diagnosed as schistosomiasis, gum disease, and pneumonia), measles,
polio, and undiagnosed deaths without any further information on the
clinical presentation of these undiagnosed deaths. There were also 2
undiagnosed veterinary outbreaks -- one involving bovines, one
involving wild birds. All of these prior reported outbreaks could
produce clusters of illness that might be associated with vomiting
and backaches as well.
The process of speculation on possible etiologic agents for this
above-mentioned outbreak would be even more "fun" if there were more
information available from knowledgeable sources in the region --
such as the age distribution of cases, possible common exposures,
other symptoms associated with the illness, and information on the
animal health in the surrounding region to help rule in or rule out
the possibility of a zoonotic disease outbreak. ProMED-mail would be
grateful to receive more information from knowledgeable sources.
Namwala can be seen in the northern part of the Southern Province in
Zambia on the following map
<http://www.lib.utexas.edu/maps/africa/zambia_pol01.jpg>.
For the interactive HealthMap/ProMED-mail map of Zambia showing other
ProMED-mail postings in Zambia and in neighboring countries, see
<http://healthmap.org/promed?v=-14,27.8,5>. - Mod.MPP]
[see also:
Anthrax, human, bovine - Zambia (WP) 20071115.3714
Measles - Zambia 20070630.2100
2006
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Undiagnosed die-off, wild birds - Zambia (Livingston ) (04) 20060625.1764
Undiagnosed die-off, wild birds - Zambia (Livingston): RFI 20060622.1726
2004
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Anthrax - Africa: Zambia, Zimbabwe 20040928.2682
Anthrax, human, livestock - Zambia (Western Prov.) 20040925.2645
Rabies, human, canine - Zambia (Central Province) 20040911.2528
Undiagnosed deaths, bovine - Zambia (02) 20040708.1839
Undiagnosed deaths, bovine - Zambia 20040414.1009
Gastroenteritis, fatal - Zambia: RFI 20040408.0954
Anthrax, human & livestock - Zambia (West) (02) 20040114.0157
Anthrax, human & livestock - Zambia (Western Province) 20040113.0135
2003
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Tuberculosis, bovine, lions - Zambia: export restrict. 20030726.1829
2002
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Anthrax, human, livestock - Zambia (Western Province) 20021110.5774
Poliomyelitis - Zambia (02) 20020220.3595
Poliomyelitis - Zambia 20020124.3376
2001
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Plague, bubonic - Zambia (04) 20010418.0769
Plague, bubonic - Zambia 20010315.0525
1999
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Rabies, canine - Zambia (Kabwe) 19990621.1053
1998
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Mortality, human, undiagnosed - Zambia: RFI 19980406.0636
1997
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Rabies - Zambia (03) 19971224.2540
Rabies - Zambia: RFI 19971220.2516
Rabies - Zambia 19971212.2471
Anthrax - Zambia 19971202.2408
Cholera - Zambia, outbreak expected 19971103.2244
Plague, bubonic - Zambia (04) 19970211.0325
Cholera - Zambia (02) 19970206.0282
Plague, bubonic - Zambia (03) 19970205.0271
Plague, bubonic? - Zambia (02) 19970203.0247
Cholera - Zambia 19970203.0246
Plague, bubonic - Zambia 19970131.0201
1996
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Cholera - Zambia (2) 19960418.0745
Cholera - Zambia 19960310.0460
1995
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Ebola - Zambia? 19950626.0458
Ebola - Zambia? 19950623.0448]
...................................mpp/mj/lm
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