Archive for December 4th, 2008

Deadly Export

4 December, 2008

Hot on the heels of the arenavirus outbreak in South Africa recently – traced back to Zambia - comes the story of an unfortunate South African business traveller who took sick and then died in Brazil recently.  While it has been in the papers, as always, ProMED does it best:

 

Date: Wed, 3 Dec 2008 13:34:00 -0500 (EST)

From: ProMED-mail <promed@promed.isid.harvard.edu>

Subject: PRO/AH/EDR> Viral hemorrhagic fever – Brazil (02): (RJ) ex South Africa

 

VIRAL HEMORRHAGIC FEVER – BRAZIL (02): (RIO DE JANEIRO) ex SOUTH AFRICA

***********************************************************************

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: Tue 2 Dec 2008

Source: Ministry of Health, Brazil (in Portuguese trans. & summ.

Mod.MPP, edited]

<http://189.28.128.100/portal/aplicacoes/noticias/noticias_detalhe.cfm?co_seq_noticia=56538>

 

 

[The following additional information has been added to the Brazilian Ministry of Health statement included in the preceding ProMED-mail

post: Viral hemorrhagic fever - Brazil (RIO) ex South Africa: RFI, archive number 20081202.3792]

 

1. A 53-year-old man arrived in Brazil on 23 Nov [2008]. On 25 Nov [2008] he presented the 1st symptoms of a febrile hemorrhagic disease as yet undiagnosed.

 

2. On [28 Nov 2008], he went to 2 private hospitals in Rio de Janeiro, with a clinical picture of fever, chills, vomiting, hematuria, hepatomegaly, and small skin eruptions [?petechiae]. On [2 Dec 2008], the patient died.

 

5. One of the viruses suspected to be the cause of death of the patient is an [South African] arenavirus. It can be transmitted by direct contact with secretions or blood from rodents or from infected patients.

 

- –

Communicated by:

Naomi Bryant

Senior Information Analyst

National Travel Health Network and Centre (NaTHNaC) United Kingdom <http://www.nathnac.org/>

 

[Previously it was stated that there had been no reports of similar symptoms among health professionals who had contact with the patient, and that implementation of quarantine was not considered necessary.

Diagnoses of dengue, malaria, and ebola [hemorrhagic fever] had already been discarded. Other etiologies, such as leptospirosis, hepatitis, and hantaviruses will be investigated.

 

This additional new information suggests that the South African visitor had contracted his illness prior to arrival in Brazil, and not during travel within the country. The patient’s illness had been diagnosed as a viral hemorrhagic fever and the results of laboratory tests are awaited. There is as yet no direct evidence that the patient had contracted the novel arenavirus recently identified as the cause of an outbreak of disease associated with the treatment of a Zambian patient in South Africa. – Mod.CP]

 

Now it is a matter of fact that there are plenty of nasty arenaviruses and other haemorhhagic fever agents in South America: however, getting sick only two days after arrival would tend to point to an external (and probably South African) source for the infection.

 

Which, if it is an arenavirus, is rather worrying – given that we have seen such a thing only recently, and only in a very limited context.

 

I am sure the folk at the National Institute for Communicable Diseases (NICD) in Johannesburg, and especially the Special Pathogens Unit, who do surveillance for these sorts of nasties, are going to be busy – let us wish them luck.

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 And latest news (9/12/08): The Mail & Guardian web site carries this story as of 8th December.

SA man in Brazil did not die from arenavirus, says NICD

JOHANNESBURG, SOUTH AFRICA Dec 08 2008 14:35

The death of a South African man in Brazil was not caused by the arenavirus, the National Institute for Communicable Diseases (NICD) said on Monday.

The institute’s deputy director, Dr Lucille Blumberg, said laboratory tests had tested negative for the virus.


Tick-bite fever, acquired in South Africa, is the likely cause of the illness, as indicated by tests performed by the reference laboratory in Brazil.”

The fever, she said, was a well-documented cause of severe illness. It did not pose any risks to those who had been in close contact with infected people. — Sapa

And can be cured with antibiotics, seeing as it is caused by a rickettsial-type prokaryote.


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