I Luv SA: Mystery deepens around SA killer virus

Sunday, October 12, 2008

Mystery deepens around SA killer virus - what is it?

Two new patients were admitted to Morningside Medi-clinic for monitoring of a mystery haemorrhagic fever which has already killed three, possibly four people in South Africa since Sept 14.

Oct 12 2008 - JOHANNESBURG, South Africa. The mystery haemorrhagic fever in SA could be a new form of arenavirus - found in the urine of infected wild mice -- but which had never been found as such a deadly disease in humans.

This was said by Dr Lucille Blumberg of South Africa's National Institute for Communicable diseases and the Department of Health on Sunday. "The causative agent of the disease... may be a rodent-borne arenavirus (picture above) related to the lassa fever virus of West Africa," said Blumberg. The tests done by the NICD and the Centres for Disease Control in Atlanta, USA indicated that the disease 'seemed to be a kind of arenavirus' but they are not conclusive - more tests are needed.

Don't usually cause disease in humans:
Arenaviruses cause chronic infections in multimammatic mice - a kind of wild mouse - who excrete the virus in their urine which can then contaminate human food or house dust.

These are viruses similar to the lassa fever virus and which are found in rodents in Africa, but except for in West Africa, have not been found to cause diseases in humans.

This finding also does not explain why it is so infectious in human-to-human contact. Therefore further tests still need to be done to find out whether this current strain is an undiscovered member of the arenavirus and what its distribution is.

This tentative diagnoses does make more sense than the initial suspicion of Congo-Crimean Haemorrhagic fever: the first patient, Afrikaner tour operator Mrs Cecilia van Deventer, 36, who lives in Zambia, had fallen ill shortly after she'd been at a wedding function in Johannesburg where many of the other guests had also came down with what was believed to be food-poisoning. She then returned to her home in Zambia but was rushed back to South Africa with a paramedic for treatment at the private Sandton hospital after she'd been progressively ill for ten days. She died several days later.

Blumberg said another female nurse and a male paramedic were currently in isolation after having been in contact with those who previously died from the illness. They had shown symptoms of the disease. The paramedic has since been diagnosed with kidney stones and Blumberg said it was "less likely" that he had the virus. The nurse is "highly suspect" and is receiving anti-viral medication. She was presently stable, but Blumberg could not say how her condition was likely to progress.

Both of these new patients are at the Morningside Medi-clinic in Sandton. "We were monitoring their temperatures. There was a discrepancy in their temperatures and that is why we admitted them," said Melinda Pelser of the clinic.

Three, possibly four people have thus died of the mysterious 'haemorrhagic fever' -- Afrikaner-Zambian tour operator Cecilia van Deventer, Afrikaner medic Hannes Els; black South African nurse Gladys Mtembu and black South African hospital-cleaner Maria Mokubung (the latter was a 'healthy' HIV-positive patient being treated with antiretrovirals - which is why the exact cause of death is still questionable). Still being monitored: their 121 contacts all over the greater Johannesburg area.

The World Health Organisation has launched an urgent probe into the mystery viral fever incidents. What puzzles scientists is that bleeding is not a marked feature of this outbreak - which is different from the Congo-Crimean haemorrhagic fever they had at first suspected.

14 Congo Fever deaths in Northern Cape province this year:
South Africa is an endemic region for Congo-Crimean haemorrhagic fever -- which is caused by bites from the hyalomma tick, which has yellow bands on its legs. Last year in the Northern Cape province alone, 14 people died of it. This week, a northern Cape abattoir worker was admitted to the Kimberley Hospital - which has a special isolation unit for this purpose -- after contracting Congo Fever from a tick bite, the SABC reported on Tuesday. The man has been quarantined to avoid further infections.

The trail of these highly infectious patients runs from super-rich Sandton right to an open ward with other patients at the Sir Albert Robinson hospital, through the overcrowded Slovo squatter camp, Leratong Hospital, the Johannesburg Academic hospital, the Baragwanath Hospital.

The entire string of events in the greater-Johannesburg region started when Mrs Van Deventer had been brought to SA suffering from a mysterious viral disease on Sept 12 2008 and died of it at the private Morningside MediClinic in upmarket Sandton.

Any travellers who had recently been to Zambia and are experiencing 'flu-like' symptoms are also being urged to contact dr. Chika Asomugha of the Gauteng health department at telephone 082 330 1490 to have themselves tested and monitored. Just don't panic... it's all just a precaution.

"All we know is that it is highly contagious. It is believed to be transmitted via drops of fluid, when one person coughs or sneezes or when someone encounters the bodily fluids of the infected person," said Ms Pelser of the Morningside Medi-Clinic... "It is serious enough to be careful. We feel compelled to warn people."

It's a rule of thumb among policemen and ambulance personnel in South Africa that whenever patients have such symptoms, they must be handled under strict barrier-nursing conditions, in total isolation, whether the tests were 'conclusive' or not - in the Northern Cape, there are standing instructions that all such suspected cases be taken to Kimberley Hospital at once, which has an isolation unit and specialised staff trained for such cases.

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