- KINSHASA, Congo (AP) -- A
rare form of plague has killed at least 61 people at a diamond mine in
the remote wilds of northeast Congo, and authorities fear hundreds more
who fled into the forests to escape the contagion are infected and dying,
the World Health Organization said Friday.
-
-
- Eric Bertherat, a doctor for the U.N. health agency,
said the outbreak has been building since December around a mine near Zobia,
170 miles north of Kisangani, the capital of the vast Oriental province.
-
-
- Nearly all the 7,000 miners have abandoned the infected
area and sought refuge in the world's second-largest tropical rain forest,
all but cut off from the outside world.
-
-
- Security fears _ mainly from bandits and militia left
over from Congo's five-year war _ also have slowed international response,
Bertherat said.
-
-
- Plague is spread mainly by fleas and causes an infection
in the lungs that slowly suffocates its victims. If caught in time, it
can be treated with antibiotics.
-
-
- Bubonic plague is the most common form of plague and
is transmitted to people through the bite of an infected flea. It usually
is spread by rodents. It does not spread person to person.
-
-
- Pneumonic plague _ the kind in the current outbreak _
is rarer but also more easily transmitted from person to person through
coughing or close contact.
-
-
- Bertherat, speaking to reporters by telephone from Geneva,
said plague commonly is found in this region of northern Congo, but an
outbreak this large was unusual.
-
-
- Unlike the deadly Ebola virus, which also is found in
the dark forests of Congo, Bertherat said this outbreak of plague was unlikely
to spread too quickly, given the remote and isolated terrain.
-
-
- "It's still a large concern," Bertherat said,
"because these are cases moving elsewhere."
-
-
- Bertherat and a 10-member team of WHO doctors will arrive
in Kisangani on Monday to prepare for a journey into the forests. He said
doctors from the aid organization Medecins Sans Frontieres, or Doctors
Without Borders, already were there, treating miners they could locate.
-
-
- The forests have long been both a refuge and a death
trap for Congolese running from war, disaster and disease.
-
-
- More than 1 million people still live rough in the forests
after fleeing Congo's devastating 1998-2002 war. Aid groups say nearly
1,000 people still die every day from war-induced starvation and disease.
-
- According to the WHO, the incubation time for plague
is two to six days. Victims develop a fever and cough. Breathing becomes
difficult as lungs fill with fluid. Unless antibiotics are given within
the first 24 hours, death can come as quickly as within 48 hours.
-
- _________________
-
- Plague In The Democratic Republic Of The Congo
-
- WHO Outbreak Reports
- 2-18-5
-
- As of Tue, 15 Feb 2005, WHO has received reports of 61
deaths from pneumonic
- plague in the district of Ituri, Oriental province, in
the northern part of
- the country. The total number of cases is still not known.
[Note this was
- posted to the WHO website on 18 Feb 2005. - Mod.JW]
-
- Preliminary results from rapid diagnostic tests in the
area confirm
- pneumonic plague, and the cases had clinical features
compatible with
- this disease. 40 samples have been taken and will be
tested by
- culture and serology at the Institut de la Recherche
Biomedicale,
- Kinshasa [Congo Rep.]. No cases of bubonic plague have
been reported to date.
-
- The cases have occurred in workers in a diamond mine
in Zobia where
- about 7000 people work. The mine was re-opened on 16
Dec 2004 and the
- 1st case occurred on 20 Dec 2004.
-
- A team from Medecins sans Frontieres (Belgium and Switzerland),
- Medair, WHO and Ministry of Health have been in the area
to assess
- the situation. An additional multi-disciplinary team
will be leaving
- for the Democratic Republic of the Congo on 19 Feb 2005.
-
- If humanitarian access is possible given the security
concerns in the
- area, the team will go to the affected area to provide
technical
- support in case management and treatment of cases, intensive
- surveillance and tracing of possible contacts and further
- epidemiological investigations.
-
- http://www.who.int/csr/don/2005_02_18/en/
-
- ProMED-mail
- promed@promedmail.org
-
-
- Thousands Flee As Plague Kills 61 In Congo
-
- By Stephanie Nebehay
- 2-18-5
-
- (Reuters) -- An outbreak of plague in northeastern Democratic
Republic of Congo has killed 61 diamond miners and infected hundreds more,
the World Health Organization (WHO) said Friday 18 Feb 2005.
-
- Many of the 7000 miners working in Zobia, north of the
city of Kisangani, have fled since the outbreak began 2 months ago, and
could have spread the highly contagious disease, the United Nations agency
said. "The epidemiological data is still incomplete but we are sure
there are at least 61 deaths. The main problem is that due to panic, maybe
two thirds of the population, ran away from the mine," Eric Bertherat,
head of the WHO team, told reporters. "There is a risk that some patients
in [the] incubation [period] run away and maybe arrive in Kisangani. So
it is very important to inform health care workers to alert them of the
risk of admission of highly contagious patients," he said.
-
- Kisangani is Congo's 3rd biggest city and a major trading
center on the Congo River.
-
- Plague, which is spread between rodents by fleas, can
also be transmitted to people through infected rodent flea bites. It has
a case-fatality rate of 50% to 60% in humans if not treated with antibiotics,
WHO says. There are 3 main forms of plague in humans and the one suspected
in the former Zaire is pneumonic plague, WHO said. "It is very important
to quarantine, isolate these people who are sick with pneumonic plague
so that the transmission is brought under control. If we can find the cases
and treat them effectively, this can be stopped," said May Chu, a
WHO expert.
-
- A 10-member WHO emergency team was leaving at the weekend
with supplies of antibiotics to try to stem the outbreak and ensure that
health workers in the region isolate suspect cases. But the remote mine
in mineral-rich Ituri, reportedly controlled by rebels, is difficult to
reach and the team will require U.N. security clearances, officials said.
-
- Cases are still occurring in the mine, where conditions
are crowded and unsanitary, and 20 workers were admitted to health facilities
in Zobia with symptoms Wednesday [16 Feb 2005], he added. The diagnosis
of plague had been verified through testing, WHO spokesman Dick Thompson
said.
-
-
- ProMED-mail
- promed@promedmail.org
-
- As implied in the posting, the epidemic curve and analysis
are needed to discover the potential cause of the outbreak. Cases have
apparently been reported over almost 2 months, so it is likely that several
generations of primary pulmonary plague have occurred, assuming the diagnosis
is correct.
-
- Primary pneumonic plague (1 percent of natural plague
presentations) arises as a result of inhalation of plague bacilli in infectious
aerosols, such as would be produced when there are pneumonic complications
in bubonic plague. It is also the form of disease contracted from infected
cats. This is, importantly, the form of the disease that would be most
likely if _Yersinia pestis_ were to be used in an aerosol as a biological
weapon. Such an aerosol would likely be used in an indoor setting to avoid
the outdoor UV radiation inactivation of the organism.
-
- Primary plague pneumonia has a short incubation period
of 1-3 days, after which there is sudden onset of flu-like symptoms including
fever, chills, headache, generalized body pains, weakness and chest discomfort.
A cough develops with sputum production, which may be bloody, and increasing
chest pain and difficulty in breathing. As the disease progresses, hypoxia
(low oxygen concentration in the blood) and hemoptysis (coughing up blood)
are prominent. The disease is invariably fatal unless antimicrobial therapy
commences within 24 hours of exposure.
-
- Patients with primary pneumonic plague generate large
quantities of infectious aerosols that pose a significant risk to close
contacts. CDC guidelines identify contacts within 2 meters as being at
greatest risk and do not consider the organism likely to be carried through
air ducts or vents. Persons who have been in contact with pneumonic plague
patients or handling potentially infectious body fluids or tissues without
appropriate protection should receive preventive antimicrobial therapy.
The preferred antimicrobial agents for prophylaxis are tetracyclines,
quinolones, or chloramphenicol. - Mod.LL
-
-
- Patricia A. Doyle, PhD
- Please visit my "Emerging Diseases" message
board at:
- http://www.clickitnews.com/ubbthreads/postlist.php?
- Cat=&Board=emergingdiseases
- Zhan le Devlesa tai sastimasa
- Go with God and in Good Health
|
