# 1897
A follow up on yesterday's report of two suspicious deaths aboard a Chinese fishing boat off the Peruvian coast.
First, Crof has a report from yesterday's Diario La República where authorities deny having issued an epidemic alert, but confirm a good many aspects of the ProMed story. Instead of a flu, this article refers to the illness as stemming from a `mutated' adenovirus.
Meanwhile the newshounds at Flu Wiki were at work while I slept, and a detailed article from La República Online was translated and posted by AlohaOR late last night.
It isn't clear whether this article is newer than the one Crof posted last night, or not. It does, however, contain a remarkable amount of detail.
A big thank you to Readymom for emailing me the Flu Wiki link.
While this story has many fascinating elements, there doesn't appear to be any link to the H5N1 bird flu virus.
It does, however, give us a hard look at the public health response in a South American country to an unknown health threat.
As you will read, all did not go smoothly, and members of the Navy and International Marine Health agency were exposed, and are now quarantined, because they failed to take standard infection control precautions before boarding the vessel.
Medical monitoring extended to 30 Peruvians of the Navy and Maritime Health that boarded the boat that was in quarantine.
A dangerous and strange mutant "adenovirus" was the cause of the death of two Chinese crew of the fishing ship "Chan An 168", who passed away last April ninth off the coast of the port of the Callao.
This has raised the epidemic alarms. The health authorities of the country have imposed a quarantine and medical monitoring on 30 medical professionals and personal of the Navy that went to the aid of the fishing boat as a precautionary measurement. Until now none of them presents/displays symptoms of the disease.
Meanwhile, the fishing ship "Chan An 168" and its 22 surviving crew remain in quarantine, in an isolated zone to eight miles (10 kilometers approximately) off the port of the Callao, until it is determined how they acquired the disease. Patrol boats of Navy military watch that nobody boards nor leaves the boat.
DEADLY VÍRUS
The medical examinations have determined that eight of the other Chinese crew have the deadly virus, although they have not developed [symptoms]. Cook Jiang Dexin (40) and the crew member Che Caiqiang (38) of this boat died April 9th, after presenting/displaying high fevers during hours. No medicine could delay the advance of the disease.
The experts of the Legal Medicine Institute of the Public Ministry have determined that the cause of the death was "adenovirus" that has become extremely deadly.
Adenovirus is spread by physical contact or through the air and is endemic in the population, and is one of the causes of the common influenza, but it is usually not considered deadly. At least not until now.
One [possible cause of death] that has been ruled out is Severe Acute Respiratory Syndrome virus (SARS by its abbreviations in English), atypical pneumonia that appeared for the first time in November of 2002 in the province of Guangdong, China.
The head of the IML, Luis Bromley Coloma, indicated that "we are faced with an adenovirus that mutated and has become deadly, but still it is not known what caused the mutation and how fast it is possible to be spread", which is why the health alert has been declared.
The autopsies performed on the two victims showed multi-organ edema in the brain, lungs, heart, liver, pancreas, kidneys and microhemorrhages in all the organs. Toxicological, biological and pathological examinations determined the presence of the mutated adenovirus.
Now, the health authorities are working to establish where and what generated the mutation to find a way to cure or contain it.
EMERGENCY MEETING
The "Chan An 168" is a fishing ship of [pota] and shrimp that weighed anchor off the port of Yautay in China on August 19, 2007 with 23 people. Since then they have not landed. On December 13 they delivered their products to another boat and received two other crew. The same it happened on March 15, 2008.
On April 9th the harbor authorities of the Callao received the distress call of the captain of the "Chan An", Uquin Zhipeng. That morning two Chinese crew, the cook and a fisherman, had died.
[AlohaOR's note: The two crewmen died 25 days after last contact with anyone other than the ship's crew.]
The only symptom that presented/displayed was a high fever that lasted two to five hours, for which none of the medicines on board did anything.
Lamentably, personnel of Navy and the International Marine Health boarded the Chinese boat to provide assistance, without taking the necessary precautions to avoid infection, for which reason it was decided to quarantine those personnel. The disease can incubate for 14 days to three months.
Specialists of the IML, Epidemiología of the Ministry of Defense, Navy military and the Ministry of Health met yesterday to evaluate the results of the biological and pathological examinations in order to adopt the preventive measures necessary to avoid the spread of the virus.
DETAIL
The virus. "Adenovirus" was described for the first time as a viral agent in 1953. It is endemic in the pediatric population. There are more than 40 strains of adenovirus and can cause illnesses of varied severity, although most frequently they occur in the respiratory tract and the intestine, the skin or at ocular level. At the present time their properties are used in the therapy of diseases like the cystic fibrosis and lung cancer.
"It is a deadly and very aggressive virus"
"The autopsies indicate that both Chinese crew died because of a pneumonia, resulting from adenovirus, a characteristic of the influenza that usually is not mortal. What happens in this case is that the virus has mutated and has become lethal and, for that reason we are on epidemiological alert, declared the head of the Legal Medicine Institute, Luis Bromley, yesterday.
The specialist added that the disease presents/displays two characteristics: a trait that has been found is that the victims are people with weakened immune systems from almost a year at sea, isolated and living in subhuman conditions. The other factor is under study, we do not know what the cause that led to the mutation and how to fight it.
"For that reason all the crew has been evaluated and eight crew members were found to be infected, they present/display the mutated adenovirus and they are under observation; it is not possible to treat them, because it is not known how to fight this virus. Normally that would disappear [not be the case?], but it has mutated [to become] deadly, [and] is extremely aggressive'', emphasized Bromley.
[...The] 30 Peruvian people who boarded the ship to provide help and came into contact with patients [mut] remain in epidemiological surveillance, isolated and without contact with their families until they have ruled out the deadly disease.
In these cases "security measures may sound extreme, but prevention is better than later having to bear the consequences if nothing was done", the head of the Institute of Forensic Medicine asserted emphatically.
