#14,159
Yesterday afternoon the dedicated newshounds of FluTrackers began compiling reports of an as-yet, unidentified outbreak in Bolivia (see FT Thread) involving several doctors. Overnight, ProMed Mail put out their own summary, and a request for information.
`Mystery' outbreaks, such as this one, are reported fairly often around the globe each year, and more often than not turn out to caused by something relatively common (e.g., Malaria, Dengue, Influenza, measles, etc.)Still, every once in awhile nature's laboratory serves up something new or unexpected - like SARS in China, MERS in Saudi Arabia, Zika Iin Brazil, H7N9/H10N8/H5N6/H7N4 in China, etc . . . - so we follow them with interest.
First a brief (translated) synopsis from yesterday's Uniradio Informa, after which I'll have two reports from the Bolivian MOH.
Bolivia Health Ministry on alert for unknown disease
by: Notimex - July 2, 2019, 2:00 pmThree days ago (June 30th) the Bolivian MOH posted the following (translated) statement, which repeatedly assures that while the cause was still unknown - the situation is `under control'.
La Paz, 2 Jul (Notimex) .- The Ministry of Health of Bolivia remains on alert for recent cases of an unknown illness, presumed to be a virus that killed a doctor and bringing to five the number of infected .
Health Minister, Gabriela Montaño, said the analysis in a medical deceased and three professionals (an infectious disease specialists from Brazil and two from the United States) who traveled the country to support the home team in research, are monitored.
Argentine newspaper Todo Noticias reported that Montaño bringing to five the number of infected. "We have three suspected cases, in addition to the first two, which are being treated in hospitals in La Paz".
New patients, had contact with the infected doctors, however, another person was unrelated to the professionals, but "symptoms" similar, Montaño said.
According to data, the situation had its origin in the town of Caranavi, about 230 kilometers from La Paz, where internist Ximena Cuellar attended a man with a picture of fever before she died of unknown causes. That patient, you were not performed laboratory tests, is considered the "zero case".
Cuéllar fell ill and moved to the capital, where he died on June 4 last despite the efforts of the two doctors, who are among the suspected infected and remain in intensive care with hemorrhagic fever.
Health authorities have ruled out influenza and other viral diseases like dengue infections are behind doctors.
Health Minister, Gabriela Montaño, confirmed on Monday that requested the Pan American Health Organization (PAHO) collaborate with sending two other specialists who will arrive Wednesday, one laboratory and another clinic , "according to a Health Ministry statement.
The health authority rejected the declaration of an epidemiological emergency, as the delegate of the Pan American Health Organization (PAHO) in Bolivia, Alfonso Tenorio, follow the protocols asked to be quiet.
Ministry of Health and epidemiological experts emergency rule, the situation is under control in the case of two doctors
La Paz - Sunday June 30, 2019 | Communication Unit
After a three-hour meeting seven health institutions, the minister of the area, Gabriela Montaño, reported Sunday that two doctors admitted suffering from an unidentified viral disease, influenza discarded, and when the situation is under control. He also anticipated that official information will be provided only for this portfolio of State and the Departmental Health Service (Headquarters) of La Paz, following up with experts.
"We will inform appropriate and official population of patients in the department of La Paz manner. (The two doctors) are not determined a diagnosis, we hypothesized as a viral disease that must be borne laboratorial, influenza was discarded. We are taking all biosafety forecasts, the population should be quiet, it is a controlled situation, "said the authority, at a press conference in the city of La Paz.
The technical meeting initiated by averaging 17:30 in the auditorium of the Ministry of Health attended directory Headquarters, Caja Petrolera Health, Hospital Obrero, Rainbow Hospital, Japanese Institute of Gastroenterology Boliviano, the Bolivian Society of Infectious Diseases and the Pan American Health Organization - World Health Organization (PAHO / WHO).
In this context, Montaño lamented that led to speculation on social networks because they frightened the population.
"Tell the people that are two patients who are medical colleagues who are in intensive care. These patients have a signosintomatología, ie, symptoms of fever and disease development, "he said.
biosecurity
As a preventive measure, the Ministry of Health will strengthen tonight with material biosafety level 4 to the Petroleum Safety Health and Hospital Workers and protect health personnel.
monitoring is also done to everyone who came in contact with both patients.
"It is following up these contacts, it is advisable in these cases is that those who need to be addressed immediately and make appropriate laboratory tests. In parallel, the National Institute of Health Laboratories (Inlasa) and the National Center for Tropical Diseases (CENETROP) work in a coordinated way to get a definitive diagnosis. With the work of Inlasa hope to have an initial laboratory diagnosis in 48 hours, "he said.
With the support of Center for Control and Prevention of Disease CDC Atlanta results can be ready in 14 days and with the cooperation of PAHO arrive on July 1 infectious disease experts (clinical and laboratory) to review cases.The most recent (translated) statement from the MOH (July 2nd) indicates that a epidemiological investigation team has been dispatched to Caranavi - some 150 miles from the Capital La Paz - where the index and secondary cases were infected early last month.
controlled situation
"I repeat it is a controlled situation there is no epidemiological emergency in our department or our country. Tell people that if tomorrow you have to take a test should normally go to hospitals. absolutely rule out all those hypotheses that circulated by social networks, "he said.
Finally, the health minister stressed that the only official source that can be disseminated will be the Ministry of Health and the Headquarters of La Paz, other information are not real and are not official.
NES /
Ministry of Health sent specialists to Caranavi for case tracking and identification of contacts
La Paz - Tuesday, July 2, 2019 | Communication Unit
A team of four specialists moved, Tuesday afternoon, the municipality of Caranavi the department of La Paz to keep track of cases and identification of possible contacts that had the first patient who died of a virus unidentified, informed the head national Epidemiology Ministry of Health, Jhemis Molina.
"The Epidemiology Unit has coordinated a trip to Caranavi, intervention will follow up cases. The committee is lead by the responsible Program Transmitted Diseases Rodent, "the authority said, minutes after the team from La Paz to the north.
This team will be tasked to identify people who had contact with the medical internist (first deceased patient) to proceed with interviews and discard suspected cases also will review medical records to search for clinical cases.
Contingency equipment will be completed Wednesday with the addition of an expert from the Pan American Health Organization / World Health Organization.
"Today (Tuesday) professionals take contact with local authorities for the coordination of joint work in different communities, in the span of four days," said Molina.
Finally, he noted that the length of their stay can be extended according to the identification of contacts and epidemiological variables required by the Ministry of Health.
as /
The cause of this event - which began at least a month ago - remains unknown, and while several possibilities come to mind (e.g., Bolivian hemorrhagic fever, Hantavirus, etc.), there simply isn't enough information available to make any guesses.
The (belated) epidemiological investigation in Caranavi could provide valuable clues, and just as importantly, tell us if there are more cases.I'll update this story when more information becomes available, but the FluTracker's thread is probably your best bet for early access to the most recent updates.
