/ 7 October 2008

Mystery illness: Another patient sickens

A 51-year-old woman has been admitted to the Chris-Hani Baragwanath Hospital with symptoms of a killer disease, suspected to be haemorrhagic fever.

A 51-year-old woman has been admitted to the Chris-Hani Baragwanath Hospital with symptoms of a killer disease, suspected to be haemorrhagic fever.

The disease has so far claimed three lives in South Africa, the Gauteng Health Department said on Tuesday.

Spokesperson Zanele Mngadi said the department had confirmed that Maria Stuurman, who was admitted to the hospital, was a cleaning supervisor at Morningside Medi-Clinic.

Stuurman was admitted on Monday with flu-like symptoms.

”She is in isolation and tests are being done to confirm her illness. Ms Stuurman is stable and there is a chance of her being discharged today or soon,” Mngadi said.

A health official said on Tuesday the disease was suspected to be Crimean-Congo haemorrhagic fever (CCHF).

”We suspect that it may be Congo haemorrhagic fever but we have not made a diagnosis yet,” said Frew Benson, the South African Health Department’s deputy director of communicable diseases.

South African health officials said on Monday they were closely monitoring the illness, which causes external and internal bleeding, but called on the public not to panic.

Health authorities were due to send blood samples to the United States Centres for Disease Control and Prevention in Atlanta on Tuesday, Benson said.

The first fatality was Cecilia Van Deventer (36), a reservations manager for Wilderness Safaris in Lusaka. After falling ill, Van Deventer was taken to three different hospitals before being flown to South Africa. She was admitted to the Morningside Medi-Clinic on September 12 and treated for tick-bite fever, but died two days later.

Hannes Els (33), a paramedic who accompanied Els, also displayed similar symptoms and was admitted to the same hospital on September 27 and was dead by October 2.

Two others who worked at the hospital have also died. Maria Mokubung (37), a cleaner, died on October 5 and Gladys Mthembu (34), a nurse, died on October 4.

Morningside Medi-Clinic’s regional marketing manager Melinda Pelser said Mokubung did not die from the viral disease.

”She died of a neurological illness. It has been established that she was not near the patient,” said Pelser.

Dr Simon Miti, the permanent secretary in the Zambian Health Ministry, said that no other cases had been reported.

”It is still quiet here. We have checked all the places the woman [Van Deventer] passed through and no one has presented with any of the symptoms or died with similar condition. Out of the 12-million Zambians no one has presented with these symptoms,” Miti said.

Meanwhile, private and public hospitals were urged by the National Education Health and Allied Workers’ Union (Nehawu) to take precautionary measures and isolate patients who were vomiting and suffering from diarrhoea.

”This outbreak has put lives of many South Africans at risk and the authorities have a duty to investigate if negligence is to blame for this serious health hazard,” said Nehawu spokesperson Sizwe Pamla.

CCHF is carried by domestic animals and can be transmitted by ticks. It is found in Africa, Eastern Europe and Asia.

Treatement possible
CCHF first appeared in Crimea in 1944 and was later identified in 1956 as the cause of an illness in what is now the Democratic Republic of Congo.

Cases have been recorded in Kosovo, Albania, Iran, Pakistan and South Africa. Symptoms include headaches, back pains, vomiting, severe bruising and nose bleeds.

According to the World Health Organisation, CCHF can be treated but recovery is slow. If treatment is not provided in time, death can occur in the second week of illness.

There are several other strains of haemorrhagic fever, including Ebola and Marburg, which have killed hundreds of people in outbreaks in Africa. These diseases cause bleeding from multiple sites and can have very high death rates.

Ebola is rare, but there is no known cure and the virus usually kills between 50% and 90% of its victims.

It is spread through contact with bodily fluids of a patient. As with other haemorrhagic fevers, patients die from dehydration, bleeding, and shock.

The latest outbreak, which ended in February in Uganda, was unusually mild, killing 37 people out of 149 infected.