Craig Eisele on …..

February 18, 2012

Strange Disease Killing Africa Children Spreads World Wide

An Unknown Disease with Unknown Origin is killing Children mostly in Africa but has now been reported world wide. See articles below for news reports from around Africa

 

Could mysterious nodding disease in Africa have global implications?

Nodding syndrome — a disease with epileptic-type symptoms prevalent in parts of northern Uganda — is a medical mystery that is confounding medical researchers and scientists alike.

The disease causes young children and adolescents to nod violently in an apparent seizure. It happens frequently throughout the day, including when they eat.

Over the past year there has been a growing outbreak in northern Uganda, specifically in Kitgum, Pader and Gulu. It is believed that thousands of cases have developed, but officials from the U.S.-based Centers for Disease Control (CDC) have only been able to confirm a couple hundred.

A team from the Atlanta-based health organization is returning to Uganda in February to consult with local officials about a treatment trial.

Some researchers have suggested the disease may be linked to river blindness, which also affects all three communities.

River blindness, carried in bacteria inside a nematode worm known as onchocerca volvulus, is transmitted to humans by a bite from a black fly infected with the worm. The disease affects 18 million people, mostly in Africa.

The worms burrow into the skin, reproduce and release millions of offspring that spread throughout the body. After they die, they trigger a severe immune inflammatory response in the body which causes vision loss and severe itching.

It isn’t clear how it is related to nodding syndrome, researchers admit. At the moment all they know is there is an association between the two diseases.

History of Syndrome

The first cases of nodding syndrome — or descriptions of what could have been the disease — date back to the early 1960s in Tanzania, said Scott Dowell, director of Global Disease Detection and Emergency Response for the CDC, in a phone interview with the Star.

Over the past decade, clusters of the disease have popped up in South Sudan and Uganda. The onset in Uganda seems to have begun in 2003 with several thousand cases in Kitgum, Dowell said.

The disease appears to strike most children and adolescents between ages 5 and 15. Children appear healthy until about age 5 and then they begin having strange head-bobbing episodes.

Dowell describes it as a kind of perpetual motion, with the head constantly nodding up and down as if to say yes.

The nodding outbreaks differ in individuals, according to Dowell. In some patients it happens every few minutes. In other cases, it happens only three or four times a week. In many cases it makes eating and drinking difficult.

Those who experience it often appear disoriented and not aware of their surroundings when it’s happening, he explained. “It’s very unusual. There is nothing like this anywhere else in the world.”

It is 40 to 100 times more common than epilepsy, he added.

Causes and treatments?

Researchers had hypothesized it might be caused by a new viral encephalitis, but that didn’t bear any fruit. They also thought perhaps it was a prion disease — such as Creutzfeldt-Jakob disease — but they have ruled that out, as well.

Now scientists are betting on the possibility that nodding syndrome is associated with river blindness. In all three CDC investigations so far, said Dowell, researchers have found an association.

Children and adolescents with the disease are more likely to have antibodies against river blindness and were more likely to be exposed to it. But scientists don’t know how river blindness transforms itself into nodding syndrome.

None of the children or adolescents who suffer from nodding syndrome recover. “Once they have it, it is forever,” said Dowell. It is very debilitating — they can’t eat, they are malnourished and they have cognitive problems, so they drop out of school and become totally dependent on their parents and the community, Dowell said.

Currently, sufferers are being treated with anti-epileptic medications and family members report the children are experiencing some relief.

The CDC has also recommended that they be treated for river blindness and malnutrition.

Global Significance

“Because we don’t know what causes it or its transmission routes, we don’t know what implications it may have for the rest of the world,” said Dowell.

Some diseases in Africa are local and others turn out to be globally important. He cites as an example “slim disease” — a wasting disease in West Africa. “It turned out to have been caused by HIV before HIV was discovered.”

In the case of nodding syndrome “we don’t know the implications of this for the rest of the world,” Dowell said. “It’s quite clear it has huge implications for those living in Kitgum district in Uganda, but it could turn out to have just as huge implications for the rest of the world.”

 

‘Nodding disease’ confounds experts, kills children

TUMANGU, Uganda (AFP) – Patrick Anywar, 14, lies curled up naked in the dust and midday heat of a Ugandan village, struggling to look up at his younger brother and sister playing in front of the family home.

After a minute’s effort to face his siblings, Anywar’s head slumps onto his chest and his emaciated body is gripped by convulsions.

Anywar is one of more than 3,000 children in northern Uganda who are suffering from a debilitating mystery ailment known as nodding disease, which has touched almost every family in the village of Tumangu.

For several years, scientists have tried and failed to determine the cause of the illness, which locals say has killed hundreds of youngsters.

What they do know is that the disease affects only children and gradually devastates its victims through debilitating seizures, stunted growth, wasted limbs, mental disabilities and sometimes starvation.

Anywar’s mother, Rugina Abwoyo, has already lost one son, named Watmon, to the disease in 2010. Now she says she can do little but watch on helplessly as another child slips away.

“Before he was walking and running like other children, but now someone always has to stay home to look after him,” Abwoyo told AFP. “The disease is terrible — it does not let him drink or eat by himself.”

Walking along footpaths cut through the sorghum plantations, Joe Otto, a volunteer health worker, explains how nodding disease has ravaged Tumangu, about 450 kilometres (280 miles) north of the capital Kampala.

“There are 780 people living in this village and we have 97 cases of the disease. It has affected almost every family,” Otto, 54, told AFP.

Whenever sporadic deliveries of medicine arrive at the local health centre several kilometres away, Otto pedals his bicycle to fetch the drugs. But he knows that they only offer a short-term solution.

“We are giving out drugs for epilepsy, like carbamazepine, but this disease is different from epilepsy,” Otto said.

Instead, as the disease has torn through their community, local residents have moved from fear to a grim acceptance, Otto says.

“We started saying that the patient who had died was the one who had been cured, because finally they were at rest from this painful disease,” Otto said.

Scientists are trying to find a cure: since 2010, researchers ranging from epidemiologists to environmental experts, neurologists, toxicologists and psychiatrists have carried out a range of tests.

Investigations have looked at possible links between the disease and everything from a parasite that causes river blindness, to malnutrition and the after-effects of a civil war that ravaged northern Uganda for decades.

“We looked at all this, but unfortunately we were not able to pinpoint any significant contributing or risk factors,” said Miriam Nanyunja, disease control and prevention officer at the World Health Organisation in Kampala.

“The search for the causative agent is still ongoing,” she added.

Often the results have thrown up more questions than answers. Scientists do not know if the disease is linked to similar outbreaks in neighbouring South Sudan and Tanzania.

Efforts continue to understand if the disease is still spreading or has peaked — and why it is seems confined only to certain communities.

Last month, after pressure from lawmakers from affected areas, Uganda’s health ministry produced an emergency response plan to try to identify and control the disease.

However, Nanyunja says that while the search for the cause and a possible cure goes on, for now, doctors can only focus on trying to alleviate the symptoms.

“There are many diseases that we continue to treat symptomatically, without knowing the exact cause,” Nanyunja said.

But for Patrick Anywar, any attempts to curb or cure the disease may come too late.

“We are hoping that the doctors work very hard to get the cure for this disease,” his mother Abwoyo says.

“There is no future for us as so many children have already been affected, but we hope that our youngest can be saved.”

 

Nigeria: Strange Disease Kills 13 Children in Borno

BY ABDULKAREEM HARUNA, 9 AUGUST 2011

Maiduguri — About 13 children have died and 14 others are in hospital following the outbreak of a strange disease that shares the traits of mumps in Kimba village, Borno State.

The children died within the period of seven days when their lower jaws and necks swell as though they were infected by mumps and then died after some few days.

Dr Edward Dika, the Principal Medical Officer of Biu Council, said most of the killed children did not make it to the hospital as the parents resorted to traditional medication, until it degenerated to near epidemic levels.

He explained that but for the quick intervention of the Biu Council which ordered the immediate evacuation of all the affected children to the Biu General Hospital more would have died.

Council Caretaker Chairman, Yusuf Adamu, said the people took the outbreak for granted; “instead of taking the first infected child to hospital they sought the services of a Wanzam (traditional surgeon) who merely made some marks on the inflamated area and the inflammation reduced. But it wasn’t the same to others who died after some few days.

“We had to rush down to Kimba village, a distance of about 30 kilometres away from Biu to force them to take these children (13 of them – one was later added on Tuesday), to General Hospital Biu for intervention.

“We also quickly released the sum of N160,000 to the Primary Healthcare Department for the procurement of all the prescribed drugs for their treatment.”

Edward said the lack of capacity of the Biu General Hospital in carrying out laboratory tests and the fatality rate make it difficult to conclude that the disease is mumps.

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Uganda: Strange Disease Kills 30 In Gulu

BY SHEILA C. KULUBYA IN KAMPALA &OKETCH BITEK, 14 OCTOBER 2000

Kampala — Thirty people including a family of eight have died following the outbreak of a disease identified as Viral Haemorrhage Fever (VHF).

In a statement released Oct 12, the director of general health services, Dr. Francis Omaswa, said the disease is characterized by high fever, severe muscle pains and bleeding from the mouth, nose and anus.

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http://www.ntvuganda.co.ug/ The Ministry of Health and Members of Parliament from Northern Uganda are in the Northern region on a fact finding mission investigating the possible causes of the mysterious Nodding disease that has killed dozens over the past few months. The Health officials and the Acholi members of parliament today visited several areas in Kitgum which are most affected. Resolutions have been made but no mention of a cure as the cause of the disease still remains unclear.

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strange disease has hit Namutumba district killing 16 children within one week. The district woman MP Florence Mutyabule says the disease mainly affects children aged between one month and 4 years. She says she has tried to contact the ministry of health but has not received any response and is calling for urgent attention from the government.

Nsoola village in Magada sub-county is the most hit with over 100 children affected so far, 4 of whom have been rushed to Iganga hospital in very critical condition. The symptoms of the strange disease include swellings which hit the babies heads and spread to the rest of the body. The skin then begins to peel off and the children die within few days.

The Ministry of health says it is still investigating the outbreak, whose cause has not yet been established. The ministry’s in-charge of surveillance Dr. Issa Makumbi says some of the symptoms with which the disease presents such as high fever, vomiting and diarrhea point to malnutrition. Makumbi says a team of experts is to be sent to Namutumba to investigate the outbreak.

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Ghana News

‘Nodding disease’ confounds experts, kills children

TUMANGU, Uganda (AFP) – Patrick Anywar, 14, lies curled up naked in the dust and midday heat of a Ugandan village, struggling to look up at his younger brother and sister playing in front of the family home.

After a minute’s effort to face his siblings, Anywar’s head slumps onto his chest and his emaciated body is gripped by convulsions.

Anywar is one of more than 3,000 children in northern Uganda who are suffering from a debilitating mystery ailment known as nodding disease, which has touched almost every family in the village of Tumangu.

For several years, scientists have tried and failed to determine the cause of the illness, which locals say has killed hundreds of youngsters.

What they do know is that the disease affects only children and gradually devastates its victims through debilitating seizures, stunted growth, wasted limbs, mental disabilities and sometimes starvation.

Anywar’s mother, Rugina Abwoyo, has already lost one son, named Watmon, to the disease in 2010. Now she says she can do little but watch on helplessly as another child slips away.

“Before he was walking and running like other children, but now someone always has to stay home to look after him,” Abwoyo told AFP. “The disease is terrible — it does not let him drink or eat by himself.”

Walking along footpaths cut through the sorghum plantations, Joe Otto, a volunteer health worker, explains how nodding disease has ravaged Tumangu, about 450 kilometres (280 miles) north of the capital Kampala.

“There are 780 people living in this village and we have 97 cases of the disease. It has affected almost every family,” Otto, 54, told AFP.

Whenever sporadic deliveries of medicine arrive at the local health centre several kilometres away, Otto pedals his bicycle to fetch the drugs. But he knows that they only offer a short-term solution.

“We are giving out drugs for epilepsy, like carbamazepine, but this disease is different from epilepsy,” Otto said.

Instead, as the disease has torn through their community, local residents have moved from fear to a grim acceptance, Otto says.

“We started saying that the patient who had died was the one who had been cured, because finally they were at rest from this painful disease,” Otto said.

Scientists are trying to find a cure: since 2010, researchers ranging from epidemiologists to environmental experts, neurologists, toxicologists and psychiatrists have carried out a range of tests.

Investigations have looked at possible links between the disease and everything from a parasite that causes river blindness, to malnutrition and the after-effects of a civil war that ravaged northern Uganda for decades.

“We looked at all this, but unfortunately we were not able to pinpoint any significant contributing or risk factors,” said Miriam Nanyunja, disease control and prevention officer at the World Health Organisation in Kampala.

“The search for the causative agent is still ongoing,” she added.

Often the results have thrown up more questions than answers. Scientists do not know if the disease is linked to similar outbreaks in neighbouring South Sudan and Tanzania.

Efforts continue to understand if the disease is still spreading or has peaked — and why it is seems confined only to certain communities.

Last month, after pressure from lawmakers from affected areas, Uganda’s health ministry produced an emergency response plan to try to identify and control the disease.

However, Nanyunja says that while the search for the cause and a possible cure goes on, for now, doctors can only focus on trying to alleviate the symptoms.

“There are many diseases that we continue to treat symptomatically, without knowing the exact cause,” Nanyunja said.

But for Patrick Anywar, any attempts to curb or cure the disease may come too late.

“We are hoping that the doctors work very hard to get the cure for this disease,” his mother Abwoyo says.

“There is no future for us as so many children have already been affected, but we hope that our youngest can be saved.”

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