Virology laboratories put on high alert

[Guest guest]

Virology laboratories put on high alert, October 12 2008 at 11:55AM

In the wake of the deaths linked to the " mystery disease " , the

National Institute for Communicable Diseases has placed several

virology laboratories around the country on alert.

What is baffling scientists is that two of the victims, Hannes Els and

Gladys Mthembu, showed an initial improvement, but then had a sudden

and marked deterioration in mental state, rhabdomyolysis (a rapid

breakdown of skeletal muscles) in one case, and evidence of acute and

severe hepatic necrosis (death of cells).

The clinical and laboratory features in all three victims included

about seven days of fever, headache, diarrhoea and myalgia (painful

muscles) in the early stages, followed by an acute illness with fever

of 38C, a morbilliform (measle-like) rash in two patients,

thrombocytopenia (abnormal decrease in the number of platelets in the

blood) and mild hepatic (liver) dysfunction in two patients.

While bleeding was not a marked clinical feature, oozing from

venepuncture sites (where needles have been inserted into the veins)

had been noted, as well as a petechial rash (small spots indicating

subcutaneous bleeding) in one patient.

The Institute said laboratory tests to date had proved negative for

Crimean-Congo haemorrhagic fever, Ebola, Marburg, Lassa fever and Rift

Valley fever viruses.

The Hantavirus (the source of Korean haemorraghic fever) had also

proved negative.

The Institute explained that no specimens were available from Van

Deventer, who died soon after arriving in South Africa, but she had

been given a diagnosis of " tick bite fever " .

Negative results to date, said the Institute, could be attributed to

the late collection of specimens (day 10 of illness), and virus

variants not detected by current molecular and serological assays.

Blood cultures to date had been negative and further laboratory

testing was continuing.

It was believed, though, that a viral haemorrhagic fever was the culprit.

No further cases had been identified in either South Africa or Zambia

and the authorities believe this was an isolated case with secondary

transmission.

Finally, the Institute said the recent case of Crimean-Congo

haemorrhagic fever (CCHF) from Calvinia in the Northern Cape was not

linked to the above cluster.

That patient, an abattoir worker, is now clinically stable.

o This article was originally published on page 5 of Tribune on

October 12, 2008

http://www.iol.co.za/index.php?set_id=1 & click_id=125 & art_id=vn20081012090148680C\

872674