Re: Not mold, but interesting outbreak of illness, Panama

[Guest guest]

Hi Carl,

That makes a lot of sense. I have a question that I am trying to

understand. You know how people were not really complaining to much about

toxicity,

HP, etc from an indoor exposure to molds until the late 90's by and large.

Do you think that is because by that time, many of the structures built

after the late 70's, (when construction standards changed and manmade materials

that wick were used) had about 20 years for many of these " petrii dishes " to

spring leaks and cause mold problems?

Or do you think the increase in these illnesses being reported is just due

to more awareness, via the internet, etc?

Or is there some other reason why there appears to be more, who are being

made ill from damp indoor environments/mold, than any other time in history?

[Guest guest]

This is an example of why mold related illness has not been

definitively diagnosed and all advances are difficult. Although the

cause of the Panama outbreak is unknown it has a fairly specific set

of symptoms and is limited primarily to those over 60 who also have

another diagnosed illness. They have some specifics to work with.

Because people are dying fairly quickly the impact is extreme so the

motivation and the diligence are at alert levels.

Mold, on the other hand, has a wide range of symptoms that vary over

time even with people in the the same location, across all ages and

very few specifics to work with. The impact can be very high, as we

all know, but death is not the usual result so the motiviation and

diligence is at a comparatively lower level.

This isn't meant to diminish the impact of mold but to illustrate

that it is very different from what public health is trained for. To

further delay diagnosis and treatment, mold related illness may very

well be the new disease paradigm that is proposing

(Google her name and TILT). If so, then new methods have to be

developed and tested. That takes time.

Carl Grimes

Healthy Habitats LLC

-----

UNDIAGNOSED DEATHS - PANAMA (02): REQUEST FOR INFORMATION

***************************************

A ProMED-mail post <http://www.promedmail.org>

ProMED-mail is a program of the International Society for Infectious

Diseases <http://www.isid.org>

Date: 5 Oct 2006

From: Doyle, PhD <dr_p_doyle@...>

Source: Reuters AlertNet [edited]

<http://www.alertnet.org/thenews/newsdesk/N04273.htm>

The death toll from a mystery illness in Panama has risen to at

least

17, with 10 others still suffering but recovering from fever,

diarrhea and partial paralysis, the Health Ministry said on

Wednesday

[4 Oct 2006].

Doctors do not know the cause but say the disease progresses rapidly

to the renal system and causes neurological damage.

Two more people suffering from the unidentified illness died on

Wednesday, health minister Camilo Alleyne told reporters. He also

bumped up the number of people fighting the mystery disease to 10

from 7.

Up to Tuesday [3 Oct 2006] the disease had killed 15 over the last

month, the ministry said.

The ministry declared a national epidemic alert on Tuesday.

The dead were all over 60 years of age and most were already

suffering from high blood pressure, diabetes and kidney problems.

The illness does not seem to be contagious and dengue fever,

influenza, West Nile virus and other illnesses have been ruled out.

******

Date: 5 Oct 2006

Source: La Prensa [trans. by Mod.MPP; edited]

<http://www.prensa.com/hoy/panorama/756606.html>

The official number of deaths increased to 17 yesterday with 27

total

cases affected by an as yet unknown syndrome which appeared in

Panama

in the month of September, according to reports from the Ministry of

Health.

The 2 new deaths had been hospitalized in the Dr. Arnulfo Arias

Madrid hospital complex, but more details on the course of their

disease were not provided.

The minister, Camilo Alleyne, who on Tuesday [3 Oct 2006] afternoon

said there were no new cases, confirmed that there were 5 new cases.

He indicated that the investigations thus far into the etiology of

the syndrome have eliminated bacteria such as _E. coli_ and

_Campylobacter_ and viruses such as those responsible for West Nile

fever, dengue, influenza A or B, equine encephalitis and

enterovirus,

as well as poisoning by substances such as arsenic.

Yesterday he explained that there had been 3 ambulatory cases

reported, that there are 4 patients hospitalized in stable condition

and that another 3 patients were in the intensive care unit, where

the area has been isolated.

The infectious disease specialist Nestor Sosa said that in the Santo

Tomas hospital there were 2 patients in serious condition. He said

that there are patients under observation to determine if they had

the same syndrome, and that the 2 new fatal cases had similar

characteristics in terms of age and symptomatology.

The Director General of Health, Cirilo Lawson, talked about the

investigations into the origins of this disease. " We are open to the

possibility that this disease is either of infectious or toxic

etiology " . [Of note... there are a number of infectious agents that

are known to produce toxins, so it is possible the etiology is both

of infectious and toxic origins. - Mod.MPP]

Lawson clarified that pharmacologic agents [medicines] are included

among possible toxicologic exposures and confirmed that

investigations into this possibility are currently underway.

Authorities were awaiting the arrival of 4 experts from the Center

for Disease Control and Prevention [CDC] from Atlanta, Georgia [uSA],

who will work together with the Pan American Health Organization

[PAHO] and the Ministry of Health to determine the cause of this

lethal syndrome.

[byline: Urania Cecilia Molina]

--

ProMED-mail <promed@...>

[upon review of the updated information, this moderator has not

significantly changed her opinion on the possible etiologies of this

outbreak. The moderator comment included in the 1st posting of this

thread is reproduced below.

" From the description given in the article from the local press in

Panama, there appears to be " confidence " on the part of the Ministry

that the outbreak does not appear to be " contagious, " so that

person-to-person transmission seems to be ruled out by the

epidemiologic studies. Obvious questions include what is the common

exposure on the part of the patients; the mention that they are all

older individuals with pre-existing medical problems could be an

indication of an exposure that, in most cases, is relatively benign,

but when a compromised individual is exposed, then problems are

seen.

Or it may be an indication of an exposure that is occurring in the

health care environment where these individuals may have a common

exposure. And a key question is whether this exposure is to an

infectious agent or a toxin.

Clearly, more information on the epidemiologic studies conducted on

this outbreak would be very much appreciated. - Mod.MPP "

According to the latest newswires, the more common infectious agents

that might be associated with a similar clinical picture have been

ruled out (such as _E. coli_, campylobacter, enteroviruses, dengue,

West Nile virus, equine encephalitis viruses). The common

denominator seems to remain somewhat older individuals with

pre-existing medical problems... leading one to ask whether some

exposure in the health care environment might be responsible for

their illness. The Ministry of Health clearly states they are

investigating medications, suggesting that these patients may have

been exposed to a common medication.

We await further information. - Mod.MPP]

............................mpp/pg/dk

*##########################################################*

UNDIAGNOSED DEATHS - PANAMA: REQUEST FOR INFORMATION

***********************************************

Date: 3 Oct 2006

From: Montgomery <LMonty911@...>

Source: Reuters Alertnet [edited]

<http://www.alertnet.org/thenews/newsdesk/N03219590.htm>

Mystery illness kills at least 6 in Panama

-----------------------------------------------

Panama's Health Ministry declared a national epidemic alert on

Tuesday [3 Oct 2006] after a mystery illness killed at least 6

people

and left others suffering with fever, diarrhea and partial

paralysis.

Doctors do not know the cause but say the disease progresses rapidly

to the renal system and causes neurological damage. Another 6 people

may have died from it in the last month [september 2006].

" These symptoms are completely unusual, and have not been detected

before in our country, " Panama's health director, Cirilo Lawson,

told

Reuters.

Ten more people have been stricken but survived.

Doctors in the central Panama and Cocle provinces are taking samples

from the affected people and seeking advice from abroad. --

******

Date: 3 Oct 2006

Source: La Prensa [trans. by Mod. MPP, edited]

<http://mensual.prensa.com/mensual/contenido/2006/10/03/hoy/panorama/7

54539.ht ml>

While the Ministry confirmed 6 deaths, medical sources are speaking

of 17 [deaths]; Alert for lethal syndrome

----------------------------------------------- Authorities have not

been able to identify the cause of a syndrome that has already

affected 22 persons. There is no evidence of direct contagion with

this syndrome, which begins with severe diarrhea.

An " epidemiologic alert " has been issued by the Ministry of Health.

The cause is an " aggressive, acute syndrome, whose origin is

unknown,

that has led to the deaths of at least 7 of the 22 [persons] who

were

treated in the Dr. Arnulfo Arias Madrid Hospital Complex of Social

Security (CSS) and in the Santo Tomas Hospital.

The patients presented with a clinical picture that, in the lethal

cases, developed over the course of one week, beginning with fever

and severe diarrhea and progressed to renal failure and neurological

deficits in the extremities.

The Minister of Health, Camilo Alleyne, reported last night [2 Oct

2006] the deaths of 6 people by cardio-respiratory arrest, but

medical sources said that there were already 17 fatalities in the

complex.

The problem began one and a half months ago, although it wasn't

until

the end of September [2006] that the authorities considered it to be

an " unusual " occurrence.

In the CSS Complex, for example, the Department of Epidemiology

issued a memorandum on 27 Sep [2006] in which it requested that all

medical personnel give notification immediately of any " renal

syndrome with neurologic manifestations. "

In addition, it was known that the Minister and the Director General

of Health, Cirilo Lawson, had met various times with investigators

of

the Gorgas Institute and medical specialists to study the medical

records of the deceased patients in order to rule out possible

causes.

In fact, the Gorgas Institute conducted studies in order to

determine

the causes and also sent specimens from the deceased to the Center

for Disease Control and Prevention in the United States.

Alleyne explained that " there [was] no evidence encountered of

direct

contagion, " and that all of the patients were persons greater than

60

years of age, with predisposing diabetes, renal disease or

hypertension. Nevertheless, medical sources reported that the

patients were between 40 and 80 years of age. The cases presented in

the metropolitan area, west Panama, San ito and Cocle

Province.

[byline: Ana ]

--

ProMED-mail <promed@...>

[From the description given in the article from the local press in

Panama, there appears to be " confidence " on the part of the Ministry

that the outbreak does not appear to be " contagious, " so that

person-to-person transmission seems to be ruled out by the

epidemiologic studies. Obvious questions include what is the common

exposure on the part of the patients; the mention that they are all

older individuals with pre-existing medical problems could be an

indication of an exposure that, in most cases, is relatively benign,

but when a compromised individual is exposed, then problems are

seen.

Or it may be an indication of an exposure that is occurring in the

health care environment where these individuals may have a common

exposure. And a key question is whether this exposure is to an

infectious agent or a toxin.

Clearly, more information on the epidemiologic studies conducted on

this outbreak would be very much appreciated. - Mod.MPP]

............................mpp/msp/dk

[Guest guest]

Sharon,

Yes to all the above.

I think it is a combination of several factors. We use building

materials that are more easily disgestable by mold and bacteria. Give

them more food and more of them grow.

We started making the building more air tight without compensating

for the accumulation of moisture. The structures changed. E.g. in

Colorado they created a petri dish in the crawlspaces when they

adjusted to expansive soils. More metal is used which increases the

locations and opportunities for condensation. Give them more water

and otherwise improve the living conditions for mold and bacteria and

they will proliferate.

On the other hand, I'm more convinced than ever that our bodies and

immune systems are failing to defend against a myriad of exposures.

20+ years ago I thought it was mostly chemicals. But my clients

received more benefit when I dealt with mold. However, I'm now

returning to the chemical factors because we have fouled our nest

with pesticides, plasticizers, fire retardants, antibiotics, food

preservatives, cleaning products and personal care products; some of

which contain chemicals not allowed in industrial plants. CDC and the

Canadian govt surveys of chemicals in humans have not found even one

person in the last dozen or so years that does not have these

pollutants in their body. Weaken our bodies and the mold sees us as

an available food source. That is their job, after all. Eat the dead

and turn it back into dirt.

Mold and other biological toxins may trigger the events but adults

and children seem to be more and more susceptible. Regardless of what

causes which, I'm convinced " something " is wrong and it is of our own

doing.

Carl Grimes

Healthy Habitats LLC

-----

> Hi Carl,

>

> That makes a lot of sense. I have a question that I am trying to

> understand. You know how people were not really complaining to much

> about toxicity, HP, etc from an indoor exposure to molds until the

> late 90's by and large.

>

> Do you think that is because by that time, many of the structures

> built after the late 70's, (when construction standards changed and

> manmade materials that wick were used) had about 20 years for many of

> these " petrii dishes " to spring leaks and cause mold problems?

>

> Or do you think the increase in these illnesses being reported is just

> due to more awareness, via the internet, etc?

>

> Or is there some other reason why there appears to be more, who are

> being made ill from damp indoor environments/mold, than any other

> time in history?

>

>

>

[Guest guest]

Yes Sharon I think you hit the nail on the head when you referenced

buildings from the

70's as having " had about 20 years for many of these petri dishes to spring

leaks and cause mold problems. "

In a message dated 10/7/2006 9:50:40 PM Central Standard Time,

snk1955@... writes:

Hi Carl,

That makes a lot of sense. I have a question that I am trying to

understand. You know how people were not really complaining to much about

toxicity,

HP, etc from an indoor exposure to molds until the late 90's by and large.

Do you think that is because by that time, many of the structures built

after the late 70's, (when construction standards changed and manmade

materials

that wick were used) had about 20 years for many of these " petrii dishes " to

spring leaks and cause mold problems?

Or do you think the increase in these illnesses being reported is just due

to more awareness, via the internet, etc?

Or is there some other reason why there appears to be more, who are being

made ill from damp indoor environments/made ill from damp indoor

environments/<W

[Non-text portions of this message have been removed]