Battle to beat killer disease

    October 07 2008 at 06:44AM

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By Louise Flanagan, Solly Maphumulo and Shaun Smillie

Four people have died from a mysterious disease, and while experts try to pinpoint the cause, details of the struggle to contain it have emerged.

On Monday, health authorities finally traced the families of Maria Mokubung, 37, from Slovoville, who died on Sunday night at Charlotte Maxeke Johannesburg Academic hospital, and nursing sister Gladys Mthembu, 34, of Westonaria, who died on Saturday.

Both worked at Morningside Medi-Clinic Private hospital in Sandton, where the first two victims died. Mokubung was a cleaner and Mthembu a nurse, and both had contact with the first victim.

On Monday, health authorities spent hours in discussions on the outbreak, then urged the public not to panic.

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Experts believe a viral haemorrhagic fever is the culprit, probably Congo fever.

"Congo fever is most likely the suspect, and a viral haemorrhagic fever is high on the list," said Dr Lucille Blumberg, of the National Institute for Communicable Diseases (NICD).

Blumberg said tests on samples from victims were continuing, but the fact that the first person to be infected came from Zambia meant that of all the haemorrhagic fevers, Congo was the most likely. The Congo fever virus is carried by a species of tick and is found throughout Southern Africa.

"They haven't had Ebola or Marberg outbreaks in Zambia, and you even get Congo fever here in South Africa," explained Blumberg.

She said that so far there were no other known cases of the mystery illness in Zambia.

"What we are doing is following the trail of possible exposure, looking for contacts that person had, trying to find the pieces of the puzzle."

National health department spokesperson Fidel Hadebe said the department could not confirm speculation linking the deaths to haemorrhagic fevers.

The NICD is conducting a battery of tests, some of which could take days to complete. The priority, explained Blumberg, was to isolate the patient.

Samples might be sent to the US for further tests.

Symptoms have included flu-like illness, fever, diarrhoea, rash and bleeding.

Health authorities urged people not to panic and warned those who developed such symptoms who had been in Zambia, or had contact with the deceased, to get help.

The first victim was tourism operator Cecilia van Deventer, 36, who was flown to the Morningside clinic on September 12 from Zambia in a critical condition after being ill for three weeks. She died two days later.

On September 27, the paramedic who had flown with her from Zambia, Hannes Els, 33, of Speciality Emergency Services in Lusaka, returned to SA and was admitted to the Morningside clinic with similar symptoms, said Morningside manager Jaco Erasmus. Els died on October 2.

Dr Nivesh Sewlal, who was treating Els at the Morningside clinic, said he had diarrhoea, high fever and a rash.

Blood samples were taken from Els and Van Deventer, 36.

"The results have been negative for viral haemorrhagic fever. However, they have died of what of what seems to be a viral illness," Sewlal said.

Morningside spokesperson Melinda Pelser said the clinic realised there was a possible outbreak when Els arrived, and they informed health authorities on September 30.

The NICD was alerted last Monday night and began investigating a possible outbreak of West Nile haemorrhagic fever.

By then, two people who worked at the Morningside clinic had fallen ill - but they ended up in hospitals that did not know they had been in contact with someone who had died from an unknown infectious disease.

Mthembu fell ill on October 1 and was admitted to a general ward with four other patients at Sir Albert Robinson hospital on the West Rand.

She had not told the Sir Albert Robinson hospital she was ill, but it was only the following day before Morningside alerted the hospital to the problem and Mthembu was put in isolation. She died on Saturday.

Sir Albert Robinson spokesperson Marion van der Walt said eight people, including staff who had contact with Mthembu, were put in isolation for observation.

"We're confident that none of those patients were affected," Van der Walt said.

By then, Morningside clinic was trying to trace all staff who had contact with Van Deventer or Els.

They could not get hold of Mokubung. "We tried to contact her since Thursday … She was the only one we couldn't get hold of," said Pelser.

Finally, on Sunday, her family was reached, only to report that Mokubung had since been in Chris Hani-Baragwanath and then Leratong hospital.

A Health Department team went to Leratong to fetch Mokubung and took her to Charlotte Maxeke Johannesburg Academic hospital on Sunday night, where she died hours later.

Both Morningside clinic and the health department emphasised that Mokubung had been ill for months before she had ever been in contact with Van Deventer.

Pelser said "there could be a possibility, but a very low possibility", that her case was linked to the others.

Jean-Louis Kayitenkore
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