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New SARS-like Mystery illness in Cambodia
Mystery disease in Cambodia
May 08 2003 at 06:09AM
Copyright Associated Press
Borghok - In a remote Cambodian jungle village, a tribal chief chanted prayers, drew pig's blood and strung up chicken feathers - all to fight a mystery illness -with symptoms alarmingly similar to Severe Acute Respiratory Syndrome - that was sweeping his community.
After weeks of investigations, Western and Cambodian doctors ruled it was not severe acute respiratory syndrome but a still unknown disease that killed seven of the 392 people in Borghok and Ping villages in the northeastern province of Ratanakkiri.
Still, the baffling illness serves as a reminder to the global medical community - already reeling under the shock of SARS - that there are other unseen and unknown diseases lurking in various parts of the world.
It also highlights the plight of areas untouched by the modern world, where electricity and running water are a luxury and even common diseases like as the flu can be life-threatening.
'The symptoms were almost identical'
Doctors who visited Borghok and Ping say the disease was like nothing they have seen before. The symptoms included fever, coughing, breathing problems - all signs of SARS. But the victims also suffered from diarrhea and maintained normal white blood cell counts, which are not usually found in SARS patients.
The outbreak began on March 2, bewildering the illiterate and poverty-stricken residents of the two villages, which have no paved roads. The nearest hospital is a three-hour trek through hilly forest. The villages are 325km northeast of the capital, Phnom Penh.
Associated Press journalists who visited Borghok were told that six residents died within four days of the outbreak, some within 24 hours of falling ill. At least 29 more villagers became afflicted over the next four weeks.
"I don't know why the spirits were angry or which spirit brought the disease," said village chief Meou Vang, squatting bare-chested amid Borghok's bamboo and thatch huts on stilts. The village is one of the country's poorest communities.
Meou Vang, 50, did what he thought best.
'It stopped tormenting us after the big ceremony'
He placated the spirits by slaughtering a pig, and mixing its blood with rice wine. The mixture was then drunk by villagers.
Two chickens were also killed, cooked and eaten; their skin and feathers mounted on sticks and hung from tree branches above the dirt road leading to the settlement.
Dr Prudence Hamade of Health Unlimited, a British non-governmental organisation, was the first Western doctor to reach the villages on March 10.
She tended to patients and distributed antibiotics. When she travelled a few days later to Phnom Penh for a conference she learned of SARS for the first time and became alarmed.
"The symptoms were almost identical," she recalled.
She described the mystery illness as a form of pneumonia preying on people perpetually in poor health.
Cambodia is one of the few countries in Asia without a confirmed case of SARS. The disease has claimed about 500 lives worldwide, most of them in China and Hong Kong.
Borghok and Ping, about 45km from the border with Vietnam, are inhabited by the Thampoeun, a tribal minority of about 25 000 people who once lived in Vietnam and Laos but today can be found only in Cambodia.
Malnutrition, tuberculosis and malaria plague the Thampoeun, and one in four of their children dies before age 6, according to the United Nations.
Representatives of the World Health organisation and the Cambodian government visited Borghok and Ping from March 19 to 21.
When it appeared that patients responded to antibiotics, health officials felt confident enough to rule out SARS.
"There is no evidence that this outbreak is in any way linked to the SARS," said the joint mission's report.
But the bad news is doctors still don't know much more about the disease.
"A spate of deaths like this caused by an illness we cannot determine by tests is unusual," said Severin Xylander, a German doctor and the only WHO representative to visit the area.
Meou Vang, the village chief, doesn't care. He says he brought the disease under control with the rituals he conducted on March 20, witnessed by about 200 villagers.
"It stopped tormenting us after the big ceremony. I know, because people stopped dying and didn't get sick anymore," he said.
Although the disease is now all but controlled, residents continue to protect themselves from evil spirits by posting guards outside their homes - straw scarecrows wearing shirts, pants, shoes, caps, and wielding sticks, guns and even discarded hand-held rocket launchers.
"They believe the sacrifices purify the villages and I believe the antibiotics cure the individuals," said Health Unlimited's Hamade. - Sapa-AP
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The new unidentified type of pneumonia has killed seven people in two poor and remote villages near the border with Vietnam.
It has Sars-like symptoms including fever, coughing and breathing problems.
But unlike in most Sars cases, patients suffer diarrhoea and maintain normal white blood cell counts.
"There is no evidence that this outbreak is in any way linked to the Sars," said a report by the World Health Organisation and Cambodian officials, who say the outbreak started in March.
Doctors administered antibiotics and other drugs to supplement the villagers' use of animal sacrifices and tribal prayers to bring the outbreak under control.
World-wide, the death toll from Sars toll has risen to at least 498, when Taiwan announced its latest of 14 deaths. The vast majority of the global deaths have been in China's mainland and Hong Kong, where thousands have been infected.
So far, Sars has mostly been an urban disease. But authorities fear it might spread into the countryside, where the majority of China's 1.3 billion people live amid a shortage of doctors and hospitals.
Who Investigators were due today to go to Hebei, a province bordering Beijing and where there been a marked surge in cases.
In the US, thousands of customs and immigration inspectors were being trained to spot Sars symptoms and were ordered to detain those who exhibit them as part of attempts to prevent an outbreak.
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CONTENT COPYRIGHT AP. THIS CONTENT IS INTENDED SOLELY FOR EDUCATIONAL PURPOSES.
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