Unexplained Neurological Illness In New York Triggers National Alert System - Tilted Forum Project Discussion Community

Mind_Storm · 10-13-2003, 04:04 AM

Hey cynth can you give more amplifying info on this?

Nothing here in up-state NY, then again nothing ever happens up here to begin with.

____________________________________________________

http://www.promedmail.org/pls/askus/..._ID:1000,23151

Archive Number 20031012.2571
Published Date 12-OCT-2003
Subject PRO/EDR> Unexplained neurological illness - USA (NYC) (02): RFI

UNEXPLAINED NEUROLOGICAL ILLNESS - USA (NYC) (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: 13 Oct 2003
From: ProMED-mail <promed@promedmail.org>
Source: Newsday 12 Oct 2003 [edited]

4 people are critically ill on Staten Island, suffering from a mysterious
infectious disease
-------------------------
New York City health officials issued a medical alert Friday night to
doctors and hospitals in the 5 boroughs and triggered the national alert
system through the U.S. Centers for Disease Control and Prevention. Though
it was not clear whether the cases are the result of the same disease or
are related in any way, the Health Department asked that all clinicians be
vigilant.

City health officials checked the new Syndromic Surveillance Network, a
hospital computer system that allows the Health Department to look for
unusual constellations of symptoms in patients admitted throughout the
city. So far, nothing like the Staten Island cases has turned up in the
other boroughs.

City health officials have ruled out SARS, and initial tests for West Nile
virus came up negative. Further tests are under way, but no results are
expected until late tomorrow or Tuesday. A city Health Department
representative said yesterday that the illness is so mysterious that "we
don't even have a hypothesis yet" as to what might be the cause.

The city Health Department initially identified 5 people (3 men and 2
women) as being treated in Staten Island hospitals. One of the 5 has been
released, department spokeswoman Sandra Mullin said last night.

The patients are unusually young to exhibit the sudden symptoms, ranging in
age from 22 to 54 years, with a median of 39. The age distribution is
alarming, health experts said, because typically illnesses of this type
strike elderly people the hardest, taking advantage of their weakened
immune systems. These cases apparently involve healthy young adults.

The 4 patients are intubated, in intensive care, classified as in critical
condition.

Among the "mental status changes" mentioned in the Health Department's
medical alert that the individuals have suffered are seizures, delirium,
memory lapses, and confusion. These sorts of symptoms are consistent with
meningitis or encephalitis -- infections of the brain and spinal cord.

All 5 of the Staten Island patients took ill between 26 Sep and Oct 8 2003,
initially suffering a vague, flu-like syndrome of headaches, fever, muscle
aches, and fatigue. The illness quickly escalated in all cases to include
the mental changes. They have breathing difficulties, in some cases
resulting in complete respiratory failure, which requires mechanical
breathing support.

Lab tests reveal all of the patients have high protein levels in their
cerebral spinal fluids -- a typical indicator of infection of the brain.
The patients also have elevated white blood cell counts, showing their
immune systems are trying to fight off an infectious agent of some kind.

One of the patients suffers from erythema multiforme, a striking type of
skin rash most commonly associated with herpes infections. Such rashes
involve raised, reddened patches all over the body that are distributed
symmetrically, so that, for example, a patch on the right forearm will have
an identical patch on the left forearm. Though other infectious agents are
suspected of being capable of causing this type of rash, only the herpes
virus is a proven culprit, and it is not known how the microbe creates this
unusual pattern of usually painless reddenings.

Some of these symptoms are consistent with illnesses produced by
encephalitis viruses, such as West Nile and Eastern Equine Encephalitis.
Such viruses are usually carried by mosquitoes, and Staten Island's marshy
areas are notorious breeding grounds for insects.

In a statement released yesterday afternoon, the city Health Department
noted, "Encephalitis, or inflammation of the brain tissue, is rare. There
were about 200 reported cases of encephalitis in New York City in 2001.

"Several viruses can cause encephalitis, which is often referred to as
viral encephalitis," the statement continued. "Most viral encephalitis
cases are caused by non-mosquito-related viruses that are common in the
late summer/early fall. Mosquito-borne encephalitis is not spread
person-to-person, and accounts for a small percentage of all reported
encephalitis cases."

The Symptoms
-----------
4 people in critical condition in Staten Island hospitals with a mysterious
illness showed *some* of the following symptoms, according to city health
officials:

Initially, a flu-like illness with headache, fever, fatigue and muscle aches.

Mental changes, including confusion, memory loss, and delirium.

Convulsive seizures, in some cases.

Difficulty breathing, leading in some cases to complete respiratory failure.

Red, raised patches on the skin that are symmetrical, that is, a rash on
one side of the body mirroring one on the other side.

[Lab Results]
------------
Elevated white blood cell count.

High protein levels in the cerebrospinal fluid.

[Byline: Laurie Garrett]

--
ProMED-mail
<promed@promedmail.org>

[The above newswire gives more details on the clinical syndromes of these
cases and strongly supports a diagnosis of a viral encephalitis. As this
year has been an active year for Eastern equine encephalitis (EEE) along
the eastern seaboard (including the identification of EEE-infected
mosquitoes further to the northeast in Montauk State Park), one wonders
whether that might be the etiology here. Interestingly enough, on first
run through the Gideon database (Global Infectious Disease Network
), infection with Powassan virus, a tick-borne
flavivirus, comes in number one in the differential diagnosis.

At present it appears as though this is an unusual cluster of severe
neurologic illness in Staten Island (one of the 5 boroughs/counties in New
York City). A definite "outbreak" per se has not yet been defined. More
information on the investigations of these cases (laboratory and
epidemiologic), as well as the extended epidemiologic investigations --
looking for possible additional cases elsewhere in the region and the USA
-- would be appreciated. - Mod.MPP]

Plan9Senior · 10-13-2003, 09:34 AM

Scary stuff, especially since I just got done reading the book 'The Stand'

. Hope they figure this out quickly before it starts showing up in other areas.

10-13-2003, 04:04 AM	#1 (permalink)
Mind_Storm Tilted Location: The Finger Lakes of New York	Unexplained Neurological Illness In New York Triggers National Alert System Hey cynth can you give more amplifying info on this? Nothing here in up-state NY, then again nothing ever happens up here to begin with. ____________________________________________________ http://www.promedmail.org/pls/askus/..._ID:1000,23151 Archive Number 20031012.2571 Published Date 12-OCT-2003 Subject PRO/EDR> Unexplained neurological illness - USA (NYC) (02): RFI UNEXPLAINED NEUROLOGICAL ILLNESS - USA (NYC) (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: 13 Oct 2003 From: ProMED-mail <promed@promedmail.org> Source: Newsday 12 Oct 2003 [edited] 4 people are critically ill on Staten Island, suffering from a mysterious infectious disease ------------------------- New York City health officials issued a medical alert Friday night to doctors and hospitals in the 5 boroughs and triggered the national alert system through the U.S. Centers for Disease Control and Prevention. Though it was not clear whether the cases are the result of the same disease or are related in any way, the Health Department asked that all clinicians be vigilant. City health officials checked the new Syndromic Surveillance Network, a hospital computer system that allows the Health Department to look for unusual constellations of symptoms in patients admitted throughout the city. So far, nothing like the Staten Island cases has turned up in the other boroughs. City health officials have ruled out SARS, and initial tests for West Nile virus came up negative. Further tests are under way, but no results are expected until late tomorrow or Tuesday. A city Health Department representative said yesterday that the illness is so mysterious that "we don't even have a hypothesis yet" as to what might be the cause. The city Health Department initially identified 5 people (3 men and 2 women) as being treated in Staten Island hospitals. One of the 5 has been released, department spokeswoman Sandra Mullin said last night. The patients are unusually young to exhibit the sudden symptoms, ranging in age from 22 to 54 years, with a median of 39. The age distribution is alarming, health experts said, because typically illnesses of this type strike elderly people the hardest, taking advantage of their weakened immune systems. These cases apparently involve healthy young adults. The 4 patients are intubated, in intensive care, classified as in critical condition. Among the "mental status changes" mentioned in the Health Department's medical alert that the individuals have suffered are seizures, delirium, memory lapses, and confusion. These sorts of symptoms are consistent with meningitis or encephalitis -- infections of the brain and spinal cord. All 5 of the Staten Island patients took ill between 26 Sep and Oct 8 2003, initially suffering a vague, flu-like syndrome of headaches, fever, muscle aches, and fatigue. The illness quickly escalated in all cases to include the mental changes. They have breathing difficulties, in some cases resulting in complete respiratory failure, which requires mechanical breathing support. Lab tests reveal all of the patients have high protein levels in their cerebral spinal fluids -- a typical indicator of infection of the brain. The patients also have elevated white blood cell counts, showing their immune systems are trying to fight off an infectious agent of some kind. One of the patients suffers from erythema multiforme, a striking type of skin rash most commonly associated with herpes infections. Such rashes involve raised, reddened patches all over the body that are distributed symmetrically, so that, for example, a patch on the right forearm will have an identical patch on the left forearm. Though other infectious agents are suspected of being capable of causing this type of rash, only the herpes virus is a proven culprit, and it is not known how the microbe creates this unusual pattern of usually painless reddenings. Some of these symptoms are consistent with illnesses produced by encephalitis viruses, such as West Nile and Eastern Equine Encephalitis. Such viruses are usually carried by mosquitoes, and Staten Island's marshy areas are notorious breeding grounds for insects. In a statement released yesterday afternoon, the city Health Department noted, "Encephalitis, or inflammation of the brain tissue, is rare. There were about 200 reported cases of encephalitis in New York City in 2001. "Several viruses can cause encephalitis, which is often referred to as viral encephalitis," the statement continued. "Most viral encephalitis cases are caused by non-mosquito-related viruses that are common in the late summer/early fall. Mosquito-borne encephalitis is not spread person-to-person, and accounts for a small percentage of all reported encephalitis cases." The Symptoms ----------- 4 people in critical condition in Staten Island hospitals with a mysterious illness showed some of the following symptoms, according to city health officials: Initially, a flu-like illness with headache, fever, fatigue and muscle aches. Mental changes, including confusion, memory loss, and delirium. Convulsive seizures, in some cases. Difficulty breathing, leading in some cases to complete respiratory failure. Red, raised patches on the skin that are symmetrical, that is, a rash on one side of the body mirroring one on the other side. [Lab Results] ------------ Elevated white blood cell count. High protein levels in the cerebrospinal fluid. [Byline: Laurie Garrett] -- ProMED-mail <promed@promedmail.org> [The above newswire gives more details on the clinical syndromes of these cases and strongly supports a diagnosis of a viral encephalitis. As this year has been an active year for Eastern equine encephalitis (EEE) along the eastern seaboard (including the identification of EEE-infected mosquitoes further to the northeast in Montauk State Park), one wonders whether that might be the etiology here. Interestingly enough, on first run through the Gideon database (Global Infectious Disease Network ), infection with Powassan virus, a tick-borne flavivirus, comes in number one in the differential diagnosis. At present it appears as though this is an unusual cluster of severe neurologic illness in Staten Island (one of the 5 boroughs/counties in New York City). A definite "outbreak" per se has not yet been defined. More information on the investigations of these cases (laboratory and epidemiologic), as well as the extended epidemiologic investigations -- looking for possible additional cases elsewhere in the region and the USA -- would be appreciated. - Mod.MPP]

10-13-2003, 09:34 AM	#2 (permalink)
Plan9Senior Banned Location: Orange County, California	Scary stuff, especially since I just got done reading the book 'The Stand' . Hope they figure this out quickly before it starts showing up in other areas.