Plurality Of Pathogens Is Cause of Mysterious Illness Killing Cambodian Children

As reported by CNN, please see CNN

Phnom Penh, Cambodia (CNN) — The World Health Organization, in conjunction with the Cambodian Ministry of Health, will conclude that a combination of pathogens is to blame for the mysterious illness that has claimed the lives of more than 60 children in Cambodia, medical doctors familiar with the investigation told CNN on Wednesday.

The pathogens include enterovirus 71, streptococcus suis and dengue, the medical sources said. Additionally, the inappropriate use of steroids, which can suppress the immune system, worsened the illness in a majority of the patients, they said.

The sources did not want to be identified because the results of the health organization’s investigation have not yet been made public.

Dr. Beat Richner, head of Kantha Bopha Children’s Hospitals — which cared for 66 patients affected by the illness, 64 of whom died — said that no new patients had been seen there since last Saturday.

The World Health Organization (WHO) is also expected to advise health care workers to refrain from using steroids in patients with signs and symptoms of the infection, which include severe fever, encephalitis, and breathing difficulties.

WHO reported the following update:

9 July 2012 –As part of the continuing investigations into the undiagnosed illness, the Ministry of Health of the Kingdom of Cambodia is finalizing the review of all suspected hospitalised cases.  This final review added an additional two cases between April to 5 July 2012, making the total number of children affected to be 59.  Of these, 52 have died.

The age of the cases range from three months to 11 years old, with the majority being under three years old.  The overall male: female ratio is 1.3:1.

Laboratory samples were not available for the majority of the cases as they died before appropriate samples could be taken.

Based on the latest laboratory results, a significant proportion of the samples tested positive for enterovirus 71 (EV-71), which causes hand foot and mouth disease (HFMD).  The EV-71 virus has been known to generally cause severe complications amongst some patients.

Additionally, a number of other pathogens, including dengue and streptococcus suis were identified in some of the samples.  The samples were found to be negative for H5N1 and other influenza viruses, SARS and Nipah.

Further investigations into matching the clinical, laboratory and epidemiological information are ongoing, and are likely to be concluded in a few days.

WHO and partners, which include lnstitut Pasteur du Cambodge and US Centers for Disease Control and Prevention, are assisting the Ministry of Health with this event.

The Government is also reinforcing awareness of good hygiene practices to the public, which includes frequent washing of hands.

Some facts on hand foot and mouth disease:

Hand foot and mouth disease (HFMD) is a common infectious disease of infants and children.  The symptoms commonly observed include fever, painful sores in the mouth, and a rash with blisters on hands, feet and also buttocks.

HFMD is most commonly caused by coxsackievirus A16, which usually results in a mild self-limiting disease with a few complications.  HFMD is also caused by enteroviruses, including enterovirus 71 (EV71) which has been associated with serious complications in certain groups, and may cause deaths.

HFMD mainly occurs amongst children under 10 years old.  The usual period from infection to onset of symptoms is 3-7 days.

The disease usually begins with fever, poor appetite, malaise, and frequently with a sore throat.  One or two days after fever onset, painful sores develop in the mouth.  They begin as small red spots that blister and then often become ulcers.  They are usually located on the tongue, gums and inside of the cheeks.  A non-itchy skin rash develops over 1-2 days with flat or raised red spots, some with blisters.  The rash is usually located on the palms of the hands and soles of the feet, and may also appear on the buttocks and/or genitalia.  A person with HFMD may not have symptoms, or may have only the rash or only mouth ulcers. In a small number of cases, children may experience a brief febrile illness, present with mixed neurological and respiratory symptoms and succumb rapidly from the disease.

HFMD virus is contagious and infection is spread from person to person by direct contact with nose or throat discharges, saliva, fluid from blisters, or the stool of infected persons.  Infected persons are most contagious during the first week of the illness but the period of communicability can last for several weeks.  HFMD is not transmitted from pets or other animals. HFMD should not be confused with the different disease in animals called foot-and-mouth disease.

Presently, there is no specific treatment available for HFMD.  Patients should drink plenty of water or other liquids and may require treatment of the symptoms.

Health care providers are advised to treat patients according to their symptoms and to refrain from using steroids.

GAR Undiagnosed Fatal Illness in Cambodia

World Health Organization WHO and please, see Video presented by CNN

Undiagnosed Illness Killing Young Children in Cambodia

My professional opinion is Hanta Virus

6 July 2012 – reported by GAR The Ministry of Health of the Kingdom of Cambodia is conducting active investigation into the cause of a recent undiagnosed syndrome that has caused illness and deaths among children in the country.

Preliminary findings of the investigation identified a total of 74 cases who were hospitalised from April to 5 July 2012.  Of these, 57 cases (including 56 deaths), presented a common syndrome of fever, respiratory and neurological signs, which is now the focus of the investigation.

The majority of the identified cases to date were under three years old.  Most of them were from the southern and central parts of the country and received treatment at Kantha Bopha Children’s hospital, which is a reference paediatric hospital.  Despite all efforts, many of the children died within 24 hours of admission.

Available samples have been tested at the Institut Pasteur in Cambodia.  Although a causative agent remains to be formally identified, all these samples were found negative for H5N1 and other influenza viruses, SARS, and Nipah.

The Ministry of Health was first alerted to this by Kantha Bopha Children’s hospital in Phnom Penh, where the majority of the cases were hospitalised.

The Ministry of Health notified WHO about this event through the IHR notification mechanism as it met the criteria for notification of any event where the underlying agent or disease or mode of transmission is not formally identified.

WHO and partners are assisting the Ministry of Health with this event which focuses on hospitalised cases, early warning surveillance data, laboratory data and field investigations.

While this event is being actively investigated, the Government is also looking at other diseases occurring in the country, including dengue, hand-foot-mouth and Chikungunya.

Parents have been advised to take their children to hospital if they identify any signs of unusual illness. The Government is also reinforcing awareness of good hygiene practices to the public, which includes frequent washing of hands.

LOCATION! LOCATION! LOCATION!

Press Release, 12-40

U.S. Commerce Department to Open Four Regional U.S. Patent Offices

For the First Time, USPTO Will Expand Operations Outside Washington, DC, to:

Detroit!

Dallas!

Denver!

AND 

Silicon Valley!

WASHINGTON – Acting U.S. Commerce Secretary Rebecca Blank and Under Secretary of Commerce for Intellectual Property and Director of the U.S. Patent and Trademark Office (USPTO) David Kappos today announced plans to open regional USPTO offices in or around Dallas, Texas, Denver, Colorado, and Silicon Valley, California. These offices are in addition to the already-announced first USPTO satellite office to open on July 13 in Detroit, Michigan. The four offices will function as hubs of innovation and creativity, helping protect and foster American innovation in the global marketplace, helping businesses cut through red tape, and creating new economic opportunities in each of the local communities. Next week, Acting Secretary Blank and Under Secretary Kappos will travel to each of the newly selected cities to meet with local businesses, entrepreneurs and public officials to discuss the new office openings.

“Intellectual property protection and innovation are engines of economic growth and the bedrock of America’s private sector,” said Acting U.S. Commerce Secretary Rebecca Blank. “The Obama administration is committed to making certain our businesses and entrepreneurs have the resources they need to grow, create jobs and compete globally. These new offices are an historic step toward further advancing our world’s best IP system, and reinforcing the United States as the number one destination for innovation capital, and research and development around the world.”

The offices announced today will help the USPTO attract talented IP experts throughout the country who will work closely with entrepreneurs to process patent applications, reduce the backlog of unexamined patents, and speed up the overall process, allowing businesses to move their innovation to market more quickly, and giving them more room to create new jobs.

 

“By expanding our operation outside of the Washington metropolitan area for the first time in our agency’s 200-plus year history, we are taking unprecedented steps to recruit a diverse range of talented technical experts, creating new opportunities across the American workforce,” said David Kappos, Director of the USPTO. “These efforts, in conjunction with our ongoing implementation of the America Invents Act, are improving the effectiveness of our IP system, and breathing new life into the innovation ecosystem.”

Patents are a significant factor in private sector job creation. In fact, the U.S. Commerce Department issued a recent report finding that IP-intensive industries are the source – directly or indirectly – of 40 million jobs, contributing $5.06 trillion to the U.S. economy in 2010.

Selection of the four sites was based upon a comprehensive analysis of criteria including geographical diversity, regional economic impact, ability to recruit and retain employees, and the ability to engage the intellectual property community. The Leahy-Smith America Invents Act of 2011 (AIA), signed into law by President Obama in September, requires the USPTO to establish regional satellite locations as part of a larger effort to modernize the U.S. patent system over the next three years.

 

The USPTO is working to develop concept of operations for the three newly-announced locations based on the Elijah J. McCoy Detroit Office and will develop best practices based on this model over the coming months and years. The Detroit office will employ approximately 120 individuals in its first year of operations. The USPTO also seeks to identify and maximize the unique regional strengths of all four offices to further reduce the backlog of patent applications and appeals.

The USPTO team plans to begin site procurement activity and establish a timeline for the three newly-announced locations in the coming months.

For additional background on the selection criteria and methodology, please click here.

For non-press inquiries pertaining to the satellite site selection, please contact Azam Khan, USPTO deputy chief of staff at azam.khan@uspto.gov.