Eastern Cape children rushed to hospital with typhoid

SABC News ^ | May 1, 2005 | Staff

[Judith Anne]

At least 15 children from Coza village in the Eastern Cape's Transkei region have been rushed to hospital in Libode, suffering from stomach aches and nose bleeding. Their illness has been diagnosed as typhoid.

Three of the children have been admitted to the hospital, while the rest were treated and discharged. Sizwe Khuphelo, the Eastern Cape health spokesperson, says an immunisation campaign is planned for next week.

[Judith Anne]

Typhoid can resemble the viral hemorrhagic fevers, for example, Ebola and Marburg.

This is really far away from Angola, on the west coast of Africa, but I thought it was curious, when I read stomach aches and nose bleeding...not all cases of typhoid have bleeding.

Here's a paragraph from another website:

"Differential Diagnosis: In early stages, Ebola or Marburg HFs may resemble influenza, malaria, typhoid fever, arboviral fevers (various forms of encephalitis, dengue fever, and other viral hemorrhagic fevers) (McCormick, 1991)."

http://www3.baylor.edu/~Charles_Kemp/ebola.htm

[Born Conservative]

Typhoid=salmonella?

[Judith Anne]

As I recall, last fall the first cases of Marburg in Angola were over 90% children. Dr. Bonino, the Italian physician, first notified health authorities in Angola in October or November 2004 that she thought there was a possible hemorrhagic fever outbreak, after an unusual number of children began dying. I wonder if typhoid was the first diagnosis then (or malaria, which can also have a bleeding diathesis).

Only 14 of those 95 children's deaths were later confirmed to have been Marburg...I wonder what the true number was...those cases were diagnosed from samples collected from the deceased children and sent to the CDC in Atlanta.

I just thought this was interesting...In Angola, it took MONTHS to find out that Marburg was present...

[EternalHope]

Does typhoid come on fast, with a large number of people needing to be rushed to get treatment all at once?

Three admitted to the hospital, the other 12 children treated and released? With typhoid?

From the web:

"Typhoid fever is treated with antibiotics. A person will usually recover in 2-3 days with prompt antibiotic treatment. People that do not get prompt medical treatment may continue to have a fever for weeks or months, and as many as 20% may die from complications of the infection."

Also, the symptoms I found at the first few sites I checked did not include bleeding from the nose, and they indicated widely varying incubation time. So how did lots of kids become symptomatic at once?

Hmmm...

[Judith Anne]

Differential Diagnosis: In early stages, Ebola or Marburg HFs may resemble influenza, malaria, typhoid fever, arboviral fevers (various forms of encephalitis, dengue fever, and other viral hemorrhagic fevers) (McCormick, 1991).

[armymarinemom]

It is interesting. Far away is a relative term these days. Makes one worry about traveling health care workers.

[Mears]

With about 1000-1500 miles between the 2 locations I certainly hope this new outbreak is not Marburg.

What a frightening thought.

[null and void]

Nothing to see here. move along...™

[Judith Anne]

Yep. I said "hmmmmm" too. Of course, it may be typhoid. But most typhoid cases do NOT involve hemorrhage.

[Judith Anne]

Makes one worry about traveling health care workers.

Yes, exactly.

[Judith Anne]

In children, typhoid CAN have a sudden onset. Usually it is more gradual. But it CAN be sudden.

[blam]

Following/watching. (Bump)

[EternalHope]

In children, typhoid CAN have a sudden onset. Usually it is more gradual. But it CAN be sudden.

Sudden onset, in lots of them at once?

[Judith Anne]

Yes, correct, typhoid is one of the salmonellas, s. typhi.

Congratulations on knowing that--I had to look it up; when I did, I found mention of intestinal bleeding in some severe cases, but NO mention of nosebleed period.

Here's some information from the web:

There are two phases of classic typhoid fever:

1st phase: the patient's temperature rises gradually to 40ºC and the general condition becomes very poor with bouts of sweating, no appetite, coughing and headache. Constipation and skin symptoms may be the clearest symptoms. Children often vomit and have diarrhoea. The first phase lasts a week and towards the end the patient shows increasing listlessness and clouding of consciousness.

2nd phase: in the second to third weeks of the disease, symptoms of intestinal infection are manifested and the fever remains very high and the pulse becomes weak and rapid. In the third week the constipation is replaced by severe pea-soup-like diarrhoea. The faeces may also contain blood. It is not until the fourth or fifth week that the fever drops and the general condition slowly improves.

Complications

Intestinal perforation or profuse bleeding from the intestinal mucosa may occur if typhoid fever is left untreated.

I found this at:

http://www.netdoctor.co.uk/travel/diseases/typhoid.htm

[Judith Anne]

Sudden onset, in lots of them at once?

Good question. But when you're looking at a sick kid, you think horses not zebras...of course, nosebleeds aren't one of the symptoms I found, for typhoid, so maybe they SHOULD have thought zebras, not horses.

We have no way to find out what the children really have. I thought the writer of the original article made a fine point, though, when he/she wrote:

Their illness has been diagnosed as typhoid.

We're not likely to ever know. If Marburg breaks out, we may not have any more information for months. This is just something to tuck in the back of our minds...

[xVIer]

Thank you...I believe you're right, if this is marburg we won't know for a long time. I think articles like this are valuable , we may see a pattern emerge...maybe it is ...maybe it's not...good to know! Thanks again.
mrs x

[Judith Anne]

You're welcome.

[Born Conservative]

Years ago, I took care of a child with typhoid fever (in the hospital). He had high fevers, bloody diarrhea, and chills; pretty sick. He did get antibiotics, but, IIRC, they were given to get rid of the bacteria, to prevent him from being a carrier, and not necessarily to treat the infection. I guess that resolves on it's own. It was assumed he got the salmonella from his pet turtle. There is a vaccine available, so it's best to get the vaccine when travelling to endemic areas (India, Asia, South America, Europe, Carribean, Central America; it's not on the recommended list for the Middle East and Canada).

As for the nosebleeds, maybe the kids' blood counts were low (platelets) from the infection, and they were having spontaneous nosebleeds (just a guess).

[Judith Anne]

Interesting...just seems kind of coincidental that all 15 got nosebleeds.

Good points.

[goldstategop]

Let me guess: illegal alien kids? There's another reason why the Open Borders' Lobby view any one who wants to come should be allowed to isn't good for our country: illegal aliens bring in communicable diseases with them that either go untreated or get treated at taxpayer expense. Like typhoid. But what about Marburg or Ebola? Imagine a terrorist illegally entering the U.S due to the laxity of our immigration policies, who's been infected with a bioweapons. Millions of Americans could be dead within days. Not that the OBL proponents and the politicians of both parties linked with it care. As far as they're concerned, lower product prices and more ethnic group (i.e, Hispandering) votes are worth the downside of illegal aliens economically displacing Americans as well as infecting them with deadly diseases we don't see in this country.

(Denny Crane: "Sometimes you can only look for answers from God and failing that... and Fox News".)