Mini Outbreak

As we sat with the team this morning we learned that several people had died (not confirmed) in the past several days at Misungwi District Hospital from an illness of diarrhea and vomiting and that there were more in the hospital and outside the hospital that were sick. Clearly my interest was peaked! As the day went forward I actually forgot about this fact until I was asked, as we were standing with the Medical Officer at Misungwi District Hospital, if I wanted to go see the ill patients? Of course – absolutely!!! My poor students – not sure they were interested in venturing into the sick wards hung out outside while several hospital staff appeared and came into the same ward filled with really sick individuals.

Those of you who know me know that what I am about to share has touched me deeply and I can only pray for those lives already lost and I am afraid for those that linger on the edge. How many sick? I am not sure – I think a few have passed and I saw 6 patients in the ward – sometimes 2 to a bed – fortunately with fluid replacement and mosquito nets (much better off than the outbreak I worked on several years ago in Kenya). Clearly these individuals are not well. The Medical Officer has already sent samples to the Regional Hospital and sent a team to investigate the area that these individuals live (they are not related but they do live near each other). As I was talking with the patients and the hospital staff I talked about putting the information about each patient together in a way to help understand why and when they got sick. The idea of a line list and an epi curve are foreign concepts but …. as I started asking about the first person to show up at the hospital the story began to take shape. The first person an adult female came to the Hospital after passing though a Dispensary (a lower level health facility) – from what I could gather she got sick initially over a week ago – the date of onset of symptoms is not something being collected (that I could ascertain). I spoke with another patient and asked him what he thought made him sick – unclean water from a pond maybe? Definitely a possibility – so many pathogens and huge opportunities for serious illness! So – the staff did not have gloves (although I do believe that there are gloves in the hospital) and while the ward was clean and they had set up an area at the door to wash one’s hands it really brings to light the challenge that infectious diseases bring here! So far no staff have become ill which is a good sign! We will be back at Misungwi District Hospital tomorrow and I will speak with the Medical Officer again – I will take a basic line list form and an epi curve outline. Maybe I can even get a chance to speak with the team that went to investigate!