Fatal SKIN disease caused by Aflatoxin

Fatal SKIN disease caused by Aflatoxin

VietNamNet Bridge – The Ministry of Health has concluded that the mysterious disease which has affected 215 people in central Quang Ngai Province's Ba To District was caused by Aflatoxin, a toxin produced by fungus in mouldy rice.

Tests showed that 100 per cent of those affected in Ba To and Son Ha District ate mouldy rice which was contaminated with the toxin nine times higher than the safe level.— Photo 24h.com.vn

Last Thursday, at Lang Reu Village in the district's Ba Dien where the disease started to rise, investigators took samples of rice from families of those infected.

Deputy head of the ministry's Preventive Medicine Department, Phan Trong Lan, said tests showed that 100 per cent of those affected in Ba To and Son Ha District ate mouldy rice which was contaminated with the toxin nine times higher than the safe level.

Lan urged residents not to eat mouldy rice or rice stored for a long time.

The toxic agent causes liver cancer in men, he said.

Ministry investigators also surveyed the residents' rice-eating habits.

Deputy head of the Pasteur Nha Trang Institute, Vien Quang Mai, said local awareness of health safety and personal hygiene has been raised.

Residents dried grain before use but storing it in their timber barns did not preserve the rice's quality due to moisture.

At a meeting on Saturday between leaders of the provincial People's Committee and the two districts and relevant authorities to discuss preventative measures, deputy chairman of the committee, Le Quang Thich, said the situation had become more complicated.

Another 11 cases had been reported in the past 20 days, he said.

Therefore, to prevent the disease spreading, provincial agencies must strengthen supervision to prevent another fatality.

Agricultural experts were asked to give advice processing and storing rice to local people, Thich said.

Residents dried grain before use but storing it in their timber barns did not preserve the rice's quality due to moisture.—Photo 24h.com.vn

Residents must also be encouraged to have health check-ups as soon as symptoms are detected, so that they can have timely treatment, he added.

Clean water must be supplied to people in affected areas, local leaders requested, adding that more research should be conducted so other causes of the disease are not overlooked.

Health centres in Ba To and Ba Dien must be equipped with the necessary equipment serving for check-ups and treatment, they said.

They also called for liver tonic and restoratives to be provided to residents.

The disease, which causes skin to peel off feet and palms, was first discovered in the province two years ago.

Son Ha is the third locality hit by the disease, with two affected people reported on February 15.
Twenty-three have died of the disease.

Source: VNS

Strange skin disease is chronic intoxication June 29, 2012 LookAtVietnam – The Ministry of Health and the World Health Organization (WHO) on June 28 made a joint-statement on the bizarre skin disease in Ba To district of the central province of Quang Ngai. According to the Ministry of Health, the strange disease in Quang Ngai is actually a chronic intoxication, which can cause inflammation and wounds in hands, feet and liver. Only people in Ba To district are discovered to suffer from this syndrome. The first patients were reported in Ba To district last April. By June 2012, a total of 216 cases have been recorded, including 12 deaths, in five communes of Ba To district. At present, 18 people are being treated at hospitals in Quang Ngai and neighboring provinces. The Ministry of Health has conducted many surveys in Ba To and until now, it has not found out the reasons causing this strange disease. However, the Ministry has excluded infection as a cause. In addition, many patients were malnourished and many of them ate rice that contained aflatoxins, which is toxic for human. Experts also did not find out heavy metal or agricultural chemicals in samples collected from patients or environment in Ba To. The WHO and the US Center for Disease Control (USCDC) have closely combined with the Ministry of Health to research this disease. In early June, two WHO and USCDC’s experts came to Vietnam to work with the Preventive Medicine Agency. “We support the Ministry of Health’s measures to control the disease in Quang Nam and we believe that the Ministry is going in the right direction. As we do not know about the source of this syndrome, seeking for the cause may be longer than schedule and would be a challenge,” said Dr. Takeshi Kasai, chief WHO representative in Vietnam.

Strange skin disease is chronic intoxication

June 29, 2012

LookAtVietnam – The Ministry of Health and the World Health Organization (WHO) on June 28 made a joint-statement on the bizarre skin disease in Ba To district of the central province of Quang Ngai.

According to the Ministry of Health, the strange disease in Quang Ngai is actually a chronic intoxication, which can cause inflammation and wounds in hands, feet and liver. Only people in Ba To district are discovered to suffer from this syndrome.
The first patients were reported in Ba To district last April. By June 2012, a total of 216 cases have been recorded, including 12 deaths, in five communes of Ba To district. At present, 18 people are being treated at hospitals in Quang Ngai and neighboring provinces.
The Ministry of Health has conducted many surveys in Ba To and until now, it has not found out the reasons causing this strange disease. However, the Ministry has excluded infection as a cause.
In addition, many patients were malnourished and many of them ate rice that contained aflatoxins, which is toxic for human. Experts also did not find out heavy metal or agricultural chemicals in samples collected from patients or environment in Ba To.
The WHO and the US Center for Disease Control (USCDC) have closely combined with the Ministry of Health to research this disease.
“We support the Ministry of Health’s measures to control the disease in Quang Nam and we believe that the Ministry is going in the right direction. As we do not know about the source of this syndrome, seeking for the cause may be longer than schedule and would be a challenge,” said Dr. Takeshi Kasai, chief WHO representative in Vietnam.
N.Anh

Dubious herbs confiscated in district plagued by fatal skin disease | Look At Vietnam

Dubious herbs confiscated in district plagued by fatal skin disease 

June 26, 2012

Health officials in central Vietnam have confiscated a large amount of herbs of unclear origins being used by people who live in an area that has been plagued by a mysterious skin condition that killed 23 people so far.
Officials from Quang Ngai Province’s Health Department have sent samples of the medicine found in Ba Dien Commune of Ba To District to the Health Ministry for testing.
Locals have been asked to stop using the medicine, which is in the form of a powder, ostensibly of roots, branches and dry leaves. Chinese labels found on the package say the medicine is for treating liver cancer.
The medicine is not in the list of products allowed by Vietnam’s Health Ministry.
It’s not clear how long the medicine has been used in the commune.
Le Huy, chief of staff of Quang Ngai Health Department, on Saturday said many people have visited the district with medicines after news about the disease broke out.
The disease, which causes thickened skin and blisters on hands and feet, and leads to multiple organ failures, has killed 23 people since April last year. The latest deaths were recorded month.
Huy said the gesture to give free medicines was “meaningful” but it could be “dangerous” as most do not have clear origins or a permit from the Ministry of Health, according to a Nhan Dan report.

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The Ministry early this month has consulted experts from the World Health Organization and the US Centers for Disease Control and Prevention to identify the disease and its causes.

Military chemicals, a prime suspect in the beginning, is yet to be found in the district. But elevated amounts of arsenic was found in a hair sample of a 9-year-old boy who died in May.
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By Hien Cu, Thanh Nien News 

HCMC treats first skin victim as more infected in central Vietnam | Look At Vietnam

HCMC treats first skin victim as more infected in central Vietnam 

May 26, 2012

A boy is examined for a strange skin disease that has killed dozens in the central province of Quang Ngai since last April.

A child afflicted by the skin condition that has plagued an ethnic minority community in central Vietnam for more than a year was admitted to Ho Chi Minh City’s Children’s Hosptial No. 1 in critical condition on Saturday.
Doctors at a hospital in Binh Dinh Province had failed to stabilize the deteriorating condition of the 9-year-old patient Pham Van Thach of Ba To District in Quang Ngai Province, north of Binh Dinh. 
Thach was admitted to Children’s Hospital 1 suffering from severe liver damage and a blood infection, according to doctors at the city hospital.
Health experts say the condition begins with blisters on hands and feet and can quickly lead to organ failure.
On Tuesday, Doctor Le Bich Lien, deputy director of the hospital, said the cause of the condition remains unknown and physicians are treating the child through a process known as "blood filtering."
Three other members of T.’s family are also suffering from the disease, doctors said.
Health minister Nguyen Thi Kim Tien has ordered hospitals to provide free treatment to patients suffering from the condition. Tien asked the hospitals to cover 5 percent of the treatment cost, and leave the rest for government health insurance.
The first cases of the symptoms were reported last April. The condition died out by the beginning of 2012, but flared up again in late March.
After a year of dispatching multiple teams of researchers and epidemiologists to the two afflicted districts, health officials remain baffled as to the cause of the illness, which continues to spread.

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Meanwhile, the World Health Organization maintains that it has not been asked to assist Vietnam’s healthcare officials in determining the cause.
Dang Thi Phuong, the medical center director of the plagued Ba To District, said the number of recorded cases rose to 209 this past week from 200 on May 8.
A tally conducted by Tuoi Tre showed that the number of cases closer to 240–including 21 deaths as of May 7.
The figure is only expected to grow, officials say, since blood tests show that over 28 percent of people in the district, which is home to mostly H’re ethnic people, are exhibiting abnormally high levels of liver enzymes–which usually precedes the other symptoms.
Health officials had previously suspected that the illness had been brought on by the practice of deliberately eating fungus-covered rice–a traditional food for the tribe. But the fungus has been ruled out as a cause–though health officials have imported clean rice as a better alternative.
Health officials have also issued new sleeping mats to residents of the affected area and incinerated their old bedding.
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Thanh Nien News 

Vietnamese doctor asked to cure foreigners of rare skin condition | Look At Vietnam

Vietnamese doctor asked to cure foreigners of rare skin condition 

May 15, 2012

Gabriel Bontas, a Romanian boy with Epidermolysis bullosa. His father has sent a letter to Vietnamese National Hospital of Pediatricts, expressing a desire to send the boy here for treatment.

Two foreigners have asked a Vietnamese doctor to treat their children for a congenital skin disease called Epidermolysis Bullosa (EB).

Dr. Nguyen Thanh Liem, director of the Hanoi-based National Hospital of Pediatrics, told online newspaper VnExpress on Monday (May 7) that a Brazilian family had contacted the hospital seeking treatment for their three-year-old child.

On May 1, a Rumanian named Gabriel Bontas also emailed the hospital seeking help for his 10-month-old son, Liem said.

Liem achieved some acclaim last September, after completing his first successful bone marrow transplant to cure a child suffering from EB.

“We are considering their requests and consulting the Health Ministry as well,” Liem told Vietweek, two days after performing his third surgery.

Liem said he had emailed the two families, asking them to seek bone marrow stem cells for the transplant.

“The best option is to take the bone marrow stem cells from the patients’ siblings because the compatibility level can be up to 100 percent,” he said. “Bone marrow stem cells taken from parents peak at 50 percent compatibility.”

The National Hospital of Pediatrics has conducted heart surgery on Lao children and provided treatment to expatriate children living in Vietnam. However, this is the first time hospital staff have received treatment requests from outside the country.

According to Liem, treatment costs around US$40,000 in Vietnam, compared to millions of dollars in the US. The disease ranges from mild to lethal, but always involves a lot of pain as the skin becomes extremely fragile.

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Children suffering from EB lack type VII collagen, a protein that binds the top layer of skin to the next. Friction — from a hug to a fall — can cause tennis ball sized blisters, which often leave behind scabs and scars.

In September 2011, Liem led a team of doctors in performing a successful marrow transplant on four year-old Nguyen Viet Anh using cells taken from his 10 year-old sister.

Forty days after the transplant, Anh’s mother said 80 percent of Anh’s existing blisters were gone. The fresh ones were smaller and healed faster, she added.

Liem said a biopsy revealed the presence of type VII collagen in Anh’s skin, indicating that the child no longer has the disease.

Early this year, Liem performed his second transplant on Le Anh Tu, 3, using marrow taken from his five-year-old sister.

Tu suffered from severe blistering as well as ulceration in his eyes, which could have led to blindness without early treatment.

Tu has reportedly recovered well.

On Tuesday, a third transplant was conducted at the National Hospital of Pediatrics—this time on a 17-year-old patient.

By Nam Son, Thanh Nien News 

Cost in Vietnam $40,000 in USA near 1 million

First foreigner patient wants rare skin disease treatment in Viet Nam

HA NOI – Viet Nam's National Hospital of Paediatrics in Ha Noi has received its first request from a foreigner to treat epidermolysis bullosa (EB), a rare genetic skin disease, according to hospital director Nguyen Thanh Liem.
The doctor said a Romanian man had asked the hospital to treat his 10-month-old son, who suffers from the inherited connective tissue disorder caused by problems with the chemicals that hold layers of skin together.
EB is a genetic disease with an incidence of 1/50,000 in the world. Even with the most intensive care, EB patients usually die before the age of 40 and their quality of life is very poor.
"The disease could absolutely be treated in Viet Nam using stem cell transplant technology," Liem said.
Nguyen Viet Anh, a four-year-old boy from the northern province of Vinh Phuc, was successfully treated for EB at the hospital last September, when he underwent a bone marrow transplant that cured his lethal skin blisters.
Another bone marrow transplant was performed on a second EB patient two months ago, and he has been recovering well.
Viet Nam is the second country in the world to successfully use a stem cell transplant to treat EB, after the method was officially introduced in the US in 2008.
Liem said that the hospital would need to ask for permission from the Health Ministry before it could make the decision about the Romanian boy.
According to the director, the cost for treating each EB patient is very high in the US - it can be up to a million dollars - but in Viet Nam, it's just about US$40,000.
"But the quality of treatment in both countries is equal," Liem said.
If the Romanian boy's case were successful, many other foreigners would come here for EB treatment, he added.
The hospital will soon publish the results of its first stem cell therapy EB treatment in an international medical journal.
"Publication will help attract a great deal of attention from around the world," Liem said. – VNS

Vietnam military experts look for toxin in skin disease area | Look At Vietnam

Vietnam military experts look for toxin in skin disease area 

April 29, 2012

Experts from Vietnam’s Military Chemical Environment Institute have visited the central province of Quang Ngai to look for some chemicals suspected of causing a skin condition that has killed 19 people over the past year.
A report on Saigon Giai Phong Sunday said during their visit Friday and Saturday, the experts met with Pham Van Mai, head of a village in Ba To District, to question him about a “strange” substance he found five years ago and to see the place where he buried it.
The scientists also checked places where American soldiers were stationed during the Vietnam War to see if there were any toxins left there, and took soil and water samples for tests.
Since it broke out in the province’s Ba To and Minh Long Districts last April, the disease, which was earlier suspected to be caused by plant protection chemicals, has affected 171 people.
It causes ulcers on hands and feet that look like severe burns and induce stiffness in the limbs. In critical cases, it can lead to liver and lung failure.
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Thanh Nien News 

BBC News - Vietnam seeks foreign help to beat mystery skin disease

Vietnam seeks foreign help to beat mystery skin disease

Medics say early intervention is key to treat the mystery infection successfully

Continue reading the main story

Related Stories

• Vietnam country profile

Vietnam says it will ask for international help to find out what is causing a skin infection that has already killed 19 people.

More than 170 people in the country's central province of Quang Ngai have reported symptoms.
The disease begins with a rash on the hands and feet: it can progress to liver problems and multiple organ failure.
Vietnamese health ministry tests have failed to pinpoint the cause.
"This disease is challenging as we have not identified the root causes. If it is just an external skin disease why is it causing deaths and failures inside internal organs?" Deputy Health Minister Thanh Long said on Friday.
Rituals and prayers The mystery illness was first reported between April and December 2011 and then subsided, but broke out again last month.
Health workers say it responds well to early intervention but is difficult to treat once established.
Frightened residents of Reu village in an impoverished, mountainous part of Quang Ngai, have laid branches across the path to the houses of infected people to try to isolate the outbreak.
"We have to block the entrances here to stop patients from getting out and spreading the disease," one resident, Pham Van Tray, told Vietnamese TV.
"Since we don't know what caused the disease, we will have to rely on our rituals and prayers."
Vietnamese media quoted officials in Quang Ngai as saying that the condition might be caused by chemicals.
But the health ministry said it had yet to draw conclusions from its own tests: it hoped to have preliminary results within 10 days.
Dozens of people are being treated at a leprosy hospital in the neighbouring province of Binh Dinh.
The government has said it will ask the World Health Organization and the US Centers for Disease Control and Prevention to join its investigation.
Those organisations have yet to comment on the disease: a WHO spokesman told the Associated Press news agency it had not yet received a request from Vietnam for help.