'Body Rot' Disease Hits Uganda While Cholera Outbreak Hits Haiti

Horror Film-esque 'Body Rot' Disease Hits Uganda

October 22, 2010

Associated Press – A disease whose progression and symptoms seem straight out of a horror movie but which can be treated has killed at least 20 Ugandans and sickened more than 20,000 in just two months.

Jiggers, small insects which look like fleas, are the culprits in the epidemic which causes parts of the body to rot. They often enter through the feet. Once inside a person's body, they suck the blood, grow and breed, multiplying by the hundreds. Affected body parts — buttocks, lips, even eyelids — rot away.

James Kakooza, Uganda's minister of state for primary health care, said jiggers can easily kill young children by sucking their blood and can cause early deaths in grown-ups who have other diseases. Most of those infected, especially the elderly, cannot walk or work.

"It is an epidemic which we are fighting against and I am sure over time we will eradicate the jiggers," Kakooza said.

The insects breed in dirty, dusty places. The medical name for the parasitic disease is tungiasis, which is caused by the female sand fly burrowing into the skin. It exists in parts of Latin America and the Caribbean, besides sub-Saharan Africa.

Kakooza said health workers are telling residents of the 12 affected districts in Uganda that jiggers thrive amid poor hygienic conditions.

"We are also telling them to use medicated soap. They can apply petrol and paraffin in places infested by jiggers and they die," Kakooza said.

The most affected part of Uganda is the Busoga region in the east, 150 kilometers (90 miles) from Kampala, Uganda's capital. Some cases have been reported in the central region, less that 70 kilometers (43 miles) from the city, which has led to fears the whole country might be affected.

Some think jiggers — whose scientific name is Tunga penetrans — were brought to Uganda and other east African countries by migrants from India who constructed the railway from Mombasa, the Kenyan seaport, to Kampala in the 19th century. Others say they came to Africa aboard a British ship that sailed from Brazil.

Over time locals were affected. One observer near the turn of the century called jiggers "the most fearful calamity that has ever afflicted the East African peoples" after seeing affected people on the slopes of Mount Kilimanjaro crawling around on all fours and groaning with pain. Colonial governments brought it under control but jiggers have since re-emerged where hygiene is poor.

Some affected people in rural Uganda, like Dakaba Kaala, think they are bewitched and simply wait to die instead of trying to remove the insects.

"For the last three years I have been suffering from jiggers," the 60-year-old said. "I lost two children killed by jiggers.They were sent to me by my neighbor who wants to grab my piece of land."

"It is common to find graves of whole families wiped away by jiggers," said Simon Wanjala, a ministry of health official in eastern Uganda.

Uganda's government has allocated 1 million US dollars to fight the epidemic. Treatment involves removal of the insect or topical medication.

A study a few years ago in Nigeria concluded that raising pigs, having sand or clay floors inside the home and having a resting place outside the house increased the risk of getting jiggers. Wearing closed shoes and using insecticides indoors helps prevent infestations.

Cholera Outbreak Creeps Closer to Haiti's Capital

October 23, 2010

Associated Press – A spreading cholera outbreak in rural Haiti threatened to outpace aid groups as they stepped up efforts Saturday hoping to keep the disease from reaching the squalid camps of earthquake survivors in Port-au-Prince.

Health officials said at least 208 people had died and 2,674 others were infected in an outbreak mostly centered in the Artibonite region north of the capital.

But the number of cases in towns near Port-au-Prince were rising, and officials worried the next target will be hundreds of thousands of Haitians left homeless by January's devastating quake and now living in camps across the capital.

"If the epidemic makes its way to Port-au-Prince, where children and families are living in unsanitary, overcrowded camps, the results could be disastrous," said Dr. Estrella Serrano, World Vision's emergency response health and nutrition manager.

Reports trickled in of patients seeking treatment in clinics closer to Port-au-Prince because the St. Nicholas hospital in the seaside city of St. Marc is overflowing, said Margaret Aguirre, an International Medical Corps spokeswoman.

At least five people who traveled from the Artibonite region to Port-au-Prince on Saturday tested positive for cholera once they arrived in the capital, where they are being treated, she said. Aguirre said they are not considered the first cholera cases of Port-au-Prince because officials believe the people contracted the disease in Artibonite...

Experts also were investigating possible cases in Croix-des-Bouquet, a suburb of the capital that could act as a transfer point of the disease because it has a widely used bus station, said Paul Namphy with Haiti's national water agency.

"This is a very mobile country," he said. "It can spread like wildfire."

Cholera is a waterborne bacterial infection, and the water agency was nearly doubling the amount of chlorine in drinking water.

Aid groups are providing soap and water purification tablets and educating people in Port-au-Prince about the importance of washing hands.

The groups also began training more staff about cholera and where to direct people with symptoms. Cholera had not been seen in Haiti for decades, and many people don't know about the disease, which causes severe diarrhea and vomiting that can lead to dehydration and death within hours.

Red Cross spokeswoman Julie Sell said teams would begin teaching people in refugee camps how to prevent cholera starting Monday — five days after the outbreak.

"We are taking this very seriously, but we also want to make sure that every one of our people have the information they need," she said.

The International Organization for Migration also was training staff before sending 64 workers out to camps Monday, spokeswoman Sabina Carlson said. But she said the group had begun sending text messages about how cholera spreads and how it can be prevented.

"It's a very new disease in Haiti," she said. "We need to make sure that we've got all the information in order."

Partners in Health also said it would give its health workers additional training Monday before they fan out in Port-au-Prince.

But humanitarian groups can do only so much, said Melody Munz, environmental health coordinator for the International Rescue Committee.

"We can provide soap, and we can provide chlorine. The thing is to get the community to participate," she said.

Mark Schuller, a human rights worker for International Action Ties, said he and others had been meeting with people at camps since Friday and were worried that many had not received information about the outbreak.

"Everyone I'm talking to is saying they haven't heard from a single NGO or government official," he said. "A lot of people don't even know that there's a cholera epidemic."