Identifier
Created
Classification
Origin
08LUSAKA982
2008-10-03 09:52:00
CONFIDENTIAL
Embassy Lusaka
Cable title:
TWO DEATHS BY UNKNOWN DISEASE IN ZAMBIA; EAC
how-toO 030952Z OCT 08 FM AMEMBASSY LUSAKA TO HQ USAFRICOM STUTTGART GE IMMEDIATE SECSTATE WASHDC IMMEDIATE 6333 CDC ATLANTA GA IMMEDIATE INFO AMEMBASSY PRETORIA PRIORITY CIA WASHINGTON DC PRIORITY
C O N F I D E N T I A L LUSAKA 000982
STATE FOR S/S-CMS, MED, AF/S, AND CA/OCS
PRETORIA FOR RMO/MED
SIPDIS
E.O. 12958: DECL: 10/03/2009
TAGS: ESTH ASEC AMED ZA
SUBJECT: TWO DEATHS BY UNKNOWN DISEASE IN ZAMBIA; EAC
MEETING HELD
Classified By: Charge d'affaires a.i., Michael Koplovsky, reasons 1.4,
b/d.
C O N F I D E N T I A L LUSAKA 000982
STATE FOR S/S-CMS, MED, AF/S, AND CA/OCS
PRETORIA FOR RMO/MED
SIPDIS
E.O. 12958: DECL: 10/03/2009
TAGS: ESTH ASEC AMED ZA
SUBJECT: TWO DEATHS BY UNKNOWN DISEASE IN ZAMBIA; EAC
MEETING HELD
Classified By: Charge d'affaires a.i., Michael Koplovsky, reasons 1.4,
b/d.
1. (C) Summary: Embassy Lusaka CDC office has learned that
two cases of "suspected" hemorrhagic fever are being
investigated in Zambia after two people died subsequent to
being med-evaced to South Africa. We understand a South
African nurse at Morningside Hospital who treated the second
Zambian case has come down with the same symptoms. Four
tourists with the same safari company from which the first
case originated were brought to Lusaka for testing, but two
were confirmed NOT to have the same illness and the other two
do not appear to be following up. EAC is attempting to
gather further information before deciding whether to issue a
warden message. End Summary.
2. (C) The first case of suspected hemorrhagic fever from
Zambia was South African woman employed by Wilderness Safaris
company in Lusaka. She fell ill on Sept. 10 with fever,
headache, diarrhea, sore throat, and later, rash. She was
med-evaced to South Africa by the local air ambulance service
Specialty Emergency Services (SES),and she died there on
Sept. 14. The Zambian paramedic who accompanied her during
the med-evac fell ill on Sept. 25 (same symptoms) and died in
RSA on Oct. 1. Death was due to organ failure/internal
bleeding. We understand that there is a third confirmed case
in an ICU nurse in South Africa who treated the paramedic.
The first case had been treated at three Lusaka clinics
without success before resorting to med-evac, including Care
for Business (used by Embassy),Corp Med, and a Korean clinic
adjacent to an AmEmbassy housing complex.
3. (C) A hemorrhagic fever is suspected in the two initial
cases, but serum samples tested by a respected South African
lab with a history of good cooperation with CDC and WHO rule
out Ebola, Marburg, and Crimean-Congo. The first victim
apparently lived in a rural area around Lusaka, with horses
and other animals on her property. Physicians brought in by
Wilderness Safaris suspect a possible tick-borne disease.
Only those who had intimate contact with the patients have
come down with similar symptoms, so person-to-person
transmission may be via bodily fluids -- vomit, saliva,
blood, etc. The first two cases indicate an incubation
period from exposure to death of about three weeks, and from
presentation of symptoms to death of about one week. Corp
Med reports that four other Wildlife Safari customers from
their bushcamp on the Lower Zambezi fell ill and have come to
Lusaka for assessment. Corp Med tells us they have tested
the first two, and they do NOT have the same illness. The
other two have not yet appeared for care.
4. (C) Embassy EAC met Oct. 3 to assess the situation. The
group assessed the risk to AmCits, Embassy personnel and EFMs
as "low" given the need for intimate contact for
transmission, but remained concerned. MGT/Health has been in
touch with RMO Pretoria; CDC is in touch its HQ in Atlanta,
RSA officials, a local doctor, the Wilderness Safari doctors,
and the Zambian Ministry of Health. Despite a rumor that
Care for Business was closed to new patients, we have
confirmed that it is open. We understand South African law
prohibits med-evacs of suspected hemorrhagic fever, and we
are attempting to confirm whether medevacs of other
emergencies would be allowed from Zambia. EAC will review
tripwires for authorized departure in public health
situations like this one.
5. (C) Given the lack of available information at this time
(e.g. whether this is really hemorrhagic fever, from where in
Zambia the other yet-to-be-tested patients are coming, and
whether Lusaka has viable medevac options for other possible
emergencies) EAC has decided not to issue a warden message at
this time (as of 1100 local) as that could fuel unnecessary
panic. EAC will review the situation and new information at
1200 local (0600 EDT) and report via cable.
KOPLOVSKY
STATE FOR S/S-CMS, MED, AF/S, AND CA/OCS
PRETORIA FOR RMO/MED
SIPDIS
E.O. 12958: DECL: 10/03/2009
TAGS: ESTH ASEC AMED ZA
SUBJECT: TWO DEATHS BY UNKNOWN DISEASE IN ZAMBIA; EAC
MEETING HELD
Classified By: Charge d'affaires a.i., Michael Koplovsky, reasons 1.4,
b/d.
1. (C) Summary: Embassy Lusaka CDC office has learned that
two cases of "suspected" hemorrhagic fever are being
investigated in Zambia after two people died subsequent to
being med-evaced to South Africa. We understand a South
African nurse at Morningside Hospital who treated the second
Zambian case has come down with the same symptoms. Four
tourists with the same safari company from which the first
case originated were brought to Lusaka for testing, but two
were confirmed NOT to have the same illness and the other two
do not appear to be following up. EAC is attempting to
gather further information before deciding whether to issue a
warden message. End Summary.
2. (C) The first case of suspected hemorrhagic fever from
Zambia was South African woman employed by Wilderness Safaris
company in Lusaka. She fell ill on Sept. 10 with fever,
headache, diarrhea, sore throat, and later, rash. She was
med-evaced to South Africa by the local air ambulance service
Specialty Emergency Services (SES),and she died there on
Sept. 14. The Zambian paramedic who accompanied her during
the med-evac fell ill on Sept. 25 (same symptoms) and died in
RSA on Oct. 1. Death was due to organ failure/internal
bleeding. We understand that there is a third confirmed case
in an ICU nurse in South Africa who treated the paramedic.
The first case had been treated at three Lusaka clinics
without success before resorting to med-evac, including Care
for Business (used by Embassy),Corp Med, and a Korean clinic
adjacent to an AmEmbassy housing complex.
3. (C) A hemorrhagic fever is suspected in the two initial
cases, but serum samples tested by a respected South African
lab with a history of good cooperation with CDC and WHO rule
out Ebola, Marburg, and Crimean-Congo. The first victim
apparently lived in a rural area around Lusaka, with horses
and other animals on her property. Physicians brought in by
Wilderness Safaris suspect a possible tick-borne disease.
Only those who had intimate contact with the patients have
come down with similar symptoms, so person-to-person
transmission may be via bodily fluids -- vomit, saliva,
blood, etc. The first two cases indicate an incubation
period from exposure to death of about three weeks, and from
presentation of symptoms to death of about one week. Corp
Med reports that four other Wildlife Safari customers from
their bushcamp on the Lower Zambezi fell ill and have come to
Lusaka for assessment. Corp Med tells us they have tested
the first two, and they do NOT have the same illness. The
other two have not yet appeared for care.
4. (C) Embassy EAC met Oct. 3 to assess the situation. The
group assessed the risk to AmCits, Embassy personnel and EFMs
as "low" given the need for intimate contact for
transmission, but remained concerned. MGT/Health has been in
touch with RMO Pretoria; CDC is in touch its HQ in Atlanta,
RSA officials, a local doctor, the Wilderness Safari doctors,
and the Zambian Ministry of Health. Despite a rumor that
Care for Business was closed to new patients, we have
confirmed that it is open. We understand South African law
prohibits med-evacs of suspected hemorrhagic fever, and we
are attempting to confirm whether medevacs of other
emergencies would be allowed from Zambia. EAC will review
tripwires for authorized departure in public health
situations like this one.
5. (C) Given the lack of available information at this time
(e.g. whether this is really hemorrhagic fever, from where in
Zambia the other yet-to-be-tested patients are coming, and
whether Lusaka has viable medevac options for other possible
emergencies) EAC has decided not to issue a warden message at
this time (as of 1100 local) as that could fuel unnecessary
panic. EAC will review the situation and new information at
1200 local (0600 EDT) and report via cable.
KOPLOVSKY