Mystery hemorrhagic fever syndrome hits Venezuela

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CARACAS, Venezuela, September 29, 2014, AMG 
– An outbreak of a mysterious hemorrhagic fever syndrome in the Venezuelan state of Aragua and the country’s capital Caracas has left ten people dead in the last three weeks. Reports indicate that nine people have so far succumbed to the disease in the northern state and a tenth person has died in the capital.
It is unclear whether the cause of the syndrome is viral or bacterial – a  distinction with implications for treatment – although autopsies have indicated that those who died were suffering from other complications, such as Chikungunya.

Venezuelan hemorrhagic fever (VHF) is endemic in the two states of Portuguesa and Barinas, but transmission from person-to-person is uncommon.

While samples have been sent to the National Institute of Health, the results have not yet been released publically and there is no suggestion from health officials that VHF is behind this particular outbreak.

This is an emergency

One doctor, who wishes to remain anonymous, attended a meeting last week at the headquarters of the Medical Association of Aragua state to discuss what action should be taken. “This is an emergency,” he said, “we do not know what we are facing and we need to know the causes in order to provide appropriate treatment, to prevent the collapse of the patient’s organs, and also to set up epidemiological surveillance.”

Similar to Ebola, this syndrome causes patients to experience high fever, skin rashes and bleeding. It has been described as an aggressive disease that leads to a fatal deterioration of health within 72 hours.

Campaign of rumours and terrorism

Doctors have urged government authorities to declare a state of emergency in Aragua state; however they have received resistance from a surprising source.

The state Governor, Tareck El Aissami, has not only denied medical reports of the disease, but has accused the president of the Aragua state Medical Association, Ángel Sarmiento, of “creating anxiety.” He went on to tweet to his 778,000 followers that he was not surprised that Sarmiento, a member of opposing political party Acción Democrática, was “heading this campaign of rumours and terrorism.”

Sarmiento was immediately defended by his colleague and President of the Venezuelan Medical Federation, Douglas León Natera, who urged the government to stop government policy from meddling with the health policy.

 

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AMG map of Venezuela showing sites of the current hemorrhagic fever outbreak (Caracas and Aragua) and the Venezuelan hemorrhagic fever endemic areas (Portuguesa and Barinas).

The shocking outburst of Governor El Aissami is as concerning as the emergence of the syndrome itself. It is all the more concerning in light of this year’s tragic Ebola epidemic and the ‘lethally inadequate’ response that has followed.

The lack of government intervention and commitment to tackling the largest Ebola outbreak the world has ever seen has been universally condemned by world leaders and NGOs alike. In Aragua, it appears that a government’s speedy, albeit ill-informed, response may create as significant set of obstacles for health professionals attempting to protect the public.

The lack of a unified and considered response may have fanned the flames of an already alarming situation.

Wait and see

Anticipated laboratory results may hold the key to discovering the pathogen to blame for this latest public health emergency, but they will not be responsible for the quality and strength of the response. Instead, this will be dictated by the speed at which the outbreak is acknowledged by politicians and health officials, and the informed multi-agency response that follows.

If the ten people who have lost their lives to this mysterious illness are isolated cases, there may be accusations of an overreaction. If they are not, then a swift and unified action plan may save many lives – a lesson being learnt all too keenly in three West African countries across the ocean.

Photo credit: Marino González

Deborah Almonddeborah almond · AMG Health Editor

Deborah Almond is AMG’s Health Editor and an infectious disease specialist, with experience in sexual and reproductive health and malaria in pregnancy | Twitter · LinkedIn · E-mail

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