nodding disease and swine fever (second edition)

Nodding Disease and African Swine Fever

Virus in Uganda

Cause or Coincidence?

Produced by http://noddingdisease.blogspot.com/

1Nodding Disease and African Swine Fever Virus in Uganda: cause or coincidence?

http://noddingdisease.blogspot.com/

In the north of Uganda, thousands of children have fallen ill with a fatal, incurable disease known as nodding disease. Communities are starting to panic and some people are losing hope as the medical community struggles to either find a cause or a cure, as the BBC's Will Ross reports.

http://www.bbc.co.uk/news/world-africa-17589445



New Video says Nodding Disease is "Spreading Quickly"

http://youtu.be/vKdS8OG_EOk


http://youtu.be/vKdS8OG_EOk

Scientific American: Thousands are dying of Nodding Disease each year

Nodding Disease Origins Remain UnexplainedBy Katherine Harmon

A strange illness [Nodding Disease] has been killing thousands of young people each year, and recently it has started claiming even more victims in Africa.

http://blogs.scientificamerican.com/observations/2012/04/12/nodding-disease-origins-remain- unexplained/


Nodding disease takes toll on Kitgum school In Okidi Primary School, the condition has taken its toll as the majority of the learners are infected with the syndrome making learning difficult for them.

“At the moment, we have 215 pupils out of the 365 enrolled in the school. They are struggling to learn with the disease, thwarting their learning processes by continuous nodding and constant seizures even during lesions,” she said, adding that the pupils are evidently disinterested in learning.

Ms Atto said it’s a normal scenario to see every after one hour, a pupil convulsing, keeping the other children in distressful mood thinking that they could be next.By Stephen Komakech, Saturday Monitor

http://www.monitor.co.ug/News/National/-/688334/1334206/-/b07ac5z/-/


A quarter of the children in some Ugandan villages are afflicted with Nodding Disease Ugandans hope Kony spotlight shifts to more urgent problem: ‘Nodding disease’

By Geoffrey York

Ugandan journalists and activists have been trying to gain attention for nodding disease, and this week they finally won a major victory: special clinics were opened in several districts of northern Uganda to offer help to the victims. More than 200 sick children were brought to the clinics on Monday alone. At medical clinics, the children are sometimes treated with anti-convulsants and epilepsy drugs to reduce their symptoms. But no cure has been found. In some villages, up to a quarter of the children are afflicted by it, and a climate of fear is growing, although the disease itself does not appear to be infectious.

http://www.theglobeandmail.com/news/world/worldview/ugandans-hope-kony-spotlight-shifts-to-more-urgent-problem-nodding-disease/article2367713/


Mother: “I watched three of my children nod to death.”By Harriet Anenahttp://www.monitor.co.ug/Magazines/Life/-/689856/1377046/-/item/0/-/i9e4hrz/-/index.html


9 children in one Ugandan family have Nodding Disease

http://youtu.be/wOuDEYd1aZs


http://youtu.be/wOuDEYd1aZs

Uganda is accused of covering up the real number of Nodding Disease deaths

[Ugandan] Govt urged to declare north a disaster zoneWritten by Ahmed Bogere Masembehttp://ssuubifm.net/kay/2012/03/govt-urged-to-declare-north-a-disaster-zone/

Ugandans living in the United Kingdom (UK) have demanded that the government declares northern Uganda a disaster zone because of the nodding disease that is ravaging most parts of the region.

The activists made the call on Saturday 3, March as they launched a campaign to solicit funds to set-up a research centre, raise awareness, and highlight the dangers of a ‘nodding disease’ which has affected thousands of children aged between 5 and 15 years in northern Uganda.

Ms Belinda Atim, who spearheaded the initiative in conjunction with Lee Oryem and the Acholi community in the UK said they decided to take action because of the situation in northern Uganda. “We feel that the government’s response is lukewarm and they could do more because it is in charge of the people. We know that they are hearing.” Ms Atim said.She added: “We know that some money has been committed by the government but that money is not enough. 100million Uganda Shilling only equates to about £23,000 or £25,000. It can’t take care of the 3000 children officially known be suffering from the disease.”She also said much as the media may say or put the death figure at less than 200, “…we know one village which has lost 264 children,” said Ms Atim, before adding that:


“In other villages the death rate is higher, we know between 1800 and 2000 children have died. We feel that the government should have declared northern region a disaster zone.”

What is Uganda covering up?

Police arrest man fundraising for nodding disease patientsBy Agatha Ayebazibwe

“The syndrome has come to light, government should stop hiding it from the public but rather take a bold step to address it,” said Ms Sandra Komuhiindo, the communication and information assistant at Uganda Women’s Network, one of the organisations running the campaign.The arrest seemed to have been uncalled for, as police chief Kale Kayihura ordered the release of Mr Mwanika and apologised for the incident. Charges were dropped but the pictures and other material remains in police custody, while the band has been prohibited from mentioning nodding disease during their show.

http://www.monitor.co.ug/News/National/-/688334/1377320/-/awo0ybz/-/


Doctor in Uganda says Nodding Disease could be from contact with some animal

http://youtu.be/_atd3ptpZKc


http://youtu.be/_atd3ptpZKc

Is it possible that "nodding disease" is coming from carrier pigs infected with a new chronic or subacute strain of African Swine Fever Virus? African Swine Fever has been a serious problem in Uganda. Scientists often quickly dismiss the notion of a human epidemic of African Swine Fever Virus because they think African Swine Fever Virus does not infect people. But that may not be the case. Sick or ASFV-infected pigs in places like Gulu, Anaka, Arua, Kitgum, Masindi, and Pader may be the source of a "nodding disease" zoonotic virus. Even if the pigs are not overtly sick, they could be carriers of a strain of this very insidious virus. African Swine Fever Virus infects many parts of the pig's body, including the brain. It causes serious neurological damage. It is also interesting that in some epidemics of African Swine Fever, it is mainly the young piglets that are affected which would be a strong parallel to "nodding disease." The ASFV-infected piglets suffer from ataxia, wasting, stunted growth, blindness, increased salivation, and opportunistic infections, just like the children with Nodding Disease.


Background on African Swine Fever Virus as a human pathogen:

"African Swine fever is an endemic disease in sub-Saharan Africa and many other parts of the developing world. It is caused by the African Swine virus that primarily replicates in macrophages and monocytes leading to the impairment of the structure and function of the immune system of the infected organisms. Until now the African Swine epidemic continues to spread despite all efforts to contain it. Thus, there is an objective need for effective, safe and affordable preventive and therapeutic approaches, in particular for effective vaccines, to control and eventually eradicate this disease. Since the characteristic feature of the African Swine virus is to impair the immune system and to cause immune deficiencies in its hosts the development of vaccines and other therapeutic approaches against the African Swine virus has implications for other immune deficiencies or diseases. Several other viruses are also known to cause immunodeficiency-like syndromes in humans, including cytomegalovirus, Epstein Barr Virus and others. Moreover, a series of cases of so-called "idiopathic" immunodeficiencies have been documented that display CD4+T-lymphocytopenia with opportunistic infections, but show no evidence of HIV infection. Since antibodies for the African Swine virus have been detected in humans, the possibility of human infection with the African Swine virus exists and may thus far have escaped any systematic screening. Thus, any preventive and therapeutic approach to African Swine fever can have far-reaching implications to control immune deficiency conditions in humans."http://www.faqs.org/patents/app/20080207875


Detection of Novel Sequences Related to African Swine Fever Virus in Human Serum and Sewage.Loh J, Zhao G, Presti RM, Holtz LR, Finkbeiner SR, Droit L, Villasana Z, Todd C, Pipas JM, Calgua B, Girones R, Wang D, Virgin HW.

Departments of Pathology & Immunology and Molecular Microbiology, Department of Medicine and Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri; Department of Biological Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania; Department of Microbiology, Faculty of Biology, University of Barcelona, Barcelona, Spain.

"The family Asfarviridae contains only a single virus species, African swine fever virus (ASFV). ASFV is a viral agent with significant economic impact due to its devastating effects on populations of domesticated pigs during outbreaks, but has not been reported to infect humans. We report here the discovery of novel viral sequences in human serum and sewage which are clearly related to the Asfarvirus family, but highly divergent from ASFV. Detection of these sequences suggests that greater genetic diversity may exist among Asfarviruses than previously thought, and raises the possibility that human infection by Asfarviruses may occur."

http://www.ncbi.nlm.nih.gov/pubmed/19812170?dopt=Abstract


African Swine Fever Virus (Asfarviridae) sequences found in people with febrile illnesses Abstract

Virus Identification in Unknown Tropical Febrile Illness Cases Using Deep Sequencing

Dengue virus is an emerging infectious agent that infects an estimated 50–100 million people annually worldwide, yet current diagnostic practices cannot detect an etiologic pathogen in ∼40% of dengue-like illnesses. Metagenomic approaches to pathogen detection, such as viral microarrays and deep sequencing, are promising tools to address emerging and non-diagnosable disease challenges. In this study, we used the Virochip microarray and deep sequencing to characterize the spectrum of viruses present in human sera from 123 Nicaraguan patients presenting with dengue-like symptoms but testing negative for dengue virus. We utilized a barcoding strategy to simultaneously deep sequence multiple serum specimens, generating on average over 1 million reads per sample. We then implemented a stepwise bioinformatic filtering pipeline to remove the majority of human and low-quality sequences to improve the speed and accuracy of subsequent unbiased database searches. By deep sequencing, we were able to detect virus sequence in 37% (45/123) of previously negative cases. These included 13 cases with Human Herpesvirus 6 sequences. Other samples contained sequences with similarity to sequences from viruses in the Herpesviridae, Flaviviridae, Circoviridae, Anelloviridae, Asfarviridae, and Parvoviridae families. In some cases, the putative viral sequences were virtually identical to known viruses, and in others they diverged, suggesting that they may derive from novel viruses. These results demonstrate the utility of unbiased metagenomic approaches in the detection of known and divergent viruses in the study of tropical febrile illness.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3274504/


Symptoms, complications and descriptions of Nodding Disease mentioned in various articles about the epidemic in Uganda

Continuous and pendulous nodding of head (precipitated by food or cold weather) that becomes progressively worse

Rhythmic chin to chest movements

Uncoordinated hand movements

Constant shaking of the hands

Disorientation, confusion

Dry skin

Dehydration

Severe itching

Rashes (that cause the skin to come off in patches)

Visible wounds

Anemia

Stunted growth

Brain atrophy

Blindness


Tiredness and sleeping

Sunken eyes

Headaches

Serious injuries or death resulting from falls during seizure episodes

Malnutrition (inability to eat)

Cognitive problems

Staring spells

Loss of consciousness

Abnormal EEG brain waves, mental retardation, brain atrophy and damage to the hippocampus and glial cells

Stunted growth

Opportunistic infections

Epilepsy

Seizures (fits) (Some have continuous seizure activity)

Sub-clinical seizures


Drooling, overproduction of saliva ("saliva is all over the body")

Vitamin A deficiency

Worms

Inability to sit

Progressive and fatal, often 3 years in duration

Loss of control of defecation and urination

Stunted growth

Crying, constant flow of tears

Constant nasal flow

Inability to close mouth

Inability to speak clearly (nonsensical talk)

Some develop pneumonia

Elevated neutrophil counts

Elevated percentages of eosinophils

Some have an elevated cell count, mainly lymphocytes and monocytes


Microscopically visible microfilaria

Loss of neck muscle tone

Loss of muscle tone of the upper extremities

Dizziness

Low serum B6 concentrations

Some children set fires

Some children become violent and hurt others

Sources:http://www.newvision.co.ug/news/628574-Nodding-disease-kills-200-children-in-North.html

http://www.newvision.co.ug/PA/8/16/703803

http://www.sott.net/articles/show/240740-Could-mysterious-nodding-disease-in-Africa-have-global-implications-

http://www.medscape.com/viewarticle/757813

http://en.wikipedia.org/wiki/Nodding_disease

http://www.monitor.co.ug/artsculture/Reviews/-/691232/1317258/-/97bml/-/

http://www.ghfn.org/1-topics-general-pages/nodding-disease


http://www.ghfn.org/3-stories_videos-individual/cdc-discusses-bizarre-nodding-disease?A=SearchResult&SearchID=1309275&ObjectID=3962521&ObjectType=35

http://www.observer.ug/index.php?option=com_content&view=article&id=16989:nodding-disease-unlocking-it-will-take-years-of-research&catid=34:news&Itemid=114

http://onlinelibrary.wiley.com/doi/10.1111/j.1528-1167.2008.01671.x/full

http://www.acholitimes.com/index.php?option=com_content&view=article&id=504:odding-disease-kills-50-people-in-pader&catid=15:health&Itemid=93

http://transitions.foreignpolicy.com/posts/2012/01/27/are_we_not_ugandans

http://www.monitor.co.ug/SpecialReports/-/688342/1305064/-/vtd6et/-/index.html

http://www.english.rfi.fr/africa/20120217-nodding-syndrome-cause-still-eludes-health-experts

http://www.nature.com/news/mystery-us-outbreak-prompts-further-tests-1.10052


http://www.cnn.com/2012/03/19/world/africa/uganda-nodding-disease/index.html

http://caledonianmercury.com/2012/04/16/the-mystery-disease-striking-ugandas-children/0032277


Is drooling the smoking gun link between Nodding Disease and African Swine Fever Virus?

This article mentions the saliva issue in pigs with African Swine Fever in Uganda:

http://www.newvision.co.ug/PA/8/16/728216

So the pigs with African Swine Fever in Uganda are drooling and we know the kids with Nodding Disease in Uganda are also drooling all the time.

And nobody says, hey, maybe these drooling pigs and drooling children have the same disease? Not one scientist?

Nobody suggests that they should look at the saliva and salivary glands of the pigs with African Swine Fever and the saliva and salivary glands of the children with Nodding Disease to see if there is an agent or pathological finding the two diseases have in common?


Nodding Disease and African Swine Fever Overlap in Arua, Gulu, Kitgum, Pader, Lango, Anaka, and Masindi, Uganda


Study says African Swine Fever is endemic to Uganda https://docs.google.com/viewer?a=v&q=cache:NdiLNGon8xsJ:www.roavs.com/pdf-files/vol_5_2011/313-317.pdf+&hl=en&gl=us&pid=bl&srcid=ADGEESh5iq_LIMhQpO3xYYD2R85na9-j-huP_qCHNBcOB4MuAw6EbZzZcdN-QUDJJAm1QV7FUElVmckKh8LEk63I9uumtFd5rQ-Hj5FgkDPl7KqL0KOqlTikSvguOfCwQU5LuMFQ2tVx&sig=AHIEtbRXGQliv_URo-LGFg5rYJc_AGHZWA


African Swine Fever in Arua, Uganda:

http://ugandaradionetwork.com/a/story.php?s=39689

Nodding Disease in Arua, Uganda:"Misunderstanding the causes of nodding disease can have disastrous consequences, as was the case with cholera some 150 years ago. So far, anti-epilepsy treatments appear to be helping children experiencing nodding disease, but supplies of these treatments are often scarce, and determining the ultimate cause of epilepsy in these children should be a high priority for health officials. Cases of epilepsy are often documented at high rates in hospitals in the region, and there is thought to be a link between epilepsy and cerebral malaria as well. In Arua Regional Referral Hospital, in northwestern Uganda at the border with Sudan and DRC, 7 percent of all outpatient children over age 5 in April 2009 were diagnosed with epilepsy. In 2004/05, 74 percent (nearly 4500) of all cases in the Mental Ward were diagnosed as epilepsy."http://www.independent.co.ug/rwanda-ed/rwanda/5094-the-search-to-understand-nodding


African Swine Fever in Gulu, Uganda:http://allafrica.com/stories/201109080222.html

Nodding Disease in Gulu, Uganda:http://www.acholitimes.com/index.php?option=com_content&view=article&id=739:nodding-disease-cases-reported-in-gulu&catid=1:news&Itemid=2

African Swine Fever Derails Pig Rearing in Gulu:UGANDA - Despite pig farming being a quick economic venture, farmers in Gulu district cannot engage in pig rearing any more following an outbreak of African swine fever (ASF) in the district in the middle of last year.http://www.thepigsite.com/swinenews/27028/african-swine-fever-derails-pig-rearing-in-gulu


African Swine Fever in Kitgum, Uganda:http://allafrica.com/stories/200609270361.html

Nodding Disease in Kitgum, Uganda:http://www.acholitimes.com/index.php?option=com_content&view=article&id=763:nodding-disease-continues-to-ravage-kitgum-district&catid=1:news&Itemid=2


African Swine Fever outbreak in Pader, Uganda in 2010:http://www.slideshare.net/ILRI/status-of-asf-in-uganda-by-c-rutebarika (See page 18)

Nodding Disease in Pader, Uganda:"It's known loosely as 'nodding disease' and almost every family in the village we've come to see in Pader District has at least one child suffering from it."

http://www.ghfn.org/1-topics-general-pages/nodding-disease


African Swine Fever in Anaka, Uganda:http://www.newvision.co.ug/PA/8/16/728216

Nodding Disease in Anaka, Uganda:http://allafrica.com/stories/201201200420.html


African Swine Fever in Lango, Uganda: http://www.newvision.co.ug/D/8/16/728216

Nodding Disease in Lango, Uganda: http://www.mail-archive.com/[email protected]/msg27417.html


Nodding Disease in Masindi, Uganda:"First 192 cases were registered in Kitgum and Pader in 2009 but over time, it has spread to other districts of Lamwo, Gulu and some traces in Masindi. The numbers have also increased from hundreds to thousands."

http://allafrica.com/stories/201202021109.html

African Swine Fever in Masindi, Uganda:http://www.slideshare.net/ILRI/status-of-asf-in-uganda-by-c-rutebarika (See Page 15)


Nodding Disease and Meningitis in Amuru, Uganda:"Along with the current meningitis outbreak, the Amuru district has also registered nearly 80 cases of the mysterious nodding disease."

Continue reading on Examiner.com Meningitis death toll climbs in Northern Ugandan town of Amuru - National infectious disease | Examiner.com http://www.examiner.com/infectious-disease-in-national/meningitis-death-toll-climbs-northern-ugandan-town-of-amuru#ixzz1pxFtwV5G

African Swine Fever in Amaru, Uganda:http://mobile.monitor.co.ug/News/-/691252/1263546/-/format/xhtml/-/1poq9uz/-/index.html


African Swine Fever Virus in Odek Sub County, Ugandahttp://www.meattradenewsdaily.co.uk/news/050811/uganda___african_swine_fever_.aspx

Nodding Disease in Odek Sub County, Ugandahttp://www.acholitimes.com/index.php/news/acholi-news/31-parents-turn-to-herbs-in-treating-nodding-children-in-odek-sub-county


African Swine Fever in Sudan:http://books.google.com/books?id=yE6ssPoWr4EC&pg=PA120&lpg=PA120&dq=sudan+%22asfv%22&source=bl&ots=ijOF_AaH1p&sig=KBwie4Pha6AnAGpGZb7Xtfmnjw8&hl=en&sa=X&ei=bO43T-nXG6bf0QG569GvAg&ved=0CB4Q6AEwAA#v=onepage&q=sudan%20%22asfv%22&f=false

Nodding Disease in Sudan:http://en.wikipedia.org/wiki/Nodding_disease


Will consuming ASFV-infected pork in Adjumani cause Nodding Disease?

Adjumani Residents Defy Quarantine on PigsUGANDA - Efforts to contain African swine fever, which broke out in Adjumani District seven months ago, is being hindered by residents' defiance of a quarantine imposed by the veterinary department.

http://www.thepigsite.com/swinenews/29417/adjumani-residents-defy-quarantine-on-pigs


Transmission of African Swine Fever Virus "ASF virus is transmitted between infected and susceptible pigs, by consumption of the meat from infected pigs, by the bites of infected tampans (Ornithodoros spp.) and by contact with material or objects (bedding, feed, equipment, clothes and footwear, vehicles) contaminated by virus-containing matter such as blood, feces, urine or saliva from infected pigs. Although warthogs are natural hosts of the ASF virus, it has been well demonstrated that they are unable to transmit the virus directly to domestic pigs. The role of other African wild suids (bush pigs of the genus Potamochoerus and the giant forest hog, Hylochoerus meinertzhageni), if any, in the epidemiology of ASF has not been clarified, but bush pigs were able to transmit virus to domestic pigs under experimental conditions. Experimental studies have shown that ASF virus can only be airborne over short distances, not much more than 2 metres. Apart from tampans, the only other arthopods that have been shown to be capable of maintaining ASF virus for a reasonable period (up to 48 hours) and transmitting it to pigs are stable flies (Stomoxys spp.) Since these are small flies, they would transmit the virus within rather between herds unless they were inadvertently transported to another farm. . . . Sexual transmission in pigs has also not been documented, but ASF virus is shed in genital secretions . . . ."

Source:www.cabi.org/isc/ShowPDF.aspx?PAN=20093263092


Evidence that Nodding Disease is Communicable

Investigation into the Nodding Syndrome in Witto Payam, Western Equatoria State, 2010Southern Sudan Medical Journal

"The school administration was in a dilemma as to whether or not they were required to have separate classes for affected children [with Nodding Disease]. If one pupil in the class showed symptoms, by the end of the year about seven other children were reported to have the same condition. This raises the question of whether this is a communicable disease."

http://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=12&ved=0CDMQFjABOAo&url=http%3A%2F%2Fwww.southsudanmedicaljournal.com%2Fassets%2Ffiles%2FJournals%2Fvol_4_iss_1_feb_11%2FSSMJ_4_1.pdf&ei=Fqp3T8riI-rL0QGVxJnCDQ&usg=AFQjCNE8RtiO8YviRD9toah7DXFd9-Dz6w


Ugandan Man Has 7 children with Nodding Disease

Each child’s nodding head eats at Ocitti’s prideHe was a proud man, because he ‘had it all’ – four beautiful women and 25 children. Animals, domestic birds and a fertile land to call his own. Augustino Ocitti was the envy of many. With his head up in the air, Okidi Village bowed at his feet – he was their village chairman for a decade. His peers regarded him as “the true definition of an Acholi man.” But as I enter Ocitti’s expansive compound, a sore silence welcomes me. I find him seated under a mango tree surrounded by a group of unsettled children. He glances up occasionally to check on them, but his head is bowed most of the time.The pride he once carried on his shoulders has faded and is now replaced by the weight of seeing seven of his children nodding helplessly because of a disease he has no clue about. His 12-year-old son, Lawrence Kabila, is the most affected by the ailment. At his age, he can be mistaken for an eight-year-old. The disease has stunted him. Kabila’s skin peels off effortlessly as he scratches himself. His sticky legs appear too weak to support his head and chest which appears heavily swollen. --Helen Anena, The Saturday Monitor http://www.monitor.co.ug/SpecialReports/-/688342/1357980/-/vwhgmi/-/


Symptoms of ASFV that overlap with Nodding Disease

Chronic African Swine Fever Symptoms (Just a very partial list)ataxiawastingstunted growthblindness increased salivationopportunistic infections

Nodding Disease Symptoms (Just a very partial list)

ataxiawastingstunted growthblindness increased salivation (drooling)opportunistic infections


Consumption of ASFV-infected Pork in Uganda

Uganda: Residents ignore warnings concerning consumption of pork from pigs killed by African Swine Fever"In Adjumani District, in the North of Uganda, residents are continuing to disregard officials’ warnings concerning consumption of pork meat from pigs that were killed by African Swine Fever (ASF). There have been health warnings regarding the risks associated with consuming meat from pigs that were killed by ASF." http://www.pigprogress.net/news/uganda-residents-ignore-warnings-concerning-consumption- of-pork-from-pigs-killed-by-asf-8129.html


Cases of Nodding Disease Found in Adults

Nodding Disease: Success stories under difficult circumstancesby Javie Ssozi

"Research shows that the disease is common between the ages of 7 and 13. However recent cases show that the disease has been found in adults."

http://ugandaspeaks.com/2012/03/nodding-disease/


Ugandan towns with ASFV epidemics

Towns in Uganda that have had African Swine Fever epidemics

ApacHoimaIgangaJinkaKalagangaKamuliKayungaKitgumLuweroMasakaMasindiMpigMubendeMukonoNakapiripiritRakaiSembabuleSorotiWakiso

Source:

Overview of African Swine Fever (ASF) Impact and surveillance in Uganda (See Page 15)


Pathology of the Brain in Nodding Disease:

"Sub-clinical seizures have been identified in electroencephalograms, and MRI scans have shown brain atrophy and damage to the hippocampus and glial cells."http://en.wikipedia.org/wiki/Nodding_disease

Pathology of the Brain in African Swine Fever:

"Hog Cholera and African Swine Fever cause neurologic signs in baby pigs with other signs of systemic disease."Source


Writer links Nodding Disease to sick pigs in Uganda

This writer, Angelo Opi-aiya Izama, is the first to mention pigs as a possible source of Nodding Disease. The writer confuses Swine Flu and African Swine Fever, but does raise the important question of the role of pigs in nodding disease:

Running with the theory that it is swine flu virus of one sort or another linked is not a stretch. It is fairly common knowledge that scientists in this field are pre-occupied with the dangers of direct transmission of swine flu to humans.

Indeed Gulu and surrounding districts are victims of outbreaks of the African swine flu that often affects pig rearing. There are many articles to this effect. Just googling now revealed several studies discussing the worries about swine flu transmissions from animals to humans and humans to humans by amongst others the CDC. The agency, which is also involved in investigating the Uganda nodding disease issue, is however yet to publicly link swine flu or its research to nodding disease. Whether or how this link has been eliminated as also not been explored judging from the coverage on the issue.

http://thisisafrica.wordpress.com/


Nodding Disease Horror: 12-year-old victim is tied to a tree for 13 hours everyday This article by Edward Echwalu in The Observer is one of the most disturbing pieces ever written about "Nodding Disease."

There is an interesting mention of pigs in the article which should catch the attention of anyone who thinks "nodding disease" may be coming from pigs infected with a strain of African Swine Fever Virus.


Constant Nasal Flow in Nodding Disease may be another indication that it could be caused by African Swine Fever Virus "The disease, which has remained a puzzle to many medical experts, is characterised by mental and physical retardation, head nodding and drooling, constant nasal flow and saliva. The victims often nod themselves to death. Many of the affected children are malnourished because eating food seems to spark bouts of nodding and seizures. Epilepsy drugs have been used to control the attacks but they do not cure the disease."http://www.monitor.co.ug/SpecialReports/-/688342/1305064/-/vtd6et/-/index.html

Constant nasal flow occurs in pigs with African Swine Fever Virus which is now endemic in the same areas of Uganda that Nodding Disease is affecting.


Scott Dowell of the CDC on Nodding Disease in Uganda: "As an example, we’ve been investigating a “nodding disease” in South Sudan and Uganda. It’s a clearly odd syndrome where kids aged five to 15 have head nodding. The kids definitely die with it – it’s not rapidly progressive, but it seems to take hold of them. The nodding is in fact a type of seizure and they do in fact have brain disease. It looks to us like an epidemic epileptic syndrome. The kids die of the things that kids with severe epilepsy die from – they fall into a fire, they die when they are bathing, they get opportunistic pneumonia, etcetera. When we first started investigating five years ago, it was unclear what the origin was. Now we have learned a lot more about what it is and is not, although we don’t know the underlying cause."--Scott Dowell

http://sciencespeaksblog.org/2012/02/15/how-the-cdc-responds-to-global-emerging-infections- a-conversation-with-scott-dowell/


CDC says Nodding Disease is a form of "atonic seizure." Dr. Scott pointed out that one of the major progress areas was the ability to conduct tests and rule out dozens of suspected causes which included the possible connection of the epidemic with wartime chemical exposure. According to this Atlanta based scientist, very little was understood about the syndrome back 2009 when CDC was starting its investigations about the disease that has since led to hundreds of deaths with about 3000 currently infected. The doctor says this has changed because CDC has discovered and documented key information regarding the cause, symptoms and treatment of the nodding disease. Much as the real cause of the nodding syndrome is still unknown, CDC researchers say they have discovered ‘the immediate cause of the nodding itself’ which they refer to as a special seizure called an atonic seizure. --Umar Weswalahttp://umaruganda.blogspot.com/2012/02/nodding-syndrome-cdc-and-uganda-govt.html

Wikipedia on "atonic seizure":

http://en.wikipedia.org/wiki/Atonic_seizure


CDC on Nodding Disease: "The children definitely die with it" For now, the already affected children are sentenced to death by the disease.

“The children definitely die with it – it’s not rapidly progressive, but it seems to take hold of them. The nodding is in fact a type of seizure which causes damage on the brain,” said Dr Scott Dowell, CDC lead investigator, in an interview with the Center for Global Health policy, United States

By Yasiin Mugerwa & Agatha Ayebazibwe, The Daily Monitor

http://www.newvision.co.ug/news/629080-nodding-disease-top-us-scientist-jets-in.html

CDC: Cases of Nodding Disease in Uganda have risen to over 3,000 from 2,000


reported at the beginning of this year. http://www.newvision.co.ug/news/629174-nodding-disease-vector-control-centre-vital-in-pader.html

CDC said Nodding Disease in Uganda "could turn out to have just as huge implications for the rest of the world."


In the case of nodding syndrome “we don’t know the implications of this for the rest of the world,” [the CDC's] Dowell said. “It’s quite clear it has huge implications for those living in Kitgum district in Uganda, but it could turn out to have just as huge implications for the rest of the world.

http://www.thestar.com/news/world/article/1121730--could-mysterious-nodding-disease-in-africa-have-global-implications

CDC: Nodding Disease is at the top of its list of mystery outbreaks


CDC planning trial for mysterious nodding syndromeby John Donnelly

The Lancet, Volume 379, Issue 9813, Page 299, 28 January 2012

Fred Hartman, Management Sciences for Health's Country Lead for South Sudan and supervisor for the USAID-funded Sudan Health Transformation Project II, has worked for 30 years in Africa, but when he first saw children with nodding syndrome in 2010 he was shocked. “I've been all over the world, and I've never seen anything like it”, he said. “All the children look like they have cerebral palsy. So many of the kids are malnourished. You bring them food and they can't eat it. And by the time you make the diagnosis, it's too late for the children. It's really sad.”Dowell called the CDC's upcoming investigation important. “We are in the business of detecting outbreaks. For the most part, when we investigate an outbreak, the cause becomes clear, but periodically we get these ones where the cause isn't clear”, he said. Asked where nodding syndrome stood on the list of mystery outbreaks, Dowell said: “It's right there at the top of the list.”

http://www.lancet.com/journals/lancet/article/PIIS0140-6736%2812%2960126-3/fulltext


BBC reports that initially the CDC suspected Nodding Disease might be "psychogenic"

The syndrome stealing Uganda and South Sudan's childrenBy Andrew Harding, BBC Africa correspondent

"Nodding Syndrome targets children exclusively, causing its victims to spasm uncontrollably and eventually to waste away and die. Many thousands of children are believed to be affected."

"Initially, the CDC suspected it might be a psychogenic episode - something like mass hysteria. But brain scans quickly confirmed that they were dealing with a disease that causes measurable brain atrophy."



World Health Organization had been treating nodding disease as a post-traumatic stress disorder

Nodding disease spreads to Gulu By Stephen Otage

http://www.monitor.co.ug/News/National/-/688334/1374304/-/awq3yhz/-/


Medical Teams International has sent over 45 volunteer medical teams to Uganda to address immediate needs and to mobilize long-term health initiatives.

http://www.salem-news.com/articles/march142012/med-teams-uganda.php

(PORTLAND, OR) - Medical Teams International has launched an emergency response campaign to fund efforts to address nodding disease in northern Uganda. This mysterious disease only attacks children and has no known cause or cure. Ugandan health officials estimate that over 3,000 children are infected, with a high incidence of occurrence in the districts Medical Teams International is currently serving.

Nodding disease syndrome is a progressive condition characterized by head nodding, mental retardation and stunted growth, body wasting and blindness. Children with the disease often die of malnutrition, secondary injuries or infections related to the disease.

Medical Teams International will collaborate with community health workers in the region to provide anti-seizure medicines, medical support, on-site mentoring of health workers, and psycho-social support to families struggling to care for children with the disease.

“Our mobile medical clinics are the only source of care for thousands of families in the Pader District of northern Uganda,” says Bas Vanderzalm, President of Medical Teams International. “More than 1,500 children in this district have this terrible disease. We’re asking people to pray for these children and to support our efforts to help.”

Medical Teams International seeks to raise $30,000 to fund an initial response to this disease. The organization has already received a $15,000 matching gift from an anonymous donor, doubling the impact of individual donations.

For more information on nodding disease or to contribute to Medical Teams International’s work in Uganda, please go to www.medicalteams.org

Since 2004, Medical Teams International has provided health care services, community health education and immunizations to nearly 500,000 displaced people in various camps, settlements and clinics in the northern districts of Uganda.

Medical Teams International has sent over 45 volunteer medical teams to Uganda to address immediate needs and to mobilize long-term health initiatives.

Medical Teams International is a Christian global health organization working to demonstrate the love of Christ to people affected by disaster, conflict and poverty around the world. Since 1979, we have sent more than 2,100 volunteer teams and shipped more than $1.5 billion in lifesaving medicines and medical supplies to care for 25 million people in 100 countries. Each year, more than 2,000 volunteers contribute their time to care for those whom Jesus called “the least of these” in our world today.


Nodding Disease can cause "violent tantrums." Shockingly, no one, not even health officials, really knows what causes this sickness or how it is transmitted. Nodding disease is a mysterious illness that stunts brain growth among the small children who are its victims, sometimes causing mental retardation. (It takes its name from the convulsive nodding motion that marks those infected with it.) Sometimes its victims break out in violent tantrums, as if possessed by demons; some act as though they're being pursued by people armed with machetes or guns. In some cases victims report being weighed down or suffocated by "something heavy" that they cannot see. Those who contract the disease usually die from it within a few years. It is a horrible thing to watch.--By Denis Barnabas

http://transitions.foreignpolicy.com/posts/2012/01/27/are_we_not_ugandans


Nodding Disease Leaves Men Sexually Starved The nodding disease is leaving many men sexually starved, according to Dr. Conan Katerega, a senior psychiatrist at Gulu Regional Referral Hospital. This is because most men fear to impregnate their wives because they are not sure about the new generation.

The disease which hit the sub region three years ago has claimed over 200 lives and infected thousand others many of whom are children below 18 years. Doctors at Gulu Regional Referral Hospital say no proper guidance has been given about the disease and more research is needed to find out more about the disease.

Doctors add that the disease has left most discouraged from producing more children. “Some communities believe that the disease is so infectious,” they said. “People have resorted to abstaining from sex with belief that it is useless to produce children when they are not sure of their generation,” they said.By Willy Cho Woo, in RedPepper, (a Ugandan newspaper)http://redpepper.co.ug/welcome/?p=26783


2009 survey found out that 83 per cent of the Nodding Disease cases verified were suspected to have eaten bush meat:

Government on the Spot Over Nodding Diseaseby Agatha Ayebazibwe, Daily Monitor, 2012-01-24

"The 2009 survey found out that 83 per cent of the cases verified were suspected to have eaten bush meat"

http://str8talkchronicle.com/?p=20097

Bush meat includes "bush pigs" and "giant forest hogs" which are probably carriers of African Swine Fever Virus, given how widespread ASFV is in northern Uganda.

Wikipedia on giant forest hogs:http://en.wikipedia.org/wiki/Giant_forest_hog


Epilepsy in Uganda was linked to pork in 2009

Thursday, December 3, 2009

http://www.thepigsite.com/swinenews/22608/epileptic-seizures-linked-to-pork-worms

Epileptic Seizures Linked to Pork WormsUGANDA - In a bid to educate the public about the risks of consuming pork, the Epilepsy Support Association, Uganda, an umbrella organisation for people living with epilepsy has gone into a partnership with the Veterinary Department of Makerere University to establish the relationship between pork and epileptic seizures.Preliminary clinical traces established by the association indicate that pork-related causes of epilepsy are due to Taenia Solium, a worm that thrives in pigs and when consumed embeds in the human brain thus causing an infection of the nervous system.

"The incidence of epilepsy is thought to be higher in the Sub Saharan Africa because of an increase in brain injury and the central nervous infections, and pork is believed to be a grave cause," Dr Angelina Kakooza Mwesige, the President Epilepsy Society Uganda said recently. She said the infection referred to as Neurocystercercosis is cerebral and partly responsible for symptomatic causes of epilepsy.

In a six-page document presented to journalists in Soroti recently, Dr Mwesige said more than 80 per cent of the global burden of epilepsy is found in the developing countries with 10 million cases in Africa alone. Soroti is one of the districts with the highest pig population, reports AllAfrica.com. "We conducted a survey last year and it was established that 25 per cent of epilepsy prevalence is linked to worms eaten through badly cooked pork," Mr Augustine Mugarura, the National Director Epilepsy Support Association Uganda said.

African Swine Fever in Soroti, Uganda

www.slideshare.net/ILRI/status-of-asf-in-uganda-by-c-rutebarika (See page 15)


Study suggests more boys than girls have Nodding Disease in Uganda "The Ministry of Health is to start its own investigations into nodding disease in Northern Uganda as they await results from the Centre for Disease Control in Atlanta. The ministry together with the Acholi Parliamentary Group is set to go on a fact finding mission in Kitgum one of the most affected of the three districts in the region where close to 3000 people aged between 2 and 15 are afflicted."

http://www.youtube.com/watch?feature=player_embedded&v=7wCam8r36X0


http://www.youtube.com/watch?feature=player_embedded&v=7wCam8r36X0

Medics To Examine Brain Of Nodding Disease Victim Medical doctors want to examine the brain of a dead person confirmed to have succumbed to the notorious Nodding Disease for thorough examining.A clinical psychiatric, Dr. Sam Okuni who works with the mental health department in Gulu Referral Hospital said that together with various partners, they have done a lot of research and are about to out the results, but need to dissect the brain of a dead victim to get to the bottom of the phenomenon. By Ojok James Onono, RedPepper (A Ugandan newspaper)http://redpepper.co.ug/welcome/?p=32380


Women tie themselves to trees over nodding diseaseBy AGATHA AYEBAZIBWE, Daily MonitorWomen activists tied themselves on trees for 30 minutes yesterday to show solidarity with mothers whose children are suffering from nodding disease syndrome. The women expressed concern for their colleagues in Acholi Sub-region, condemning government’s failure to quickly address the nodding disease problem. They said mothers in northern Uganda are suffering psychologically because of having to tie their sick children to trees to save them from injury when they fall. Read more.

http://www.monitor.co.ug/News/National/-/688334/1361630/-/axeneez/-/


A Day in the Life of the PAZ Project: Pig farming and slaughtering in Western Kenya

by James Miser Akoko

There is close interaction between pigs and people as they are either tethered within the homestead or are allowed to scavenge around the homestead for food. In some homes, pigs wallow in mud mixed with their urine and faecal materials, as flies and other insects celebrate. The role played by pigs in transmitting zoonotic diseases and the risk factors for human infection are poorly understood in western Kenya. The methods of slaughter used in slabs in the area also raise welfare issues. The pig’s legs are tied and a sharp knife or a machete is used to cut around the neck of a struggling pig that cries loudly as blood spills on the bare hands and feet of the unprotected slaughter men. The noise that emanates from these slabs is normally disturbing for many people. It is normal to find people slaughtering without protective clothing, and dogs are always on duty waiting for any meat that could drop; and of course you cannot rule out the presence of flies. It is also not uncommon to find children and people eating other foodstuffs next to the slab, an obvious public health hazard. This means that the hygiene and safety of the slaughter house workers and the pork consumers served by the slabs is an issue that requires action.http://biolives.wordpress.com/2012/02/28/a-day-in-the-life-of-the-paz-project-pig-farming-and-slaughtering-in-western-kenya/


http://farm8.staticflickr.com/7202/6940485487_96665351b8.jpg

Ugandan government seems to be trying to control what people know about Nodding Disease

Censorship ahead of the IPU assembly in Kampala: On Nodding Diseasehttp://ugandaspeaks.com/2012/03/censorship-ahead-of-the-ipu-assembly-in-kampala-on-nodding-diseas e/


Beatrice Anywar is praised as "Mamma Nodding Disease"

Anywar to the rescue

By Rukiya Makuma

http://www.independent.co.ug/news/news-analysis/5461?task=view

She was desperate to call attention to the gravity of a rare disease ravaging northern Uganda that is crudely called “nodding disease”. Opposition firebrand Beatrice Anywar, however, never imagined how ferrying some of the affected children to the capital would turn out.The Kitgum Woman MP first identified 10 children and made arrangements to move them to Mulago National Referral Hospital in Kampala. Then she placed an important phone call – to President Yoweri Museveni. It was a smart move.She wanted the President to know her intentions.

“Initially the President was worried about whether the disease was contagious but when he was informed that it was not, he offered his support,” she says.

Beatrice Atim Anywar From Wikipedia, the free encyclopedia

http://en.wikipedia.org/wiki/Beatrice_Atim_Anywar

Beatrice Atim Anywar, also known as Mama Mabira, born 1964 in Kitgum,[1] is an Ugandan politician and member of Parliament for the opposition party FDC, and minister of the Environment in the Shadow Cabinet.[2] She was chosen to the parliament in 2006 by defeating the NRM candidate Santa Okot.[3]

She became well known for her work to save the Mabira Forest in Uganda. The president Yoweri Museveni, and the government, had prior to her work decided to sell the forest to the sugar company Scoul to cut it down and convert it into a sugar cane plantation for ethanol production. Atim fought along with for example National Association of Professional Environmentalists to stop the felling, and organized a boycott of Scoul's sugar.[2] Her work has led to several environmental prizes.[3]


School Becomes an Unfriendly Environment for Children with Nodding Disease http://www.acholitimes.com/index.php/news/acholi-news/34-nodding-disease-is-destroying-families-and-communities


Report from Gulu: Nodding Disease is Destroying Families and Communities http://www.acholitimes.com/index.php/news/acholi-news/34-nodding-disease-is-destroying-families-and-communities


WHO and CDC plan to hold Nodding Disease conference in July

Why are Uganda's children nodding to their deathsBy Amy Fallon

The illness is having a tragic impact on the Pader, Lamwo and Kitgum districts of northern Uganda. At least 170 children have died, with more than 3,000 affected in the area, the World Health Organisation (WHO) estimates. The figures are likely to be higher because not all cases are reported. "The nodding syndrome is a serious public health problem, with psychological, social and economic consequences," says Dr Charles Okot, the organisation's country advisor in Uganda. The situation is so grim that the WHO and the Centers for Disease Control and Prevention, a US federal agency, are hoping to hold a conference on the disease in July, attended by medical experts from around the world.

http://www.independent.co.uk/news/world/africa/why-are-ugandas-children-nodding-to-their-deaths-7628107.html


10 Reasons that Uganda absolutely cannot admit that Nodding Disease is caused by African Swine Fever Virus even if that is the obvious cause.

1. There would be mass panic in Uganda and in other countries.

2. All pigs in the northern part of Uganda as well as the rest of the country would be suspected of being carriers of the virus. They would all have to be killed.

3. Many people rely on pigs for food and financial support.

4. In rural areas most people have two or three pigs. They are allowed to roam around freely.

5. If people are now infected by ASFV the epidemiology of ASFV suggests they are capable of transmitting ASFV to others.

6. Health care workers will be terrified of contracting African Swine Fever Virus from children with Nodding Disease.

7. Tourism in Uganda would stop immediately. Movement of people in or out of the country would stop.

8. The economy of Uganda would collapse.

9. Other countries with their own ASFV epidemics would encourage Uganda to keep a lid on this information.

10. The situation would be made even worse by the probability that bush pigs and forest hogs are also carrying the virus. Ticks also carry the virus.


The CDC’s scientists have been investigating Nodding Disease since November, 2009. Strangely, they still haven’t tested the Nodding Disease cases for African Swine Fever Virus even though scientists at Uganda’s largest university can test pigs in 24-48 hours.

Why? What’s that all about?


nodding disease and swine fever (second edition)

Health & Medicine