The World Health Organization is an under-appreciated institution, which often takes on critical tasks. For example, in 2011 it brokered an agreement to end a controversy about viral sample sharing particularly related to avian influenza. This agreement will greatly help with the development of pre-pandemic vaccines, but such achievements attract little press coverage. The WHO receives much more press when it acts as the world’s medical sleuth. When invited, it quickly arrives on the scene wherever a new disease is emerging. At the moment there are no fewer than three new diseases that merit the WHO’s attention. Although they may not each be the next SARS, they all have worrisome aspects.
The first disease has appeared in Central Vietnam’s Quang Ngai province, where 171 people have fallen sick and nineteen people have died. All the cases seem to follow the same general course. People develop a “rash on their hands and feet, along with high fever, loss of appetite and eventually organ failure.” The illness began in April 2011, but it had begun to fade away by the end of the year. Sadly, the disease has since returned. Careful work by Vietnamese doctors has failed to identify the illness. As a result, the Vietnamese government has decided to call for help from the World Health Organization. According to an article in BBC, the disease is causing panic in the village of Reu, where people are building blockades built of branches to seal the trails to the homes where infected people live: “`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 rituals and prayers.’” The epidemic is continuing in one of Vietnam’s poorest regions, particularly amongst the Hre ethnic minority. Nearly seventy cases have appeared in the last month. Without medical care, people suffer liver failure, then one organ after another shuts down.
Another strange disease is nodding sickness in Southern Sudan, Uganda and Tanzania. Some people believe that the disease first appeared in a mountainous area of Tanzania in the 1960s. What is known that in Eastern Africa a terrible disease is impacting children, mostly between the ages of five and fifteen. At first they appear tired, and their heads begin to droop. Their personality then changes, and they begin to have seizures, which in some cases can last for hours. As the children are transformed they become so difficult to care for that -in some cases- their overwhelmed families abandon them. At least three thousand children have the disease in Northern Uganda. Authorities from the World Health Organization have tried to discover the cause of the disease, but so far little progress has been made, although some suspect that it may be linked to river blindness. For a video report by Al Jazeerah on the illness, see here. As the video suggests, local people wonder if the displacement caused during the years when the Lord’s Resistance Army terrorized the region somehow caused the illness. What is certain is that entire villages are currently suffering, and the disease shows no signs of abating.
The third mystery illness is plaguing Central America, where it particularly seems to attack field workers, who succumb to kidney failure. The number of people affected by the illness is large. Some suggest that 24,000 people have died since it first appeared in 2000, and perhaps 150,000 have become sick. The disease has spread in both Nicaragua and El Salvador (although there are some reports from as far apart as Panama and southern Mexico), and it particularly impacts people in the sugar growing industry. Working in sugar cane is hot, dangerous and thirsty work. One question has been whether the source of the problem is dehydration. But people have been cutting sugar in the Americas for centuries. Why has this illness appeared now? Are peoples’ kidneys failing because they are exposed to pesticides in the fields, and in particular chemicals that are banned in the North? Why are only manual laborers falling ill? And will the disease continue to spread? At the time that I write this, there are far more questions than answers. There is as yet no good evidence that pesticides are to blame. The disease does not even have a name. For a photo blog, which conveys the diseases’ impact, click here. And for a great radio program on the illness, listen to this great CBC coverage from the program, the Current (you may need to search “Mystery Disease” on the site). Despite the seriousness of the illness, the WHO does not yet seem to have become involved. Its support would appear to be badly needed.
There have been some recent books on AIDS -long my area of research- that have described its origins in Central Africa in the 1930s, and the forces that led to its dispersal. To the curious, I recommend The Origins of AIDS by Jacques Pepin (whom I do not know). One point that these works make is that in an era of globalization, we are all bound to one another. There are no longer truly isolated epidemics. For this reason, we should all be glad that the WHO exists, and wish both it and the local experts luck in their investigations.
Shawn Smallman, Portland State University