Outbreak of an unknown disease in Angola

Nov 19 2007

An outbreak of a disease of unknown etiology is currently ongoing in Cacuaco municipality, Angola.

The first cases were reported on 2 October. As of 15 November 2007, a total of 370 cases had presented for treatment at the Municipal Hospital in Cacuaco.

It is anticipated that additional unreported cases may be occurring within communities among patients preferring to remain at home or to receive treatment from traditional healers. The clinical symptoms of the disease are extreme drowsiness, waking only to painful stimuli. Patients recover slowly, over a number of days, but remain ataxic with many unable to walk unaided. The symptoms are most extreme in children.

The neurological indication is of a cerebellar abnormality with no sign of peripheral neuropathy. Reflexes are normal. The case presentation suggests a toxicological cause, however, the etiological agent has not yet been identified. Samples taken from patients have been tested for 300 organic solvents and a general drug screen covering 800 compounds has also been carried out.

These tests have so far proved negative. Tests for cadmium, lead, mercury and manganese have shown levels within the normal range. Environmental samples, as well as food and drinking water, have also been taken and results of tests are awaited.

Epidemiological investigations so far have not revealed a common source or route of exposure, and these investigations are now being extended in scope.