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  (Source: Capcom)
World Health Organization is on high alert about new Ugandan outbreak, cause is not fully known

Updated:
Added commentary from Jason Oh, a Johns Hopkins Univ. public health studies student who is currently in Uganda studying the disease post-conflict transformation. Mr. Oh described some of the symptoms in more detail, and offered different perspective from the CNN reporters' experience.

CNN has also reworded their report to tone down the suggestion of violent behavior.

It's called the "nodding disease" and it's a baffling illness that has struck thousands of children in northern Uganda.  The illness brings on seizures, violent behavior in some (debated), personality changes, and a host of other unusual symptoms.

I. Mental Degradation: Child Victims Have no Cure, no Future

Grace Lagat, a northern Uganda native, is mother of two children -- Pauline Oto and Thomas -- both of whom are victims of the disease.  For their safety, when she leaves the house, she now ties them up, using fabric like handcuffs.  She recalls, "When I am going to the garden, I tie them with cloth. If I don't tie them I come back and find that they have disappeared."

Reportedly the children gnaw at their fabric restraints, like a rabid animals -- or "zombies" of popular fiction -- in an attempt  to escape.  (This is based on CNN's commentary.)

(Jason Oh points out that the restraints are intended to protect the chidlren from harm, and from starting fires.)

The effort to restrain the children is not unwarranted.  In one of the most bizarre symptoms of this tragic illness, children with the disease are reportedly setting fire to buildings in their communities.  Coupled with the aimless wandering this disease provokes in victims, this is a deadly combination.  More than 200 people have been killed in fires believed to be set by the zombified children.

(According to Jason Oh, there have been few reports of violent behavior.  It is unclear where our primary source CNN received this information, though a reader suggested that a CDC report indicated that 10 to 15 percent of children were found to exhibit increased aggression.  We were unable to locate this report.)


Nodding disease zombie child
The disease leaves child victims in an often-violent "zombiefied" state. [Image Source: CNN]

The disease is not new.  It popped up in the 1960s in Sudan.  From there it slowly spread to Libya and Tanzania.  

The Uganda infections, though, are a new outbreak -- a troubling sign.  The jump into a new region could be pure coincidence, or it could indicate the disease has become more virulent or found a new transmissions vector.

Africa map
Uganda is located in central Africa [Image Source: U of Tex., Modifications: Jason Mick]

Infected children typically have regular seizures, which are proceeded by a repetitive nodding of the head.  This characteristic symptom has given rise to the unofficial title for the malady.

II. World Medical Organizations Racing for a Cure

The Center for Disease Control (CDC) and World Health Organization (WHO) have been tracking the spread of this frightening ailment.  Dr. Joaquin Saweka says the scene in Uganda is horrific, stating, "It was quite desperate, I can tell you.  Imagine being surrounded by 26 children and 12 of them showing signs of this. The attitude was to quickly find a solution to the problem."

Yet the WHO and CDC are not fully sure what is causing the illness, which cripples children and turns them into mindless, violence-prone zombies.  The best clue they have is that most of the cases occur in regions inhabited by "Black flies", which carry the parasitic worm Onchocerca Volvulus.  That worm is responsible for another dangerous disease dubbed "river blindness", the world's second leading cause of infectious blindness.

(Jason Oh states that CNN misunderstood this reference.  While it's true the cause of the disease is unknown and the literature papers on the topic indicate an overlap with part of the river blindness afflicted regions, but he feels this reference was only intended to "state the obvious", not hypothesize causation.)

Black Fly and worm
The illness may have something to do with Black flies (left, center) and their parasitic worm (right). [Image Source: WHO (left), Wikimedia Commons (center), Human Healths (right)]

However 7 percent of infected children live in regions not inhabited by the Black fly, so a link is speculative at best.

Children with the disease also frequently exhibit vitamin B6 deficiency, leading medical experts to believe that the disease may be nutrition related.  However, infections by microbes, parasites, fungi, or even fungi/microbes carried by a parasitic host, can all lead to nutritional deficiencies.

Dr. Scott Dowell, director of global disease detection and emergency response at CDC, says the race is on to determine the cause and a cure.  He states, "At first we cast the net wide. We ruled out three dozen potential causes and we are working on a handful of probabilities.  We know from past experience an unknown disease could end up having more global implications."

In the current cases children as old as 19 have been found to be stricken, with the majority of the worst symptoms being spread over the 3-11 age range.

One mystery surrounding the disease is the seizures themselves.  While typically seizures are either randomly occurring or follow some singular cue/pattern, the nodding disease seems to have multiple triggers, including eating new foods, changing weather, and other changes.

(Jason Oh says CNN reporters messed up and that it's familiar foods trigger the seizures, not unfamiliar ones like bars of chocolate.)

Seizure often leave the children soiled with urine and drooling.  Local nurses are afraid to touch the infected.  States local nurse Elupe Petua, "I feel, because I don't know what causes it, I don't even know how it transmits, when I touch them I feel that I can also get the infection because I don't know what causes it."

III. Medication is Ineffective

Anti-epileptic medication slows the onset of symptoms, but is unable to stop the progression of the disease.  The seizures eventually leave many children unable to walk, only able to drag their bodies along the ground as flies tried to attack them.

Nodding disease
The current treatment approach of anti-epileptics has done little to halt the illness.
[Image Souce: CNN]

(Jason Oh says that the diseases offers a tragic, slow mental degradation, taking years to develop.  Affected children, embarassed about the nodding and afraid of infecting classmates often drop out of school, while still mentally capable.  Eventually the seizures lead to the more severe symptoms mentioned in the intro -- loss of speech, partial paralysis, personality changes, and -- according to CNN -- violence.)

The government of Uganda has come under criticism for not being vocal enough in addressing the tragedy and demanding foreign aid/research expertise.  Local politicians have taken to transporting victims from affected villages by bus to city hospitals in order to force the issue into the eyes of the more affluent city-dwellers.

(Jason Oh adds some perspective writing, "Uganda had asked the CDC to investigate in 2009.  Most of the backlash against the government is because the Ministry of Health has been slow to use emergency funds that the Parliament made available.  They've established many local centers for Nodding Syndrome, but they are under-staffed and under-equipped.  The kids are being referred to and transported to Mulago Hospital (famous for being in The Last King of Scotland) so the top doctors at Makerere University and in Kampala can monitor them.")

The issue is yet another woe for a nation in which the impoverished majority was terrorized for years by warlord Jospeph Kony's militia, dubbed the "Lord's Resistance Army."

Mr. Kony is currently wanted by the International Criminal Court on multiple counts of violent war crimes, including rape and murder.  These offenses are punishable by death (life in prison), if he is ever brought to trial. (Jason Oh clarified that under the new Rome Statute of 2002, the ICC is not allowed to seek the death penalty, even in murder cases.)

IV. What if the "Nodding Disease" Found a Way to Reach the U.S.?

Dr. Saweka says that for all the hand-waving by the government about using better anti-epileptics and offering more funding, he appreciates and shares in the villagers frustration.  He states, "People complain that it looks like the lives in developing countries have less value than the lives in the western countries. When you know the root cause, you address the cure. Now you are just relieving the symptoms. We don't expect to cure anybody."

Ugandans
Ugandans, grief stricken, feel somewhat abandoned by the government and the wealthy developed "First World". [Image Source: CNN]

While the "First World" may not be focused on -- or even aware of -- the zombification that is leaving children in these African nations violent (debated), crippled shells of their former selves -- tied like dogs -- it is an issue that must be addressed.  After all, viruses, bacteria, parasites thanks to the wonders of evolution can mutate and adapt to new environments and new transmission vectors.

Thus this zombie virus  While reports of violence or strange behavior -- like biting -- are disputed, the disease is very serious.  It may seem like a foreign issue to regions like the U.S. and EU who are struggling with their own financial crisises.  But if the illness finds a way to broaden its spread, this outbreak could cripple children across the globe.

(A word of clarification... CNN has reworded their report slightly to tone down the suggestion of violent behavior.  The reports of fire starting stand, but in the new context it's possible these were just innocent accidents triggered by the childrens' loss of coordination.

Source: CNN



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A tad insensitive, don't you think?
By DNAgent on 3/20/2012 9:27:06 PM , Rating: 0
Good job DT, way to sensationalize the suffering of these people by calling the affected children "zombies" and drawing completely unwarranted parallels to Resident Evil.

Callous much? You should be ashamed.




RE: A tad insensitive, don't you think?
By paydirt on 3/20/12, Rating: -1
RE: A tad insensitive, don't you think?
By amanojaku on 3/20/12, Rating: -1
RE: A tad insensitive, don't you think?
By BushStar on 3/21/12, Rating: 0
RE: A tad insensitive, don't you think?
By dark matter on 3/21/2012 9:54:18 AM , Rating: 2
As far as I can see his use of the word retarded was entirely in context.

If you were trying irony, keep to the ironing.


RE: A tad insensitive, don't you think?
By BushStar on 3/21/12, Rating: 0
RE: A tad insensitive, don't you think?
By BushStar on 3/21/2012 4:40:02 PM , Rating: 2
Fine. Keep calling children retards, spastics, mongs, zombies and so on, ignoring the permanent damage this can cause to them.

-1


By lagomorpha on 3/22/2012 2:41:02 PM , Rating: 2
Originally, ignoramus and moron were medical terms to describe children that performed within a certain portion of intelligence tests. Then people became upset that they became terms of offense so the official term changed to "retarded" to take away the stigma and that became a term of offense. So now it's "differently abled" and guess what? People now use that to call other people stupid. When I was in school "special education" was the common term and if you wanted to call someone stupid you'd just as often tell them they were "special".

It doesn't matter how many times you change the term to refer to people with lower intelligence, it doesn't change what they are. The problem occurs when schools get funding based on average test scores and they start putting kids that are merely below average in the "special needs" group in order to make themselves look better without actually having to figure out how to teach those students.


By concern4kids on 3/26/2012 12:55:32 PM , Rating: 2
Political correctness has become a psychological social disease in itself. In America it did not take long for Developmentally Disabled to carry the same stigma as retarded. And retarded is actually accurate. Those people don't lack mental capabilities as somebody suggested. If they had actually talked to some of them and tried to listen, as opposed to following a popular stance, then they would have witnessed the frustration in their eyes as their synapses misfire, preventing them from responding as they wish. If we only cared enough, we could cure mental retardation.


RE: A tad insensitive, don't you think?
By JasonMick (blog) on 3/20/2012 9:39:56 PM , Rating: 5
quote:
Good job DT, way to sensationalize the suffering of these people by calling the affected children "zombies" and drawing completely unwarranted parallels to Resident Evil.

It's not meant to be insensitive or trite. I have complete sympathy, which is why I chose to publish this story in hopes of it gaining attention and a cure.

That said, the similarities to literary portrayals such as Resident Evil are obvious and unavoidable, particularly given that the children become aggressive, mindlessly wander, are unable to normally vocalize, violently bite (by CNN's account), and set fires.

Am I guilty of presenting this in the context of pertinent pop culture people can understand and relate to? Yes.

But this disease is the closest to a real-life "zombie" epidemic I've ever heard of.

It's crucial that a cure is found, for the children's sake and for the sake of humanity.


RE: A tad insensitive, don't you think?
By Amedean on 3/20/2012 10:05:52 PM , Rating: 2
I don't see a Pulitzer prize in your future. You have a tendency towards sensationalism but in your defense I bet it makes you click revenue.

P.S. your choice of title/pictures are a tad tasteless and indifferent to human suffering.


RE: A tad insensitive, don't you think?
By JasonMick (blog) on 3/20/2012 10:14:23 PM , Rating: 4
quote:
P.S. your choice of title/pictures are a tad tasteless and indifferent to human suffering.

The majority of those pictures are from CNN. I would be arrogant to presume I have better judgement than their large editorial staff.

The photographed children are real victims. People need to know about this.

Hiding it (as you seemingly would wish) does not help.

Maybe it's disturbing or sickening to you, but it's reality for these poor (in multiple ways) people. Let's hope this tragedy is cut short by research.


RE: A tad insensitive, don't you think?
By Amedean on 3/20/12, Rating: -1
RE: A tad insensitive, don't you think?
By TSS on 3/21/2012 5:21:01 AM , Rating: 4
Oh get off your high horse. Nothing wrong with a little dark humor.

In fact i'd expected more. A real life zombie virus? that's just too good to pass up.

I'm pretty sure the only reason CNN paid any attention to it is because their in the region anyway because of this whole kony hoax. Uganda = hot topic, uganda = views, uganda = profit. Nothing more then that.

Because otherwise, Why wasn't it reported before? Appearantly this is only the 4th country it strikes.

Simply put, nobody gives a crap about africa. So a couple of pictures and title that tie in an important issue with popular culture to increase interest? That's not tasteless, that's smart.

If you want to take out the tasteless, remove the pictures of the actual diseased kids. I'm sorry but i read this while eating breakfast and around that time i'd prefer to see more left for dead concept art and resident evil screenshots then actual disease ridden zombie kids. I don't need to see them either to belive it's a serious issue.


RE: A tad insensitive, don't you think?
By FaaR on 3/21/12, Rating: -1
RE: A tad insensitive, don't you think?
By Amedean on 3/21/2012 12:05:37 PM , Rating: 2
Isn't that nice how TSS can say something really stupid and get a rating boost - I mean the kind of stupid you would slap in public but get away with on the internet. I would be on the same level of irrational stupidity if I recommend grinding the dead children to feed dogs - seriously who the hell rates these fucktards up so much?


RE: A tad insensitive, don't you think?
By TSS on 3/22/2012 7:43:02 PM , Rating: 1
Sensible people.

The other guy basically suggested that every docter in the world needs "a cricket bat to the forehead" to have some sense knocked into him. How do you think those people get by day by day, after seeing the most horrid things that have happened to people and to have to tell tens, maybe even hundreds of families there loved ones have died or are going to die?

I saw a documentairy on it once where a doctor described it very accurately: "It might seem morbid, but when you have to deal with it every day, you can either laugh or cry about it. And since you'd otherwise spend the entire day crying, all you can do is laugh".

Shit happens. All over the world. Every day. Now it's zombie kids, but what about the tens of thousands that die every year, simply due to starvation?

So what now? spend the entire day crying? Do i need to feel bad for every deceased person on the planet?

Fuck no. I'll laugh it off and go on with my life, because that is what life does. Life goes on.

Except when you get hit with a cricket bat to the head. Or die in a fire. And he has the nerve to call me the sociopath, lol.


RE: A tad insensitive, don't you think?
By rs2 on 3/20/2012 10:38:21 PM , Rating: 4
I wound't go as far as to say that the article was insensitive, though I did get the impression that you enjoyed having an excuse to make gratuitous use of the word "zombie" in a nonfictional context.


RE: A tad insensitive, don't you think?
By JasonMick (blog) on 3/20/2012 11:46:46 PM , Rating: 3
quote:
I wound't go as far as to say that the article was insensitive, though I did get the impression that you enjoyed having an excuse to make gratuitous use of the word "zombie" in a nonfictional context.
Well...

Enjoy would be a wrong way of putting it.

But in a way you're sort of close in that I do definitely get a kick out of writing interesting articles -- the kind I would actually want to read. With me, the article and title aren't about getting clicks, rather it's about writing news that I think the majority of people would find interesting and worth reading.

I think it's easy to put things in a dry, clinical sort of language, be it a smartphone or disease, but there's a lot of art to writing it in an approachable, interesting way such that people can understand and appreciate.

To someone who hasn't played RE5 the reference might seem a bit odd, but to me it was an image I could relate to and that I figured a lot of readers of a tech site would get and appreciate. Basically, in RE5 the premise is that terrorists unleash a virus on Africa which causes (living) individuals to become mindless, wandering people, who are inclined to violence (among other more wild fictional sci-fi stuff).

Versus the traditional RE zombies or the zombies of say Ray Harryhausen films that 'boomers might be more familiar with, these fictional afflicted are a bit different in that they are reanimated dead corpses -- they're simply infected humans.

Plus it's set in Africa!

Of course anytime you toss in pop culture in a serious story you risk offending some politically correct folk, but I think as long as it's well intentioned and pertinent, it's OK.

I'd rather have a few PC police rag on me than to leave you guys dying of boredom, or worse yet have less people read a story like this, about a cause that really needs support ASAP.


By Kurz on 3/21/2012 2:50:50 PM , Rating: 2
It was well put together, You caught in the average techy with the reference and then you produced a reasonable article that went into the specifics and facts of the disease.

I never thought it would was insulting since you kept the reference only to the title, you were just drawing in a group of techy people who knew at least of the Resident Evil francise.

Not sure why people love being critical of you Jason,
There are times where you do take a side and I stay at least civil since everyone is entitled to their opinion.
Doesn't keep me from reading it or at least arguing it the other way.


RE: A tad insensitive, don't you think?
By JasonMick (blog) on 3/20/2012 9:50:03 PM , Rating: 2
P.S. I purposefully sought out a picture of Sheva (the Resident Evil 5 character on the fp) unarmed out of respectfulness to the victims.

Yes, I think the disease's symptoms mimic many of the traits of fictional and REAL-LIFE "zombies". If you deny that you clearly didn't read the story.

It's silly to debate whether they ARE zombies or whether the term is appropriate as:
a) The word has multiple meanings
b) In a literary sense there's been dozens of different "kinds" of zombie diseases.
c) Even in the RE universe nearly every game has introduced new and different zombies and symptoms.

The common traits are mental degradation, violent behavior, and unpredictability -- all symptoms exhibited by these children.

Recall, the word "zombie" originally entered the pop culture vernacular in 1930s/1940s as a word to describe people who were "possessed" or otherwise invoked into a mind-altered state by voodoo ritualists in Haiti.

Thus it's been applied historically to real world altered mental states -- in fact this use PREDATES the modern literary interpretations, though it shares some similarities with these modern takes.

(Learn some history, it won't hurt!)

That said, I don't want people to get the wrong idea.

That's why I put a picture of Sheva -- a strong, attractive, African video game character who people will recognize, but purposefully did not select one of the many pictures of her shooting guns, which would be inappropriate and insensitive.

I think you're trying overly hard to be politically correct, rather than focusing on the problem/tragedy at hand. Let's talk about that, shall we?


RE: A tad insensitive, don't you think?
By Iaiken on 3/21/2012 9:57:41 AM , Rating: 4
quote:
violent behavior


Define violent behaviour please Jason.

From what I have read, only an estimated 10-15% of victims have ever behave violently towards other people. In all of the other articles on the web and in print that I have including CDC documentation, the word "violent" is use exclusively as an adjective to describe the nature of the convulsions that the victims experience.

Your use of language creates the perception that these children are commonly committing mindlessly violence towards other people and that they should be feared when that simply is not the case. In the overwhelming majority of cases they simply stop responding to other people, even if directly interfered with. The only zombie-like characteristics are their continuous aimless wandering and complete ignorance of the physical harm inflicted upon themselves from repeated falls or from dragging themselves across the ground.

Seriously man, do your reading if you are going to write.


By Natfly on 3/21/2012 11:50:38 AM , Rating: 2
Your comment made me go read the CNN article. I wish I would have read it first, it gives a completely different understanding of the conditions. What a sad, seizure inducing, and brain degenerating disease.


RE: A tad insensitive, don't you think?
By JasonMick (blog) on 3/22/2012 3:18:54 AM , Rating: 2
quote:
From what I have read, only an estimated 10-15% of victims have ever behave violently towards other people. In all of the other articles on the web and in print that I have including CDC documentation, the word "violent" is use exclusively as an adjective to describe the nature of the convulsions that the victims experience.

Your comment fails to note that the children are also setting fires, killing numerous people in the process.

Again, if you read the Ugandan statistics, ~4,000+ children have been affected, with the most severe cases likely being less that 1,000. Meanwhile 200+ adults have been killed.

This means that for every 20 of these children, approximately one adult has been directly killed by them.

This may not be movie horror zombiefication, but I would still say that's pretty serious.

Even if a symptom only shows up 10-15 percent of the time if it creates extreme chaos it is often prominently noted.

For example, if a drug had a 10-15 percent risk of killing you, news headlines would likely read "Drug xxxx found to be deadly", even though statistically there is a smaller chance of it being deadly.

It is certainly tragic, and I do agree with you that it is fortunate that the violent symptoms have a lower occurrence, hence keeping the secondary adult death toll low.


By CometFix on 3/22/2012 12:20:50 PM , Rating: 2
For the record, the words Zombie and Retarded were words with meanings before they were ever recognized as Politically correct or not.

Zombification being a state brought on to living people via some disease or illness. If you brought any Hollywood images to mind when hearing the word then that's on you.

Example - The children under the effects of the disease acted like "zombies".

Retarded is a word that describes anyTHING that is or has been retarded from doing something. It's not just a derogatory word used to describe only handicapped children. Again, if you thought that... that's on you.

Example - The car's turning capabilities were "retarded" without power-steering fluid.


RE: A tad insensitive, don't you think?
By Iaiken on 3/22/2012 2:40:53 PM , Rating: 2
quote:
Your comment fails to note that the children are also setting fires, killing numerous people in the process.


No, I included that in my line of thinking, but there are no actual proven documented cases of the child being the one to have set the fire deliberately. The only documented cases of fire with regards to children is of them falling into cooking fires or bumping into oil lamps and knocking them over over and getting seriously burned.

You're projecting a knowledge and value structure onto these that they simply don't share. Some of these remote towns still have shaman/witch-doctors and strongly believe in magic and mysticism. In several other cases it is suspected by the local authorities that other villagers burned the houses down with family inside because they thought the children and their mother were cursed.

These children routinely wander off and die of exposure and drown themselves, some have even died from catastrophic head injuries sustained from falling on rocks, they don't even try to catch themselves by putting their hands out. In one documented case, a child fell face first into a cooking fire and was killed while medical staff were visiting, the child didn't even try to escape the fire and the parents had to pull them out.

I'm sorry, but I think we're just going to have to disagree here.


By Iaiken on 3/22/2012 2:43:19 PM , Rating: 2
quote:
onto these people that they simply don't share


Sorry, missing word.


RE: A tad insensitive, don't you think?
By arztmat on 3/24/2012 9:33:24 AM , Rating: 2
Jason please give us verifiable and credible sources, i.e sources at the source, that talk about pyromania in these children.

If you cannot, then please refrain from sensationalizing what may be a serious problem for some of us.


By arztmat on 3/25/2012 4:29:17 AM , Rating: 2
ps. Where is the requisite fly-encrusted face?


By concern4kids on 3/26/2012 1:05:51 PM , Rating: 2
Excuse me for pointing this out, but did I not read something which said VIOLENT SEIZURES? That could mean several things, could it not?

Are you all daft? We have a serious problem and you bicker about semantics as if you are superior by birth or something. Go down there and volunteer so you can earn a right to your arrogant attitudes please. I doubt you will come back with them.


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