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

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, 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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RE: I wonder if this is a neurotropic virus?
By vol7ron on 3/20/2012 10:26:24 PM , Rating: -1
We all think different things. I was thinking this was a fake article. "Kids in third world countries nodding their heads and setting fires to buildings." I immediately thought of anti-American flags being waved and people shooting guns. Especially when Sudan and Libya was mentioned.

I almost laughed when it said they were gnawing at the cloths around their wrists. If you tie me up and leave me somewhere with cloths around my wrist, I will try anything I can to get them off -- who wants to be restrained for an extended period of time?

RE: I wonder if this is a neurotropic virus?
By wordsworm on 3/21/12, Rating: -1
RE: I wonder if this is a neurotropic virus?
By tayb on 3/21/12, Rating: -1
RE: I wonder if this is a neurotropic virus?
By Breathless on 3/21/2012 10:17:38 AM , Rating: 1
whoaaa.... delusional much?

RE: I wonder if this is a neurotropic virus?
By tayb on 3/21/2012 10:50:25 AM , Rating: 3
How could people possibly not understand the sarcasm there? President Obama has literally done the 100% exact opposite of the three things I said. That was exactly the point. Why call out Republicans when Democrats do the EXACT same things...

RE: I wonder if this is a neurotropic virus?
By Breathless on 3/21/2012 11:23:13 AM , Rating: 2
Because liberals think that everything that you said was absolutely true and not sarcastic at all. I simply thought you were a liberal douche.

RE: I wonder if this is a neurotropic virus?
By SPOOFE on 3/21/2012 3:07:46 PM , Rating: 4
It's hard to tell the difference between sincere extremism and a parody of that extremism.

RE: I wonder if this is a neurotropic virus?
By fredgiblet on 3/21/2012 3:47:50 PM , Rating: 4
I've heard that there are conservatives who think that Stephen Colbert is actually one of them.

By vol7ron on 3/24/2012 10:40:59 AM , Rating: 2
He claims to be Democrat, but I think he's actually more Libertarian.

And I'm not too sure why my comment was voted down so poorly, by stating that the symptoms in this article seemed like the actual actions of many extremist, which reside in the same countries that this "disease" is taking place.

By tayb on 3/22/2012 9:33:17 AM , Rating: 4
As opposed to what, a conservative douche?

By Mint on 3/23/2012 5:03:17 PM , Rating: 1
The zero rating makes sense when you realize that Republicans criticize Obama for doing those very things despite him doing the opposite. They think he's too soft with Iran, doesn't support Israel enough, pulled the troops out of Iraq too early, and pays too much attention to liberal pansies when it comes to foreign affairs.

By concern4kids on 3/26/2012 12:43:31 PM , Rating: 2
Because thanks to today's biased press, it is the Republicans who are the current target. And people trust the media far too much. Freedom of the Press is important for reporting all the news. But a law or two requiring them to report the entirety of the stories they choose to print might be a good idea at this stage of the game. Heed the advice of Teddy Roosevelt. Neither party is innocent these days.

By tastyratz on 3/27/2012 8:58:25 AM , Rating: 2
Because it has nothing to do with the price of tea in China?

Why on earth would we entertain a political argument in an article about a disease outbreak in uganda?
Ask the infected children if they are republican or democrat but the blank stare might not just be from the disease.
Let's at least try to stay a shred on topic here

By woody1 on 3/21/2012 5:33:46 PM , Rating: 2
Yeah, I really wish Obama would go to war with Iran. I'm bored. We really could use another war right now. And, of course, we should always be willing to risk our lives and economy to support the 51st state, Israel.

By kattanna on 3/21/2012 11:17:43 AM , Rating: 5
who wants to be restrained for an extended period of time?

funnily enough.. here in the west some people pay good money for such an experience

RE: I wonder if this is a neurotropic virus?
By MozeeToby on 3/21/2012 11:26:17 AM , Rating: 3
Sorry but no. The seizures range from unnoticeable, to nodding of the head (hence the name of the disease), to full on gran mal, life threatening seizures. They have been confirmed by ECG and MRI in many patients. There's also the permanent stunting of growth and massive personality changes. Oh yeah, there's also the fact that the disease is nearly universally fatal, with a median survival rate of just over 3 years.

This isn't some made up thing. It isn't all in someone's head. It's a real disease, most likely related to River Blindness which is caused by a parasite. If the cause is the same there is good news and bad: The good, since 1988 Merck, in a rare case of corporate goodwill, has provided effective treatment for river blindness free of charge. The bad, the parasite has recently been showing signs of resistance.

RE: I wonder if this is a neurotropic virus?
By MrBlastman on 3/21/2012 2:00:00 PM , Rating: 1
Given the slow progression of the disease, I tend to think that it is not a virus at all. Even bacteria would show a quicker result (not to mention measurable via blood counts) so parasitic infection seems even more plausible or perhaps some strange fungal infection? (even fungal tend to be fast in some cases)

It sounds to me that the brain is almost rotting from the inside, effecting all major centers in one way or another.

RE: I wonder if this is a neurotropic virus?
By SPOOFE on 3/21/2012 3:10:24 PM , Rating: 2
Given the slow progression of the disease, I tend to think that it is not a virus at all.

HIV can take up to ten years to progress into full-blown AIDS.

RE: I wonder if this is a neurotropic virus?
By Lerianis on 3/22/2012 12:34:46 AM , Rating: 2
Actually, some people have had it since it was called "Grid" and still don't have full-blown AIDS. That's going on 40 years.

But AIDS is the exception to the rule (sole exception, by the way, the only one that comes close to it is syphilis), so we cannot judge all viruses by AIDS.

Personally, I've always thought that the 'long gap' between first exposure and onset of disease spoke of AIDS being a man-made virus.

RE: I wonder if this is a neurotropic virus?
By MozeeToby on 3/22/2012 1:35:44 PM , Rating: 2
AIDS isn't an exception, there are many viruses that have long incubation times. Measles can take a decade to show symptoms, Rubella seldom shows symptoms in less than 10 years. Chicken pox can lay dormant for decades before resurfacing as shingles. Not to mention that many retrovirus infections (which HIV is) are also very slow moving, taking years or decades to become apparent. And finally, there are a huge array of viral infections that almost never show symptoms unless something else sets them off or gives them an opening.

Try donating bone marrow sometime. They test your blood for literally dozens of viral infections that you've probably never heard of because they are commonly found in healthy individuals, but if a bone marrow recipient were to contract them before the immune system reestablishes itself they would be devastating.

By Lerianis on 3/23/2012 1:14:49 AM , Rating: 2
With all due respect, my parents work in a hospital and do those screenings. They do them to make sure that you do not have the disease AT THAT VERY MOMENT and are asymptomatic due to a strong immune system.

The only point you got right is that there are viral infections that almost never show symptoms until something else sets them off or gives them an opening. HOWEVER, the way that AIDS does it (by hijacking T cells) is AIDS-only.

We have NO other diseases that do that, coming from reading many books on the subject and asking doctors about that.

RE: I wonder if this is a neurotropic virus?
By gixser on 3/21/2012 9:06:11 PM , Rating: 2
You clearly have no idea what you are talking about so why even bother posting? Eveverything you just said is complete and utter bollocks.

By MrBlastman on 3/22/2012 11:17:57 AM , Rating: 2
And you do, Mr. Smartypants? Oh, wait, what's that? Yeah! That's right, instead of posting a worthwhile rebuttal with facts and data, you instead point out that I just spent the last few hours enjoying your mom's bollocks! I must say, also, that it was just that. Furry, full of hair and not velvety smooth like I'd expect. Good thing I bagged it!

See, I can counter with an equally useless post if I try (and not that hard).

By mindless1 on 4/4/2012 12:43:05 PM , Rating: 2
Lighten up, I do that all the time ;)

"If you mod me down, I will become more insightful than you can possibly imagine." -- Slashdot

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