Mysterious skin disease reduces in Quang Ngai

QUANG NGAI -- The Health Department of central Quang Ngai Province reported no new cases of the mysterious skin disease that has killed 23 people and continues to baffle scientists.

The main symptoms of the disease are thickened skin on the palms and soles (keratosis), stiffness in the limbs and ulcers on hands and feet that look like burns.

Department office head Le Huy said there had been no new cases since June 8. He said four out of six patients with the disease at Quang Ngai Hospital had been discharged on July 1 while 18 other patients remained at Ba To District clinic. Five patients in Ha Noi for treatment had returned in good health.

The Ministry of Health sent four doctors to Quang Ngai Hospital and Ba To Clinic to help with diagnosis and treatment. The government ordered 250 tonnes of rice be provided free to patients in five communes in six months.

The World Health Organisation said Viet Nam was "on the right track" in the measures it had taken to treat patients and prevent, investigate and monitor the development of the mysterious skin disease that had occurred mostly in Ba To District.

Dr Takeshi Kasai, WHO representative in Viet Nam, said it would take more time to find out the cause of the disease that it calls the Inflammatory Palmoplantar Hyperkeratosis Syndrome (IPPH).

"As we do not know what causes the syndrome, or its source of transmission, identifying the cause may take longer than anticipated or prove elusive," he said.

The Ministry of Health has been actively supported by other agencies and ministries, the statement said.

Health Minister Nguyen Thi Kim Tien has said that besides continuing investigations to identify the cause, health officials should work out comprehensive intervention measures to reduce mortality and occurrence of new cases, and improve the overall health status of people living in the district.

WHO and the US Center for Disease Control and Prevention (US CDC) have been in close communication with the ministry over investigation and measures to prevent the spread of the disease.

Early this month, Health Ministry's General Department of Preventive Medicine invited two experts from WHO and US CDC, who conferred with local investigators of the outbreak, reviewed data collected to date and made recommendations for additional studies and testing to guide intervention and direct further investigation.

Meanwhile, local health experts said during a recent seminar that dioxin must be considered as a possible cause of the unidentified skin disease.

Millions of Vietnamese citizens and thousands of hectares of land and water sources have been affected by the toxic chemical that was sprayed by US forces during the American War.

Dr Pham Due, director of the Poison Control Center at Bach Mai Hospital in Ha Noi, said dioxin should be considered a possible agent because it causes liver damage and keratosis.

Tran Hau Khang, director of the Central Dermatological Hospital, said patients might have been infected with dioxin in pesticides.

People with IPPH syndrome were first reported on April 19, 2011, in Ba To district.

The Ministry of Health has conducted several field investigations focusing on epidemiology, clinical medicine, occupational health, nutrition, toxicology and environmental factors, but has yet to find a cause.

After investigations, no evidence of elevated levels of heavy metals or agrochemicals was found in human or environmental samples.