Update on Chiang Mai Mystery Deaths; Ukraine Leptospirosis Cases; and Legionella in Latvia

Undiagnosed Deaths in Chiang Mai Possibly Due to Insecticide
As written in a March 23, 2011 HealthMap blog entry, there have been seven mysterious deaths since January 2011 linked to Chiang Mai, Thailand’s Downtown Inn. The undiagnosed deaths prompted travel warnings to be issued for the popular tourist destination, and led authorities to investigate many different potential causes (mushroom poisoning, toxic seaweed, and pure coincidence to name a few).

New findings released by a New Zealand news investigation team suggests the tourist deaths are connected, and due to a toxic bed bug insecticide. Small traces of the insecticide Chlorpyrifos were found in the hotel rooms where the victims had stayed. While additional test samples have been sent to the US Centers for Disease Control as well as Osaka University in Japan, other pesticides are now being looked at, as health officials work to determine the cause of the deaths.

Leptospirosis in Ukraine
For the first time in 10 years, leptospirosis has returned to the capital of Ukraine. Kiev officials have confirmed cases of leptospirosis in individuals who had gone swimming in a local pond.

Leptospirosis is a dangerous infectious disease that is accompanied by fever, possible liver damage and often requires intensive care treatment. Leptospirosis is sometimes found in fresh water that has been contaminated by animal urine, and primarily occurs in warmer climates. As a general rule, pond beaches in the Ukraine should be decontaminated before swimming is allowed.

Несистемное и очень некачественное проведение малых гидротехнических работ и дератизации (уничтожения грызунов) на киевских пляжах ставит под угрозу здоровье и даже жизнь людей. Так, впервые за 11 лет после последнего зафиксированного случая заболевания, в столицу вернулся лептоспироз.

Это опасное инфекционное заболевание, которое сопровождается волнообразной лихорадкой, поражением печени и, чаще всего, требует реанимационного лечения. Лептоспироз, преимущественно, попадает в воду с мочой больных домашних животных и крыс. Вот почему борьба с грызунами в зонах отдыха людей особо актуальна накануне открытия пляжного сезона.
«В 2010 году были случаи заболевания лептоспирозом и даже уже в 2011. И это на водоемах с официальными пляжами.

Legionnaires' Disease in Latvia
According to the Latvian Centre of Infectology (LTSI) since last autumn, the country has experienced extended cases of the acute infectious disease, legionellosis (or Legionnaires' disease). This month, Latvia has confirmed the death of one individual due to Legionella.

Experts have determined that all cases of infection have occurred in apartment buildings. This is typically the case for Legionnaires’ disease, as it prospers in humid, confined, and heavily populated spaces.

According to the Mayo Clinic:

“Legionnaires' disease primarily affects the lungs, it occasionally can cause infections in wounds and in other parts of the body, including the heart.”

“A mild form of Legionnaires' disease — known as Pontiac fever — may produce symptoms including fever, chills, headache and muscle aches. Pontiac fever doesn't infect your lungs, and symptoms usually clear within two to five days.”

По информации Латвийского центра инфектологии (ЛЦИ), начиная с осени прошлого года по стране стало резко распространяться опасное острое инфекционное заболевание легионеллез ("болезнь легионеров"). В этом году в результате этой болезни уже скончался один человек.
Как отмечает NRA, эксперты установили, что все случаи заражения произошли в квартирах многоквартирных домов.

Легионеллез (питтсбургская пневмония, понтиакская лихорадка, легионелла-инфекция) — редкое острое инфекционное заболевание. Заболевание протекает, как правило, с выраженной лихорадкой, общей интоксикацией, поражением легких, центральной нервной системы, органов пищеварения, возможно развитие синдрома полиорганной недостаточности.

Mysterious Deaths in Chiang Mai, Thailand

On February 7th, 2011, New Zealand news sources announced that a Wellington woman was dead and two others were seriously ill after returning from Chiang Mai, Thailand (a popular tourist destination in Northern Thailand). Food poisoning was initially suspected by authorities.

A press conference was held in Chiang Mai on March 8th after it was discovered that the New Zealand native had stayed at the Downtown Inn, in a room neighboring that of a Thai woman who was found dead on February 3rd. In addition, on February 19th, the bodies of an English couple were discovered inside the hotel. While Thai authorities stated that the investigation was ongoing, it was suspected that the deaths were coincidental.

On March 12th, additional information revealed that the tourist from New Zealand was infected with an echovirus, and likely died of myocarditis. Autopsies on the English husband and wife showed block arteries in both, which may have contributed to their deaths.

Travel warnings for Chiang Mai were issued via media outlets on March 18th after the deaths of an additional two people (an American woman and a French woman) were linked to recent travel to Chiang Mai.  It was also stated that the two died suddenly and had similar symptoms as the previous victims, including myocarditis. Speculations began to circulate about the possibility that the deaths were linked to eating at local food markets.

On March 21st, the death toll rose to seven when it was discovered that a 59 y.o. male, Canadian tourist that had used facilities at the Downtown Inn in Chiang Mai, died in early January.  As of March 23rd, no confirmation of a common viral infection or other cause has been given. The victims’ families continue to demand answers.