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Nodding Disease andAfrican Swine Fever  Virus in UgandaCause or Coincidence?     Produced by http://noddingdisease.blogspo...
In the north of Uganda, thousands ofchildren have fallen ill with a fatal,incurable disease known as noddingdisease. Commu...
New Video saysNodding Disease is"Spreading Quickly"           http://youtu.be/vKdS8OG_EOk                                 ...
Scientific American: Thousands are dying of Nodding Disease each yearNodding Disease Origins RemainUnexplainedBy Katherine...
Nodding disease takes toll onKitgumschoolIn Okidi Primary School, the condition has taken its toll asthe majority of the l...
A quarter of the children in someUgandan villages are afflicted withNodding DiseaseUgandans hope Kony spotlight shifts to ...
Mother: “I watchedthree of my childrennod to death.”By Harriet Anenahttp://www.monitor.co.ug/Magazines/Life/-/689856/13770...
9 children in oneUgandan family haveNodding Disease             http://youtu.be/wOuDEYd1aZs                               ...
Uganda is accused of covering up thereal number of Nodding Diseasedeaths[Ugandan] Govt urged to declare north adisaster zo...
What is Uganda covering up?Police arrest manfundraising fornodding diseasepatientsBy Agatha Ayebazibwe“The syndrome has co...
Doctor in Uganda saysNodding Disease couldbe from contact withsome animal             http://youtu.be/_atd3ptpZKc         ...
Is it possible that "nodding disease" is coming from carrier pigsinfected with a new chronic or subacute strain of African...
Background on African Swine FeverVirus as a human pathogen:"African Swine fever is an endemic disease in sub-Saharan Afric...
Detection of Novel Sequences Relatedto African Swine Fever Virus inHuman Serum and Sewage.Loh J, Zhao G, Presti RM, Holtz ...
African Swine Fever Virus (Asfarviridae)sequences found in people with febrileillnessesAbstractVirus Identification in Unk...
Symptoms, complications and descriptions ofNodding Disease mentioned in variousarticles about the epidemic in UgandaContin...
Brain atrophyBlindnessTiredness and sleepingSunken eyesHeadachesSerious injuries or death resulting from falls during seiz...
Sub-clinical seizuresDrooling, overproduction of saliva ("saliva is all over the body")Vitamin A deficiencyWormsInability ...
Some have an elevated cell count, mainly lymphocytes andmonocytesMicroscopically visible microfilariaLoss of neck muscle t...
http://www.monitor.co.ug/artsculture/Reviews/-/691232/1317258/-/97bml/-/http://www.ghfn.org/1-topics-general-pages/nodding...
Is drooling the smoking gun linkbetween Nodding Disease and AfricanSwine Fever Virus?This article mentions the saliva issu...
Nodding Disease andAfrican Swine FeverOverlap in Arua,Gulu, Kitgum, Pader,Lango, Anaka, andMasindi, Uganda                ...
Study says AfricanSwine Fever isendemic to Ugandahttps://docs.google.com/viewer?a=v&q=cache:NdiLNGon8xsJ:www.roavs.com/pdf...
24Nodding Disease and African Swine Fever Virus in Uganda: cause or coincidence?
African Swine Fever in Arua, Uganda:http://ugandaradionetwork.com/a/story.php?s=39689Nodding Disease in Arua, Uganda:"Misu...
African Swine Fever in Gulu, Uganda:http://allafrica.com/stories/201109080222.htmlNodding Disease in Gulu, Uganda:http://w...
African Swine Fever in Kitgum,Uganda:http://allafrica.com/stories/200609270361.htmlNodding Disease in Kitgum, Uganda:http:...
African Swine Fever outbreak inPader, Uganda in 2010:http://www.slideshare.net/ILRI/status-of-asf-in-uganda-by-c-rutebarik...
African Swine Fever in Anaka,Uganda:http://www.newvision.co.ug/PA/8/16/728216Nodding Disease in Anaka, Uganda:http://allaf...
African Swine Fever in Lango,Uganda:http://www.newvision.co.ug/D/8/16/728216Nodding Disease in Lango, Uganda:http://www.ma...
Nodding Disease in Masindi, Uganda:"First 192 cases were registered in Kitgum and Pader in 2009 but over time, it hassprea...
Nodding Disease and Meningitis inAmuru, Uganda:"Along with the current meningitis outbreak, the Amuru district has also re...
African Swine Fever Virus in OdekSub County, Ugandahttp://www.meattradenewsdaily.co.uk/news/050811/uganda___african_swine_...
African Swine Fever in Sudan:http://books.google.com/books?id=yE6ssPoWr4EC&pg=PA120&lpg=PA120&dq=sudan+%22asfv%22&source=b...
Will consuming ASFV-infected pork in Adjumani cause Nodding Disease?Adjumani Residents Defy Quarantineon PigsUGANDA - Effo...
Transmission of African Swine FeverVirus"ASF virus is transmitted between infected and susceptible pigs, by consumptionof ...
Evidence that Nodding Disease is CommunicableInvestigation into the NoddingSyndrome in WittoPayam, WesternEquatoria State,...
Ugandan Man Has 7 children with Nodding DiseaseEach child‟s nodding head eats at Ocitti‟sprideHe was a proud man, because ...
Symptoms of ASFV that overlap withNodding DiseaseChronic African Swine FeverSymptoms (Just a very partial list)ataxiawasti...
Consumption of ASFV-infected Pork in UgandaUganda: Residents ignore warningsconcerning consumption of pork frompigs killed...
Cases of Nodding Disease Found inAdultsNodding Disease: Success stories underdifficult circumstancesbyJavieSsozi"Research ...
Ugandan towns with ASFV epidemicsTowns in Uganda that have hadAfrican Swine Fever epidemicsApacHoimaIgangaJinkaKalagangaKa...
Pathology of the Brain in Nodding Disease:"Sub-clinical seizures have beenidentified in electroencephalograms,and MRI scan...
Writer links Nodding Disease to sick pigs in Uganda This writer, Angelo Opi-aiyaIzama, is the first to mention pigsas a po...
Nodding Disease Horror: 12-year-oldvictim is tied to a tree for 13 hourseverydayThis article by Edward Echwalu in The Obse...
Constant Nasal Flow in NoddingDisease may be another indication thatit could be caused by African SwineFever Virus"The dis...
Scott Dowell of the CDC on NoddingDisease in Uganda:"As an example, we’ve been investigating a “nodding disease” inSouth S...
CDC says Nodding Disease isa form of "atonic seizure."Dr. Scott pointed out that one of the major progress areas was the a...
CDC on Nodding Disease: "Thechildren definitely die with it"For now, the already affected children are sentenced todeath b...
CDC: Cases of NoddingDisease in Uganda have risento over 3,000 from 2,000reported at the beginning ofthis year.http://www....
CDC said Nodding Disease in Uganda"could turn out to have just as hugeimplications for the rest of the world."In the case ...
CDC: Nodding Disease is at the top of its list of mystery outbreaksCDC planning trialfor mysteriousnodding syndromeby John...
BBC reports that initially the CDC suspectedNodding Disease might be "psychogenic"The syndrome stealing Uganda and SouthSu...
World Health Organization had beentreating nodding disease as a post-traumatic stress disorderNodding disease spreads to G...
Medical Teams International has sent over 45 volunteermedical teams to Uganda to address immediate needs and tomobilize lo...
Nodding Disease can cause "violenttantrums."Shockingly, no one, not even health officials, really knowswhat causes this si...
Nodding Disease Leaves Men SexuallyStarvedThe nodding disease is leaving many men sexually starved,according to Dr. Conan ...
2009 survey found out that 83 per cent of the NoddingDisease cases verified were suspected to have eatenbush meat:Governme...
Epilepsy in Uganda was linked to pork in 2009Thursday, December 3, 2009http://www.thepigsite.com/swinenews/22608/epileptic...
Study suggests more boysthan girls have NoddingDisease in Uganda"The Ministry of Health is to start its own investigations...
Medics To Examine Brain Of NoddingDisease VictimMedical doctors want to examine the brain of a dead personconfirmed to hav...
Women tie themselves to trees overnodding diseaseBy AGATHA AYEBAZIBWE, Daily MonitorWomen activists tied themselves on tre...
A Day in the Life of the PAZ Project: Pig farming andslaughtering in Western Kenyaby James Miser Akoko There is close inte...
Ugandan government seems to be trying to control what people know aboutNodding DiseaseCensorship ahead of the IPU assembly...
Beatrice Anywar is praised as "Mamma Nodding Disease"Anywar to the rescueBy RukiyaMakumahttp://www.independent.co.ug/news/...
School Becomes an UnfriendlyEnvironment for Children withNodding Diseasehttp://www.acholitimes.com/index.php/news/acholi-n...
Report from Gulu: Nodding Disease isDestroying Families and Communitieshttp://www.acholitimes.com/index.php/news/acholi-ne...
WHO and CDC plan to hold Nodding Disease conference in JulyWhy are Ugandas children nodding to theirdeathsBy Amy FallonThe...
10 Reasons that Uganda absolutelycannot admit that Nodding Disease iscaused by African Swine Fever Viruseven if that is th...
The CDC’s scientists have beeninvestigating Nodding Disease sinceNovember, 2009. Strangely, they stillhaven’t tested the N...
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Nodding Disease and Swine Fever (Second Edition)

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Is it possible that "nodding disease" in Uganda is coming from pigs infected with a new chronic or subacute strain of African Swine Fever Virus? African Swine Fever has been a serious problem in Uganda. It has become endemic in Uganda. Scientists often quickly dismiss the notion of a human epidemic of African Swine Fever Virus because they think African Swine Fever Virus does not infect people. But that may not be the case. Sick or ASFV-infected pigs in places like Gulu, Anaka, Arua, Kitgum, Masindi, and Pader may be the source of a "nodding disease" zoonotic virus. Even if the pigs are not overtly sick, they could be carriers of a strain of this very insidious virus. African Swine Fever Virus infects many parts of the pig's body, including the brain. It causes serious neurological damage. It is also interesting that in some epidemics of African Swine Fever, it is mainly the young piglets that are affected which would be a strong parallel to "nodding disease." The ASFV-infected piglets suffer from ataxia, wasting, stunted growth, blindness, increased salivation, and opportunistic infections, just like the children with Nodding Disease.

America's Centers for Disease Control has been investigating Nodding Disease for almost three years without figuring out what the cause is. They have yet to test the Ugandan children with Nodding Disease for African Swine Fever Virus. That raises serious questions about the CDC's credibility and competence.

According to a patent,"Polypeptides from African Swine Fever virus as vaccines for preventive and therapeutic use," (http://www.google.com/patents/US20080131449) filed by Matthias Rath, "African Swine Fever is an endemic disease in sub-Saharan Africa and many other parts of the developing world. It is caused by the African Swine Fever virus that primarily replicates in macrophages and monocytes leading to the impairment of the structure and function of the immune system of the infected organisms. Until now the African Swine epidemic continues to spread despite all efforts to contain it. Thus, there is an objective need for effective, safe and affordable preventive and therapeutic approaches, in particular for effective vaccines, to control and eventually eradicate this disease. Since the characteristic feature of the African Swine Fever virus is to impair the immune system and to cause immune deficiencies in its hosts the development of vaccines and other therapeutic approaches against the African Swine Fever virus has implications for other immune deficiencies or diseases. Since antibodies for the African Swine Fever virus have been detected in humans, the possibility of human infection with the African Swine Fever virus exists and may thus far have escaped any systematic screening. Thus, any preventive and therapeutic approach to African Swine Fever can have far-reaching implications to control immune deficiency conditions in humans. "

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Transcript of "Nodding Disease and Swine Fever (Second Edition)"

  1. 1. Nodding Disease andAfrican Swine Fever Virus in UgandaCause or Coincidence? Produced by http://noddingdisease.blogspot.com/ 1 Nodding Disease and African Swine Fever Virus in Uganda: cause or coincidence?
  2. 2. In the north of Uganda, thousands ofchildren have fallen ill with a fatal,incurable disease known as noddingdisease. Communities are starting topanic and some people are losinghope as the medical communitystruggles to either find a cause or acure, as the BBCs Will Ross reports.http://www.bbc.co.uk/news/world-africa-17589445 2 Nodding Disease and African Swine Fever Virus in Uganda: cause or coincidence?
  3. 3. New Video saysNodding Disease is"Spreading Quickly" http://youtu.be/vKdS8OG_EOk 3 Nodding Disease and African Swine Fever Virus in Uganda: cause or coincidence?
  4. 4. Scientific American: Thousands are dying of Nodding Disease each yearNodding Disease Origins RemainUnexplainedBy Katherine HarmonA strange illness [Nodding Disease] has been killing thousandsof young people each year, and recently it has started claimingeven more victims in Africa. http://blogs.scientificamerican.com/observations/2012/04/12/nodding-disease-origins-remain-unexplained/ 4 Nodding Disease and African Swine Fever Virus in Uganda: cause or coincidence?
  5. 5. Nodding disease takes toll onKitgumschoolIn Okidi Primary School, the condition has taken its toll asthe majority of the learners are infected with the syndromemaking learning difficult for them.“At the moment, we have 215 pupils out of the 365 enrolled inthe school. They are struggling to learn with the disease,thwarting their learning processes by continuous noddingand constant seizures even during lesions,” she said, addingthat the pupils are evidently disinterested in learning.MsAtto said it’s a normal scenario to see every after one hour,a pupil convulsing, keeping the other children in distressfulmood thinking that they could be next.By Stephen Komakech, Saturday Monitorhttp://www.monitor.co.ug/News/National/-/688334/1334206/-/b07ac5z/-/ 5 Nodding Disease and African Swine Fever Virus in Uganda: cause or coincidence?
  6. 6. A quarter of the children in someUgandan villages are afflicted withNodding DiseaseUgandans hope Kony spotlight shifts to more urgentproblem: „Nodding disease‟By Geoffrey YorkUgandan journalists and activists have been trying to gain attention for nodding disease, andthis week they finally won a major victory: special clinics were opened in several districts ofnorthern Uganda to offer help to the victims. More than 200 sick children were brought to theclinics on Monday alone.At medical clinics, the children are sometimes treated with anti-convulsants and epilepsy drugsto reduce their symptoms. But no cure has been found. In some villages, up to a quarter of thechildren are afflicted by it, and a climate of fear is growing, although the disease itself does notappear to be infectious.http://www.theglobeandmail.com/news/world/worldview/ugandans-hope-kony-spotlight-shifts-to-more-urgent-problem-nodding-disease/article2367713/ 6 Nodding Disease and African Swine Fever Virus in Uganda: cause or coincidence?
  7. 7. Mother: “I watchedthree of my childrennod to death.”By Harriet Anenahttp://www.monitor.co.ug/Magazines/Life/-/689856/1377046/-/item/0/-/i9e4hrz/-/index.html 7 Nodding Disease and African Swine Fever Virus in Uganda: cause or coincidence?
  8. 8. 9 children in oneUgandan family haveNodding Disease http://youtu.be/wOuDEYd1aZs 8 Nodding Disease and African Swine Fever Virus in Uganda: cause or coincidence?
  9. 9. Uganda is accused of covering up thereal number of Nodding Diseasedeaths[Ugandan] Govt urged to declare north adisaster zoneWritten by Ahmed BogereMasembehttp://ssuubifm.net/kay/2012/03/govt-urged-to-declare-north-a-disaster-zone/Ugandans living in the United Kingdom (UK) have demanded that the government declaresnorthern Uganda a disaster zone because of the nodding disease that is ravaging mostparts of the region.The activists made the call on Saturday 3, March as they launched a campaign to solicitfunds to set-up a research centre, raise awareness, and highlight the dangers of a „noddingdisease‟ which has affected thousands of children aged between 5 and 15 years in northernUganda.Ms Belinda Atim, who spearheaded the initiative in conjunction with Lee Oryem and theAcholi community in the UK said they decided to take action because of the situation innorthern Uganda. “We feel that the government‟s response is lukewarm and they could domore because it is in charge of the people. We know that they are hearing.” MsAtim said.She added: “We know that some money has been committed by the government but thatmoney is not enough. 100million Uganda Shilling only equates to about £23,000 or £25,000.It can‟t take care of the 3000 children officially known be suffering from the disease.”She also said much as the media may say or put the death figure at less than 200,“…we know one village which has lost 264 children,” said MsAtim, before addingthat: “In other villages the death rate is higher, we know between 1800 and 2000children have died. We feel that the government should have declared northernregion a disaster zone.” 9 Nodding Disease and African Swine Fever Virus in Uganda: cause or coincidence?
  10. 10. What is Uganda covering up?Police arrest manfundraising fornodding diseasepatientsBy Agatha Ayebazibwe“The syndrome has come to light, government should stop hiding it fromthe public but rather take a bold step to address it,” said Ms SandraKomuhiindo, the communication and information assistant at UgandaWomen’s Network, one of the organisations running the campaign.The arrest seemed to have been uncalled for, as police chief KaleKayihura ordered the release of MrMwanika and apologised for theincident. Charges were dropped but the pictures and other materialremains in police custody, while the band has been prohibited frommentioning nodding disease during their show.http://www.monitor.co.ug/News/National/-/688334/1377320/-/awo0ybz/-/ 10 Nodding Disease and African Swine Fever Virus in Uganda: cause or coincidence?
  11. 11. Doctor in Uganda saysNodding Disease couldbe from contact withsome animal http://youtu.be/_atd3ptpZKc 11 Nodding Disease and African Swine Fever Virus in Uganda: cause or coincidence?
  12. 12. Is it possible that "nodding disease" is coming from carrier pigsinfected with a new chronic or subacute strain of AfricanSwine Fever Virus? African Swine Fever has been a seriousproblem in Uganda. Scientists often quickly dismiss the notionof a human epidemic of African Swine Fever Virus because theythink African Swine Fever Virus does not infect people. But thatmay not be the case. Sick or ASFV-infected pigs in places likeGulu, Anaka, Arua, Kitgum, Masindi, and Pader may be thesource of a "nodding disease" zoonotic virus. Even if the pigsare not overtly sick, they could be carriers of a strain of thisvery insidious virus. African Swine Fever Virus infects manyparts of the pigs body, including the brain. It causes seriousneurological damage. It is also interesting that in someepidemics of African Swine Fever, it is mainly the young pigletsthat are affectedwhich would be a strong parallel to "noddingdisease." The ASFV-infected piglets suffer from ataxia, wasting,stunted growth, blindness, increased salivation, andopportunistic infections, just like the children with NoddingDisease. 12 Nodding Disease and African Swine Fever Virus in Uganda: cause or coincidence?
  13. 13. Background on African Swine FeverVirus as a human pathogen:"African Swine fever is an endemic disease in sub-Saharan Africa andmany other parts of the developing world. It is caused by the AfricanSwine virus that primarily replicates in macrophages and monocytesleading to the impairment of the structure and function of the immunesystem of the infected organisms. Until now the African Swine epidemiccontinues to spread despite all efforts to contain it. Thus, there is anobjective need for effective, safe and affordable preventive andtherapeutic approaches, in particular for effective vaccines, to controland eventually eradicate this disease. Since the characteristic feature ofthe African Swine virus is to impair the immune system and to causeimmune deficiencies in its hosts the development of vaccines and othertherapeutic approaches against the African Swine virus has implicationsfor other immune deficiencies or diseases. Several other viruses are alsoknown to cause immunodeficiency-like syndromes in humans, includingcytomegalovirus, Epstein Barr Virus and others. Moreover, a series ofcases of so-called "idiopathic" immunodeficiencies have beendocumented that display CD4+T-lymphocytopenia with opportunisticinfections, but show no evidence of HIV infection. Since antibodies forthe African Swine virus have been detected in humans, the possibility ofhuman infection with the African Swine virus exists and may thus farhave escaped any systematic screening. Thus, any preventive andtherapeutic approach to African Swine fever can have far-reachingimplications to control immune deficiency conditions in humans."http://www.faqs.org/patents/app/20080207875 13 Nodding Disease and African Swine Fever Virus in Uganda: cause or coincidence?
  14. 14. Detection of Novel Sequences Relatedto African Swine Fever Virus inHuman Serum and Sewage.Loh J, Zhao G, Presti RM, Holtz LR, Finkbeiner SR, Droit L, VillasanaZ, Todd C, Pipas JM, Calgua B, Girones R, Wang D, Virgin HW.Departments of Pathology & Immunology and Molecular Microbiology,Department of Medicine and Department of Pediatrics, WashingtonUniversity School of Medicine, St. Louis, Missouri; Department ofBiological Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania;Department of Microbiology, Faculty of Biology, University ofBarcelona, Barcelona, Spain."The family Asfarviridae contains only a single virus species, Africanswine fever virus (ASFV). ASFV is a viral agent with significanteconomic impact due to its devastating effects on populations ofdomesticated pigs during outbreaks, but has not been reported to infecthumans. We report here the discovery of novel viral sequences in humanserum and sewage which are clearly related to the Asfarvirus family, buthighly divergent from ASFV. Detection of these sequences suggests thatgreater genetic diversity may exist among Asfarviruses than previouslythought, and raises the possibility that human infection by Asfarvirusesmay occur."http://www.ncbi.nlm.nih.gov/pubmed/19812170?dopt=Abstract 14 Nodding Disease and African Swine Fever Virus in Uganda: cause or coincidence?
  15. 15. African Swine Fever Virus (Asfarviridae)sequences found in people with febrileillnessesAbstractVirus Identification in Unknown Tropical Febrile IllnessCases Using Deep SequencingDengue virus is an emerging infectious agent that infects an estimated 50–100million people annually worldwide, yet current diagnostic practices cannot detectan etiologic pathogen in ∼40% of dengue-like illnesses. Metagenomic approachesto pathogen detection, such as viral microarrays and deep sequencing, arepromising tools to address emerging and non-diagnosable disease challenges. Inthis study, we used the Virochip microarray and deep sequencing to characterizethe spectrum of viruses present in human sera from 123 Nicaraguan patientspresenting with dengue-like symptoms but testing negative for dengue virus. Weutilized a barcoding strategy to simultaneously deep sequence multiple serumspecimens, generating on average over 1 million reads per sample. We thenimplemented a stepwise bioinformatic filtering pipeline to remove the majority ofhuman and low-quality sequences to improve the speed and accuracy ofsubsequent unbiased database searches. By deep sequencing, we were able todetect virus sequence in 37% (45/123) of previously negative cases. Theseincluded 13 cases with Human Herpesvirus 6 sequences. Other samples containedsequences with similarity to sequences from viruses in the Herpesviridae,Flaviviridae, Circoviridae, Anelloviridae, Asfarviridae, and Parvoviridae families.In some cases, the putative viral sequences were virtually identical to knownviruses, and in others they diverged, suggesting that they may derive from novelviruses. These results demonstrate the utility of unbiased metagenomic approachesin the detection of known and divergent viruses in the study of tropical febrileillness.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3274504/ 15 Nodding Disease and African Swine Fever Virus in Uganda: cause or coincidence?
  16. 16. Symptoms, complications and descriptions ofNodding Disease mentioned in variousarticles about the epidemic in UgandaContinuous and pendulous nodding of head (precipitated byfood or cold weather) that becomes progressively worseRhythmic chin to chest movementsUncoordinated hand movementsConstant shaking of the handsDisorientation, confusionDry skinDehydrationSevere itchingRashes (that cause the skin to come off in patches)Visible woundsAnemiaStunted growth 16 Nodding Disease and African Swine Fever Virus in Uganda: cause or coincidence?
  17. 17. Brain atrophyBlindnessTiredness and sleepingSunken eyesHeadachesSerious injuries or death resulting from falls during seizureepisodesMalnutrition (inability to eat)Cognitive problemsStaring spellsLoss of consciousnessAbnormal EEG brain waves, mental retardation, brain atrophyand damage to the hippocampus and glial cellsStunted growthOpportunistic infectionsEpilepsySeizures (fits) (Some have continuous seizure activity) 17 Nodding Disease and African Swine Fever Virus in Uganda: cause or coincidence?
  18. 18. Sub-clinical seizuresDrooling, overproduction of saliva ("saliva is all over the body")Vitamin A deficiencyWormsInability to sitProgressive and fatal, often 3 years in durationLoss of control of defecation and urinationStunted growthCrying, constant flow of tearsConstant nasal flowInability to close mouthInability to speak clearly (nonsensical talk)Some develop pneumoniaElevated neutrophil countsElevated percentages of eosinophils 18 Nodding Disease and African Swine Fever Virus in Uganda: cause or coincidence?
  19. 19. Some have an elevated cell count, mainly lymphocytes andmonocytesMicroscopically visible microfilariaLoss of neck muscle toneLoss of muscle tone of the upper extremitiesDizzinessLow serum B6 concentrationsSome children set firesSome children become violent and hurt othersSources:http://www.newvision.co.ug/news/628574-Nodding-disease-kills-200-children-in-North.htmlhttp://www.newvision.co.ug/PA/8/16/703803http://www.sott.net/articles/show/240740-Could-mysterious-nodding-disease-in-Africa-have-global-implications-http://www.medscape.com/viewarticle/757813http://en.wikipedia.org/wiki/Nodding_disease 19 Nodding Disease and African Swine Fever Virus in Uganda: cause or coincidence?
  20. 20. http://www.monitor.co.ug/artsculture/Reviews/-/691232/1317258/-/97bml/-/http://www.ghfn.org/1-topics-general-pages/nodding-diseasehttp://www.ghfn.org/3-stories_videos-individual/cdc-discusses-bizarre-nodding-disease?A=SearchResult&SearchID=1309275&ObjectID=3962521&ObjectType=35http://www.observer.ug/index.php?option=com_content&view=article&id=16989:nodding-disease-unlocking-it-will-take-years-of-research&catid=34:news&Itemid=114http://onlinelibrary.wiley.com/doi/10.1111/j.1528-1167.2008.01671.x/fullhttp://www.acholitimes.com/index.php?option=com_content&view=article&id=504:odding-disease-kills-50-people-in-pader&catid=15:health&Itemid=93http://transitions.foreignpolicy.com/posts/2012/01/27/are_we_not_ugandanshttp://www.monitor.co.ug/SpecialReports/-/688342/1305064/-/vtd6et/-/index.htmlhttp://www.english.rfi.fr/africa/20120217-nodding-syndrome-cause-still-eludes-health-expertshttp://www.nature.com/news/mystery-us-outbreak-prompts-further-tests-1.10052http://www.bbc.co.uk/news/world-africa-17319434http://www.cnn.com/2012/03/19/world/africa/uganda-nodding-disease/index.htmlhttp://caledonianmercury.com/2012/04/16/the-mystery-disease-striking-ugandas-children/0032277 20 Nodding Disease and African Swine Fever Virus in Uganda: cause or coincidence?
  21. 21. Is drooling the smoking gun linkbetween Nodding Disease and AfricanSwine Fever Virus?This article mentions the saliva issue in pigswith African Swine Fever in Uganda:http://www.newvision.co.ug/PA/8/16/728216So the pigs with African Swine Fever in Uganda are droolingand we know the kids with Nodding Disease in Uganda arealso drooling all the time.And nobody says, hey, maybe these drooling pigs and droolingchildren have the same disease? Not one scientist?Nobody suggests that they should look at the saliva and salivaryglands of the pigs with African Swine Fever and the saliva andsalivary glands of the children with Nodding Disease to see ifthere is an agent or pathological finding the two diseases have incommon? 21 Nodding Disease and African Swine Fever Virus in Uganda: cause or coincidence?
  22. 22. Nodding Disease andAfrican Swine FeverOverlap in Arua,Gulu, Kitgum, Pader,Lango, Anaka, andMasindi, Uganda 22 Nodding Disease and African Swine Fever Virus in Uganda: cause or coincidence?
  23. 23. Study says AfricanSwine Fever isendemic to Ugandahttps://docs.google.com/viewer?a=v&q=cache:NdiLNGon8xsJ:www.roavs.com/pdf-files/vol_5_2011/313-317.pdf+&hl=en&gl=us&pid=bl&srcid=ADGEESh5iq_LIMhQpO3xYYD2R85na9-j-huP_qCHNBcOB4MuAw6EbZzZcdN-QUDJJAm1QV7FUElVmckKh8LEk63I9uumtFd5rQ-Hj5FgkDPl7KqL0KOqlTikSvguOfCwQU5LuMFQ2tVx&sig=AHIEtbRXGQliv_URo-LGFg5rYJc_AGHZWA 23 Nodding Disease and African Swine Fever Virus in Uganda: cause or coincidence?
  24. 24. 24Nodding Disease and African Swine Fever Virus in Uganda: cause or coincidence?
  25. 25. African Swine Fever in Arua, Uganda:http://ugandaradionetwork.com/a/story.php?s=39689Nodding Disease in Arua, Uganda:"Misunderstanding the causes of nodding disease can havedisastrous consequences, as was the case with cholera some 150years ago. So far, anti-epilepsy treatments appear to be helpingchildren experiencing nodding disease, but supplies of thesetreatments are often scarce, and determining the ultimate causeof epilepsy in these children should be a high priority for healthofficials. Cases of epilepsy are often documented at high rates inhospitals in the region, and there is thought to be a link betweenepilepsy and cerebral malaria as well. In Arua Regional ReferralHospital, in northwestern Uganda at the border with Sudan andDRC, 7 percent of all outpatient children over age 5 in April2009 were diagnosed with epilepsy. In 2004/05, 74 percent(nearly 4500) of all cases in the Mental Ward were diagnosed asepilepsy."http://www.independent.co.ug/rwanda-ed/rwanda/5094-the-search-to-understand-nodding 25 Nodding Disease and African Swine Fever Virus in Uganda: cause or coincidence?
  26. 26. African Swine Fever in Gulu, Uganda:http://allafrica.com/stories/201109080222.htmlNodding Disease in Gulu, Uganda:http://www.acholitimes.com/index.php?option=com_content&view=article&id=739:nodding-disease-cases-reported-in-gulu&catid=1:news&Itemid=2African Swine Fever Derails PigRearing in Gulu:UGANDA - Despite pig farming being a quick economic venture, farmers in Gulu district cannotengage in pig rearing any more following an outbreak of African swine fever (ASF) in thedistrict in the middle of last year.http://www.thepigsite.com/swinenews/27028/african-swine-fever-derails-pig-rearing-in-gulu 26 Nodding Disease and African Swine Fever Virus in Uganda: cause or coincidence?
  27. 27. African Swine Fever in Kitgum,Uganda:http://allafrica.com/stories/200609270361.htmlNodding Disease in Kitgum, Uganda:http://www.acholitimes.com/index.php?option=com_content&view=article&id=763:nodding-disease-continues-to-ravage-kitgum-district&catid=1:news&Itemid=2 27 Nodding Disease and African Swine Fever Virus in Uganda: cause or coincidence?
  28. 28. African Swine Fever outbreak inPader, Uganda in 2010:http://www.slideshare.net/ILRI/status-of-asf-in-uganda-by-c-rutebarika (See page 18)Nodding Disease in Pader, Uganda:"Its known loosely as nodding disease and almost every family in the village weve come to seein Pader District has at least one child suffering from it."http://www.ghfn.org/1-topics-general-pages/nodding-disease 28 Nodding Disease and African Swine Fever Virus in Uganda: cause or coincidence?
  29. 29. African Swine Fever in Anaka,Uganda:http://www.newvision.co.ug/PA/8/16/728216Nodding Disease in Anaka, Uganda:http://allafrica.com/stories/201201200420.html 29 Nodding Disease and African Swine Fever Virus in Uganda: cause or coincidence?
  30. 30. African Swine Fever in Lango,Uganda:http://www.newvision.co.ug/D/8/16/728216Nodding Disease in Lango, Uganda:http://www.mail-archive.com/ugandanet@kym.net/msg27417.html 30 Nodding Disease and African Swine Fever Virus in Uganda: cause or coincidence?
  31. 31. Nodding Disease in Masindi, Uganda:"First 192 cases were registered in Kitgum and Pader in 2009 but over time, it hasspread to other districts of Lamwo, Gulu and some traces in Masindi. The numbershave also increased from hundreds to thousands."http://allafrica.com/stories/201202021109.htmlAfrican Swine Fever in Masindi,Uganda:http://www.slideshare.net/ILRI/status-of-asf-in-uganda-by-c-rutebarika (See Page 15) 31 Nodding Disease and African Swine Fever Virus in Uganda: cause or coincidence?
  32. 32. Nodding Disease and Meningitis inAmuru, Uganda:"Along with the current meningitis outbreak, the Amuru district has also registered nearly 80cases of the mysterious nodding disease."Continue reading on Examiner.com Meningitis death toll climbs in Northern Ugandan town ofAmuru - National infectious disease | Examiner.comhttp://www.examiner.com/infectious-disease-in-national/meningitis-death-toll-climbs-northern-ugandan-town-of-amuru#ixzz1pxFtwV5GAfrican Swine Fever in Amaru,Uganda:http://mobile.monitor.co.ug/News/-/691252/1263546/-/format/xhtml/-/1poq9uz/-/index.html 32 Nodding Disease and African Swine Fever Virus in Uganda: cause or coincidence?
  33. 33. African Swine Fever Virus in OdekSub County, Ugandahttp://www.meattradenewsdaily.co.uk/news/050811/uganda___african_swine_fever_.aspxNodding Disease in Odek Sub County,Ugandahttp://www.acholitimes.com/index.php/news/acholi-news/31-parents-turn-to-herbs-in-treating-nodding-children-in-odek-sub-county 33 Nodding Disease and African Swine Fever Virus in Uganda: cause or coincidence?
  34. 34. African Swine Fever in Sudan:http://books.google.com/books?id=yE6ssPoWr4EC&pg=PA120&lpg=PA120&dq=sudan+%22asfv%22&source=bl&ots=ijOF_AaH1p&sig=KBwie4Pha6AnAGpGZb7Xtfmnjw8&hl=en&sa=X&ei=bO43T-nXG6bf0QG569GvAg&ved=0CB4Q6AEwAA#v=onepage&q=sudan%20%22asfv%22&f=falseNodding Disease in Sudan:http://en.wikipedia.org/wiki/Nodding_disease 34 Nodding Disease and African Swine Fever Virus in Uganda: cause or coincidence?
  35. 35. Will consuming ASFV-infected pork in Adjumani cause Nodding Disease?Adjumani Residents Defy Quarantineon PigsUGANDA - Efforts to contain African swine fever, which broke out in Adjumani District sevenmonths ago, is being hindered by residents defiance of a quarantine imposed by the veterinarydepartment.http://www.thepigsite.com/swinenews/29417/adjumani-residents-defy-quarantine-on-pigs 35 Nodding Disease and African Swine Fever Virus in Uganda: cause or coincidence?
  36. 36. Transmission of African Swine FeverVirus"ASF virus is transmitted between infected and susceptible pigs, by consumptionof the meat from infected pigs, by the bites of infected tampans (Ornithodorosspp.) and by contact with material or objects (bedding, feed, equipment, clothesand footwear, vehicles) contaminated by virus-containing matter such as blood,feces, urine or saliva from infected pigs. Although warthogs are natural hosts ofthe ASF virus, it has been well demonstrated that they are unable to transmit thevirus directly to domestic pigs. The role of other African wild suids (bush pigs ofthe genus Potamochoerus and the giant forest hog, Hylochoerusmeinertzhageni), ifany, in the epidemiology of ASF has not been clarified, but bush pigs were able totransmit virus to domestic pigs under experimental conditions. Experimentalstudies have shown that ASF virus can only be airborne over short distances, notmuch more than 2 metres. Apart from tampans, the only other arthopods that havebeen shown to be capable of maintaining ASF virus for a reasonable period (up to48 hours) and transmitting it to pigs are stable flies (Stomoxys spp.) Since these aresmall flies, they would transmit the virus within rather between herds unless theywere inadvertently transported to another farm. . . . Sexual transmission in pigs hasalso not been documented, but ASF virus is shed in genital secretions . . . ."Source:www.cabi.org/isc/ShowPDF.aspx?PAN=20093263092 36 Nodding Disease and African Swine Fever Virus in Uganda: cause or coincidence?
  37. 37. Evidence that Nodding Disease is CommunicableInvestigation into the NoddingSyndrome in WittoPayam, WesternEquatoria State, 2010Southern Sudan Medical Journal"The school administration was in a dilemma as to whether or not they were required to haveseparate classes for affected children [with Nodding Disease]. If one pupil in the class showedsymptoms, by the end of the year about seven other children were reported to have the samecondition. This raises the question of whether this is a communicable disease."http://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=12&ved=0CDMQFjABOAo&url=http%3A%2F%2Fwww.southsudanmedicaljournal.com%2Fassets%2Ffiles%2FJournals%2Fvol_4_iss_1_feb_11%2FSSMJ_4_1.pdf&ei=Fqp3T8riI-rL0QGVxJnCDQ&usg=AFQjCNE8RtiO8YviRD9toah7DXFd9-Dz6w 37 Nodding Disease and African Swine Fever Virus in Uganda: cause or coincidence?
  38. 38. Ugandan Man Has 7 children with Nodding DiseaseEach child‟s nodding head eats at Ocitti‟sprideHe was a proud man, because he ‘had it all’ – four beautiful women and 25children. Animals, domestic birds and a fertile land to call his own.AugustinoOcittiwas the envy of many. With his head up in the air, Okidi Village bowed at his feet– he was their village chairman for a decade. His peers regarded him as “the truedefinition of an Acholi man.” But as I enter Ocitti’s expansive compound, a soresilence welcomes me. I find him seated under a mango tree surrounded by a groupof unsettled children. He glances up occasionally to check on them, but his head isbowed most of the time.The pride he once carried on his shoulders has faded andis now replaced by the weight of seeing seven of his children nodding helplesslybecause of a disease he has no clue about.His 12-year-old son, Lawrence Kabila, isthe most affected by the ailment. At his age, he can be mistaken for an eight-year-old. The disease has stunted him. Kabila’s skin peels off effortlessly as he scratcheshimself. His sticky legs appear too weak to support his head and chest whichappears heavily swollen.--Helen Anena, The Saturday Monitorhttp://www.monitor.co.ug/SpecialReports/-/688342/1357980/-/vwhgmi/-/ 38 Nodding Disease and African Swine Fever Virus in Uganda: cause or coincidence?
  39. 39. Symptoms of ASFV that overlap withNodding DiseaseChronic African Swine FeverSymptoms (Just a very partial list)ataxiawastingstunted growthblindnessincreased salivationopportunistic infectionsNodding Disease Symptoms (Just avery partial list)ataxiawastingstunted growthblindnessincreased salivation (drooling)opportunistic infections 39 Nodding Disease and African Swine Fever Virus in Uganda: cause or coincidence?
  40. 40. Consumption of ASFV-infected Pork in UgandaUganda: Residents ignore warningsconcerning consumption of pork frompigs killed by African Swine Fever"In Adjumani District, in the North of Uganda, residents are continuing to disregard officials’warnings concerning consumption of pork meat from pigs that were killed by African SwineFever (ASF). There have been health warnings regarding the risks associated with consumingmeat from pigs that were killed by ASF." http://www.pigprogress.net/news/uganda-residents-ignore-warnings-concerning-consumption-of-pork-from-pigs-killed-by-asf-8129.html 40 Nodding Disease and African Swine Fever Virus in Uganda: cause or coincidence?
  41. 41. Cases of Nodding Disease Found inAdultsNodding Disease: Success stories underdifficult circumstancesbyJavieSsozi"Research shows that the disease is common between the ages of 7 and 13.However recent cases show that the disease has been found in adults."http://ugandaspeaks.com/2012/03/nodding-disease/ 41 Nodding Disease and African Swine Fever Virus in Uganda: cause or coincidence?
  42. 42. Ugandan towns with ASFV epidemicsTowns in Uganda that have hadAfrican Swine Fever epidemicsApacHoimaIgangaJinkaKalagangaKamuliKayungaKitgumLuweroMasakaMasindiMpigMubendeMukonoNakapiripiritRakaiSembabuleSorotiWakisoSource:Overview of African Swine Fever (ASF) Impact and surveillance in Uganda (See Page 15) 42 Nodding Disease and African Swine Fever Virus in Uganda: cause or coincidence?
  43. 43. Pathology of the Brain in Nodding Disease:"Sub-clinical seizures have beenidentified in electroencephalograms,and MRI scans have shown brainatrophy and damage to thehippocampus and glial cells."http://en.wikipedia.org/wiki/Nodding_diseasePathology of the Brain in African Swine Fever:"Hog Cholera and African SwineFever cause neurologic signs in babypigs with other signs of systemicdisease."Source 43 Nodding Disease and African Swine Fever Virus in Uganda: cause or coincidence?
  44. 44. Writer links Nodding Disease to sick pigs in Uganda This writer, Angelo Opi-aiyaIzama, is the first to mention pigsas a possible source of Nodding Disease. The writer confusesSwine Flu and African Swine Fever, but does raise the importantquestion of the role of pigs in nodding disease:Running with the theory that it is swine flu virus of one sort or another linked is not a stretch. Itis fairly common knowledge that scientists in this field are pre-occupied with the dangers ofdirect transmission of swine flu to humans.Indeed Gulu and surrounding districts are victims of outbreaks of the African swine flu that oftenaffects pig rearing. There are many articles to this effect. Just googling now revealed severalstudies discussing the worries about swine flu transmissions from animals to humans andhumans to humans by amongst others the CDC. The agency, which is also involved ininvestigating the Uganda nodding disease issue, is however yet to publicly link swine flu or itsresearch to nodding disease. Whether or how this link has been eliminated as also not beenexplored judging from the coverage on the issue.http://thisisafrica.wordpress.com/ 44 Nodding Disease and African Swine Fever Virus in Uganda: cause or coincidence?
  45. 45. Nodding Disease Horror: 12-year-oldvictim is tied to a tree for 13 hourseverydayThis article by Edward Echwalu in The Observer is one of themost disturbing pieces ever written about "Nodding Disease."There is an interesting mention of pigs in the article whichshould catch the attention of anyone who thinks "noddingdisease" may be coming from pigs infected with a strain ofAfrican Swine Fever Virus. 45 Nodding Disease and African Swine Fever Virus in Uganda: cause or coincidence?
  46. 46. Constant Nasal Flow in NoddingDisease may be another indication thatit could be caused by African SwineFever Virus"The disease, which has remained a puzzle tomany medical experts, is characterised bymental and physical retardation, head noddingand drooling, constant nasal flowand saliva.The victims often nod themselves to death.Many of the affected children are malnourishedbecause eating food seems to spark bouts ofnodding and seizures. Epilepsy drugs havebeen used to control the attacks but they donot cure the disease."http://www.monitor.co.ug/SpecialReports/-/688342/1305064/-/vtd6et/-/index.htmlConstant nasal flow occurs in pigs withAfrican Swine Fever Virus which isnow endemic in the same areas ofUganda that Nodding Disease isaffecting. 46 Nodding Disease and African Swine Fever Virus in Uganda: cause or coincidence?
  47. 47. Scott Dowell of the CDC on NoddingDisease in Uganda:"As an example, we’ve been investigating a “nodding disease” inSouth Sudan and Uganda. It’s a clearly odd syndrome where kidsaged five to 15 have head nodding. The kids definitely die with it –it’s not rapidly progressive, but it seems to take hold of them. Thenodding is in fact a type of seizure and they do in fact have braindisease. It looks to us like an epidemic epileptic syndrome. Thekids die of the things that kids with severe epilepsy die from –they fall into a fire, they die when they are bathing, they getopportunistic pneumonia, etcetera. When we first startedinvestigating five years ago, it was unclear what the origin was.Now we have learned a lot more about what it is and is not,although we don’t know the underlying cause."--Scott Dowell http://sciencespeaksblog.org/2012/02/15/how-the-cdc-responds-to-global-emerging-infections-a-conversation-with-scott-dowell/ 47 Nodding Disease and African Swine Fever Virus in Uganda: cause or coincidence?
  48. 48. CDC says Nodding Disease isa form of "atonic seizure."Dr. Scott pointed out that one of the major progress areas was the ability to conduct tests andrule out dozens of suspected causes which included the possible connection of the epidemic withwartime chemical exposure.According to this Atlanta based scientist, very little was understood about the syndrome back2009 when CDC was starting its investigations about the disease that has since led to hundredsof deaths with about 3000 currently infected.The doctor says this has changed because CDC has discovered and documented key informationregarding the cause, symptoms and treatment of the nodding disease.Much as the real cause of the nodding syndrome is still unknown, CDC researchers say theyhave discovered „the immediate cause of the nodding itself‟ which they refer to as a specialseizure called an atonic seizure.--Umar Weswalahttp://umaruganda.blogspot.com/2012/02/nodding-syndrome-cdc-and-uganda-govt.htmlWikipedia on "atonic seizure":http://en.wikipedia.org/wiki/Atonic_seizure 48 Nodding Disease and African Swine Fever Virus in Uganda: cause or coincidence?
  49. 49. CDC on Nodding Disease: "Thechildren definitely die with it"For now, the already affected children are sentenced todeath by the disease.“The children definitely die with it – it’s not rapidlyprogressive, but it seems to take hold of them. The noddingis in fact a type of seizure which causes damage on thebrain,” said Dr Scott Dowell, CDC lead investigator, in aninterview with the Center for Global Health policy, UnitedStatesBy YasiinMugerwa& Agatha Ayebazibwe, The Daily Monitorhttp://www.newvision.co.ug/news/629080-nodding-disease-top-us-scientist-jets-in.html 49 Nodding Disease and African Swine Fever Virus in Uganda: cause or coincidence?
  50. 50. CDC: Cases of NoddingDisease in Uganda have risento over 3,000 from 2,000reported at the beginning ofthis year.http://www.newvision.co.ug/news/629174-nodding-disease-vector-control-centre-vital-in-pader.html 50 Nodding Disease and African Swine Fever Virus in Uganda: cause or coincidence?
  51. 51. CDC said Nodding Disease in Uganda"could turn out to have just as hugeimplications for the rest of the world."In the case of nodding syndrome “we don’t know theimplications of this for the rest of the world,” [the CDCs]Dowell said. “It’s quite clear it has huge implications for thoseliving in Kitgum district in Uganda, but it could turn out tohave just as huge implications for the rest of the world.http://www.thestar.com/news/world/article/1121730--could-mysterious-nodding-disease-in-africa-have-global-implications 51 Nodding Disease and African Swine Fever Virus in Uganda: cause or coincidence?
  52. 52. CDC: Nodding Disease is at the top of its list of mystery outbreaksCDC planning trialfor mysteriousnodding syndromeby John DonnellyThe Lancet, Volume 379, Issue 9813, Page 299, 28 January 2012Fred Hartman, Management Sciences for Healths Country Lead forSouth Sudan and supervisor for the USAID-funded Sudan HealthTransformation Project II, has worked for 30 years in Africa, but whenhe first saw children with nodding syndrome in 2010 he was shocked.“Ive been all over the world, and Ive never seen anything like it”, hesaid. “All the children look like they have cerebral palsy. So many of thekids are malnourished. You bring them food and they cant eat it. And bythe time you make the diagnosis, its too late for the children. Its reallysad.”Dowell called the CDCs upcoming investigation important. “We are inthe business of detecting outbreaks. For the most part, when weinvestigate an outbreak, the cause becomes clear, but periodically we getthese ones where the cause isnt clear”, he said. Asked where noddingsyndrome stood on the list of mystery outbreaks, Dowell said: “Itsright there at the top of the list.”http://www.lancet.com/journals/lancet/article/PIIS0140-6736%2812%2960126-3/fulltext 52 Nodding Disease and African Swine Fever Virus in Uganda: cause or coincidence?
  53. 53. BBC reports that initially the CDC suspectedNodding Disease might be "psychogenic"The syndrome stealing Uganda and SouthSudans childrenBy Andrew Harding, BBC Africa correspondent"Nodding Syndrome targets children exclusively, causing its victims to spasm uncontrollablyand eventually to waste away and die. Many thousands of children are believed to be affected.""Initially, the CDC suspected it might be a psychogenic episode - something like mass hysteria.But brain scans quickly confirmed that they were dealing with a disease that causes measurablebrain atrophy."http://www.bbc.co.uk/news/world-africa-17319434 53 Nodding Disease and African Swine Fever Virus in Uganda: cause or coincidence?
  54. 54. World Health Organization had beentreating nodding disease as a post-traumatic stress disorderNodding disease spreads to GuluBy Stephen Otagehttp://www.monitor.co.ug/News/National/-/688334/1374304/-/awq3yhz/-/ 54 Nodding Disease and African Swine Fever Virus in Uganda: cause or coincidence?
  55. 55. Medical Teams International has sent over 45 volunteermedical teams to Uganda to address immediate needs and tomobilize long-term health initiatives.http://www.salem-news.com/articles/march142012/med-teams-uganda.php(PORTLAND, OR) - Medical Teams International has launched an emergency response campaign to fundefforts to address nodding disease in northern Uganda. This mysterious disease only attacks childrenand has no known cause or cure. Ugandan health officials estimate that over 3,000 children are infected,with a high incidence of occurrence in the districts Medical Teams International is currently serving.Nodding disease syndrome is a progressive condition characterized by head nodding, mental retardationand stunted growth, body wasting and blindness. Children with the disease often die of malnutrition,secondary injuries or infections related to the disease.Medical Teams International will collaborate with community health workers in the region to provideanti-seizure medicines, medical support, on-site mentoring of health workers, and psycho-social supportto families struggling to care for children with the disease.“Our mobile medical clinics are the only source of care for thousands of families in the Pader District ofnorthern Uganda,” says Bas Vanderzalm, President of Medical Teams International. “More than 1,500children in this district have this terrible disease. We’re asking people to pray for these children and tosupport our efforts to help.”Medical Teams International seeks to raise $30,000 to fund an initial response to this disease. Theorganization has already received a $15,000 matching gift from an anonymous donor, doubling theimpact of individual donations.For more information on nodding disease or to contribute to Medical Teams International’s work inUganda, please go to www.medicalteams.orgSince 2004, Medical Teams International has provided health care services, community health educationand immunizations to nearly 500,000 displaced people in various camps, settlements and clinics in thenorthern districts of Uganda.Medical Teams International has sent over 45 volunteer medical teams to Uganda to address immediateneeds and to mobilize long-term health initiatives.Medical Teams International is a Christian global health organization working to demonstrate the love ofChrist to people affected by disaster, conflict and poverty around the world. Since 1979, we have sentmore than 2,100 volunteer teams and shipped more than $1.5 billion in lifesaving medicines andmedical supplies to care for 25 million people in 100 countries. Each year, more than 2,000 volunteerscontribute their time to care for those whom Jesus called “the least of these” in our world today. 55 Nodding Disease and African Swine Fever Virus in Uganda: cause or coincidence?
  56. 56. Nodding Disease can cause "violenttantrums."Shockingly, no one, not even health officials, really knowswhat causes this sickness or how it is transmitted. Noddingdisease is a mysterious illness that stunts brain growthamong the small children who are its victims, sometimescausing mental retardation. (It takes its name from theconvulsive nodding motion that marks those infected withit.) Sometimes its victims break out in violent tantrums, asif possessed by demons; some act as though theyre beingpursued by people armed with machetes or guns. In somecases victims report being weighed down or suffocated by"something heavy" that they cannot see. Those whocontract the disease usually die from it within a few years. Itis a horrible thing to watch.--By Denis Barnabashttp://transitions.foreignpolicy.com/posts/2012/01/27/are_we_not_ugandans 56 Nodding Disease and African Swine Fever Virus in Uganda: cause or coincidence?
  57. 57. Nodding Disease Leaves Men SexuallyStarvedThe nodding disease is leaving many men sexually starved,according to Dr. Conan Katerega, a senior psychiatrist at GuluRegional Referral Hospital. This is because most men fear toimpregnate their wives because they are not sure about thenew generation.The disease which hit the sub region three years ago hasclaimed over 200 lives and infected thousand others many ofwhom are children below 18 years. Doctors at Gulu RegionalReferral Hospital say no proper guidance has been given aboutthe disease and more research is needed to find out more aboutthe disease.Doctors add that the disease has left most discouraged fromproducing more children. “Some communities believe that thedisease is so infectious,” they said. “People have resorted toabstaining from sex with belief that it is useless to producechildren when they are not sure of their generation,” they said.By Willy Cho Woo, in RedPepper, (a Ugandan newspaper)http://redpepper.co.ug/welcome/?p=26783 57 Nodding Disease and African Swine Fever Virus in Uganda: cause or coincidence?
  58. 58. 2009 survey found out that 83 per cent of the NoddingDisease cases verified were suspected to have eatenbush meat:Government on the Spot OverNodding Diseaseby Agatha Ayebazibwe, Daily Monitor, 2012-01-24"The 2009 survey found out that 83 per cent of the cases verifiedwere suspected to have eaten bush meat"http://str8talkchronicle.com/?p=20097Bush meat includes "bush pigs" and "giant forest hogs" whichare probably carriers of African Swine Fever Virus, given howwidespread ASFV is in northern Uganda.Wikipedia on giant forest hogs:http://en.wikipedia.org/wiki/Giant_forest_hog 58 Nodding Disease and African Swine Fever Virus in Uganda: cause or coincidence?
  59. 59. Epilepsy in Uganda was linked to pork in 2009Thursday, December 3, 2009http://www.thepigsite.com/swinenews/22608/epileptic-seizures-linked-to-pork-wormsEpileptic Seizures Linked to Pork WormsUGANDA - In a bid to educate the public about the risks of consuming pork, the EpilepsySupport Association, Uganda, an umbrella organisation for people living with epilepsy hasgone into a partnership with the Veterinary Department of Makerere University toestablish the relationship between pork and epileptic seizures.Preliminary clinical traces established by the association indicate that pork-related causes ofepilepsy are due to TaeniaSolium, a worm that thrives in pigs and when consumed embeds in thehuman brain thus causing an infection of the nervous system."The incidence of epilepsy is thought to be higher in the Sub Saharan Africa because of anincrease in brain injury and the central nervous infections, and pork is believed to be a gravecause," Dr Angelina KakoozaMwesige, the President Epilepsy Society Uganda said recently.She said the infection referred to as Neurocystercercosis is cerebral and partly responsible forsymptomatic causes of epilepsy.In a six-page document presented to journalists in Soroti recently, DrMwesige said more than 80per cent of the global burden of epilepsy is found in the developing countries with 10 millioncases in Africa alone. Soroti is one of the districts with the highest pig population, reportsAllAfrica.com. "We conducted a survey last year and it was established that 25 per cent ofepilepsy prevalence is linked to worms eaten through badly cooked pork," Mr AugustineMugarura, the National Director Epilepsy Support Association Uganda said.African Swine Fever in Soroti, Ugandawww.slideshare.net/ILRI/status-of-asf-in-uganda-by-c-rutebarika (See page 15) 59 Nodding Disease and African Swine Fever Virus in Uganda: cause or coincidence?
  60. 60. Study suggests more boysthan girls have NoddingDisease in Uganda"The Ministry of Health is to start its own investigations intonodding disease in Northern Uganda as they await results fromthe Centre for Disease Control in Atlanta. The ministry togetherwith the Acholi Parliamentary Group is set to go on a factfinding mission in Kitgum one of the most affected of the threedistricts in the region where close to 3000 people aged between2 and 15 are afflicted."http://www.youtube.com/watch?feature=player_embedded&v=7wCam8r36X0 60 Nodding Disease and African Swine Fever Virus in Uganda: cause or coincidence?
  61. 61. Medics To Examine Brain Of NoddingDisease VictimMedical doctors want to examine the brain of a dead personconfirmed to have succumbed to the notorious Nodding Diseasefor thorough examining.A clinical psychiatric, Dr. Sam Okuni who works with the mentalhealth department in Gulu Referral Hospital said that togetherwith various partners, they have done a lot of research and areabout to out the results, but need to dissect the brain of a deadvictim to get to the bottom of the phenomenon.By Ojok James Onono, RedPepper (A Ugandan newspaper)http://redpepper.co.ug/welcome/?p=32380 61 Nodding Disease and African Swine Fever Virus in Uganda: cause or coincidence?
  62. 62. Women tie themselves to trees overnodding diseaseBy AGATHA AYEBAZIBWE, Daily MonitorWomen activists tied themselves on trees for 30 minutes yesterday toshow solidarity with mothers whose children are suffering from noddingdisease syndrome.The women expressed concern for their colleagues inAcholi Sub-region, condemning government’s failure to quickly addressthe nodding disease problem. They said mothers in northern Uganda aresuffering psychologically because of having to tie their sick children totrees to save them from injury when they fall. Read more.http://www.monitor.co.ug/News/National/-/688334/1361630/-/axeneez/-/ 62 Nodding Disease and African Swine Fever Virus in Uganda: cause or coincidence?
  63. 63. A Day in the Life of the PAZ Project: Pig farming andslaughtering in Western Kenyaby James Miser Akoko There is close interaction between pigs and people as they are either tethered within thehomestead or are allowed to scavenge around the homestead for food. In some homes, pigswallow in mud mixed with their urine and faecal materials, as flies and other insects celebrate.The role played by pigs in transmitting zoonotic diseases and the risk factors for human infectionare poorly understood in western Kenya.The methods of slaughter used in slabs in the area alsoraise welfare issues. The pig‟s legs are tied and a sharp knife or a machete is used to cut aroundthe neck of a struggling pig that cries loudly as blood spills on the bare hands and feet of theunprotected slaughter men. The noise that emanates from these slabs is normally disturbing formany people.It is normal to find people slaughtering without protective clothing, and dogs arealways on duty waiting for any meat that could drop; and of course you cannot rule out thepresence of flies. It is also not uncommon to find children and people eating other foodstuffs nextto the slab, an obvious public health hazard. This means that the hygiene and safety of theslaughter house workers and the pork consumers served by the slabs is an issue that requiresaction.http://biolives.wordpress.com/2012/02/28/a-day-in-the-life-of-the-paz-project-pig-farming-and-slaughtering-in-western-kenya/ 63 Nodding Disease and African Swine Fever Virus in Uganda: cause or coincidence?
  64. 64. Ugandan government seems to be trying to control what people know aboutNodding DiseaseCensorship ahead of the IPU assemblyin Kampala: On Nodding Diseasehttp://ugandaspeaks.com/2012/03/censorship-ahead-of-the-ipu-assembly-in-kampala-on-nodding-disease/ 64 Nodding Disease and African Swine Fever Virus in Uganda: cause or coincidence?
  65. 65. Beatrice Anywar is praised as "Mamma Nodding Disease"Anywar to the rescueBy RukiyaMakumahttp://www.independent.co.ug/news/news-analysis/5461?task=viewShe was desperate to call attention to the gravity of a rare disease ravaging northern Ugandathat is crudely called “nodding disease”. Opposition firebrand Beatrice Anywar, however, neverimagined how ferrying some of the affected children to the capital would turn out.The Kitgum Woman MP first identified 10 children and made arrangements to move them toMulago National Referral Hospital in Kampala. Then she placed an important phone call – toPresident YoweriMuseveni. It was a smart move.She wanted the President to know her intentions.“Initially the President was worried about whether the disease was contagious but when he wasinformed that it was not, he offered his support,” she says.Beatrice AtimAnywarFrom Wikipedia, the free encyclopediahttp://en.wikipedia.org/wiki/Beatrice_Atim_AnywarBeatrice AtimAnywar, also known as Mama Mabira, born 1964 in Kitgum,[1] is an Ugandan politicianand member of Parliament for the opposition party FDC, and minister of the Environment in the ShadowCabinet.[2] She was chosen to the parliament in 2006 by defeating the NRM candidate Santa Okot.[3]She became well known for her work to save the Mabira Forest in Uganda. The presidentYoweriMuseveni, and the government, had prior to her work decided to sell the forest to the sugarcompany Scoul to cut it down and convert it into a sugar cane plantation for ethanol production. Atimfought along with for example National Association of Professional Environmentalists to stop the felling,and organized a boycott of Scouls sugar.[2] Her work has led to several environmental prizes.[3] 65 Nodding Disease and African Swine Fever Virus in Uganda: cause or coincidence?
  66. 66. School Becomes an UnfriendlyEnvironment for Children withNodding Diseasehttp://www.acholitimes.com/index.php/news/acholi-news/34-nodding-disease-is-destroying-families-and-communities 66 Nodding Disease and African Swine Fever Virus in Uganda: cause or coincidence?
  67. 67. Report from Gulu: Nodding Disease isDestroying Families and Communitieshttp://www.acholitimes.com/index.php/news/acholi-news/34-nodding-disease-is-destroying-families-and-communities 67 Nodding Disease and African Swine Fever Virus in Uganda: cause or coincidence?
  68. 68. WHO and CDC plan to hold Nodding Disease conference in JulyWhy are Ugandas children nodding to theirdeathsBy Amy FallonThe illness is having a tragic impact on the Pader, Lamwo andKitgum districts of northern Uganda. At least 170 children havedied, with more than 3,000 affected in the area, the WorldHealth Organisation (WHO) estimates. The figures are likely tobe higher because not all cases are reported."The noddingsyndrome is a serious public health problem, with psychological,social and economic consequences," says Dr Charles Okot, theorganisations country advisor in Uganda. The situation is sogrim that the WHO and the Centers for Disease Control andPrevention, a US federal agency, are hoping to hold aconference on the disease in July, attended by medical expertsfrom around the world.http://www.independent.co.uk/news/world/africa/why-are-ugandas-children-nodding-to-their-deaths-7628107.html 68 Nodding Disease and African Swine Fever Virus in Uganda: cause or coincidence?
  69. 69. 10 Reasons that Uganda absolutelycannot admit that Nodding Disease iscaused by African Swine Fever Viruseven if that is the obvious cause.1. There would be mass panic in Uganda and in other countries.2. All pigs in the northern part of Uganda as well as the rest of the country wouldbe suspected of being carriers of the virus. They would all have to be killed.3. Many people rely on pigs for food and financial support.4. In rural areas most people have two or three pigs. They are allowed to roamaround freely.5. If people are now infected by ASFV the epidemiology of ASFV suggests theyare capable of transmitting ASFV to others.6. Health care workers will be terrified of contracting African Swine Fever Virusfrom children with Nodding Disease.7. Tourism in Uganda would stop immediately. Movement of people in or out ofthe country would stop.8. The economy of Uganda would collapse.9. Other countries with their own ASFV epidemics would encourage Uganda tokeep a lid on this information.10. The situation would be made even worse by the probability that bush pigs andforest hogs are also carrying the virus. Ticks also carry the virus. 69 Nodding Disease and African Swine Fever Virus in Uganda: cause or coincidence?
  70. 70. The CDC’s scientists have beeninvestigating Nodding Disease sinceNovember, 2009. Strangely, they stillhaven’t tested the Nodding Disease cases forAfrican Swine Fever Virus even thoughscientists at Uganda’s largest university cantest pigs in 24-48 hours. Why? What’s that all about? 70 Nodding Disease and African Swine Fever Virus in Uganda: cause or coincidence?

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