Mystery Disease Resurfaces in Vietnam

Emma Hitt, PhD

April 23, 2012

April 23, 2012 — An unexplained illness in Vietnam has reportedly killed 19 people, mostly children, and as of Monday has affected more than 170 people. The symptoms of the disease include limb stiffness and palmoplantar keratoderma.

"We have little if no idea of what this might be," World Health Organization (WHO) spokesperson Gregory Hartl told Medscape Medical News. "However, it is a disease/event which flared up in 2010, died down, flared up again in 2011, died down, and is now flaring again," he said.

According to Hartl, the "flare-up" is "always in the same area and never beyond that area, and it is too soon to think about any international spread, especially as there is no evidence of this event outside one district/province in Vietnam." Hartl added that the WHO is currently in talks with the government of Vietnam.

The US Centers for Disease Control and Prevention (CDC) is "aware of the illness in Vietnam that is currently being reported in the media, but we have not received a request for assistance from the Vietnam Ministry of Health or the World Health Organization," Arleen Porcell-Pharr, public affairs specialist with the CDC's Center for Global Health, told Medscape Medical News. "We will determine the level of response and assistance once a formal request is received," she said.

"This is an unexplained illness at this point," said James M. Hughes, MD, professor of medicine and public health at Emory University in Atlanta, Georgia. "It might be infectious or it might be due to some sort of toxin in the environment," he told Medscape Medical News in a phone interview.

"This is an impoverished area of Vietnam, where the water supply might be compromised and the sanitation poor — there are lots of potential routes of exposure," said Dr. Hughes, who is also immediate past president of the Infectious Diseases Society of America and former director of the CDC's National Center for Infectious Diseases.

According to Dr. Hughes, the illness may not spread, but it may not die down either — "it depends on what is causing it."

"Though the health sector has yet to identify the cause of the skin disease, everybody should not worry excessively," Dr. Tran Hau Khang, director of Vietnam's National Hospital of Dermatology and Venereology, stated in a report published in a Vietnamese newspaper (disseminated by ProMed Mail of the International Society for Infectious Diseases).

"We are continuing with our investigation and discovering some factors that might give rise to the disease, such as pesticide, fertilizer, and chemicals that are being used locally," Dr. Khang said.