Mystery Illness Strikes Again Near Night Bazaar

[JohnLocke]

Archive Number 20110420.1227

Published Date 20-APR-2011

Subject PRO/EDR> Undiagnosed deaths - Thailand (05): (CM)

UNDIAGNOSED DEATHS - THAILAND (05): (CHIANG MAI)

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A ProMED-mail post

<http://www.promedmail.org>

ProMED-mail is a program of the

International Society for Infectious Diseases

<http://www.isid.org>

Date: Thu 14 Apr 2011

Source: cnews.canoe.ca, WorldWatch, QMI Agency [edited]

<http://cnews.canoe.ca/CNEWS/World/2011/04/14/17995481.html>

Mystery Thai illness strikes another tourist

--------------------------------------------

Another Thailand traveller was treated in hospital after spending

time in Chiang Mai, where a number of tourists have mysteriously died

since January. A 26 year old woman from Seattle [uSA] became violently

ill on 4 Apr 2011 along with 2 friends after eating and using

restrooms at the Night Market in Chiang Mai, Thailand, on 30 Mar

2011.

The Night Market is next door to a hotel plagued with mysterious

tourist deaths since the beginning of this year [2011], including an

Edmontonian [Canada] who was found dead after using the hotel's

facilities 26 Jan 2011. His symptoms began with severe chest pain

keeping him up through the night, a close friend earlier reported. He

later died of "suspected natural cause", after being diagnosed with

acid reflux in a Thailand hospital and sent home.

The Seattle woman and her husband had to abruptly cut their one-year

world tour short, after 2 weeks in Chiang Mai resulted in the 26 year

old woman making 2 emergency hospital visits -- "the worst week of

their lives".

She was treated in a Chiang Mai hospital after suffering chest pains

and flu-like symptoms on 8 Apr 2011. They were staying at another

nearby hotel. "My hands and legs were shaking and really sore, and

later my husband told me that my eyes had rolled back in my head and

my lips were blue. We were really scared," she said.

After arriving at the hospital, staff ran tests including an EKG

(electrocardiogram) and concluded it to be either food poisoning or

acid reflux. While in the hospital, the couple ran a Google search and

discovered the 7 cases in the area of tourists with similar symptoms

since January [2011] -- all of whom died after experiencing similar

symptoms.

They returned to the hotel from the hospital, where the woman again

collapsed and began vomiting in the elevator. The couple packed their

bags and headed for the airport to catch the next flight home but once

in the car, she began convulsing again. They went to the hospital

instead. "All that could go through my mind was the stories of the

recent victims," said the woman. Medical staff hooked her up to an IV,

ran another EKG and did blood tests before sending her home.

Upon arrival back into the US, the affected tourist saw a doctor to

follow up on her symptoms and has an appointment with an infectious

disease specialist. "I'm feeling exhausted, relieved and sore. I am

hopeful that the source [will be] identified soon so that no one else

becomes ill and so that people can continue to enjoy the wonderful

city of Chiang Mai without worrying," she said.

"The doctors in Thailand said it was probably food poisoning and

dehydration. In Seattle, we haven't received all of the test results,

but initial diagnosis was infectious enteritis. I had an x-ray and an

EKG, and my heart looks normal. The doctor also referred me to follow

up with an infectious disease specialist."

The other Chiang Mai cases

--------------------------

The death toll now stands at 7 between January and March of this year

[2011] - all with similar circumstances.

An elderly couple from England died simultaneously of a heart attack

inside their Downtown Inn hotel room on 28 Feb 2011.

A 23 year old woman from New Zealand, died in hospital 3 Mar 2011

after she and 2 friends became ill in the same hotel.

That same day, a 47 year old tourist guide was found dead in a room

located next door to the New Zealander.

A 33 year old American woman also died after experiencing similar

symptoms as Carter. However, she was not staying at the Downtown Inn

and lab results for the cause of death have not been received. Her

husband has demanded the Inn be closed and that he receive the lab

reports.

A French woman was identified as being the 6th person to die with

similar circumstances.

Evidence of [a] coxsackievirus infection was found in the New Zealand

woman and [an] echovirus was found in another victim. Four of the

deaths have been linked to myocarditis, an inflammation of the heart

muscle that masks itself as flu symptoms or chest pain resembling a

heart attack.

The World Health Organization [WHO] told QMI [Press] Agency that the

cases are under watch. "This event is being investigated by the

authorities in Thailand," said Gregory Härtl, communications of WHO

global Art and Response team. "The investigation is still on-going and

no conclusions have been reached. I cannot tell you much more than

that right now."

Freelance journalist Andrew Drummond in Thailand has been closely

following the cases and reported the Thailand Department for Disease

Control said so far there are no links between the deaths of cases

examined of people visiting Chiang Mai in January and February, and no

link to the Downtown Inn.

[byline: Jasmine Franklin with files from Andrew Drummond]

--

communicated by:

HealthMap alerts via ProMED-mail

<[email protected]>

[The evidence for linkage between these deaths and cases of severe

illness remains almost entirely circumstantial, with provisional

diagnoses including food poisoning, myocarditis, and virus infection.

The association with the Downtown Inn in Chiang Mai seems no longer

considered to be the relevant factor. A final verdict from the Thai

authorities is awaited.

Chiang Mai in northern Thailand can be located using the

HealthMap/ProMED-mail interactive map of Thailand available at

<http://healthmap.org/r/00cC >. - Mod.CP]

[see also:

Undiagnosed deaths - Thailand (04): (CM) 20110325.0949

Undiagnosed deaths - Thailand (03): (CM) 20110322.0904

Undiagnosed deaths - Thailand (02): (CM) 20110318.0866

Undiagnosed deaths - Thailand: (CM) RFI 20110312.0802]

.................................................sb/cp/ejp/sh

*##########################################################*

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are posted, but the accuracy and completeness of the

information, and of any statements or opinions based

thereon, are not guaranteed. The reader assumes all risks in

using information posted or archived by ProMED-mail. ISID

and its associated service providers shall not be held

responsible for errors or omissions or held liable for any

damages incurred as a result of use or reliance upon posted

or archived material.

************************************************************

[SadieMBeagle]

Glad she made it out alive. Hopefully the Seattle doctors will be able to come up with an actual diagnosis...

[Ulysses G.]

It is starting to seem like the media is just reporting about every farang who gets sick in Chiang Mai as if they are all related.

[Loaded]

It is starting to seem like the media is just reporting about every farang who gets sick in Chiang Mai as if they are all related.

True.

The description in the OP matches incidents of illness I've experienced in Chiang Mai... India, Indonesia and China.

[JohnLocke]

It is starting to seem like the media is just reporting about every farang who gets sick in Chiang Mai as if they are all related.

True.

The description in the OP matches incidents of illness I've experienced in Chiang Mai... India, Indonesia and China.

I've had very serious food poisoning a few times, including 5 days hospitalized in Saigon. Never had chest pains, nor sore arms or blue lips. Therefore, based merely on anecdotal experience, I'd hesitate to discount this one as unrelated.

The report in the paper leaves out two vital pieces of information that I truly wish were included: WHERE did this couple stay, and WHAT did they eat at the Night Bazaar (if she's fairly sure it was directly from that meal)?

[Deserted]

'The evidence for linkage between these deaths and cases of severe

illness remains almost entirely circumstantial, with provisional

diagnoses including food poisoning, myocarditis, and virus infection.

The association with the Downtown Inn in Chiang Mai seems no longer

considered to be the relevant factor. A final verdict from the Thai

authorities is awaited.'

Much more needs to be said here. Many toxins cannot be diagnosed as a cause unless they are specifically tested for. Has the water supply been examined for impurities do we know?

[bridge]

It is starting to seem like the media is just reporting about every farang who gets sick in Chiang Mai as if they are all related.

Probably because they are.

Oop's that right, coincidental.

[Contractor]

It is starting to seem like the media is just reporting about every farang who gets sick in Chiang Mai as if they are all related.

Probably because they are.

Oop's that right, coincidental.

My brother phoned me today to say that there was a very interesting report on this topic today on a BBC Radio 4 programme. The conclusion appeared to be that the deaths are linked due to some kind of chemical poisoning. I will see if I can stream the programme off iPlayer and get some further info which I will post.

Rgds

Edited April 22, 2011 by Contractor

[WinnieTheKhwai]

It is starting to seem like the media is just reporting about every farang who gets sick in Chiang Mai as if they are all related.

Yes, a mystery illness that affects Farangs only.

[Ulysses G.]

And apparently only tourists.

[CMX]

Every time the press in Occidental countries picks up the story of these deaths, we are closer to a solution.

It appears that the only button the West can push, one that gets the attention of Thai officials at high levels, is tourism. No U.N. inspectors for voting for Thais!

Yet as we know from other threads where stories disappear, Thai Tourism departments have great power. With regard to this issue, pressures from the press may lead to forcing Government to arrive at an accurate report, rather than those too easily disproved. A great press to arrest the tragedies must occur.

I admit to being mystified as to why Western autopsies have not been sufficiently thorough to point to a specific cause (chemical is a bit vague, I think). It could be that the mystery is indeed a puzzle.

[BarnicaleBob]

And apparently only tourists.

Not so! Waraporn Pungmahisiranon, age 47 a Thai, was found dead in her room at the Downtown Inn on the morning of 3 February, the same day that Sarah Carter (NZ 23 year old who died) became ill in the room next to Waraporn's. This is not food poisoning, food poisoning usually results in the victim having diarrhea, none of the seven dead victims had any signs of having diarrhea. All of the victims illnesses were consistent to toxic poisoning, perhaps by chemicals used in the area where they became ill for pest control or cleaning .

[Ulysses G.]

She was most likely a Thai tourist if she was staying in a hotel, but it is not the hotel guests that I am wondering about. It is the new "links" to tourists that did not stay there which seem questionable to me. if it is hitting other places in Chiang Mai, why does it not (as far as I know) make any non-tourists sick?

[smiling mantis]

Check for toothpaste being sold in a convenience store in the immediate area that would only be frequented by tourists.

...after eating and using restrooms at the Night Market in Chiang Mai, Thailand, on 30 Mar 2011...

Using the restrooms to brush their teeth?

...found dead after using the hotel's facilities 26 Jan 2011...

Including the restroom to brush his teeth.

...They returned to the hotel from the hospital, where the woman again collapsed and began vomiting in the elevator...

Because she brushed her teeth while in her room.

...An elderly couple from England died simultaneously of a heart attack inside their Downtown Inn hotel room on 28 Feb 2011...

Using the same tube of toothpaste to brush their teeth.

...A 23 year old woman from New Zealand, died in hospital 3 Mar 2011 after she and 2 friends became ill in the same hotel...

Again, sharing toothpaste.

...That same day, a 47 year old tourist guide was found dead in a room located next door to the New Zealander...

Used the same convenience store... to buy toothpaste.

A 33 year old American woman also died after experiencing similar symptoms as Carter.
However, she was not staying at the Downtown Inn and lab results for the cause of death have not been received.

Don't need to be staying in the same hotel to use the convenience store located near the hotel.

If anything's going to kill you in Chiang Mai it's going to be the crazy drivers, and surely not the food.

Toothpaste fits better than food poisoning. Maybe mouthwash or floss. But probably toothpaste.

[Lizard2010]

It is starting to seem like the media is just reporting about every farang who gets sick in Chiang Mai as if they are all related.

Yes, a mystery illness that affects Farangs only.

Not quite true the first person to die in the Downtown Inn Hotel.

Was a Thai Guide.

She was a friend of a Bangkok guide who works for someone i know from Bangkok.

So will still are no further forward as to what is causing this.

So what ever it is that makes people sick is still around Chiang Mai area.

[msg362]

Check for toothpaste being sold in a convenience store in the immediate area that would only be frequented by tourists.

...after eating and using restrooms at the Night Market in Chiang Mai, Thailand, on 30 Mar 2011...

Using the restrooms to brush their teeth?

...found dead after using the hotel's facilities 26 Jan 2011...

Including the restroom to brush his teeth.

...They returned to the hotel from the hospital, where the woman again collapsed and began vomiting in the elevator...

Because she brushed her teeth while in her room.

...An elderly couple from England died simultaneously of a heart attack inside their Downtown Inn hotel room on 28 Feb 2011...

Using the same tube of toothpaste to brush their teeth.

...A 23 year old woman from New Zealand, died in hospital 3 Mar 2011 after she and 2 friends became ill in the same hotel...

Again, sharing toothpaste.

...That same day, a 47 year old tourist guide was found dead in a room located next door to the New Zealander...

Used the same convenience store... to buy toothpaste.

A 33 year old American woman also died after experiencing similar symptoms as Carter.
However, she was not staying at the Downtown Inn and lab results for the cause of death have not been received.

Don't need to be staying in the same hotel to use the convenience store located near the hotel.

If anything's going to kill you in Chiang Mai it's going to be the crazy drivers, and surely not the food.

Toothpaste fits better than food poisoning. Maybe mouthwash or floss. But probably toothpaste.

I think it was the shampoo, much more likely!

[msg362]

Check for toothpaste being sold in a convenience store in the immediate area that would only be frequented by tourists.

...after eating and using restrooms at the Night Market in Chiang Mai, Thailand, on 30 Mar 2011...

Using the restrooms to brush their teeth?

...found dead after using the hotel's facilities 26 Jan 2011...

Including the restroom to brush his teeth.

...They returned to the hotel from the hospital, where the woman again collapsed and began vomiting in the elevator...

Because she brushed her teeth while in her room.

...An elderly couple from England died simultaneously of a heart attack inside their Downtown Inn hotel room on 28 Feb 2011...

Using the same tube of toothpaste to brush their teeth.

...A 23 year old woman from New Zealand, died in hospital 3 Mar 2011 after she and 2 friends became ill in the same hotel...

Again, sharing toothpaste.

...That same day, a 47 year old tourist guide was found dead in a room located next door to the New Zealander...

Used the same convenience store... to buy toothpaste.

A 33 year old American woman also died after experiencing similar symptoms as Carter.
However, she was not staying at the Downtown Inn and lab results for the cause of death have not been received.

Don't need to be staying in the same hotel to use the convenience store located near the hotel.

If anything's going to kill you in Chiang Mai it's going to be the crazy drivers, and surely not the food.

Toothpaste fits better than food poisoning. Maybe mouthwash or floss. But probably toothpaste.

I think it was the shampoo, much more likely!

[james24]

Check for toothpaste being sold in a convenience store in the immediate area that would only be frequented by tourists.

...after eating and using restrooms at the Night Market in Chiang Mai, Thailand, on 30 Mar 2011...

Using the restrooms to brush their teeth?

...found dead after using the hotel's facilities 26 Jan 2011...

Including the restroom to brush his teeth.

...They returned to the hotel from the hospital, where the woman again collapsed and began vomiting in the elevator...

Because she brushed her teeth while in her room.

...An elderly couple from England died simultaneously of a heart attack inside their Downtown Inn hotel room on 28 Feb 2011...

Using the same tube of toothpaste to brush their teeth.

...A 23 year old woman from New Zealand, died in hospital 3 Mar 2011 after she and 2 friends became ill in the same hotel...

Again, sharing toothpaste.

...That same day, a 47 year old tourist guide was found dead in a room located next door to the New Zealander...

Used the same convenience store... to buy toothpaste.

A 33 year old American woman also died after experiencing similar symptoms as Carter.
However, she was not staying at the Downtown Inn and lab results for the cause of death have not been received.

Don't need to be staying in the same hotel to use the convenience store located near the hotel.

If anything's going to kill you in Chiang Mai it's going to be the crazy drivers, and surely not the food.

Toothpaste fits better than food poisoning. Maybe mouthwash or floss. But probably toothpaste.

Are you obsessed with teeth, I just noticed your avatar too lol

[Lizard2010]

Check for toothpaste being sold in a convenience store in the immediate area that would only be frequented by tourists.

...after eating and using restrooms at the Night Market in Chiang Mai, Thailand, on 30 Mar 2011...

Using the restrooms to brush their teeth?

...found dead after using the hotel's facilities 26 Jan 2011...

Including the restroom to brush his teeth.

...They returned to the hotel from the hospital, where the woman again collapsed and began vomiting in the elevator...

Because she brushed her teeth while in her room.

...An elderly couple from England died simultaneously of a heart attack inside their Downtown Inn hotel room on 28 Feb 2011...

Using the same tube of toothpaste to brush their teeth.

...A 23 year old woman from New Zealand, died in hospital 3 Mar 2011 after she and 2 friends became ill in the same hotel...

Again, sharing toothpaste.

...That same day, a 47 year old tourist guide was found dead in a room located next door to the New Zealander...

Used the same convenience store... to buy toothpaste.

A 33 year old American woman also died after experiencing similar symptoms as Carter.
However, she was not staying at the Downtown Inn and lab results for the cause of death have not been received.

Don't need to be staying in the same hotel to use the convenience store located near the hotel.

If anything's going to kill you in Chiang Mai it's going to be the crazy drivers, and surely not the food.

Toothpaste fits better than food poisoning. Maybe mouthwash or floss. But probably toothpaste.

I think it was the shampoo, much more likely!

You could be onto something there with the Shampoo.

They probably recycle the used ones and maybe they put the wrong stuff in them when refilling.

Or was it the water out of the tap instead of using bottle water!

[Dellboy218]

This from Todays Daily Telegraph for any one that is interested:

http://www.telegraph.co.uk/news/worldnews/asia/thailand/8473400/Thai-authorities-accused-of-cover-up.html

[TheFishman1]

Was this the same place as the others stayed?

[Dellboy218]

Was this the same place as the others stayed?

Yes, I believe it is.

[realthaideal]

Despite the urge to add a chuckle here about the capers of the powers-that-be that have failed to produce results or any conclusive (or any leading) ideas, I would like to mention that it's sad that all of these people have 'conicidentally' perished, lest we make this a gag thread - it's a little insensitive for my tastes. I'd also like to think maybe the relatives and friends of those concerned might be following along with how this is all shaping up here in CM.

Anyway, googled Cm today and found this article, different but similar to the other one linked to above. There is some new info here, sad that none of the ppl involved are telling us by name - off one of their tourist maps, say, where they ate. Details are still foggy but a little better. http://www.smh.com.au/travel/travel-incidents/thai-mystery-seven-tourists-die-after-falling-ill-20110426-1duee.html

[Maejo Man]

In the same vein, this today from New Zealand,,,,,,

http://www.stuff.co.nz/national/4925249/Kiwi-tourists-Thai-holiday-from-hell

[Dellboy218]

Despite the urge to add a chuckle here about the capers of the powers-that-be that have failed to produce results or any conclusive (or any leading) ideas, I would like to mention that it's sad that all of these people have 'conicidentally' perished, lest we make this a gag thread - it's a little insensitive for my tastes. I'd also like to think maybe the relatives and friends of those concerned might be following along with how this is all shaping up here in CM.

Anyway, googled Cm today and found this article, different but similar to the other one linked to above. There is some new info here, sad that none of the ppl involved are telling us by name - off one of their tourist maps, say, where they ate. Details are still foggy but a little better. http://www.smh.com.a...0426-1duee.html

Yes RTD it is unfortunate that CNX will probably get a bad name out of this. Not necessarily because of the people falling ill, after all, with the best will in the world that is going to happen. But from the aftermath, the official response, to a number of people located in the same area all falling ill. It certainly sends out the wrong signals around the world as evidenced by both these articles. It appears that no one with any authority even wants to limit the damage from those signals. To call it 'concidence' is not going to satisfy the family and friends involved. It may or may not be the truth but I think they deserve a little more information than that backed up with hard facts.

[HTWoodson]

Another news article here.

It says that Sarah Carter had contracted Echovirus.

[Lizard2010]

Here is another article.

NZ Herald

This is the website that was setup to warn people.

NZ Warning

We have stayed at the Hotel in question many times with no problems.

We were even there when the Thai Tour Guide died, we did not even know till we home for a few weeks.

Then the NZ girl died the night we went up to Chiang Rai.

We were booked to stay there next trip, but have re booked somewhere else.

This has not put us off going to Thailand.

But we are careful where we eat.

We use our own hand wash all the time.

As personal hygiene is also so important.

Will we ever know what has happened.

I wonder how the test are going in the USA & Japan :jap:

[HTWoodson]

According to the echovirus article, "...the fecal-oral route is the predominant mode (of infection)".

I'll put my money on one of the predominantly tourist-frequented restaurants in the Anusarn market. I've always found that places catering to tourists, and therefore not worrying about repeat customers, usually have sh^^ty food. Literally.

Edited April 27, 2011 by HTWoodson

[Lizard2010]

Another news article here.

It says that Sarah Carter had contracted Echovirus.

INteresting

Viral structure and infection

An echovirus measures 24-30 nanometres (nm), and is similar to other viruses, since it has a naked protein capsid, which makes up 75% of the virus particle that encloses a dense central core of single-stranded RNA. This RNA has a length of approximately 7.5 kilobase (kb), contains an RNA replicase, viral-coded proteins, and a single polyprotein that is responsible for the formation of structural proteins and other proteins necessary for cellular replication. The structural proteins determine host range and play a very important role in delivering the RNA genome into the cytoplasm of new host cells.^[3]

Some viral replication of an echovirus occurs in the nasopharynx after infection and then spreads to regional lymph nodes. However, most viral particles are swallowed and they reach the lower gut tract, where the virus is presumed to bind to specific receptors. The virus then spreads to the lower intestinal tract, replicating but not causing any major cellular effects along the way. Next, the virus spreads to many secondary sites in the body such as the central nervous system, liver, spleen, bone marrow, heart and finally the lungs. Additional replication of the virus will occur, causing symptoms 4 to 6 days after infection. The most deadly part however is delayed when symptoms of a central nervous system disease start to appear. Enteroviruses are capable of infecting any cell in the body. These viruses are highly infectious. They can spread through the air to other hosts 1–3 weeks after infection and can spread through feces to other hosts eight weeks after infection.

So if this is the case.

The people concerned may have been infected elsewhere before they arrived in Chiang Mai.

Going on the 3 to 4 days incubation period.

[Contractor]

http://www.thailandt...ltragedies.com/

I understand that the above website has been set up by the father of the deceased NZ girl.

The BBC Radio programme had a professor from a London hospital see little likelihood of bacterial food poisoning, more likely a toxin being ingested - based on reported cause of death only.

It was reported that similar types of (initially unexplained) deaths had been found amongst third-world agricultural workers handling pesticides/fertilisers (although many of these cases are not reported/fully investigated).

RIP to all those poor souls and I hope pressure is kept on the Thai authorities to get this properly looked at.

Edited April 28, 2011 by Contractor