Manganese mine incident…‘Mystery’ illness identified as Histoplasmosis- Infection caused by Fungus found in droppings of birds, bats and rats in humid areas

Apr 16, 2019 News

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The mystery illness which was erroneously assumed to be H1N1 (Swine Flu) and as leptospirosis in two cases, affecting employees working in the Guyana Manganese Inc. tunnel in Matthew’s Ridge, Region One, Barima-Waini, has finally been determined to be Histoplasmosis, an infection by a fungus found in the droppings of birds, bats and rats in humid areas.
This was confirmed when the Ministry of Public Health held a press conference yesterday in its Mental Health Unit Boardroom, to provide an update on the recent outbreak and related issues.
Samples were collected from all patients and initially some testing was done at the National Public Health Reference Laboratory (NPHRL). Further samples were sent to the Caribbean Public Health Agency Laboratory (CARPHA) in Trinidad for confirmation.
The results initially were negative for Influenza A and B inclusive of H1N1, Chikungunya, Zika and Dengue. All patients underwent malaria tests in Matthews Ridge and they were also negative.
Chief Medical Officer (CMO) Dr. Shamdeo Persaud provided a detailed update.
Relating the developments sequentially, the CMO said that the first four cases were reported on March 28; one died while receiving care at Pakera District Hospital in Region One.
The following day, four more were brought in to Pakera District Hospital complaining of similar symptoms (fever, headaches, joint pains, mild shortness of breath). Subsequently, the seven Chinese workers were transferred to the Georgetown Public Hospital Corporation (GPHC).
An additional six employees, including one Guyanese, were attended to at the Port Kaituma Hospital, but later transferred to the GPHC. One of the six persons visited the hospital on his own. He was evaluated but not admitted.
Once the cases were reported, several teams visited the site from the regional level. The teams included the Regional Health Officer and the Regional Environmental Health Officer, along with some supporting medical staff.
“In the initial stage, we weren’t sure what we were dealing with, but since it was a febrile illness with respiratory symptoms, we took all the necessary precaution to restrict access to both the site and the hospital where the patients were being kept.
“The additional staffers that were sent to the region set up a temporary facility at the community centre in Matthews Ridge where they were seeing the regular patients,” the CMO recounted.
“Following the transfer of the patients on April 3, they cleaned up the Pakera District Hospital and closed down the temporary sites. Work resumed as normal at the hospital for Maternal Child Health and other services.”
“Two persons are dead; one died at Pakera District Hospital and one at GPHC. Of those admitted at the GPHC, two were discharged. An additional person was discharged from Pakera District Hospital.
“Ten workers were transferred to China on Monday, April 9. Sixteen Chinese workers were under care and treatment. Following the transfer, two more were admitted to Pakera Hospital bringing it to a total of 18.”
Blood, sputum and urine samples were collected from those that were under care, while tissue samples were collected during the post mortem from the two deceased. Testing for these samples was done locally at the National Public Health Reference Laboratory (NPHRL) and confirmation was done at Caribbean Public Health Agency (CARPHA) in Trinidad.
“All tests were negative for Influenza A & B, Dengue, Chikungunya and Zika. Even though reported, we had two positive for Leptospirosis, according to the NPHRL, those were later found negative through confirmation from CARPHA.
“On the weekend of April 7, a team was flown in to Matthews Ridge. The team included officers from Environmental Protection Agency and Occupational Safety and Health, and they did an evaluation of the work site and looked at some of the risk factors relating to the environment. A community meeting was also held with residents,” Dr. Persaud said.
It was disclosed that from April 8 to April 10, two Consultants from the Pan American Health Organisation/World Health Organisation (PAHO/WHO) along with the Chief Medical Officer and a team from the Ministry of Public Health visited the area.
A team of nine officers from the Centre for Disease Control (CDC), China, was also part of the visiting team.
“During the visit, the team met with the hospital staff. We reviewed their procedures for infectious disease control and prevention and we met with company officials. Interviews were conducted with the persons who were working in the mine.”
A total of 23 Chinese workers were interviewed. They were working in the four different tunnels.
The CMO continued: “On April 10, we received word from CARPHA that five samples were tested for histoplasmosis, four were positive. The Chinese CDC tested an additional six persons and five were positive for histoplasmosis.
One person tested showed weak positive hantavirus, but this may have been because a past exposure to that germ.
“Currently, we are monitoring persons at Matthews Ridge. During the last two days, two persons developed fever and they were admitted to Pakera District Hospital and are under close observation and treatment for hantavirus, which is a fungal infection. We also took samples from them and they are presently being processed for shipment to CARPHA.”
Meanwhile, the absence of safety gear for workers was highlighted. Interviews were done with employees who had not developed any illness. And this revealed the shortcomings.
Officials were told that the safety gear was in the country, but was not on site. They had not cleared customs at the wharf at that time. However, that claim was never confirmed.
Occupational Safety and Health (OSH) Consultant Gwyneth King said, “Our information to date is that the workers were not wearing [any] personal safety gear. That is to say that they were not wearing respirators, so they were exposed to breathing in the fungus.
“If you have to do a job like that, you need to wear personal safety gear, otherwise to that you could expose yourself.”
King said that officials will be working within the confines of the Occupational Safety and Health Act to see what action, if any, can be taken against the company for this major inadequacy.
However, they are only now going through their findings and preparing the report.

 

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