Medical report from Syria

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    • #4473
      Juliane
      Member

      I am writing this report at @Lisa ’s request, to help her and her team in their research. However, I believe it is important in times like these to share any information we may have, which is why I will be sharing it here. It is based on my field observations of the past few weeks and I will update it whenever I find the time to do so or if I find out something new that might be useful.

      As it has been mentioned before by @Nesto, I have also observed patients with red blistering patches of skin that look like burns. From my observations however, this seems to happen mostly on keratinised skin in the case of contact contamination. In the case of oral contamination, the mucosae of the oral cavity, although irritated, do not exhibit the same blistering.

      Blisters appear within 24 hours after contact contamination and somewhat resemble bullous impetigo seen in Staphylococcus aureus infections. This picture was taken about 8 hours after the patient came into contact with contaminated water, this is one of the most extreme cases of blistering I have encountered so far :

      From what I have seen it is hard to tell appart the progression of contact contamination and oral contamination since in all the cases I have encountered so far, they both go hand in hand and the blistering of the skin seems to be meerly an additional symptom when there has been also contact contamination.

      When contamination happens “per os”, as is the case with drinking water, the mucosal irritation often remains undetected until the pain appears. This happens 12 to 15 hours post infection. The pain is generalised and upon examination I have established 3 stages :

      • Stage I. is the invasive phase, it lasts approximately 2 to 3 days. The pain is in this phase mostly muscular, some kind of acute myositis (skeletal muscle inflammation), accompanied by muscle weakness and fluctuating fever. It appears almost at once in every muscle, suggesting a rapid hematogenous (through blood) spread of the pathogen to all parts of the body. Laboratory evaluation reveals leukocytosis with a left shift and an elevated erythrocyte sedimentation rate. From reports, I have read from other parts of the globe, it seems this stage is in length according to geographic situation, maybe because of different environmental conditions and health care availability, or even genetic differences.
      • Stage II., succeeds to stage I. and last 5 to 6 days. The pain intensifies and spreads to organs which start failing. The kidneys go first, resulting in acute glomerulonephritis, possibly due to bacterial and immune complexes damaging the glomeruli (blood filter). This leads to accumulation of waste products in the body. The irritated mucosae ulcerate leading to bloody stools, diarrhea, nausea and vomiting. This stage is the most unclear to me since so many systems start dysfunctioning simultaneously…
      • Stage III., succeeds to stage II. It is the last and shortest phase, can be as short as a few hours. The pain disappears completely, possibly due to exhaustion of neurotransmitters, habituation of the CNS or degeneration of nerve endings… It is difficult to tell without proper tools for examination and autopsy. Ensues septic shock and multiple organ failure. Considering the insufficient medical means and supplies at our disposal here and the lack of knowledge concerning this disease, I have unfortunately recorded a 100% mortality rate, even for patients that have been diagnosed early and cared for to the end. I have try most know antibiotics without result, it is urgent to find a cure…

      More thorough laboratory testing as well ultrasound, computed tomography and magnetic resonance imaging scans could give us more dearly-needed information. Would that I could, I would send you some samples for your research, however I think I will have to bring them myself since the posting services do not seem to be functioning.

      Human-to-human contamination : For now water is the only confirmed vector of the pathogen. Water being spread far and wide in our environment, I have not been able to prove human-to-human contamination, however it can be assumed it is possible. As a measure of security, I have instructed everyone around me to pay special attention to hygiene; wash hands thoroughly, wear masks, gloves and protective clothing at all times in insecure environment… We have also all been administered a dose of prophylactic antibiotic cocktail. So far, none of us have shown any signs of contamination. I therefore recommend caution if any of you think you are at risk of contamination (or contaminating), better safe than sorry!

      Stay safe!     _Juliane L.

      • This topic was modified 3 years, 7 months ago by Juliane.
      • This topic was modified 3 years, 7 months ago by Juliane.
    • #4479
      Ellie Burton
      Member

      Holy crappin’ Christ. This is unbelievable. Thanks for keeping us updated Juliane!

    • #4480
      Haradin
      Member

      Thank you very much for the information, Juliane. Are you able to confirm you could die just by having touched contaminated water?

    • #4481
      Zeno
      Member

      This is horrible. No words. Thank you for doing what you do.

    • #4490
      Sam
      Member

      This is really important and everyone should know this. Thank you for sharing this it means a lot. It sounds really bad. I am also interested in how dangerous contact with contaminated water is.

    • #4519
      Nesto
      Member

      @Juliane, I want to try to distill water from industrial plant : there are here some reactors containing 4000l, and I know how to use them. Unfortunately, the factory is closed, but I still have the keys and know to start boilers and pumps. I’ll try to distill water bringing it under pressure at 200 ° C.

      @Juliane
      , it seems you know medical stuff, tell me if in your opinion I can get clean water. and, in case, if I can do something!
      thank you
      stay safe

      Nesto

      • This reply was modified 3 years, 7 months ago by Nesto.
    • #4527
      Juliane
      Member

      @Haradin, no, unfortunately I cannot be sure you could die just by having touched contaminated water. Like I said, all the patients I examined that have come into contact with it had been drinking it as well, so it is hard to tell.


      @Nesto
      , distilling could work to purify the water however we have very few information about the pathogen for now so there is no way to be sure about it… There are 2 problems :

      • The main problem is that we have yet no information on the pathogen’s structure. If it is indeed a bacteria, what is it’s cell wall structure? gram +? gram -? something new? to what extent is it heat sensitive? what are it’s virulence factors? does it produce toxins? does it make spores? (perhaps @Lisa will be able to give us more information soon) All these factors are important to understand how the bacteria work and therefore how to get rid of them. Regular boiling of the water might not be enough to eliminate bacterial spores which are highly resilient forms of the bacteria that can only be killed under certain circonstances. For instance, in medical practice, instruments are sterilised by autoclaving (saturated steam under pressure) at 121°C for 15 minutes. I am no expert with boilers and distillation but you would have to recreate at least the same conditions to hope obtaining drinkable water. Not to mention that we might be facing some completely new species with higher resistance than what we have come across until now…
      • The second problem is that even if you manage to obtain water that is safe to drink, the process will have also destroyed most of the natural minerals in it, such as calcium, magnesium, iron… Of course, this is far less dangerous that a having a virulent bacteria swimming in your drinking water but you might have to keep it in mind and get some dietary supplements to counter this effect.

      I suppose it is still worth a try but please be careful and make sure to have the resulting water studied in a microbiology lab before using it for any purpose!

      • This reply was modified 3 years, 7 months ago by Juliane.
    • #4619
      Lisa
      Member

      Thank you for this report, @Juliane! This is very valuable information – and frightening at the same time.

      Of course it would be very helpful to get samples from you, but I fear it has become difficult to make it happen (with the  very limited transportation possibilities left). I hope we will get some samples from the university hospital in Zurich, where (as far as I know) some people who drank contaminated water have been taken.

      I’ll post my next report with some preliminary results of the water analyses in a minute (in the reports section).


      @nesto
      : Boiling the water is not enough (as the spores we found will survive it). Distilling – if your steam has 200°C – might work, but there’s no guarantee yet – many questions are still open. Crucial (and maybe difficult) for your distillation will be that you have to ensure that no re-contamination is possible in the process of condensating the water again – so it really must be a sterile, closed system (until you have the water in the – uncontaminated! – bottles). And as Juliane says: When you try it, do not use the resulting water before it has been analysed in a microbiological lab.

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