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Biological Hazard – (Fatal), Mystery Disease Outbreak: São Tomé and Príncipe, Africa


Published Date: 2017-03-01 08:31:09
Subject: PRO/EDR> Buruli ulcer – São Tomé and Príncipe (04): fatal, susp, RFI
Archive Number: 20170301.4871346

Date: Sun 26 Feb 2017
Source: Africa Review [edited]

At least 2000 people have been reported infected by a mystery disease in São Tomé and Príncipe. DW [Deutsche Welle] Radio quoted authorities saying 42 new cases had been reported in the past week alone, from the disease that has been code-named “necrosant cellulite” [machine translated as necrotizing cellulitis].

A total of 1994 cases of infections were reported as at January [2017], from when it was first detected in October last year [2016], DW Radio said.

So far, 4 people have died from the infection.

The infection attacks the lower limbs, with men more prone to it than women, DW Radio explained. The symptoms, according to the DW report, include itching body, swollen legs and skin discolouration. DW Radio quoted the island nation’s director of health, Ms Maria Tomé Palmer, saying there was no known cure for the infection.

The World Health Organisation (WHO) has dispatched a representative to the island to investigate and report on the mystery outbreak.

São Tomé and Príncipe is a Portuguese-speaking nation consisting of 2 islands. It lies off the north-western coast of Gabon and is Africa’s 2nd least populated country after Seychelles. The country officially gained independence from Portugal in 1975.

[Byline: Arnaldo Vieira]

Communicated by:

[ProMED-mail has been posting reports of this outbreak of cutaneous ulcer disease in São Tomé and Príncipe. Initially (3 Feb 2017), we were told that authorities had requested support from the World Health Organization (WHO), which was sending a Benin specialist in Buruli ulcer. At that time, there were 1094 cases reported since October 2016. The number has increased to “at least 2000” cases with 4 deaths due to the disease. The news report says that the ulcers have been described as “necrosant cellulite”; the histopathology of Buruli ulcer is said to be characterized by coagulation necrosis, where the cell nuclei and intracellular structure are absent, leaving “ghost cells” ( However, Buruli ulcer is rarely fatal.

It is obvious that more information on this outbreak in São Tomé is urgently needed — a clear clinical description of the skin lesions and the results of tests used to confirm the diagnosis of Buruli ulcer, that is, polymerase chain reaction (PCR) and culture for _Mycobacterium ulcerans_, acid-fast staining, and histopathology, and that of other conditions that should be considered in the differential diagnosis of Buruli ulcer disease ( – Mod.ML

A HealthMap/ProMED-mail map can be accessed at:]

See Also

Buruli ulcer – São Tomé and Príncipe (03): A. fumigatus, PCR, bone biopsy, RFI 20170216.4842731
Buruli ulcer – São Tomé and Príncipe (02): comment, RFI 20170210.4830051
Buruli ulcer – São Tomé and Príncipe 20170208.4824961

A ProMED-mail post
ProMED-mail is a program of the International Society for Infectious Diseases

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