African outbreak stumps experts.

Abstract

The boy was perhaps seven or eight, although he could have been older: among other things, the disease that afflicts him stunts growth. When a seizure began, his mother summoned Sudhir Bunga, who found the boy sitting under a tree in a school playground. “The child was staring blankly and his head was intermittently nodding every five to eight seconds,” Bunga says. “This lasted about three minutes.” Bunga was not surprised by what he saw. A physician and epidemiologist with the US Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia, he was in rural southern Sudan in May as part of an emergency-response team trying to assess a mysterious illness seen in children in the region. But despite his preparation, Bunga was deeply affected by his first encounter with ‘nodding syndrome’. “Actually seeing it out in the community was overwhelming and distressing,” he says. “The burden of the disease looked really high.” Nodding syndrome is a poorly understood and seemingly growing problem in eastern Africa, where it is devastating communities in South Sudan and northern Uganda. It has existed separately for decades in a secluded mountainous area of southern Tanzania. In South Sudan, “it’s affecting thousands of children,” says Abdinasir Abubakar, a physician for the World Health Organization (WHO) based in South Sudan who coordinated the recent CDC trip. “Of course, the question is whether this syndrome is spreading to new communities.” For South Sudan, which achieved political independence only on 9 July, the syndrome raises the additional fear that the new nation’s limited capacity to deal with an emerging medical threat will be quickly overwhelmed without outside resources and expertise. “Nodding syndrome cannot be left with the nascent government in South Sudan,” says Martin Opoka, an epidemiologist with the WHO’s eastern Mediterranean regional office in Cairo. “They will certainly need assistance from the international community.” Opoka helped to investigate the occurrence of nodding syndrome in southern Sudan as part of a WHO team in 2002, and returned to the region this year to assist the CDC investigators. The CDC team — consisting of four physician-epidemiologists with specialities in paediatrics, neurology and nutrition — was dispatched by the US agency’s Division diversity exposed by the impact. Three types of meteorite found on Earth — eucrites, howardites and diogenites — are thought to be chips of Vesta, blasted away by the collision. Linking these convenient specimens to particular internal layers of Vesta is a key driver of the Dawn mission, notes Binzel. “It’s a little bit like the Humpty Dumpty problem — we’ve got a lot of pieces of Vesta and we’d like to see how they all fit together,” he says. After its tour of Vesta, Dawn will fire up its ion thrusters — solarpowered jets that supply a weak but long-lasting push — and set a course for Ceres, which it will inspect over five months in 2015. Before launch, budget issues caused the mission team to drop two instruments originally meant to fly aboard Dawn; one of them, a magnet ometer, will be especially mourned once the craft reaches Ceres. The magnetometer could have looked for fluctuations in the strength of the asteroid’s magnetic field that might have provided clues as to whether the body harbours a briny ocean. Losing the instrument “was a big blow”, says Raymond. Although Dawn has so far survived the ravages of budget changes, politics and four years in interplanetary space, Russell says that he won’t relax until the craft enters orbit around Ceres. Casey Lisse, a planetary scientist at Johns Hopkins University’s Applied Physics Laboratory in Laurel, Maryland, agrees. “We’ve learned most of what we can from remote observations of Ceres, and we need an up-close and personal look,” he says. ■

DOI: 10.1038/475148a

Cite this paper

@article{Wadman2011AfricanOS, title={African outbreak stumps experts.}, author={Meredith Wadman}, journal={Nature}, year={2011}, volume={475 7355}, pages={148-9} }