nodding syndrome

Nodding Syndrome

Over the past few years there have been many reports coming out of Uganda and Sudan about the emergence of a strange disease in children. Parents and local health officials describe the gradual development a mental disease characterized by a physical nodding of the head. Those suffering from the disease often appear to be losing attention and nodding off to sleep, despite feeling awake and alert. This unexplained condition has been the focus of many epidemiology, infectious disease, toxicology, and health specialists since the turn of the decade (GHFN, 2013) (GHFN).

The World Health Organization began to investigate this strange disease in 2001, but much in still unknown. In 2009, the Uganda Ministry of Health requested that the United States CDC develop a tasks force to learn more about the growing disease. Investigators and researchers have examined and document thousands of children presenting symptoms in order to learn more of the disease. Interestingly, the disease only seems to affect a small age range of children, typically around 15 years old. The syndrome has been confirmed as a neurological disorder associated with other seizure activity, neurologic and cognitive impairment, delayed puberty, and growth retardation.

Although research has confirmed the disease as an impairment of the brain, there is still now known definitive cause. Patients suffering from nodding syndrome have been associated with malnutrition, and a parasitic infection called onchocerciasis. The CDC and other research organizations have ruled out several potential associations such as trypanosomiasis, cysticercosis, loiasis, lymphatic filariasis, cerebral malaria, measles, prion disease, or novel pathogens; or deficiencies of folate, cobalamin, pyridoxine, retinol, or zinc; or toxicity from mercury, copper, or homocysteine. Although there is association with onchocerciasis, many countries in Africa have numerous cases of this infection, but do not report any cases of nodding syndrome. Experts continue to examine specimens and search for an underlying cause to this mysterious and horrible affliction.

 Currently there are no known cases of children improving from the disease, but some have died as a result of the disease of opportunistic infections. Epileptic medications show mild improvement of symptoms but do not treat the disease. In addition to the obvious symptoms, the disease put the children at risk for many other dangers.  These children are very vulnerable to injury and accidental death due to the frequent seizure like states the can incapacitate the control of their body.

The burden of the disease is also extended upon the family of the children who must constantly monitor their mental and physical state to avoid such injuries or accidents. Parents often have to accompany the child and watch as they gradually lose mental capacity.

Reports of the disease have only been found in Uganda, Sudan, Tanzania, and Liberia, but the prevalence appears to be rising. It is a major priority for researchers to learn more about the debilitating disease and find treatment solutions. Public health solutions must be developed and implemented in order to increase detection of this disease. Additionally if a treatment or underlying cause is found, methods of prevention and treatment delivery will also be a major concern for local health officials.

 

Works Cited

Dowell, S., Sejvar, J., Reik, L., Vandemaele, K., Lamuna, M., Kuesel, A., et al. (2013, September). Nodding Syndrome. Emerging Infectious Diseases.

GHFN. (2013). Nodding Disease Kills and Confounds. Retrieved December 6, 2013, from Global Health Frontline News: http://www.ghfn.org/

GHFN. (n.d.). Nodding disease baffels experts. Retrieved from http://www.youtube.com/watch?v=5S7QLocaS0M