What links five sudden deaths in two months in UAE

Dubai: Is there a deadly infection in the air? The sudden death of a young Indian man C.N. Nabhan Nasser in Ajman on December 29 was the latest fatality in the last two months, sending shock waves in the expatriate community. Circumstances surrounding five sudden deaths indicate some similarities between the victims, a Gulf News investigation has found.

They died suddenly, had respiratory infection and their conditions quickly worsened leading to multiple organ failure.

On December 19, a two-and-half year old girl, Mia Susan Markose died of encephalitis and Influenza A virus at the Zulekha Hospital, Sharjah.

Time is of essence and instead of taking paracetamols and pain killers, it is important to catch the nature of infection and start an effective protocol.

- Dr Arun Kumar Sharma | Medeor 24/7 Hospital

On November 28, seven-year old Shiba Fatima died at the NMC Specaility hospital, Dubai, hours after being brought to the emergency. She had been suffering from mild to high fever, nausea and vomiting for three days, for which she was treated at her local clinic. As her condition deteriorated, tests revealed her blood platelet count had fallen to 7,000 which should have been above 70,000 and she died of sepis and multiple organ failure.

On November 13, Alia Niyaz Ali, a grade 12 student, died of suspected flu symptoms within hours after reporting to the emergency of Rashid Hospital. She too was under treatment for mild grade fever and respiratory infections, but was not responding to her GPs protocols and died of fluid collection around her heart and intestines.

On October 30, Ameenah Annum Sharaf, a nine-year old grade 3 student, was the first to die after suffering from flu like symptoms for more than a week. She went to her local clinic and was eventually admitted to the Al Jalila Children’s Speciality Hospital where she died of heart failure.

Kerala connection

All the five belonged to the state of Kerala in India and at least four of them belonged to Kannur district. None had any history of illnesses and led healthy lives before contracting fever, in less than a week before their death. At least three had visited their hometown, Kannur in July for summer holidays. But it is unlikely that they contracted some kind of infection there as medical experts say viruses have a gestation period of maximum 15 days. Very few viruses or bacteria have a slow incubation period that could stretch to months before symptoms are visible.

Similar symptoms

Besides being from Kerala, all of them had a mild to high fever with respiratory infections. In case of Alia, Ameenah, Mia and Shiba, they had al consulted their local family GP. Nasser, who was a fitness freak, had intermittent fever for a few months for which he took paracetamols and it subsequently subsided, according to his cousin, Rameez. Nasser worked for Thumbay clinic, Sharjah, but he first reported to the clinic only on December 28 and was immediately referred to the hospital where he died after few hours. Most of the patients were fully conscious when brought to the hospital with Alia, Nasser and Shiba walking to the hospital for consultation. All of them suffered from multiple organ failure.

But Dr Shaikh Altaf Basha specialist in internal medicine who attended on Nasser at the Thumbay Hospital told Gulf News: “The patient had developed pneumonia and the pleura around his lungs was infected. He was going into renal, liver and heart failure when he was admitted to the hospital. A blood test revealed his White Blood Cell (WBC) count to be 190,000 when it should have been less than 10,000. He probably had underlying leukaemia which could not be ascertained definitively and this could have led to him contracting infections.”

Sudden death

Nasser died just four hours after getting admitted. His cousin Rameez who was looking after him told Gulf News: “I am finding it difficult to believe this as he walked to the hospital himself at about 8pm. He complained of chest pain. He was weak and only after reaching there he collapsed. His heart stopped working at 1am. They tried to resuscitate him but he died at 3am on Saturday morning.”

His parents, O.K. Nasser and C.N. Najma, were unable to travel for his funeral which was held at Al Quoz cemetery on Saturday afternoon.

Why did the organs shut down?

Commenting on the recent fatalities, Dr Arun Kumar Sharma, Head of Neurology and clinical director of Medeor 24/7 Hospital, told Gulf News: “In case of Nasser, the WBC count of 190,000 did not conclusively prove he had leukaemia. What it looked like was a case of septicaemia due to infection which led to respiratory distress and multiple organ failure.”

Dr Basha informed that a peripheral Blood Film (PBF) of the patient showed his platelet count was fine but patient had 16 per cent blast cells indicative of acute lymphoblastic leukaemia onset. However. Dr Sharma insisted: “Even if the peripheral blood film indicated some blast cells, no one really dies of leukaemia unless there is a blast ciris with heamhorhhage due to platelet deficiency. The patient in all likelihood died of septicaemic shock.”

Preventive vaccination

While it might be difficult to ascertain the cause of these deaths, it is important for people to go for preventive vaccinations. Dr Sharma said: “Do not take the mildest of fevers lightly and go in for a thorough viral and bacterial blood investigation, Within ten minutes a doctor can ascertain the nature of the infection and start the patient on Tamiflu or antibiotics, whichever is required. Patients suffering from the common strains of influenza respond well to Tamiflu. The GP needs to rule out flu and bacterial infection with a complete blood count (CBC) investigation that also reveals the paletelet, WBC and red blood cell count. Time is of essence and instead of taking paracetamols and pain killers, it is important to catch the nature of infection and start an effective protocol.”

Timeline

CN Nabhan Nasser

December 29: Aged 29, died hours after being admitted to hospital. He developed pneumonia, his organs failed and had a WBC of 190,000.

Mia Susan Markose

December 19: Aged 2.5 years, died of encephalitis and Influenza A virus

Shiba Fatima

November 28: Aged 7, died at the NMC Specaility hospital, Dubai. She was suffering from mild to high fever.

Alia Niyaz Ali

November 13: Grade 12 student died of suspected flu symptoms within hours of reporting to emergency at Rashid Hospital.

Ameenah Annum Sharaf

October 30: Aged 9, grade 3 student died after suffering from flu like symptoms. She was the first casualty.