In response to the ProMED posting, the HEAS has received the following report from a Canadian healthcare provider who worked in Haiti last month. We are deeply thankful to have received this critically important information.
Our world is so small. From Nov 29 to Dec 7 I worked in a CTC in Seminaire Limbe with Dr. Steve James and Dr. Manno. Just yesterday I received this ProMED notification from a nurse here in Canada that received the e-mail from a Canadian agency. She had heard about our experience and remembered me talking about an unusual case of paralysis with one of the cholera patients.
Both myself and another nurse were stumped. This woman was in her 40’s…don’t know her name. She presented with cholera and was recovering. On Dec 1st / 2010, she developed a fever. Dec 2nd she lost the use of both legs and another nurse and I watched this move up her body into both arms. My nurse colleague who is an OR nurse from Canada said at that time “This looks like Guillain-Barre Syndrome”. The patient’s voice became gargled and she had difficulty saying words. When we tried to give her sips of ORS, she began to choke and aspirate and struggled with respirations. I could only watch her helplessly. Her body was stiff and rigid when we would roll her from side to side for washing. 3 physicians were asked to examine her. Dr. Jensen wondered about electrolyte imbalances, and a Mexican physician from MSF wondered about dengue. Dr. Esther from MSF was asked to examine her and ordered ceftriaxone 2 gms daily for 5 days (because of the fever) but the physicians were stumped by the case. On Dec 5 she started to move her arms and was taking sips of soup. I saw her again on the Day I left for Canada ( Dec 6) and her husband had sat her up in bed and was feeding her. She was able to move her feet and was grasping items with her hands. I felt she was going to make it but I always wondered what was going on. It was really good to read the cases in the ProMED notice. Dr. Steve James suggested I write you about our experience as it may prove helpful to your work.
Below is a photograph of this patient, taken on Dec 1, 2010:
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