Virulent bacteria reported moving north in Panamá

Government photo shows a worker disinfecting parts of a Panamá hospital ventilating system.

A long-running wave of drug resistant bacterial infections in nearby Panamá may have been detected in Costa Rica. However, health officials here have yet to address the issue in public.

In Panamá, the offical death toll surpassed 80, mainly hospital patients. However, informal sources say that there have been more cases and more deaths.

The bacteria, klepsiella pneumeniae carbapemenase, is known to have a mortality rate of over 50 percent, and even higher in certain instances in which victims have a compromised immune system or other medical complications. The symptoms include hemorrhaging and inflammation of the lungs, which can cause the patient to emit a bloody mucous.

Since the medical crisis in Panamá reached a head in August, the brunt of the criticism in the news media and public forum has been directed toward the Panamanian Caja de Seguro Social, which operates and oversees the large hospital that has been the epicenter of the disease. The controversy is wrapped up in local politics.

“The doctors are on strike now, and the management’s slow reaction to the problem and then its attempt to cover it up are one of the underlying causes of the bad blood, even if the scandal doesn’t play directly in the strikers’ demands,” said Eric Jackson, editor of The Panamá News. His newspaper has been reporting on the situation in depth.

Patients visiting the Arnulfo Arias Madrid in Panama City were becoming infected while being seen by doctors for other illnesses.

The Panamerican Health Organization said in a press release that the bacteria causing the deadly pneumonia can exist in virtually any hospital and that such outbreaks can typically be prevented with universal sanitary controls in place.

The infections also prompted action by sectors of the government, including an investigation by the Ministerio Publico into the hospital’s management and sanitation practices. The national assembly also addressed the issue by providing funds for combating the spread of the bacteria, according to the government’s Web site.

The possibility exists that neighboring Costa Rica will have to confront a similar problem. Prensa Latina reported in mid-October that cases had been reported in the Hospital Rafael Hernandez in Davíd, which is located in the Panamanian province of Chiriqui adjacent to Costa Rica.

The press spokesman for the Costa Rican Ministerio de Salud declined to comment Thursday one way or the other on reports of some persons ill with similar symptoms here. In Panamá, the head of the Caja actually issued a gag order to employees in June, according to The Panamá news.

The real danger is if the highly contagious bacteria enters the general population from the hospitals. That also would have a devastating effect on tourism.

The politics in Panamá clouded the situation. The lack of transparency was the main violation of World Health Organization guidelines that has been clearly shown, said Jackson. “The matters of whether and when and how effective measures were taken are hotly disputed,” he added. “There has been a lot of unhelpful and uninformative sensationalism by media people who don’t know better and by some who do and are trying to score political points.”

His newspaper Aug. 2 reported President Ricardo Martinelli of Panamá saying that “Bacteria exist in all hospitals and places. They tell me that everything is under control.”

A representative of the physician’s union said that the Martinelli administration has put the health of the Panamanian people in direct danger by not buying the necessary cleaning materials, surgical supplies and other services, the consequence of which is the contamination of the hospital environment with hard-to-control bacteria, according to the news story.

There are at least two strains of drug-resistent Klebsiella pneumoniae going around in the world, the newspaper said. In July 2010 there was an outbreak in Argentina and this year there were outbreaks in several European countries, said the newspaper, adding that the death rate was 40 percent.

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