Mysterious disease killing thousands in Central America

A strange kidney ailment leaves scientists searching for answers.

The disease itself is hardly a new phenomenon, though the strain affecting Nicaragua and neighboring countries is unique; many of those affected are far younger and healthier than typical CKD patients, and a staggering number work in sugarcane fields.

And while theories and hypotheses abound, scientists have yet to figure out what’s actually causing it.

There’s a growing suspicion that agricultural chemicals may be the x factor behind the epidemic. A 2012 study found that two toxic metals — cadmium and arsenic — may be responsible for the spike in cases there over the past 20 years.

Both of the metals are used in farming chemicals (cadmium in fertilizer, arsenic in pesticides), and sugarcane  farmers in the region had relatively high levels of each in their blood.

Although their levels were within the safe range, experts from the World Health Organization (WHO) suggested that continuous exposure to the metals could explain the elevated CKD rates.

The situation has dramatically worsened over time, as well. Over the past 20 years, the number of men who died from CKD in El Salvador and Nicaragua increased by a factor of five.

A mysterious epidemic is devastating the Pacific coast of Central America, killing more than 24,000 people in El Salvador and Nicaragua since 2000 and striking thousands of others with chronic kidney disease at rates unseen virtually anywhere else.

Scientists say they have received reports of the phenomenon as far north as southern Mexico and as far south as Panama.

Many of the victims were manual laborers or worked in sugar cane fields that cover much of the coastal lowlands.

Patients, local doctors and activists say they believe the culprit lurks among the agricultural chemicals workers have used for years with virtually none of the protections required in more developed countries. But a growing body of evidence supports a more complicated and counterintuitive hypothesis.

The roots of the epidemic, scientists say, appear to lie in the grueling nature of the work performed by its victims, including construction workers, miners and others who labor hour after hour without enough water in blazing temperatures, pushing their bodies through repeated bouts of extreme dehydration and heat stress for years on end. Many start as young as 10.

The punishing routine appears to be a key part of some previously unknown trigger of chronic kidney disease, which is normally caused by diabetes and high-blood pressure, maladies absent in most of the patients in Central America.

In comparison with Nicaragua, where thousands of kidney disease sufferers work for large sugar estates, in El Salvador many of them are independent small farmers. They blame agricultural chemicals and few appear to have significantly changed their work habits in response to the latest research, which has not received significant publicity in El Salvador.

While some of the rising numbers may be due to better record-keeping, scientists have no doubt they are facing something deadly and previously unknown to medicine.

Source | Associated Press

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