Case Reports in Neurology (Feb 2019)

An Outbreak of Peripheral Neuropathy in a Prison

  • Somsak Tiamkao,
  • Anuwat Boonsong,
  • Kamol Saepeung,
  • Narongrit Kasemsap,
  • Metha Apiwattanakul,
  • Narupat Suanprasert,
  • Thiravat Hemachudha,
  • Prakai Pithak,
  • Kittiphit Juntee,
  • Chamnan Waisaen,
  • Supat Madha,
  • Rome Buathong,
  • Kittisak Sawanyawisuth

DOI
https://doi.org/10.1159/000496536
Journal volume & issue
Vol. 11, no. 1
pp. 53 – 60

Abstract

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Prisoners are at risk for both physical and psychological diseases. Here, we report an outbreak of peripheral neuropathy in a prison in northeast Thailand. Between July and December 2014, there were 88 male prisoners at Bueng Kan Provincial Prison in Bueng Kan, Thailand suffering from peripheral neuropathy out of a total of 1,464 prisoners (6.01%). The common age range was 20–39 years (58 patients; 65.91%). The three most common features were hyporeflexia/areflexia of the lower extremities (36 patients; 83.72%). On laboratory vitamin B1 deficiency was detected in 4/5 patients, positive rhinovirus polymerase chain reaction in 3/4 patients, positive Mycoplasma pneumoniae IgM in 1/12 patients, and positive urinary arsenic in 4/7 patients. A dT vaccination was given on October 14 during the outbreak. This was a large outbreak of peripheral neuropathy in male prisoners. There are several possible causes of this outbreak including vitamin B1 deficiency, dT vaccination, arsenic toxicity, rhinovirus, and Mycoplasma infection.

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