Toxic seaweed was a red herring

The tragic death of beautiful Kiwi backpacker, Sarah Carter, in Thailand last month was initially blamed on a meal containing toxic seaweed.  Sarah and two other women suffered vomiting and heart complications while they were staying in Chiang Mai.  Privately, I thought that this explanation was highly unlikely, partly because of the symptoms and partly because it appeared that only these three were poisoned.

It now seems that Sarah had been infected with an ECHO virus.  These Enteric Cytopathic Human Orphan viruses are found in the gastrointestinal tract and primarily cause disease in children.  (Their name originated in the 1950s, when cell culturing allowed the viruses to be identified, but no disease was associated with them). 

ECHO viruses are highly contagious and exposure to them can result in an infection of the lower intestine, which then spreads to other organs.  Death is usually the result of overwhelming liver failure or myocarditis (inflamation of the heart muscle).

Because of their association with the gastrointestinal tract, ECHO viruses are usually transmitted by unhygienic conditions and person-to-person transmission via the faecal-oral route.  Respiration of infected droplets and contact with fomites (contaminated objects) may also be important in transmission.  I believe that it is significant that three other people died of heart problems in the same hotel in the space of two weeks, though a doctor from the Thailand Department of Disease Control said that the elderly British couple who died both had blocked arteries.

I guess that the messages we can take from this tragedy is that foreign travel is wonderfully mind-broadening, but that visiting areas where environmental and food hygiene are poor can be hazardous to health.  We should be careful, however, before thinking that Asia is the only
place we can contract ECHO viruses - poor hygiene can be found in any country.