Mystery disease strikes remote area of Panama

''We're studying it, and the Gorgas Lab is working on it, but to say anything now would be speculation,'' said a ministry official who asked for anonymity because he lacked authorization to comment on the case.

Federal government officials say they know of only 10 deaths, but some of their comments on the case have been contradictory.

LIMITED ACCESS

The information problem has been made worse by the difficulty in getting to Ñurum in central Veraguas province, where the dirt roads become impassable to most vehicles in this, the rainy season. The population in many cases lives a long walk from even those precarious roads.

Word of a problem first got out in mid-September when local officials contacted the Health Ministry and then, alarmed by what they considered a lackadaisical response, took their story to the news media.

On September 23 Gladys Guerrero, the ministry's director of epidemiology, denied to a reporter for the tabloid El Siglo that there was any viral or bacterial pathogen at work, attributing the problem to complications of rainy season colds that are common in the area, especially because of its poor sanitary conditions.

Guerrero also said that local claims at the time of 10 deaths since late August were exaggerated. Within five days, Ngobe officials were reporting 40 deaths and many more sick. The La Prensa newspaper has reported that more than 30 children from Ñurum are being treated in various hospitals around the country.

PRESS RELEASE

The country's disease control center, the Gorgas Memorial Institute, is working to identify the cause of the outbreak.

The Health Ministry said in a Sept. 29 press release that the problem appears to be ''a known acute viral respiratory situation like influenza,'' but on Monday a ministry spokesman said that no flu or other virus had yet been identified.

The U.S. government has offered help, but as of Tuesday Panama had not asked for international assistance.

The Ngobe-Bugle district, the youngest of Panama's semi-autonomous indigenous regions, comprises about 9 percent of the country's land mass and has its biggest concentration of poverty. Many of the inhabitants leave for part of the year to pick coffee or other crops.

FRACTIOUS AREA

The district, shared among its Ngobe majority and Bugle and other minorities, is politically fractious and its self-governing institutions are not as developed as in some other indigenous areas in Panama.

After news of the illness broke, President Martín Torrijos cut short a trip to the United States and flew into Ñurum with a team of some 60 healthcare workers.

Government officials fanned out to visit thousands of families and advise them to cooperate with health officials and that nobody evacuated to a city hospital would be left stranded -- a concern that had led some of the poor parents to refuse to let their children be taken to a hospital.