Investigation of unknown deaths liked to Vitamin B1 Deficiency in Khammouane Province, Lao PDR, 2018

Vitamin B1 deficiency (beriberi) is a significant public health issue, manifesting in cardiovascular, neurological, and other systemic symptoms. This investigation was prompted by reports of patients presenting with symptoms such as fever, stomachache, and headache, followed by sudden deaths. Active case finding and retrospective data collection through patient records from various health facilities across the province were conducted between 1 June 2018 and 19 September 2018. A total of 224 cases were identified, including 8 deaths (CFR = 3.57%). Most patients (51.3%) were female, although all deaths occurred in males. Ages ranged from 1 to 75 years, with a mean age of 33 years. The most affected age group was 10-20 years (24.1%), followed by 30-40 years (17%). Common symptoms included paraesthesia in legs and/or hands (100%), oedema in legs (36.36%), nausea (18.75%), and chest tightness and fatigue (13.39%). Affected individuals predominantly consumed rice, salt, and bamboo shoots, with limited dietary diversity. Poor sanitation and recent flooding likely exacerbated the outbreak. The investigation concluded that the unknown deaths were primarily due to Vitamin B1 deficiency. These findings highlight that immediate actions, including Vitamin B1 distribution, nutritional interventions, and health education, are essential to prevent future outbreaks.