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Warning! New Epidemic Swept Across Sub-Saharan Africa
A new epidemic has swept across Sub-Saharan Africa. The disease itself is not new, and is actually as old as the human race, but until now it has been neglected by medicine, especially pediatrics. Its common name is Contagious Unsmiling although as if contagious or contagious unsmiling would be more correct to call it.
Before we discuss the clinical picture of this recent childhood epidemic, let’s talk about the classic form of the disease.
It is a very rare disease hosted by people without the physical ability to form a smile. The reason behind this is due to paralysis affecting symmetrical parts of the face (congenital facial diplegia) and paralysis of the symmetrical facial nerves with or without congenital musculoskeletal disorders affecting the skull and facial bones (bilateral abducens nerve palsy).
Most cases are diagnosed during childhood. Feeding problems, inability to smile and lack of facial movement during crying – they do form the clinical picture. An eye abduction defect is often present along with the drooping of the eyelid (ptosis).
This disease was first described by Moebius in the late nineteenth century. Its etiology has been unclear since that time. It could be primary nuclear hypoplasia, degenerative brainstem lesion or primary muscle-peripheral nerve lesion. Cocaine and prostaglandin abuse is sometimes associated with it as well. Most cases are sporadic, but autosomal-dominant, recessive and X-linked patterns of inheritance have been described.
Isolated facial diplegia and abducens palsy can be detected in adulthood due to the inability to smile. One of the latest cases was reported by Mala V Kaneria in the Journal of the Indian Academy of Clinical Medicine. “A 65-year-old male presented with five days of fever, headache, and vomiting. There was no history of seizures or focal neurologic deficit. He had bilateral ptosis and difficulty opening his mouth. His face was masklike, with difficulty frowning and smiling. One observed that his two sons, who took care of him, also had these characteristics, i.e. absence of wrinkling and bilateral ptosis. All three also had a bilateral eye catch defect beyond the midline. On investigation, they informed that these characteristics were present since birth. “
And now let’s come to our case.
Lots of Moebius Syndrome (Contagious Unsmiling)
Multiple Moebius Syndrome has been observed recently in various countries of East and Southern Africa among children aged 0-15 years. Its etiology has been well explained unlike cases of the classic Moebius Syndrome. They are either psychological distress, depression or other mental illnesses caused by suffering beyond endurance.
In one study conducted in rural Uganda by Atwine B. and others, high levels of psychological distress were found in children who had been orphaned by AIDS. Anxiety, depression and anger were found to be more common among AIDS orphans than other children. 12% of AIDS orphans claimed they wished they were dead, compared to 3% of other children interviewed.
There could be another root of the disease that causes the same lack of smile in children. We know that social smiles or “real smiles” can occur as early as four weeks of age and usually as a result of the caregiver’s voice, face or concern. The lack of smiling faces around the babies prevents the development of a smile reflex in them.
The spread of the epidemic was probably facilitated by phenomena such as orphanages (in 2008 more than 14 million children in sub-Saharan Africa lost one or both parents to AIDS alone), long-term malnutrition, lack of micronutrients, AIDS, extreme poverty. , water-related diseases such as cholera and childhood diarrhea, child slaves and wars. Due to the fact that a child dies every three seconds from AIDS and extreme poverty and every year six million children die from malnutrition before their fifth birthday and the under-five death rate in 2008 in Somalia 200 (Sweden 3. Under-five death rate is the probability in 1,000 that a newborn baby will die before reaching the age of five.) The continuous encounter with terrible images of death and extreme suffering of parents and neighbors is one of the main facilitators of the disease.
One of the latest cases was reported by a missionary who visited an orphanage in Uganda last year. (By the way, the number of orphans in Uganda stands at 2 million out of a population of about 22 million.) While the Caucasian missionary held in his arms the seven-year-old orphan girl, named Acanit, the orphan began to finger. hair and face of a lady. “Do you like my hair?” – asked a lady. – Would you like to have blonde hair? – The girl nodded: no. Her fingers did move on the lady’s face. – Would you like to have white skin? – The girl nodded: no. Then she touched the lady’s mouth and said – I would like to smile.
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