internal review blasted paterno and other school officials for their handling of the child sex abuse scandal. it totaled $5.5 million in payouts and benefits including paying his wife $1,000 a month for the rest of her life. i'll be pack at the top of the hour with more news as it happens. first, "sanjay gupta m.d." starts right now. hello and welcome to "sgmd." i'm dr. sanjay gupta reporting from phnom penh, cambodia. i came here to investigate this medical mystery. and by way of background, this is the part of the world that gave us sars, nipa virus, the deadly bird flu. in fact almost every new strain of influenza over the years. as we heard of a deadly new disease, we paid attention. it started with this diligent

doctor noticing something unusual -- young patients were coming into his hospital and dying very quickly, within 24 hours. he wrote a letter of warning describing a terrifying picture -- a disease that he'd never seen before that was nearly 100% lethal. so we decided to go to the hospital in the center of the city. >> the majority of these cases, mostly under the age of 3, were seriously ill. and many of them had died within 24 hours of admission. >> that's frightening, i think, for people to hear. >> absolutely. >> there's a lot of diseases in this part of the world. many parts of the world. but that kill that quickly -- the backdrop is important here. the hospital treats thousands of children suffering from dang a fever, malaria, and tuberculosis every week. and remember, this is a part of the world where bird flu and sars originated. still, right away, dr. richner

knew this was different. >> it's a new picture for us. we've never seen this before -- >> he's the head of the hospital and allowed us into the icu where the patients were treated. give to see give you an idea of how busy this is, as we were talking, did richter got called because another child needed help. dr. richter said 66 children came to the hospital with the mystery illness. for 64 of them, it was 24 hours of hell before they died. you heard right -- all but two died. [ crying ] >> in many of these children, it started off rather mild. a mild fever. but then things progressed quickly from there. for example, in this 2-year-old's case, we don't know what's causing his encephalitis. but this is typically what happens. the fontenell start to bulge and the eyes become disconginate, as

well, going from the head to the brain to the lungs. >> you see this, 842, and five hours later, his lungs -- >> in the last few hours of life, this unknown illness completely destroyed the child's lungs. and there was no way to stop it. never seen anything like this before. >> no. this is a first time at the end of april. and this make us worry. >> something called entero virus 71, typically associated with hand, foot, and mouth disease, was found in more than a dozen patients. but that's only adding to the mystery. the virus lead to this -- >> never, never, never. never. >> it has to be something else? >> i think so. but we cannot prove. but we must look for it. >> that's where the investigation goes next. cambodian health officials and the w.h.o. are looking into expired medication, the wrong medication, or inappropriate medication such as steroids

could be to placemeblame. >> steroids can make a suddenly harmless infection much more severe. >> that is a possibility. >> it was all so heartbreaking, but it was this puzzle that doctors and disease detectives had to solve. the first question right off the bat -- is this contagious? and if so, how fast does it spread? the answer to that was encouraging. it wasn't showing up in big clusters. meaning, it wasn't spreading fast from person to person. instead, the cases seem to have come one by one from around the country. i also learned most of the sick children came prosecute smafrom villages. i headed out to see for myself. this is what a place looks like that ranks in the bottom 10% of childhood mortality anywhere in the world. it's rainy season here in cambodia. it lasts from may to october. and you can see what one of the first problems is in terms of controlling disease. many of the people who have had

this mysterious illness, we're told, come from villages like this. there are no tvs or nepapers. the only way people are learning about it oftentimes are from schoolchildren who hear about it in school. i was talking to this 14-year-old and his 4-year-old sister earlier. they were told by their teacher that there's this mysterious illness, and if they get it, people die, and they die quickly. they're healthy, but this is obviously of great concern. just looking around here, you see how challenging conditions are. for example, there's no indoor plumbing. so if you simply want to collect water, you oftentimes have to do it right outside your tiny little home. they get these big buckets. one of the first things they're told is no standing water anywhere near their home. so you imagine, you look at a situation like this where they have vats of water, and they collect it. the only way they can get any. but this is where mosquitoes live, as well. mosquitoes that transmit disease. diseases like dengue. malaria, as well. the mosquitoes that bite during

the day are more likely to cause dengue, we're told, and the ones that bite at night more likely to cause malaria. so many people getting sick here, in the thousands. if they do, what happens next? oftentimes they have to rally their neighbors, gather a little money, and hire a vehicle like this to get to a hospital as soon as possible. meanwhile, back in phnom penh, there was another side to this instigation. in the lab. see, by the second day of our visit, there was already a lot of attention on one particular virus -- ev71. that virus isn't new, and it's even been deadly before. more than 160 people died from it in china last year. and 18 people in vietnam just this spring, mostly children. but in those countries, children hadn't died as quickly as in cambodia. so ev71 was a big piece of this, but we knew it wasn't the whole story because it wasn't found in all the children who died. so where did all that leave us? the only thing doctors knew for sure is when the children arrived at the hospital, they

were dying and fast. a fever, convulsions, encephalitis. and then the lungs, completely destroyed. since the end of april, doctors in cambodia struggled with a medical mystery. and that mystery was ultimately solved right over here. blood samples from those sick and dying children were eventually brought to this laboratory, analyzed like you see there, and eventually concluded that this were several different pathogens. there was enterovirus 71, streppy to caucus, and dengue. all made worse by the use of steroids. to crack the case the lab had to work backwards. first, eliminate known viruses like avian flu, sars, and nippa. >> the first thing that goes through your head is to try and determine whether this is one of the usual suspects that you haven't detected before. if it is, has it mutated or changed in such a way that it causes more severe disease?

or is it something completely new? >> emdeemiologist, dr. arna arnaudtarantola, helped solve the mystery. one of the thing we've heard from the world health organization is no steroids should be used. they seem to say that steroids made this problem worse. >> when you have a dying child, you try to use what you have at hand. and they were right to try that. now whether or not it helps remains to be determined. >> i don't want to belabor this point, but they really seem to indicate that it hurt. that these infections, a lot of times, they can be a problem, but they're not particularly dangerous. but something pushes them over the top. and they thought that the steroids seemed to be a common denominator. >> from the cases that we reviewed, almost all of the children died, and almost all of

them had steroids. >> steroids can be a poetdent anti-in-- potent antiinflammatory. when given to children with aggressive infections, steroids can suppress the body's own immune system, allowing the infection to become even worse. as was the case with enterovirus 71, also called ev71. you hear about a lot of viruses, avian flu, nipa virus. ev-71 as far as they can tell had not been in cambodia before for sure. why does it appear like this and with such a vengeance? >> it looks like this has emerged strongly probably because it had not circulated to the same -- with the same intensity in the past years. >> it's believed that a slight variation in the ev71 made the virus stronger, and the steroids made the body's resistance even weaker. so case closed. it sounds like the case is closed now from your standpoint.

>> yes. i think we can -- we can close the case. >> so here's the bottom line -- the worst case fears did not come true. this is not a highly contagious, deadly virus that's about to spread around the world. but these are terrible diseases. they're still a major threat to children in cambodia and all of southeast asia. for the time being, the w.h.o. has told health care workers to stop using steroids in patients with these infections. and of course, reminding them to prevent transmission. hand to mouth is still the most common way. after all is said and done, the basics apply -- wash your hands often, whether in cambodia or anywhere else in the world. good news is there hasn't been another confirmed case in over a week. these are tough challenges, but this is a place with people who are used to tough challenges. coming up, a man who was handed an ak-47 at age 15. he went from being a child soldier to learning medicine. [ male announcer ] it's simple physics...

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million people dead. even today, they're holding trials for former leaders of the khmer rouge. at age 15, sonal ray was forced to join that terrible army as a child soldier. somehow he found a way to put down his gun, become a healer, and find hope. >> you were ready to fight, to run -- >> his childhood memories are filled with unimaginables. did you see violence -- did you see people getting killed? >> i see my friend and fellow soldier being, you know, killed by -- struck by landmine, blown off their legs. chest gone, head gone, face gone. >> at age 15, sona says he was taken from his family and forced to be a child soldier under the khmer rouge regime. >> i didn't know where my parent -- i had one sister, and i didn't know where they were during that time. >> you were so child, a child soldier at a very violent time.

did you ever lose hope? >> hard to have hope that one day i don't have to do this -- i don't have to live like this. i think that was why i want to smile at hope. something like that. >> his initial nightmare training was with a gun. then he got his break. the regime decided to make him a paramedic. >> i did not know anything at that time. when i look back, i think that was when i am safe from being a killer, a real killer, to be a lifesaver. >> today, sona ray is saving lives at world vision's crisis trauma recovery center in cambodia. thyse these children that you help now, can you see part of your own life in them? tell me about them. who are they, where do they come from? >> these are children who are victims of sexual abuse and trafficking. >> this is what happens. they're abused, and they're

sold? >> yes. >> for sex? >> yes. i don't want these children, this boy, this girl, to experience that kind of life i have. like i want them to have big dreams for themselves. >> is this your life's work now? is this what you will do for the rest of your life? >> this the thing that make -- that help make joys in my heart. and -- and that dream, the dream that the children will one day become a good mother, good wife, and good father. those are the dreams i want -- i had that dream. i want them to have that dream in their heart, too. >> he's now turning his childhood nightmare into hope for others. and that's part of the reason we do these "human factor" stories. stories of people turning tragedy and really challenging conditions into hope. we'll have much more from phnom penh after this. [ buzz ] off to work!

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and we are back with "sgmd." while i'm here in phnom penh, up in russia this weekend, astronauts are set to blast off for the international space station. it's going to be racing the nautica triathlon along with me, but she's doing it from space. before i left for cambodia, i visited sunny to see what life is like up there and also how she's planning on training for this race. >> what goes on in here? >> so, this is a place where we spend a lot of time because these are our sleep stations. sleeping in space s of course, justs a important as earth. >> can i go inside? >> yeah. >> you literally go inside here. it's roomy. but then i guess, you know, it doesn't really matter your

position. >> right. you can be upside right, upside down, sideways, backwards, forwards, as soon as you close your eyes you don't know. >> booster ignition and lift off. >> when i flew before we were right in the middle of the construction of the space station, so it was pretty regular that people going up in the space station were going to be doing space walks. >> a good view of suni williams helping to tie down this aft radiator. >> that's so wild. >> we're going to put you on the front. you'll be facing backwards but you're like a statue on the front of the car. you're right on the front of node two but looking back toward the space station. >> let's fly around a little bit. >> fly around a little bit? >> yeah. wow, what a view. >> we might have a space walk. we have lots of science. >> and a triathlon. >> yes. and a triathlon. >> you're going to do this? >> yes. >> we're going to be doing this on earth. >> this is the gym.

>> is this going to be able to model a swim for her? >> it's a resistive exercise. this is the only other thing we have for her to do. >> we're down in the pacific ocean, she'll be doing this up in space. this will be her version of swim. about 11 minutes you think, right? >> so if we go from node three over to the lab and we'll start out on the bike. >> so in terms of hills and stuff you can -- >> so i can get a profile of what the race looks like. i'm feeling it. >> climbing a hill. >> now i'm clipimbing. this would be how many miles? >> 18. >> we'll have to do it on time. i'll be done way before you. >> maybe an hour roughly. i'd say -- >> 18 miles an hour. that sounds good.

we're back to node three. so a little transition. get a little walk between hand, well, not really a little float. and we jump on the treadmill. so get on, you need a harness, of course, because if you were just on the treadmill and you ran, you would float away. and so you need to get your harness on that's going to connect you to the treadmill. and here you can do distance and time. so i can get the four miles done this way. >> you ran the boston marathon. >> finally. >> that's pretty amazing. >> i flew in december and the marathon is in april so it took me that long to build up to it. >> 2 hours and 30 minutes? >> oh, shoot, no. >> a little longer? >> a little longer than that. >> awesome. what about your hydration and food requirements? do you take that into account for training and the actual events. >> i always have a couple bags of water in the vicinity right close by.

>> this is how we send the beverages to orbit. >> does this look familiar? >> way too familiar. >> they're all in dry form. there's a septum adaptor assembly that has a septum inside that allows the addition of water using the rehydration station on orbit. in order to drink, they're going to insert the straw into the septum, hold it open, and then they can sip and they have a clamp to keep it from flowing out of the package. >> i imagine you want really energy-dense foods that give you a lot of calories in a small amount of space. >> first of all, space, you don't want toer to tour yourself with eating something you don't like, but a big consideration people have is how convenient it is. >> i imagine foods that are crumbly would -- >> horrible. >> awful. >> crumbs everywhere. >> yeah. people think, you know, one of those things you miss like potato chips, like, yeah, some people bring up little pringles and stuff but it's a mistake. as soon as you break one, stuff is everywhere. it's a mess.

>> that's how you haze the rookies. >> even big chocolate bars i was like don't send big chocolate bars. you break them and the little pieces fly everywhere. you want to have minis. >> as you can see, suni is no rookie. if all goes according to plan, we'll be racing while she's some 250 miles high in the sky. it's going to happen in two months. last year as you might remember, i had to pull out of the new york city triathlon the day before to cover the famine unfolding in somalia. this year i'm ready. in fact, i have been wearing my fit bit trying to exercise a little bit on the road. i'm going to kick my training into high gear when i get home. get ready, suni. it's on. coming up, living longer and better. my "chasing life" tip from cambodia. [ male announcer ] this is rudy. his morning starts with arthritis pain. and two pills. afternoon's overhaul starts with more pain.

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we are back with sgmd reporting from phnom penh. one of the things you may know about cambodia is that the

official religion is buddhism. you can see reminders of this just about everywhere you look. for example, this is a prayer area here in phnom penh. you see these sprinkled throughout the city, really throughout the entire country. a buddhist statue over there. and, you know, you're reminded that there's a strong tradition of meditation along with buddhism. i've always been fascinated by this because of the proven health benefits of meditation. for example, if you meditate, you can actually reduce your stress. you can become more empathetic toward others. you can even increase your attention span. there's more than that even. there's a recent study that showed simply meditating can reduce your risk of heart disease. they found that people who meditated for 20 minutes two times a day cut their risk of a heart attack and stroke by half. sounds pretty good. i do it myself. other times i focus on a single word. my word is gentle. i just focus on that word, i do this in the morning, i do it in the evening, i can feel my blood pressure start to drop, i can feel my heart rate s