Ebola in Uganda: November 30 - December 17, 2007

[Treyfish]

Re: New Ebola Strain in Uganda Spreading - Death toll rising

<TABLE cellSpacing=0 cellPadding=0 width="100%" border=0><TBODY><TR><TD class=satnews>

December 06, 2007

<!-- InstanceEndEditable --></TD></TR><TR><TD class=headline><!-- InstanceBeginEditable name="hd" -->Govt denies hiding Ebola for CHOGM?s sake <!-- InstanceEndEditable --></TD></TR><TR><TD style="PADDING-RIGHT: 3px; PADDING-LEFT: 3px; PADDING-BOTTOM: 3px; PADDING-TOP: 3px"><!-- InstanceBeginEditable name="story" -->By David Lumu
WEEKLY OBSERVER
It has taken three and a half months for the government to declare that the ?mysterious? disease killing people in western Uganda was actually the dreaded Ebola.
Just as the Minister of State for Health, Emmanuel Otaala, confirmed during a press conference at the Media Centre this week, Ebola has so far claimed 18 lives.
The disease spreads quickly from person to person and can be transmitted through direct contact with wounds, body fluids and physical handling of the dead, among others. Symptoms include vomiting, diarrhoea, headache as well as constant bleeding through the nose, ears and eyes, among others. It kills in a short time but can be prevented through avoiding direct contact with patients.
By December 4, 75 cases had been reported, with 18 fatalities. Another 28 people are getting treatment, many of them in Bundibugyo Hospital. These include six nurses and two doctors.
?They were dealing with the disease without personal protection,? Otaala said.
One ?alert? case has been recorded in Mbarara after a man suddenly vomited blood and died a few moments later. Two other cases are being investigated in Fort Portal. One patient is receiving treatment at Mulago Hospital?s ?isolation ward.? ?All of you will agree that my ministry has done a lot in the fight,? concluded the minister.
Why the delay?
Otaala noted that much as the first case of the ?mysterious disease? was first registered on August 20, 2007, ?there was no need for panic then because we weren?t sure of the exact diagnostic name.?
It took another one month for the ministry to take samples to the Uganda Virus Research Institute (UVRI) laboratory in Entebbe on September 29.
The Director of Health Services, Dr. Sam Zaramba, explained that all the initial five samples returned negative results, prompting the ministry to send another 20 samples on November 29 to another laboratory in Atlanta, USA. Eight of the samples were found to contain the Ebola virus.
CHOGM factor
Speculation is rife that government deliberately withheld information about Ebola outbreak in order to save the Commonwealth Heads of Government Meeting (CHOGM) that was held in Kampala from November, 22-24.
?We need to be patriotic on this one,? Otaala said to the allegation. ?I can assure you we wouldn?t have kept quiet if we knew we were dealing with the Ebola. This rumour that we didn?t want the world to know is wrong.?
The minister maintained that his ministry was working hand in hand with UNICEF, WHO and M?decins sans Fronti?res (MSF). ?Can they all keep quiet?,? he asked.
However, an official of one of the mentioned agencies who attended the press conference told this writer separately that their organisation was told about the ?mysterious? disease only a month ago.
Much as Otaala defended his ministry?s handling of the situation, he was quick to admit a few shortfalls. ?We are short of funds but I?m going to Cabinet meeting tomorrow (Wednesday) to present the ministry?s case for not less than Shs 6bn,? he said. ?You see, the last outbreak also cost Shs 6bn,? he explained, when asked about a budget for the task at hand.
And if the confusion surrounding the press conference itself is a reflection of the Ministry of Health?s preparedness to deal with the virus, there is reason to worry. Not only did the press conference begin one hour late, the minister kept on receiving phone calls during the conference, and adjusting Ebola figures accordingly.
Ebola was last reported in Uganda on October 8, 2000 in Rwot-Obillo village, 14 km from Gulu town. Until January 16, 2001 when it was declared conquered, Ebola had killed 224 people of the 425 cases registered countrywide. http://www.ugandaobserver.com/new/ne...s200712063.php
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http://www.ugandaobserver.com/new/news/news200712063.php

[AlaskaDenise]

Re: New Ebola Strain in Uganda Spreading - Death toll rising

Commentary at

http://www.recombinomics.com/News/12...ola_HCW_5.html

Commentary

Five Uganda Health Care Workers Die from Ebola
Recombinomics Commentary
December 5, 2007

A medical doctor and four health workers, who treated the first Ebola patients in Bundibugyo, have died of the disease. Dr. Jonah Kule, the medical superintendent of Kikyo Health Centre, succumbed on Tuesday night. He had been quarantined at Mulago Hospital.

Senior clinical officer Joshua Kule, senior nursing officer Rose Bulimpikya, matron Peluce Tabiita and another nurse not yet identified died yesterday in Bundibugyo Hospital, according to senior clinical officer James Agaba.

The above comments indicate two additional health care workers have died, raising the total to five fatalities in the past 24 hours. These numbers suggest the number of infected patients may be markedly higher than reported to date.

The hospitalization and deaths of health care workers has reduced the number of hospitalized patients significantly, and many with symptoms will avoid hospitals. Although some PPE’s are just arriving, most of the health care workers would have gloves, and would be aware of potential transmission of the infectious agent. Therefore, their fatal infections signal efficient transmission.

Media reports describe multiple suspect fatalities at more distant locations, and confirmation of cases will be reduced because the Ebola virus is a new species and PCR primers are still under development. Positives will be dependent on antibody tests, which may have a high specificity, but a low sensitivity. Similarly, infected patients that avoid hospitals will also reduce the number of confirmed cases.

More information on suspect Ebola fatalities at distant locations would be useful.


.

[Treyfish]

Re: New Ebola Strain in Uganda Spreading - Death toll rising

Ebola Outbreak in Uganda

<TABLE class=content cellSpacing=0 cellPadding=0 width=500><TBODY><TR vAlign=top><TD align=left>Bundibugyo, Uganda - Tests confirmed an outbreak of Ebola near WHM?s team in Bundibugyo on Thursday, November 29, 2007. The outbreak originally seemed to center on Kikyo, a small village 12 km away from Bundibugyo town, but has since spread throughout Bundibugyo district. As of December 5, news reports indicate 24 deaths and 91 suspected cases. While the majority of WHM?s team members have been evacuated from the district, Team Leaders Drs. Scott and Jennifer Myhre, and Dr. Scott Will remain in Bundibugyo. The Myhres have been serving in Uganda with World Harvest Mission since 1993. We are receiving regular updates from them and will be posting them here for you. Please keep this situation in your prayers, and share with others as you have opportunity.

<TABLE class=content style="FONT-SIZE: 10px" cellSpacing=0 cellPadding=0 width=230 align=left><TBODY><TR vAlign=top><TD>
Team Leaders,
Drs. Scott and Jennifer Myhre</TD><TD width=30></TD><TD>
Dr. Jonah - deceased (12.04.07)

</TD></TR></TBODY></TABLE></TD></TR></TBODY></TABLE>


http://www.whm.org/news/ebolainuganda

[sharon sanders]

Re: New Ebola Strain in Uganda Spreading - Death toll rising

Thank you to everyone working on this thread.

We send our condolences to the families and friends of those affected by this situation.

It is hard enough to watch this develop here in cyberspace. I can only imagine the courage needed to face it in person.

Best wishes.

[Treyfish]

Re: New Ebola Strain in Uganda Spreading - Death toll rising

Ebola Kills Two Doctors, Bringing Death Toll in Uganda to 21

By Jason Gale
<!-- WARNING: #foreach: $wnstory.ATTS: null at /bb/data/web/templates/webmacro_en/20601202.wm:289.2 --><!-- WARNING: #foreach: $wnstory.ATTS: null at /bb/data/web/templates/webmacro_en/20601202.wm:303.19 -->Dec. 6 (Bloomberg) -- Two doctors fighting an Ebola outbreak in Uganda died of the hemorrhage-inducing virus, bringing the death toll to 21, Integrated Regional Information Networks said, citing an official.
The medical workers died during the past two days, Samuel Kazinga, resident district commissioner for Bundibugyo, the epicenter of the outbreak, told the humanitarian news and analysis service yesterday. Ebola causes high fevers, diarrhea and vomiting and often leads to severe internal bleeding.
Eight pathogen specialists from the U.S. Centers for Disease Control and Prevention arrived in Uganda on Dec. 4 to help battle the disease that has infected at least 64 people, Irin said. Efforts to isolate suspected patients in Bundibugyo, a rural district neighboring the Democratic Republic of Congo, have failed because many residents fear hospitals are unsafe, the report said.
There's no specific treatment or vaccine for the illness, which causes death in 50 to 90 percent of all those who contract the disease, according to the World Health Organization.
More than 1,850 human cases, including 1,200 deaths, have been recorded since the Ebola virus was first identified more than three decades ago in Sudan and the Democratic Republic of the Congo, formerly known as Zaire.
Irin is part of the United Nations Office for the Coordination of Humanitarian Affairs. Its reports don't necessarily reflect the views of the UN, its agencies or member states. http://www.bloomberg.com/apps/news?p...fer=healthcare

[Niko]

Re: New Ebola Strain in Uganda Spreading - Death toll rising

Wednesday, December 5, 2007

Even Darker Days


Bundibugyo, Uganda
Volume 2, Issue 16
December 5, 2007

-Even Darker Days-
?when no news is good news?

**snipped**
Posted by Scott J. Will at <a class="timestamp-link" title="permanent link" href="http://yoggerinuganda.blogspot.com/2007/12/even-darker-days.html" rel="bookmark"><abbr class="published" title="2007-12-05T10:15:00-08:00">10:15 AM</abbr> http://yoggerinuganda.blogspot.com/

Had to post his picture...

http://profile.myspace.com/index.cfm?fuseaction=user.viewprofile&friendid=35157185

[sharon sanders]

Re: New Ebola Strain in Uganda Spreading - Death toll rising

Viral Hemorrhagic Fever Infection Control Manual in English:

http://www.flutrackers.com/forum/showthread.php?t=43570

Controle de l'Infectiom en Cas de Fieve Hemorragigue Virale

http://www.flutrackers.com/forum/showthread.php?t=43569

[Gert van der Hoek]

Re: New Ebola Strain in Uganda Spreading - Death toll rising

Ugandan health workers hit by Ebola, causing panic

The Associated Press

Published: December 6, 2007


KAMPALA, Uganda: Health workers are among the dead in an Ebola outbreak in Uganda, spreading panic among those needed to help.

Doctors and nurses did not at first know what they were facing, so failed to protect themselves, according to a lawmaker representing the western area at the center of the outbreak. Experts say the Ebola subtype that sparked the outbreak is new and the classic Ebola symptoms were not always present, slowing diagnosis.

"We are facing a crisis in health care here," said Jane Alisemera, the lawmaker representing Bundibugyo, the district 200 kilometers (120 miles) from Kampala where the outbreak has claimed at least 18 lives. Health workers "are scared and morale is low."

"There is a very big shortage of nursing staff now at the hospital," she said.

According to the Ministry of Health's latest figures, Bundibugyo has 93 suspected cases of Ebola, among them 22 deaths. Four health workers were among the dead in an outbreak that began on Aug. 20 but the disease was not confirmed as Ebola until Nov. 29.


"The staff at the hospital didn't know they were dealing with a highly contagious outbreak so they took inadequate precautions," Alisemera said. The hospital had not protective clothing at the time of the outbreak, she said, though aid agencies have since donated supplies.

Two teams including infection control doctors from the World Health Organization and the United States' Centers for Disease Control and Prevention, recently arrived in Uganda to help local officials contain the outbreak. In previous Ebola outbreaks, the virus has often spread in health care centers where doctors and nurses are not properly protected.

WHO and CDC experts recommend that when caring for Ebola patients, doctors and nurses wear gowns, gloves, goggles, masks and boots.

Local press reported that nursing staff in the isolation unit at Bundibugyo hospital were working without gloves and masks, and that the door of the ward was not locked.

Some health workers have threatened to strike unless they are paid extra for the risk they are taking, Alisemera said.

"The staff are moving in a state of fear," said Samuel Kazinga, a local government official and head of the district Ebola task force. "They have lost many of their colleagues and have put themselves at great risk in the line of duty. It is only fair that they should get some extra money, unfortunately we did not have the funds available immediately."

He said that negotiations with hospital staff had resolved their complaints and that medical personnel were attending patients.

Doctors would be paid a daily risk allowance of 40,000 Uganda shillings (US$23, ?16), nurses and auxiliary staff 30,000 (US$17, ?12) and 20,000 (US$12, ?8) respectively, he said.

Since the threat of the strike, the United Nations children's agency has offered to contribute money toward the extra payments.

"Health workers are taking a great risk in supporting their communities and they need to be supported in that," said UNICEF's country representative Keith McKenzie.

Ebola typically kills most of those it strikes through massive blood loss, and has no cure or treatment. It is spread through direct contact with the blood or secretions of an infected person, or objects that have been contaminated with infected secretions.

http://www.iht.com/articles/ap/2007/12/06/africa/AF-GEN-Uganda-Ebola-Health-Workers.php

[Gert van der Hoek]

Re: New Ebola Strain in Uganda Spreading - Death toll rising

Reliefweb: Map of Bundibugyo District:

http://www.reliefweb.int/rw/rwb.nsf/db900sid/SSHN-79LGXF?OpenDocument

[Niko]

Re: New Ebola Strain in Uganda Spreading - Death toll rising

Africa Focus: Ugandan legislators cry for ban on public gatherings over Ebola


<!--docTitle--><!--Attention ligne utilis?e pour l'impression--> <!--Attention ligne utilis?e pour l'impression-->
KAMPALA, Dec 6, 2007 (Xinhua via COMTEX) -- Ugandan legislators have demanded that the Ministry of Health ban all public gatherings in the country as a preventive measure against the deadly Ebola Hemorrhagic Fever.

MPs called on the cabinet during a debate at parliament to suspend public gatherings like weddings, rallies and church masses, saying handshakes and public gatherings expose the risk of spreading the disease that has so far reportedly killed five health workers.

"We should immediately ban these gatherings like Kwanjula and weddings because we don't know who is carrying the disease now," said State Minister for Defense Ruth Nankabirwa, who was quoted by Daily Monitor on Thursday as saying.

Ibanda MP Otada Amooti said the Health Ministry should treat the outbreak as a matter of urgency and "ban people who travel from the affected areas."

An outbreak of Ebola was confirmed last Thursday by the Ugandan government, which hit parts of Bundibugyo district bordering the Democratic Republic of Congo since August.

It is established the virus that has killed 20 out of 91 infected cases in western Uganda is a new strain of Ebola, which is characterized by high fever, abdominal pain and diarrhea but less internal and external bleeding.
The virus, though seems milder than other four known strains, has cast people of western parts of the country into panic.

For fear of contracting the virus, some patients fled Buhinga Regional Hospital in Kabarole district, including a woman in isolation unit for suspected infection after she vomited blood. The woman was classified as an alert case as local radios ran announcements for anybody who spots her to notify the authorities, though the results of her test had not come back yet.

To cut the corridor of the viral infection, residents of Mbarara town in Mbarara district have stopped their traditional culture of greeting with a hug and a handshake, resorting to waving at each other.

The banks in town have instructed their staff to wear protective gloves before handling money from clients, following the death of a woman who vomited blood at Mbarara University Hospital.

The Ministry of Health took samples of her blood for testing and buried her body immediately as a precautionary measure.

Paul Kaggwa, the spokesman for the Ministry of Health, said that a horde of districts in western, southwestern and part of central Uganda, including Kampala, had been put on higher alert as they are deemed highly susceptible to possible Ebola outbreak.

Meanwhile, some foreign missions in the country had issued notices to their nationals not to travel to the areas affected by the virulent disease.
"Americans living in or who must travel to Bundibugyo District should be extremely careful and intensify personal health precautions at this time to avoid contracting this illness," the Dec. 3 advisory from the U.S. embassy in Kampala said.

The British High Commission in Kampala said they had also given out similar travel advisory to their citizens in the country.

Ebola is one of the most virulent viral diseases known to humankind with a death rate ranging from 50 to 90 percent and can be spread by close contact with the body fluids of the infected.

It is reported that experts from the Centers for Disease Control and Prevention (CDC) based in Atlanta, the United States, and Uganda's Health Ministry were assembling the Ebola-testing machine at the Uganda Virus Research Institute in Entebbe, 40 km south of Kampala.

Eight pathogen experts from the CDC also arrived in the country on Tuesday.

The equipment expected to be operational by next week will make testing for Ebola and other hemorrhagic viruses faster and intervention quicker.
Currently, samples have to be sent to labs in South Africa and the United States, causing delays.

The Ebola virus was first identified in a western equatorial province of Sudan and in a nearby region of Zaire (now DRC) in 1976 after significant epidemics in Yambuku, northern Democratic Republic of the Congo, and Nzara, southern Sudan.

The last outbreak of Ebola in Uganda killed 224 people from October 2000 to March 2001, which started in northern Uganda and later spread into other parts of the country, according to statistics from the World Health Organization.

http://www.reliefweb.int/rw/RWB.NSF/db900SID/PANA-79MHAD?OpenDocument

[HenryN]

Re: New Ebola Strain in Uganda Spreading - Death toll rising

Commentary at

http://www.recombinomics.com/News/12060701/Ebola_HCW_Concern.html

[HenryN]

Re: New Ebola Strain in Uganda Spreading - Death toll rising

UNICEF External Situation Report Uganda – Dec 2007

<!--docTitle--><!--Attention ligne utilis&#233;e pour l'impression-->
<!--Attention ligne utilis&#233;e pour l'impression-->
BACKGROUND
Ebola Outbreak (Western Uganda)
Government of Uganda and U.S. Centers for Disease Control and Prevention have confirmed 51 cases of suspected hemorrhagic fever, reported in Bundibugyo, Kabarole and Mbarara Districts since September 2007, as Ebola. Case fatality rate (CFR) is 31.4&#37;. Considered by CDC as a new strain, with a different genetic design than previously identified ones (Zaire, Sudan, Cote d’Ivoire), the outbreak has so far claimed 16 lives. Of the 51 cases, four are aged under-5 years; nine, 5-14; nine, 15-24; and 29, aged 25 years and over. In Bundibugyo District, the outbreak has affected Kasitu and Bubikwanga Sub-counties, comprising 7 parishes and 12 villages, with a total population of 54,448 (attack rates of 99/100,000 in Kasitu; and 68/100,000 in Bubikwanga). The most recently reported three cases, of whom one has died, were recorded in Kabarole’s Fort Portal and Mbarara, and referred to the Ebola Isolation Unit in Bundibugyo.
Health authorities have identified three clusters of infection, each originating from different sites by relative proximity. However, as the most recently identified case was not from the original areas of contamination, investigations are ongoing to determine if there has been an additional outbreak. Two isolation units have been established in Bundibugyo’s Kikywa Health Centre IV (8 cases) and district hospital (9 cases), managed with MSF Switzerland's support. A third centre was established in Kampala's Mulago Hospital (2 cases), managed with MSF Spain support.
Cholera Outbreak (Northwestern Uganda)
Regular reports of cholera persist in Nebbi District, with 260 cases hospitalized in the past three weeks. With four deaths, CFR is 1.5%. A concentration of cases appears to be in Panyimur Sub-county, with its Nyakagei Health Centre treating over 60% of the cases. 12 new cases were admitted over the weekend, with the source believed to be in DR Congo.
Measles Outbreak (Eastern Uganda)
As at end-November, following reports earlier in the month of a measles outbreak in Kumi and Bukedea Districts, in flood-affected Teso sub-region, a total 36 cases (31 in Kumi, 5 in Bukedea) and one death (CFR 3%) were confirmed. Of the total, two are above the targeted age-group of up to age 5. While there has been no significant displacement due to floods in these locations, there does appear to have been loss of herd immunity against measles, with routine immunization coverage hampered by frequent stock-out of vaccines and gas for cold-chain maintenance.
Suspected Yellow Fever (Northern Uganda)
28 cases of suspected yellow fever, reported in the Madi-Opei camp for internally displaced persons in Kitgum, are now believed to be Hepatitis E. Testing to determine pathology of disease process is ongoing.
Refugees Influx (Western Uganda)
Western Uganda's Kisoro District continues to experience a fluid influx of refugees from DR Congo, fleeing insecurity created by armed clashes in North Kivu (eastern DRC) between government forces and troops allied to renegade Army General Laurent Nkunda. More than 20,800 people are estimated to have crossed into Uganda from 22 villages along the border, staying with relatives and friends, seeking temporary shelter at UNHCR's Nyakabande transit camp, returning to DR Congo or opting to be relocated to the more permanent Nakivale settlement in neighbouring Isingiro District.
At present, the total number of refugees at the Nyakabande site is approximately 8,000, and some 1,000 had registered to be relocated to the Nakivale camp. It should be noted that while those staying at the transit site have often returned to their original homesteads, whenever indications of improved security conditions emerged, the situation remains fluid particularly since the expiration on 1 November of the government's deadline to Nkunda's forces to disarm. Given the situation's unpredictability, humanitarian organisations present in Kisoro (including UNICEF) estimate that the number of refugees seeking shelter in Uganda in the coming weeks could reach 60,000 or more.
Flood Damage (Eastern & Northern Uganda) Children and women comprise 80% of the roughly 300,000 people affected by the dangerous levels of flooding in Teso, Karamoja, Elgon and the lowlands of Lango and Acholi sub-regions, caused by heavy and persistent rains since July. Of those 300,000, about 200,000 required immediate, emergency shelter. The floods have further disrupted basic services, already overstretched in many areas (especially areas of IDP returns in Lango and Acholi sub-regions).


Full_Report (pdf* format - 255.7 Kbytes)

http://www.reliefweb.int/rw/RWB.NSF/db900SID/DPAL-79MK8G?OpenDocument

[HenryN]

Re: New Ebola Strain in Uganda Spreading - Death toll rising

Rwanda acts against Ebola

<SMALL>Written By:claire wanja , Posted: Thu, Dec 06, 2007</SMALL>


Rwanda has tightened its control at border with Uganda against a possible spillover of the deadly Ebola epidemic into the country.
The Rwandan minister of state in charge of HIV/AIDS and other epidemics Innocent Nyaruhirira said.
"We have put in place a team of experienced health workers to examine immigrants from Uganda, particularly, those from the affected districts," he said.
Mobile clinics have been set up at Gatuna, the common border post with Uganda, where medical personnel are screening Ugandans entering the country.
Minister Nyaruhirira visited the health workers at the busy customs post early this week and instructed the nurses and medical officers to ensure effective surveillance on immigrants, especially Ugandans.
Daily Monitor reported that on Monday Ugandans crossing to Rwanda were being questioned extensively, and some suspected cases were isolated while many other people were sent to the mobile clinics for further screening.
A number of epidemiological experts from the World Health Organization, the U.S.-based Centre for Disease Control and the Treatment and AIDS Research Centre of Rwanda have moved to Gatuna to strengthen the medical practitioners working in tents erected near the Clearinghouse.
The virulent hemorrhagic fever has so far killed 20 people out of 91 infected cases in Uganda's western region.

http://www.kbc.co.ke/story.asp?ID=46907

[mordan]

Re: New Ebola Strain in Uganda Spreading - Death toll rising

Ebola Burial Bundibugyo Uganda

http://www.flickr.com/photos/drsmyhre/sets/72157603392453209/

[hawkeye]

Re: New Ebola Strain in Uganda Spreading - Death toll rising

Personally, I don't see how they expect border control to stop anything.

Rwanda acts against Ebola

<SMALL>Written By:claire wanja , Posted: Thu, Dec 06, 2007</SMALL>


Rwanda has tightened its control at border with Uganda against a possible spillover of the deadly Ebola epidemic into the country.
The Rwandan minister of state in charge of HIV/AIDS and other epidemics Innocent Nyaruhirira said.
"We have put in place a team of experienced health workers to examine immigrants from Uganda, particularly, those from the affected districts," he said.
Mobile clinics have been set up at Gatuna, the common border post with Uganda, where medical personnel are screening Ugandans entering the country.
Minister Nyaruhirira visited the health workers at the busy customs post early this week and instructed the nurses and medical officers to ensure effective surveillance on immigrants, especially Ugandans.
Daily Monitor reported that on Monday Ugandans crossing to Rwanda were being questioned extensively, and some suspected cases were isolated while many other people were sent to the mobile clinics for further screening.
A number of epidemiological experts from the World Health Organization, the U.S.-based Centre for Disease Control and the Treatment and AIDS Research Centre of Rwanda have moved to Gatuna to strengthen the medical practitioners working in tents erected near the Clearinghouse.
The virulent hemorrhagic fever has so far killed 20 people out of 91 infected cases in Uganda's western region.


http://www.kbc.co.ke/story.asp?ID=46907