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Uganda: Ebola Sudan identified in 17 deaths, all monitoring completed, outbreak declared over
. . . On a related note, I am beginning to suspect that many of the 30 or so "suspect" cases in isolation at Kagadi do not have Ebola. If one assumes a CFR of 50% (which is probably low) and a time from hospitalization to death of a week (which is probably high), then 1 in 14 hospitalized Ebola patients should die each day on average. That would be 2 deaths a day in that isolation unit. That's not happening. If one shorterns the time to death or increases the CFR, the estimated number of fatalities per day would be even higher.
This argues that many of the patients in isolation have something with a CFR significantly lower than Ebola.
This is an important point. Whenever you have a a high CFR disease, the most accurate indicator of how fast it is spreading is how fast the dead body count increases.
"Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear." -Nelson Mandela
Re: Uganda: Ebola Sudan identified in 16-25? deaths, 253+ contacts being monitored
EA in panic as Ebola strikes again in Uganda
By JOINT REPORT Special Correspondents (email the author)
Posted Saturday, August 4 2012 at 19:44
Uganda is studying the puzzling behaviour of the Ebola Sudan virus in the latest outbreak that had killed 16 people mid last week.
“So far what we see is that it is atypical. Its behaviour is very suspicious,” Dr Anthony Mbonye the Commissioner for Health Services at the Ministry of Health told The EastAfrican, explaining that unlike the typical Sudan strain, victims in the latest suffer fevers without the bleeding normally associated with the virus.
“Thank God we took a sample early because we would be thinking they are suffering from fever yet it is Ebola,” said Mbonye.
The Uganda Ministry of Health declared an outbreak of Ebola in Kibaale district, about 160km west of Kampala.
Confirmatory test results were done at the Centres for Disease Control, Uganda Virus Research Institute (UVRI) laboratory in Entebbe.
Authorities were following 176 people that came into contact with the deceased while another 38 suspected cases were under observation.
Although it is confirmed as the Sudan Ebola strain, a viral haemorrhagic fever, it is presenting with less bleeding or haemorrhage, as should be the case with Ebola.
Ebola has no cure and vaccine while this particular strain, Ebola Sudan, kills at least 50 per cent of the people who get infected so more deaths are expected.
“We are not seeing much of the bleeding this time,” said Dr Jackson Amone, the Assistant Commissioner Integrated Services at the Ministry of Health who was travelling to Kagadi Hospital in Kibaale, western Uganda, where the first cases were reported.
Ebola typically presents with fever, fatigue, vomiting, diarrhoea, joint pains and bleeding.
“Most of the patients bleed when they are about to die with the cases we are handling. Sometimes you can confuse it for malaria because there is a high fever, vomiting, diarrhoea,” said Dr Amone.
According to health workers, in the absence of body fluids the latest strain is easier to manage because Ebola virus is transmissible through contact with body fluids-saliva, vomit, sweat, blood or other fluids in the body of an infected person.
Like in all Ebola outbreaks in Uganda, patients may have transmitted it to medical personnel. All medical personnel who were initially in contact with the people who died have been asked to stay at home until after 21 days.
As more investigations are ongoing, samples have been sent to the Centres for Disease Control and Prevention (CDC), Viral Haemorrhagic Fevers (VHF) laboratory in USA. Results are expected after one week.
“CDC is sending samples to Atlanta to do additional sequencing. But the indication now is that it is not a new strain. It is the Sudan strain based on PCR testing, which is specific,” said Erik Friedly, the associate head of communication at CDC-Uganda.
A day after this newspaper published the logistical outcry of health personnel fighting against the deadly Ebola epidemic; the government on Friday said it had released Shs627 million to...
[snip]
Reports also indicate that three people died in the villages of Ngerebwe and Waihembe on Thursday night after they reportedly showed signs of the disease but health workers could not confirm whether the victims succumbed to Ebola hemorrhagic fever or some other sickness.
Burial committee dispatched
?We sent a burial committee to bury them because they had symptoms similar to those of Ebola,? Mr Stephen Mfashingabo, the vice chairperson of the Ebola taskforce, said. However, a number of residents from the two villages have fled to neighbouring parishes.
Reports also indicate that three people died in the villages of Ngerebwe and Waihembe on Thursday night after they reportedly showed signs of the disease but health workers could not confirm whether the victims succumbed to Ebola hemorrhagic fever or some other sickness.
Burial committee dispatched
“We sent a burial committee to bury them because they had symptoms similar to those of Ebola,” Mr Stephen Mfashingabo, the vice chairperson of the Ebola taskforce, said. However, a number of residents from the two villages have fled to neighbouring parishes.
Also at the above link:
"Dr Dan Kyamanywa, the district health officer, said the epidemic is increasing with more suspected patients admitted to Kagadi Hospital. “Things are not moving on well because we are admitting between three to four people on a daily basis."
Re: Uganda: Ebola Sudan identified in 17-25? deaths, 253+ contacts being monitored
Uganda: Psychologists Join Ebola Team
6 AUGUST 2012
A combined team of psychosocial experts from Mulago and Butabika hospitals in Kampala has arrived in Kibaale district which has recorded several cases of Ebola heamorragic fever.
Psychosocial intervention is the process of helping meet a person's emotional, social, mental and spiritual needs to decrease the traumatic consequences of disasters.
Twenty-one people are believed to have succumbed to the deadly haemorrhagic fever, although only three of them were confirmed positive for the virus that causes Ebola.
The cause of death of 16 of the initial cases was never established because their blood samples were never collected for testing since their bodies had already been buried.
The remaining five of the 21 are said to have died over the weekend, four in the community and one at the isolation centre. Test results from the samples of the deceased people had not been ascertained by yesterday, but their sicknesses presented with the symptoms exhibited by those who had been found with Ebola. All the five were buried by the health teams.
...
A combined team of psychosocial experts from Mulago and Butabika hospitals in Kampala has arrived in Kibaale district which has recorded several cases of Ebola heamorragic fever.
Twitter: @RonanKelly13
The views expressed are mine alone and do not represent the views of my employer or any other person or organization.
newstimeafrica.com is your first and best source for all of the information you’re looking for. From general topics to more of what you would expect to find here, newstimeafrica.com has it all. We hope you find what you are searching for!
Health officials in Uganda?s Kagandi Hospital have so far confirmed 8 new emerging cases of Ebola. Statistics released by Health officials on Friday indicate that the number of people currently ?actively being followed up? has increased from 232 to 253 in the recent 24 hours. Speaking on the matter, the chairman of the Ebola National Task Force, Mr. Anthony Mbonye said, ?Of the 46 samples collected since the outbreak, by August 2, eight of them were confirmed positive and all are from Kibaale.?
--------
[Since no sample was able to be collected from the first 14-16 fatalities (see above), that makes the total number of probable Ebola infections only about 22-24. The rest of of the cases, especially outside of Kibaale, may very well have had some other illness. It remains unclear whether any confirmed/probable cases actually travelled to Kampala. - alert]
This weekly bulletin provides updates on threats monitored by ECDC
In addition to those reported elsewhere in this CDTR, the following events have been monitored this week due to the global public health dimension of the Olympics:
Ebola haemorrhagic fever, Kibaale District, West Uganda
Source: Uganda MoH, WHO, media, CDC
The previously reported unknown disease in the Kibaale District has been identified as Ebola haemorrhagic fever. As of 31 July 2012, the latest update from the WHO Regional Office for Africa reports 38 cases and 16 deaths, from the Kibaale District. One healthcare worker who cared for cases in Kibaale became unwell, travelled to Kampala and subsequently died in Mulago National Referral Hospital, Kampala.
There are media reports of potential cases in other Ugandan districts: one suspected case in Mbarara District and five deaths and seven hospitalised cases in Ntungamo District. In addition, afro-news reports three cases from the same family being treated in Mulago Hospital, Kampala. Media reports should be taken with caution, as these reports are not yet verified.
The Ugandan Ministry of Health is working with stakeholders and partners to control the outbreak. Public health measures being carried out include: treatment of suspected and confirmed cases in temporary isolation wards in Kibaale and Kampala hospitals; active contact monitoring of up to 40 people in Kibaale district for 21 days; isolation of healthcare worker contacts in Kampala for 21 days; public advice issued in a statement by the Ugandan president; laboratory testing for the cases in Ntungamo District.
In Kenya, the media are reporting one case being admitted to hospital after having come from Sudan, through Uganda, to seek medical attention while presenting with signs of haemorrhagic fever. In Siaya, western Kenya there was initial concern about one possible case but Ebola has now been excluded. In addition, the media are reporting that Kenya is implementing a screening at its border with Uganda in Busia and Malaba counties.
Ebola haemorrhagic Fever, Kibaale District, West Uganda: ECDC is closely monitoring this outbreak. At present there is no increased risk level for spread to or within the EU or for EU-citizens moving in Uganda as tourists.
6 August 2012 - The Ministry of Health in Uganda has reported a cumulative number of 59 suspected cases of Ebola including 16 deaths. Ten (10) cases have been laboratory confirmed by the Uganda Virus Research Institute (UVRI) in Entebbe, of whom 6 were acute cases and 4 convalescent cases.
Currently 36 cases are admitted to an isolation facility in Kagadi hospital, Kibaale district, of whom 29 are in the convalescent ward and will soon be discharged.
Of the 398 contacts listed, 84 have completed 21 days, while 292 are still under active follow up. So far all samples from other districts have tested negative for Ebola. However a clinical officer who attended to a case in Kibaale district was transferred to Mulago Hospital in Kampala for treatment but later died. None of the seven health workers who attended to this fatal case has developed symptoms of the disease by day 16 of follow up. This indicates that there has been no expansion of the outbreak beyond Kibaale District.
Response
The Government of Uganda is continuing to work with a number of partners to control the outbreak.
At the central level the Prime Minister has established a Ministerial Task Force, chaired by the Minister of Health, to facilitate and coordinate the outbreak response. The Task Force addressed a well-attended press conference on Friday 3 August 2012.
In Kibaale district, the local health authorities are working through its task force with several partners to mobilize resources and supplies. These partners include WHO, US Centers for Disease Control and Prevention (US CDC), the Uganda Red Cross Society (URCS), African Field Epidemiology Network (AFENET) and M?decins Sans Fronti?res (MSF). WHO has deployed epidemiologists, infection control specialist, logisticians and supplies, including personal protective equipment (PPE) to Uganda.
Required funds for local operations are being mobilized. The government of Uganda has released 627 million UGX (approx. USD 250,000) to Kibaale district to support the response. Additional support is being received from the EMESCO Foundation (a local NGO), Members of Parliament from Kibaale district, the Infectious Diseases Institute (IDI), the Uganda Red Cross Society (URCS) and World Vision.
With the support of MSF, the construction of a new isolation facility in Kagadi, Kibaale district has been completed. A ward for convalescent cases who are Ebola negative has been opened. The convalescent patients are receiving psychosocial support in preparation for discharge. WHO is supporting the provision of a discharge package to facilitate resettlement in the community?
Red Cross volunteers and village health teams are conducting social mobilization and public awareness activities. Additionally, public announcements are being disseminated in 11 local languages on 20 radio stations. WHO is facilitating the deployment of a medical anthropologist to assist in these activities.
Neighbouring countries
A number of countries neighbouring Uganda have taken proactive steps to enhance their surveillance to detect and respond to cases of Ebola haemorrhagic fever. The neighbouring countries of Kenya, Rwanda South Sudan and Tanzania have investigated rumors of suspected cases. Both Kenya and Rwanda have investigated the rumors and ruled out Ebola. The governments of Kenya and South Sudan have issued guidance to the general public and also activated their national task force to undertake enhanced surveillance. Tanzania is still investigating the rumors.
WHO does not recommend that any travel or trade restrictions are applied to Uganda.
Twitter: @RonanKelly13
The views expressed are mine alone and do not represent the views of my employer or any other person or organization.
By David Ford
Aug 6, 2012 3:08pm
EXCLUSIVE: ABC News Reports ?Inside the Hot Zone: The Ebola Outbreak?
ABC?s Dr. Richard Besser the Only American Reporter to Go Inside the Ward Where Victims of the Deadly Ebola Virus in Africa are Being Isolated
...Dr. Besser will give viewers a rare look inside the Ebola ward where the infected are being isolated from the rest of the population to prevent the spread of the brutal disease. His exclusive reports, ?Inside the Hot Zone: The Ebola Outbreak,? will air MONDAY, AUGUST 6 on ?World News with Diane Sawyer? and later this week on ?Nightline.? Besser?s first report aired this morning on ?Good Morning America...?
Re: Uganda: Ebola Sudan identified in 16-25? deaths, 36 in isolation Kagadi hospital, 398 contacts monitored
3 more Ebola cases detected
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<!-- Video added to the Media Field--> Tuesday, August 7 2012 at 01:00
In Summary The latest on ebola
Admissions. 36 people have so far been admitted on suspicion of having the varus
Contact cases. 398 people are suspected to have got into contact with Ebola patients but of these, 295 has so far been followed
To be discharged. 29 patients who were admitted on suspicion of Ebola and tested negative will be discharged from Kagadi hospital.
More detected cases. 3 more people tested positive of Ebola.
Funds needed. Shs3 billion needed by the Ministry of Health to fight Ebola. Shs627 million has so far been released
Three more people had by yesterday tested positive of the Ebola virus and were admitted to Kagadi Hospital, raising the number of confirmed cases to 13. Of these, six are still admitted, three http://www.monitor.co.ug/News/Nation...0/-/index.html
Re: Uganda: Ebola Sudan identified in 16-25? deaths, 36 in isolation Kagadi hospital, 398 contacts monitored
Evidently health care delivery is quite a challenge in Uganda:
Jinja Hospital is the largest hospital in Eastern Uganda.
Medical workers at Jinja Hospital go on strike, patients stranded
Posted Monday, August 6 2012 at 14:29
Patients at Jinja Hospital have been forced to fend for themselves after more than 60 medical personnel at the hospital went on strike protesting the arrest of their colleague.
Dr Charles Barungi was arrested after a patient he had operated on at the hospital theatre died on Friday, August 3. He is in detention at Nalufenya police station.
snip
This reporter counted over 40 women at wards seven and eight with both pre and post-birth complications, unattended to.
Patients at Jinja Hospital have been forced to fend for themselves after more than 60 medical personnel at the hospital went on strike protesting the arrest of their colleague. Dr Charles Barungi...
----------------
"The care was basic at best." Dr. Richard Besser about the ebola ward in Kagadi hospital
Re: Uganda: Ebola Sudan identified in 16-25? deaths, 36 in isolation Kagadi hospital, 398 contacts monitored
I would like to make a comment that we publish official government reports in print or video, like the post above, as a public service. We do not warranty these reports.
We will make comments about various disease outbreaks around the world using the talents and experience of our team here.
Sometimes we feel the official numbers are a reasonable representation of the actual situation, sometimes we do not.
Ebola is a disease that is transmitted by body fluids. It is possible to gain control of an outbreak using quarantine methodology.
Influenza is airborne and is impossible to contain through quarantine. This is why influenza is so dangerous. It is a genetically unstable virus and it causes mass infections before new vaccines can be produced and distributed.
Is this ebola outbreak "contained" or "controlled" yet? We do not know. We are watching.
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