Ebola in Uganda: November 30 - December 17, 2007

[AlaskaDenise]

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

Commentary at

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

Commentary

State of Emergency Call Linked To Uganda Ebola Spread
Recombinomics Commentary
December 7, 2007

MPs yesterday unanimously asked the government to immediately declare a State-of-emergency over the rapidly spreading Ebola epidemic and impose quarantine on already affected areas in western Uganda.

"We need to take radical measures if we are to save our people from this deadly virus," Theodore Ssekikubo, the MP for Rwemiyaga constituency in Ssembabule district, said.

In the afternoon plenary session dominated by the Ebola debate, most MPs called on the government not to drag its feet when people are dying in the countryside.

"Ebola is a serious disease and the government must declare all affected areas a no-go area.

The above comments call for a state of emergency in western Uganda, but recent reports suggest the disease may have already spread to the eastern border and cover most of southern Uganda (see satellite map).

Most of the cases are in and around Bundibugyo, but the confirmed and suspect cases have led to monitoring of border crossings by the Democratic Republic of the Congo, Rwanda, Tanzania, and Kenya.

The recent deats of health care workers have emptied the hospitals of both patients and health care workers. The fleeing patients could spread the virus, which appears to be readily transmitted. Over 330 contacts are being monitored, but patient avoidance of hospitals will create additional contact tracing problems.

More information on the sequence of the new strain, which is likely a recombinant, and further confirmation of suspect cases will be useful.


.

[Treyfish]

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

<TABLE cellSpacing=0 cellPadding=0 width="99%" border=0><TBODY><TR><TD><TABLE cellSpacing=0 cellPadding=0 width="100%" border=0><TBODY><TR><TD class=DetaildTitleGolden id=tdMainHeader width="100%">Ebola outbreak kills many in Uganda</TD><TD vAlign=center></TD><TD vAlign=center align=left></TD></TR><TR><TD id=tdbyLine width="100%" colSpan=3></TD></TR><TR><TD colSpan=3></TD></TR></TBODY></TABLE></TD></TR><TR><TD style="PADDING-RIGHT: 5px"><TABLE height=350 cellSpacing=0 cellPadding=0 width="100%" border=0><TBODY><TR><TD colSpan=2 height=1></TD></TR><TR><TD class=PaddingTop10 id=tdSubHeader vAlign=top colSpan=2 height=60><TABLE cellSpacing=0 cellPadding=0 width="100%" border=0><TBODY><TR><TD vAlign=top><TABLE style="DISPLAY: inline" cellSpacing=0 cellPadding=0 width=309 align=right border=0><TBODY><TR><TD align=right width="100%"><TABLE borderColor=#c0c0c0 cellSpacing=0 cellPadding=0 width=0% border=0 imageTableTakeCare><TBODY><!-- TOKEN --><TR><TD></TD></TR><TR><TD style="FONT-WEIGHT: bold; FONT-SIZE: 8pt; COLOR: #000000; FONT-FAMILY: Verdana" align=middle>The World Health Organisation is concerned about the way the Ebola virus keeps mutating [EPA]</TD></TR><!-- /TOKEN --></TBODY></TABLE>



















<TABLE border=0><TBODY><TR></TR></TBODY></TABLE></TD></TR></TBODY></TABLE>At least 22 people have died and 94 thought to be infected by a new strain of the Ebola virus in Uganda, reports say.

Some 330 people are being monitored for possible infection in western Uganda, health officials said on Thursday.

<TABLE border=0><TBODY><TR><TD></TD></TR></TBODY></TABLE><TABLE style="DISPLAY: none" border=0><TBODY><TR><TD><SCRIPT language=javascript>bodyVariable350="Htmlphcontrol 1_lblError";</SCRIPT></TD><TD></TD></TR></TBODY></TABLE><TABLE height=10><TBODY><TR><TD></TD></TR></TBODY></TABLE>The outbreak started in August and 58 cases have so far been confirmed by laboratory tests.

Authorities are facing problems investigating the extent of the outbreak in the Bundibugyo district, bordering the Democratic Republic of Congo (DRC).

<TABLE border=0><TBODY><TR><TD></TD></TR></TBODY></TABLE><TABLE style="DISPLAY: none" border=0><TBODY><TR><TD><SCRIPT language=javascript>bodyVariable300="Htmlphcontrol 2_lblError";</SCRIPT></TD><TD></TD></TR></TBODY></TABLE><TABLE height=10><TBODY><TR><TD></TD></TR></TBODY></TABLE><TABLE id=ServicesList style="DISPLAY: inline" cellSpacing=0 cellPadding=0 align=right border=0><TBODY><TR><TD align=middle></TD></TR><TR><TD id=tdRelated align=middle></TD></TR><TR><TD height=5></TD></TR></TBODY></TABLE>The area is home to an estimated 250,000 people and considered the epicentre of the disease.

Many villagers are reportedly unwilling to co-operate with medical authorities.

Sam Zaramba, Uganda's director of health services, told Reuters news agency that a doctor had died in the Mulago hospital in Kampala, the capital, after looking after a patient in its isolation ward.

Three other medical staff died after treating infected patients.

According to Zaramba, all other cases and deaths had occurred where the outbreak started.

Zaramba said: "We've had one more admission today, someone in Bundibugyo. It is 94 now."

"Twenty-two have died. Out of them, four [are] health workers, one a doctor. He died in Mulago."

Kenyan alert

Kenya has been screening travellers entering from Uganda at the Busia crossing - on the main road out of Kenya's western region, into east and central Africa - since last week, health officials said.

James Nyikal, the head of medical services, said: "Screening is going on at Busia. People are being asked questions about where they have travelled and their health."

Ugandan health officials say that the genetic analysis of samples taken from victims shows the virus as a previously unrecorded type of Ebola, making it a fifth strain.

They also said that the low death rate of this type - at roughly 22 per cent, when the virus normally kills between half and 90 per cent of those infected - shows it is less lethal than previous epidemics.

Uganda was last hit by an Ebola outbreak in 2000, when 425 people were infected and over half died.

Some of the first recorded cases of Ebola were found in the DRC in 1976.

It killed 280 people and infected up to 380.

<TABLE border=0><TBODY><TR><TD></TD></TR></TBODY></TABLE>http://english.aljazeera.net/NR/exer...B5713C3A28.htm</TD></TR></TBODY></TABLE></TD></TR></TBODY></TABLE></TD></TR></TBODY></TABLE>

[HenryN]

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

Uganda has over 100 Ebola cases, 350 more at risk

Fri 7 Dec 2007, 9:55 GMT
<INPUT id=CurrentSize type=hidden value=13 name=CurrentSize>
[-] Text [+]

By Tim Cocks
KAMPALA, Dec 7 (Reuters) - Uganda now has more than 100 suspected cases of the lethal Ebola virus and 350 more people are being closely monitored because they were in contact with those infected, the Health Ministry said on Friday.
There were no new deaths from the virulent haemorrhagic fever, which usually causes victims to die of bleeding through various orifices, Health Ministry Spokesman Paul Kabwa said.
Twenty two people have so far died of the fever.
"Cumulatively, we have got 101 cases of Ebola -- those who fit the case definition," Kabwa said, adding that all were in western Uganda's Bundibugyo district, except for two in Kampala, including a doctor who died.
He said 39 had been admitted to hospital in serious condition and 350 others suspected of having been exposed to the virus were being urged to stay at home.
"They are being observed because they are possible contacts with Ebola cases," Kabwa said. "They are not being confined."
The outbreak, which started in August, has sparked panic amongst officials, health workers and the public.
"A bigger Ebola bomb could explode, claiming many more lives," Bundibugyo district chairman Jackson Bambalira was quoted as saying in the state-owned New Vision daily on Friday.
Bundibugyo borders Democratic Republic of the Congo, whose Ebola river gave the virus its name after some of the first cases of Ebola were recorded in its valley in 1976.
The independent Daily Monitor reported on Friday that Congo had sealed the border with the district. Congolese officials were not immediately available for comment.
Neighbours Kenya and Rwanda, to the east and southwest, respectively, are screening travellers entering from Uganda.
The four-month delay between the start of the outbreak and confirmation last week that it was Ebola has raised suspicions the government covered it up so as not to scare delegates -- Britain's Queen Elizabeth and 53 heads of government -- who met in Kampala two weeks ago for a Commonwealth summit.
The government denies it withheld information. It says it took time for test results to come back from the Centres for Disease Control and Prevention in the United States.
Commentators have criticised the government's response as sluggish and say Uganda should have learned from an Ebola outbreak in 2000, when 425 people caught it and over half died.
"When Ebola first struck in 2000 in northern Uganda, we were plunged into panic. Seven years later when we should have been better prepared ... we are ill-equipped as before," read an editorial in the Monitor on Friday.
Uganda's medical workers union have called on staff to refuse to care for patients unless they have proper protective gear, following the death of four medical staff.
The government says all those treating Ebola cases are protected. "We are distributing protective gear. We don't want to risk our own staff," Kabwa said.
(Editing by Sophie Walker)

http://africa.reuters.com/wire/news/usnL07590270.html

[HenryN]

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

<TABLE cellSpacing=4 cellPadding=0 width="100%" border=0><TBODY><TR><TD colSpan=2>UGANDA: Medical staff bore the brunt of "sly" new Ebola virus

<HR style="WIDTH: 100%; COLOR: #000000" SIZE=1><TABLE style="BORDER-RIGHT: #bbbbbb 1px solid; PADDING-RIGHT: 5px; BORDER-TOP: #cccccc 1px solid; PADDING-LEFT: 5px; PADDING-BOTTOM: 5px; MARGIN: 2px 5px 8px 0px; BORDER-LEFT: #cccccc 1px solid; WIDTH: 120px; PADDING-TOP: 5px; BORDER-BOTTOM: #bbbbbb 1px solid; BACKGROUND-COLOR: #eeeeee" cellSpacing=0 cellPadding=0 align=left border=0><TBODY><TR><TD style="PADDING-TOP: 3px" align=right>
Photo: Stuart Price/IRIN </TD></TR><TR><TD class=ImgCreditCaption style="FONT-SIZE: 7pt; FONT-FAMILY: Tahoma">Authorities are monitoring hundreds of people</TD></TR></TBODY></TABLE>KAMPALA, 7 December 2007 (IRIN) - As Uganda's western district of Bundibugyo grapples with the consequences of an outbreak of the Ebola virus, which has killed 22 people in three months, medical officials have blamed what they term the "slyness" of the virus for the high death toll among medical staff.

"It has taken us three months to diagnose that this was Ebola," Sam Zaramba, the director-general of health services, told IRIN on 6 December. "It presented itself differently from the known haemorrhagic fevers. Instead of patients passing blood from body openings, it was characterised by high fever, abdominal pain, diarrhoea, vomiting and headaches."

When the disease broke out in September, health workers in Bundibugyo thought it was one of the many common ailments prevalent among the 250,000 population, mainly farmers of cocoa, rice and vanilla and small-scale cattle-raisers.

Zaramba said the disease could have spread unnoticed in the ensuing medical confusion, with its characteristic haemorrhaging obscured by companion ailments, only to emerge when cases were tested at hospital. This presentation, he said, made health workers think the disease was a ?normal" ailment.

"This was the main reason why many [medical personnel] have fallen victim and four of them have since died," Zaramba said. Three of these medical workers died on 5 December; one was the head of a health centre in Bundibugyo.

"They did not use any protection when attending to patients," Zaramba said. "However, we have now supplied enough protective gear to all health units in the affected district and we have asked them to treat every patient with caution."

Sam Okware, the chairman of the National Ebola Taskforce, said the Ebola strain identified in Bundibugyo was "completely different" from the four known sub-types of the highly contagious haemorrhagic fever - Ebola Sudan, Ebola Zaire, Ebola Reston, which only affects monkeys, and Ebola Tai, recorded in C?te d'Ivoire.

Ebola last struck Uganda in 2000 in the northern district of Gulu, and killed at least 170 people, including Matthew Lukwiya, then medical superintendent of Lacor hospital, who spearheaded the fight against the disease.

Several other medical workers also lost their lives during the 2000 epidemic, suspected to have struck soon after the return of Ugandan soldiers from the Democratic Republic of Congo (DRC) where the national army fought alongside rebels against the government of then president Laurent Kabila. <TABLE style="BORDER-RIGHT: #336699 1px solid; PADDING-RIGHT: 5px; BORDER-TOP: #336699 1px solid; PADDING-LEFT: 5px; PADDING-BOTTOM: 5px; MARGIN: 2px 8px 8px; BORDER-LEFT: #336699 1px solid; WIDTH: 160px; PADDING-TOP: 5px; BORDER-BOTTOM: #336699 1px solid; BACKGROUND-COLOR: #aabbdc" cellSpacing=0 cellPadding=0 align=right><TBODY><TR><TD style="COLOR: #ffffff; FONT-FAMILY: tahoma; size: 12px" align=left bgColor=#aabbdc>It presented itself differently from the known haemorrhagic fevers. Instead of patients passing blood from body openings, it was characterised by high fever, abdominal pains, diarrhoea, vomiting and headaches </TD></TR></TBODY></TABLE>

Monitoring patients

Zaramba said the authorities were monitoring hundreds of people believed to have had contact with some of those infected. "We are monitoring 330 people in the community," Zaramba said. "These are the people who had contact or had been near Ebola patients."

Zaramba said of the 330, 93 fitted the diagnosis of Ebola and 38 were admitted to health centres in Bundibugyo where isolation units had been erected. The death toll in this outbreak is 22 so far.

Samuel Kazinga, resident district commissioner for Bundibugyo, said some patients had gone into hiding for fear of possible contamination in hospitals. This, he said, had complicated the drive to isolate cases.

"The Congolese have also closed their border at Busunga and installed customs officers, who are not allowing the movement of people between the two nations," he said.

At the same time as the Ebola outbreak spread to districts neighbouring Bundibugyo, the health ministry was swamped with outbreaks of plague, meningitis, hepatitis and cholera that have killed 33 people.

The ministry reported 569 cases of cholera in western and northwestern Uganda with 12 deaths; 121 plague cases in Arua with 10 deaths and 39 cases in Nebbi, with nine deaths.

At least 255 cases of meningitis have been reported in Arua district and 32 cases of viral hepatitis with two deaths in northern Kitgum district.

According to the ministry, the main victims of plague are women because they sleep on the ground while men sleep on beds; fleas that spread plague can only jump six inches from the ground.

"They feast on those sleeping on the ground and these are mainly women," Emmanuel Otaala, the state minister for health, said. "We are encouraging men to allow women sleep on beds also."

vm/js/mw
</TD></TR><TR><TD colSpan=2>
Themes: (IRIN) Health & Nutrition</TD></TR><TR><TD colSpan=2>
[ENDS] </TD></TR><TR><TD colSpan=2>Report can be found online at:
http://www.irnnews.org/Report.aspx?ReportId=75738 </TD></TR></TBODY></TABLE>

[HenryN]

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

D<SUP class=typo_exposants>r</SUP>. Jonah Kule, a first son of World Harvest Mission, succombs to Ebola Virus

<SMALL>vendredi 7 d?cembre 2007</SMALL>
<TABLE align=left border=0><TBODY><TR><TD><SCRIPT type=text/javascript><!--google_ad_client = "pub-8126303992385778";google_ad_width = 250;google_ad_height = 250;google_ad_format = "250x250_as";google_ad_type = "text";//2007-08-21: Finance, M?dias, Voyage, cash for structured settlement, faire de l argent sur internetgoogle_ad_channel = "1955222947+9431141123+9432790818+3653009034+77559 64615";//--></SCRIPT><SCRIPT src="http://pagead2.googlesyndication.com/pagead/show_ads.js" type=text/javascript></SCRIPT></SCRIPT></TD></TR></TBODY></TABLE>
By Michael Ireland
D<SUP class=typo_exposants>r</SUP>. Jonah Kule was in many ways a first son of World Harvest Mission?s (www.whm.org) work in Uganda.
WHM?s Dan Herron writes : ? We were shocked learn of Jonah?s death after he had been up walking around. ?
World Harvest sent out this note yesterday :
? It is with deep sadness that I share the news of the death of D<SUP class=typo_exposants>r</SUP>. Jonah Kule ? in many ways a ?first son? of World Harvest, having learned about Jesus many years ago through Isingoma Edward Amooti, Dan Herron and Robert Carr. ?D<SUP class=typo_exposants>r</SUP>. Jonah, an integral part of the community health effort in Bundigbugyo for many years, quite literally laid down his life to proclaim the Kingdom of Christ through healing," says WHM?s Dan Herron.
Herron writes of the current Ebola Virus outbreak in Uganda : ? I know that many of you have already received this news and are caring for the Myhres and the entire Uganda team through your ongoing prayer and support of them. Thank you. Don?t grow weary in doing this good and important work. ?
Dan and Gini Herron are on their way from Spain heading to Uganda to help with spiritual care for the WHM folks coming out of the Ebola zone.
? It will include caring for the children of the two missionary doctors who are remaining there. Both have been exposed and have been asked to remain in the district. The Ugandan government is sending in other doctors since the two Ugandan doctors are in isolation sick with Ebola. Some of our missionaries seem quite concerned and rightly so. That is why Gini and I are going to meet them in Kampala. We will be there for at least a month. Pray for safety, compassion, and wisdom. ?
Earlier, WHM?s Bob Osborne began his December 3 update with the news that D<SUP class=typo_exposants>r</SUP>. Jonah and D<SUP class=typo_exposants>r</SUP>. Sessanga were ? also very pleased (though cautiously optimistic) to report that D<SUP class=typo_exposants>r</SUP>. Jonah seems to be showing signs of healing. Yesterday he was strong enough to walk around and interact with the medical staff caring for him. D<SUP class=typo_exposants>r</SUP>. Sessanga also appears to have turned a corner in his recovery. ?
Please pray in particular for Jonah?s widow Melen and their five children. ? Melen is also pregnant ? this tragedy truly knows no bounds, ? saya Herron.
Dan and his wife Gini are currently en route to Uganda.
They write : ? We are at the airport in Madrid on our way to Kampala. Please pray for us to have wisdom in comforting those who are grieving and who may fear for their own lives. We are so appreciative of your emails and expressions of standing with us. ?
Dan Herron adds that their access to email may be limited for some days.
If you want to read more go to the World Harvest website ([->www.whm.org] ) or the Myhres? blog ([->www.paradoxuganda.blogspot.com
]) .
http://www.spcm.org/Journal/spip.php?breve4525

[sharon sanders]

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

Ebola Forum on FluTrackers :

http://www.flutrackers.com/forum/forumdisplay.php?f=1262

Infection Protocols in French and English, Historical Information, Research Studies


Please let us know if we can obtain information that you need at Contact Us or at :

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Thank you to everyone.

[FrenchieGirl]

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

350 confined over Ebola outbreak
Thursday, 6th December, 2007

http://www.newvision.co.ug/D/8/12/600844


Margaret Lukwiya at the requiem mass of her husband in Gulu yesterday
By Vision Reporters

ABOUT 350 people who have had contact with Ebola victims have been confined to their homes for monitoring in Bundibugyo and Kasese districts. About 253,000 people in the five sub-counties of Bundibugyo district are at risk of contracting the deadly haemorrhagic fever, the World Health Organisation and the Ministry of Health said yesterday.

They added that Bundibugyo town council was the most affected.

?We have established that 335 such people participated in burying some of the cases, either as relatives or sympathisers,? the Bundibugyo district chairman, Jackson Bambalira, said.

The National Task Force put the figure of the people being followed at 327.

?I am greatly worried that a bigger Ebola bomb could explode, claiming many more lives,? Bambalira said.

He added that another 20 people in Kasese had also been confined at home. The suspects were tracked down by local and international experts this week.

Since August when the killer disease broke out, ninety-three were confirmed infected, 24 of whom have died among them Dr Jonah Kule, and four health workers. Kasese, Mbarara and Kabarole districts have been put on high alert.

Blood specimens are being collected for testing at the newly-established Ebola lab, which begins to work this weekend. Results will now be out within 24 hours unlike in the past when the samples would be taken to the US.

Community leaders in Bundibugyo and Kasese have also been registering suspected cases and deaths. LCs have been ordered to restrict movement into homesteads where cases are suspected.

UPDF doctors have also joined the local and international experts in Bundibugyo to combat Ebola, including sensitising the population. Dr. Kule and the other health workers who died of Ebola were buried yesterday at Bundibugyo Hospital.

Dr. Richard Kaddu Ssessanga, the medical superintendent, who until the time of the burial had not learnt of his colleague?s death, forced himself out of bed to attend the burial. ?He looked really hard-hit by Dr. Kule?s death,? an official said. Ssessanga barred his relatives who had travelled from Kampala from entering the room where he is confined.

Meanwhile, in Gulu, a memorial service was held on Wednesday for the victims who died of Ebola in Gulu in the 2000 outbreak, the first ever in Uganda. Dr. Matthew Lukwiya, the head of Lacor Hospital, was one the victims.

Kabarole
In neighbouring Kabarole district, residents of Kichwamba have threatened to flee if an isolation centre for Ebola cases is set up in their village.

?People fear to risk their lives and those of their children and are relocating,? resident Evanice Manyireho said.

?We are worried. Some of our elderly people and drunkards may stray into the isolation centres and get infected. We ask the Government to identify another place far away from human settlement,? Manyireho pleaded. The concerns were raised during a meeting called by the district disaster preparedness committee at Bukuku sub-county hall.

Kichwamba Health Centre III has been made an isolation centre after two unconfirmed cases were admitted in Buhinga and Virika hospitals in Fort-Portal.

The World Health Organisation (WHO) has provided gloves, gowns, gumboots and jik for use at the centre. The Ministry of Health advised people with other ailments to seek help at the Bukuku health centre and Buhinga Hospital.

Kabale
Meanwhile, Kabale authorities have set up a task force as a precautionary measure to handle any cases.

The head of health services, Dr. Patrick Tumusime, was afraid that the disease could be carried to the district by unsuspecting infected people. He advised that suspicious illnesses be immediately reported.

(By Anne Mugisa, John B. Thawite, Bizimungu Kisakye, Colombus Tumusiime, Dennis Ojwee, Bwogi Buyera)

[tropical]

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

I don't understand why the WHO don't wan't to restrict even partialy (for turists) the traveling through Uganda if that's an maybe H5 addition recombinant new Ebola virus with diferent symptoms (vomiting, maybe no bleeding) similar with starting of many other diseases - how will an esigue staff of doctors control all the international passengers through Uganda succesfuly?

______
"Recommendations for U.S. Travelers
The World Health Organization (WHO) has reported that there is no need for any travel restrictions to Uganda. Generally, the risk of contracting Ebola virus is low for travelers." ...

[HenryN]

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

Commentary

http://www.recombinomics.com/News/12070702/Ebola_Uganda_Flee.html

[hawkeye]

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

Kemri to investigate suspected Ebola samples
Written By:Judith Akolo , Posted: Fri, Dec 07, 2007



The Kenya Medical Research Institute -Kemri has been mandated as the sole recipient of samples of any suspected cases of Ebola.

Director of Medical Services Dr James Nyikal says that Kemri has the capacity to diagnose any form of haemorrhagic fever including the dreaded Ebola.

In a statement to media houses, Nyikal said the government has reactivated its surveillance systems countrywide to detect and respond to any possible threat.

A rapid response team has been established at the Ministry headquarters to support any districts that might report suspected cases of Ebola.

Nyikal however maintained that the public are free to travel to and from Uganda.

Over 350 people in Bundibugyo and Kasese districts of Uganda who had contact with Ebola victims have been quarantined in their homes for monitoring.

Since August when the killer disease broke out, ninety-three people, have been infected while 24 have already succumbed to the deadly fever.

Nyikal and Health Minister Paul Sang were quick to reassure the Kenyan public that the government is on high alert and monitoring the situation in Uganda.

Nyikal advised those traveling to Uganda to ensure that they avoid any contact with Ebola patients or their body fluids, including needles or medical waste.

They should also avoid contact with wild animals or consuming bush meat.

They should report to the nearest health facility any person with symptoms suggestive of malaria or typhoid if they have visited the Western parts of Uganda or the DRC.

[HenryN]

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

Va. Physician Confronts Ebola, Buries Best Friend


POSTED: 11:59 am EST December 7, 2007
UPDATED: 12:12 pm EST December 7, 2007


<SCRIPT src="/js/13260191/script.js" type=text/javascript></SCRIPT><LINK href="/css/13260803/style.css" type=text/css rel=stylesheet><!--startindex-->KAMPALA, Uganda -- For more than a week, Dr. Scott Myhre didn't take any special precautions when treating the listless patients who were flocking to his hospital in western Uganda.
Only now does the American physician from northern Virginia know the risk he took. The patients were suffering from a new strain of Ebola, a highly contagious disease that has already killed 22 people, including four health workers, among them a doctor Myhre counted as his best friend.
"I'm not in the clear yet but I'm hopeful," Myhre told The Associated Press by telephone from Bundibugyo Hospital, which is at the epicenter of the outbreak. Myhre, who has lived in Uganda for 14 years, must wait 21 days from his last unprotected contact with an Ebola patient to be declared clear of the disease.
For now, he is studiously following the recommended precautions: gowns, gloves, goggles, masks and boots.
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.
Friday, the Ministry of Health said there were 101 suspected cases of Ebola in Bundibugyo district and 22 deaths.
Doctors and nurses did not at first know what they were facing, so they failed to protect themselves. Experts say the Ebola subtype that sparked the outbreak is new and the classic Ebola symptoms were not always present, slowing diagnosis. The outbreak began on Aug. 20, but the disease was not confirmed as Ebola until Nov. 29.
Since the confirmation, health workers have fled the job in Bundibugyo.
Hospital officials have been urging staff to return, to little avail. Meanwhile, the 100-bed hospital is trying to discharge all non-emergency patients and is operating very limited services.
"Many of the staff are not coming in but there aren't many patients either," said Myhre, who is from Vienna, Va. "The hospital is pretty much empty except for the isolation ward where the Ebola patients are being treated."
The ward houses 24 patients -- some of whom are on mattresses on the floor -- and is separated from the rest of the hospital by an orange mesh fence. Ebola is not airborne so the fence is designed to stop people wandering in accidentally.
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.
Everyday operations at Bundibugyo Hospital are difficult at the best of times. The area -- remote even by Ugandan standards -- has no electricity. The hospital owns a powerful generator but the cost of fuel prohibits its use for more than a few hours daily. Solar panels provide lighting, and the wards have concrete floors and paint peeling off the walls.
Doctors attending Ebola patients are now being paid a daily risk allowance of $23, while nurses and auxiliary staff are getting $17 and $12 -- up to twice what they normally receive.
"It is difficult to be with the patients sometimes, there is a lot of emotional pressure and a lot of hard work to be done," said David Kasumba, a nurse who has worked at the hospital for 12 years. "The patients are scared. We try to reassure them but it doesn't always work. They have seen what it can do."

http://www.nbc4.com/print/14798710/detail.html

[HenryN]

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

Nation on Ebola alert
TABU BUTAGIRA,HUSSEIN BOGERE &JOSEPH MUGISA
Virus spreads to seven more districts
Cabinet approves Shs6 billion for epidemics
Deaths at 22 out of 101 cases, no state of emergency
KAMPALA/BUNDIBUGYO
THE government yesterday announced that suspected cases of the lethal Ebola hemorrhagic fever have been reported in seven more districts.
State Minister for Primary Healthcare, Dr Emmanuel Otaala said eight sporadic alert cases have been registered in the districts of Adjumani in West Nile, Mbale in the east, Masaka and Mubende in Buganda region and Kasese, Fort Portal (Kabarole) and Kanungu in western Uganda; implying the whole country is now under Ebola siege. <TABLE cellSpacing=5 cellPadding=0 width=250 align=right border=0><TBODY><TR><TD class=caption> CAREFUL: A nurse attends to a patient at Mulago Hospital yesterday. Photo by Samuel Nalwala
</TD></TR></TBODY></TABLE>
The case in Adjumani involves a UPDF soldier who couldn't easily be identified. But Dr Otaala said :"Alert cases do not necessarily mean they are (confirmed) cases of Ebola but they ring a bell in our minds that there is something to investigate," the minister said.
Dr Otaala said reported Ebola infections countrywide since August had surged to 101 while deaths from the virulent disease stagnated at 22.
The Cabinet in an emergency sitting chaired by Prime Minister Apollo Nsibambi yesterday approved Shs6 billion to handle the spate of Ebola, plague, meningococcal meningitis, suspected cholera and yellow fever/Hepatitis A epidemics currently ravaging different parts of the country.
But as Ebola threatens to engulf the whole country, acting government spokesman Dr. James Nsaba Buturo said cabinet threw out pleas by lawmakers on Thursday that a state of emergency be urgently declared to draw international attention to the exploding incurable hemorrhagic fever.
"The work (declaration of) state of emergency is not in our vocabulary because we (government) are on top of things (containing the epidemic)," Dr Buturo said.
But it emerged yesterday that Mr Moses Natukunda, a guard with Delta Security suspected to be ill with Ebola was on Thursday night admitted to Mulago Isolation Ward; the same unit where Kikyo Health centre IV Medical Superintendent Dr. Jonah Kule died of the viral hemorrhagic fever three days ago.
"He (Natukunda) was brought in by his employers, Delta Security, after vomiting and passing out blood," Dr Ayati Omoruto, a community health officer at Mulago Hospital said.
A group of Kyambogo University students who had moved to attend a funeral of a relative in the Ebola hit western Uganda have caused a scare at the campus, forcing Ministry of Health officials to put them under medical observation.
The Director General of Health services, Sam Zaramba said an elaborate surveillance network had been established to trace prior contacts of all victims and now a total of 338 persons are being monitored to establish if they are in gestation period of the contagion.
President Yoweri Museveni, while speaking at the on-going Kampala City of God Crusade at Kololo Airstrip on Thursday warned Ugandans to wave but not shake hands while greeting.
Minister Otaala, himself a medical doctor, told a media briefing yesterday that cabinet had established a new Emergency Fund to be under the docket of the Ministry of Disaster Preparedness to which the Treasury will annually allocate money to cater for epidemic control.
He said the Cabinet had also directed that the risk allowance for health workers battling Ebola, be increased from the Sh20, 000 - 40, 000 to a higher figure that is yet to be established.
Dr Otaala said the government would expedite compensation payment to the families of the six medics who died while treating Ebola patients and ensure full protection for volunteer doctors and nurses in the Ebola zone so that none contracts the killer fever again.
"I am going to write to the Mufti (Sheik Shaban Mubajje) to inform his subjects; the Muslims not to wash dead bodies and the corpses should instead be put in bags and buried immediately by trained health workers," Dr Otaala said.
In Bundibugyo; the epicentre of the epidemic, anxious and panic stricken residents have resorted to using an unnamed local medicinal plant, which they deem to be effective in treating Ebola.
The Ministry of Health says there were a total of 39 admissions of suspected Ebola cases at Bundibugyo hospital and Kikyo health centre IV.
"On a positive note three people who were admitted are ready for discharge. Of the three, two are in Bundibugyo Hospital and one in Kikyo Isolation Unit," the ministry statement said.
The known symptoms of Ebola include; sudden onset of high fever, diarrhoea, vomiting associated with red eyes and a measles-like rash.
The disease is spread through contact with body fluids of infected persons or people who have died of Ebola. Anybody handling suspected cases must use appropriate protective wear including masks, gowns, gumboots and gloves and afterwards wash hands with Jik detergent. Daily Monitor will keep the public informed of any new developments.
In Kampala major hospitals and health centres have taken precautionary measures to stem the spread of Ebola. All major hospitals have set up isolation units from where they can refer cases to Mulago Hospital. Hospital workers and community leaders are also being educated on the early warning practices.
Kampala City Council Health Director Mesach Mubiru says nurses from all the 10 KCC clinics in the five divisions have been trained to identify and handle suspected Ebola cases .
Travelers have been advised to avoid, if possible the western districts of Bundibugyo, Fort Portal and Kasese.
According to the National chairman of the Uganda Taxi Operators and Drivers Association, Mr John Ndyomugyenyi, drivers and passengers alike have been alerted about a possible spread of the epidemic.
But in the city's numerous slums, little effort has been made to educate the people about the epidemic. In Katanga slum, at Wandegeya, residents have not taken any precautionary step against the epidemic.
Even with Katanga?s high concentration of people, the leadership here says the dwellers have not yet received any sensitisation on Ebola. Mr Ssekadebe Karugaba, the LC 1 chairman in Katanga said the biggest problem is in educating the population about the disease and how it is transmitted.
Mr Karugaba says business is still going on as usual and communal drinking of local brew where people share tubes is still practiced.
This kind of drinking exposes people to the disease because Ebola can also be transmitted through fluids like saliva.
Ms Florence Namubiru ,a local brew seller in this slum says the Ebola scare has not yet affected her business because customers are still coming in. "People still come to my bar," she says.
Additional reporting by grace natabaalo, EVELYN LIRRI
& JANE NAFULA

http://www.monitor.co.ug/artman/publish/news/Nation_on_Ebola_alert.shtml

[HenryN]

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

Updated map

http://maps.google.com/maps/ms?ie=UTF8&hl=en&msa=0&msid=106484775090296685271.000440a9f060622a05059&ll=1.208406,31.992188&spn=9.10699,17.29248&t=h&z=6&om=0

[HenryN]

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

Healing, or nearly ready for discharge: 4 in Bundibugyo, 2 in Kikyo, plus Dr. Sessanga who has essentially discharged himself from his self-imposed isolation. Scott saw him today and took a lab tech to get his blood sample for the CDC. This is hopeful. People do recover. One of the epidemiologists said she counts only 4 deaths among 18 admissions, which is less than a quarter, similar to the deaths among the confirmed positive lab samples in the original batch that led to the identification of the epidemic (2 of 8).
http://paradoxuganda.blogspot.com/20...y-numbers.html

[Gert van der Hoek]

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

Ebola haemorrhagic fever in Uganda - update

7 December 2007

The number of suspected cases of Ebola haemorrhagic fever in the Bundibugyo District of western Uganda has now risen to 93, including 22 fatalities. Laboratory analysis has confirmed the presence of a new species of the virus in 9 of these cases. Four health care workers are among the fatalities. Five sub-counties of Bundibugyo District are affected with a total population of approximately 250,000.

So far, a total of 327 contacts have been identified. Tracing and follow-up of these contacts is being performed with the involvement of Village Health Teams and Community Medicine Distributors.

Specimens from suspected cases are being collected and referred for confirmation as part of intensive surveillance activities. Laboratory experts from the Centers for Disease Control and Prevention (CDC), Atlanta, are providing support to the Uganda Virus Research Institute in diagnosis and analysis of samples.

Isolation wards have been established at hospitals in Kikyo and Bundigugyo, and training provided for health care workers and auxiliary staff in appropriate triage and infection control measures. Teams are being trained in safe burial practices. Additional peer and social support is being offered to staff at the two hospitals.

Agencies in the field, including UNICEF, M&#233;decins Sans Fronti&#232;res and WHO, are providing support to the health authorities with logistics and provision of drugs and Personal Protection Equipment. The Ministry of Health and IFRC are conducting intensive social mobilization activities, including the use of radio broadcasts and mobile film vans to reach at-risk communities. Fact sheets, brochures and posters are also being distributed.

Ecological studies into the new species of Ebola that has been detected in this outbreak are also being planned.

WHO advises that there is no indication for restrictions on travel or trade with Uganda.

http://www.who.int/csr/don/2007_12_07/en/