Ebola in Uganda: November 30 - December 17, 2007

[sharon sanders]

Re: New Ebola Strain in Uganda May Be Spreading

<table border="0" cellpadding="4" cellspacing="0" width="480"><tbody><tr><td colspan="2" class="headline1">Ebola: Mbarara, Fort Portal put on high alert</td> </tr> <tr> <td>Sunday, 2nd December, 2007</td> <td align="right"> <!-- E-mail and Print Article -->
</td> </tr> <tr> <td colspan="2"> <table align="center"> <tbody><tr> <td align="center"> </td> </tr><tr> <td> Kabarole RDC Kakonge Kambarage addresses the district Ebola task force
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SIX more people have been confirmed infected with the deadly Ebola virus, health officials said yesterday. This puts the number of infected people at 58, sixteen of whom have died since the outbreak of the deadly disease in August.

The Commissioner for Health Services in the health ministry, Dr.six new cases were admitted at Bundibugyo Hospital after they attended the burial of an Ebola victim. Another two suspected cases were yesterday reported in Fort Portal. Sam Okware, said the

A 13-year-old school boy came from Kyenjojo district with the mother yesterday morning and was admitted to Virika hospital, according to the Kabarole district director of medical services, Dr. Joa Okech. The boy, who was only identified as Katusabe, was temporarily admitted to Virika, where he was resuscitated and transferred to Buhinga Hospital.

At Virika, the outpatient room was turned into an emergency ward to accommodate the boy. When the visited the ward, the door to the room bore a warning: �Do not enter unprotected�.
The second patient, a woman, also reported to Virika late afternoon, but she was sent to Buhinga hospital, according Dr. Musa Walakira, who is handling the cases. The woman�s identity could not be readily established.
�She was vomiting blood when she went to Virika, so they suspected Ebola and sent her to Buhinga Government Referral Hospital where an isolation centre has been set up.

Another suspected patient bled to death in Mbarara yesterday, Dr. Okware said.
He said ministry of health officials picked blood samples for testing. He said he had also instructed a quick burial of the body.
Meanwhile, the head of Nyahuka Health Centre 4 in Bundibugyo district, Dr. Richard Ssesanga Kaddu, his deputy Jonah Kule and two medical officers have been isolated after they complained that they felt unwell.

Okware, explained that Ssesanga was isolated at his home in Bundibugyo, while Kule who had traveled to Kampala, was put in the ministry�s isolation facility in the city.

He could not say whether Ssesanga, Kule, Kisughu, an enrolled nurse and Amon Kule, an ophthalmic officer, were infected with Ebola.

�We have taken specimen from them and it will be sometime before we can tell,� he said, before adding that the medical officers were improving steadily.
He lamented that there was a shortage of medical personnel in Bundibugyo, affecting the out-patients department most. �We need additional personnel to run the hospitals.�

Dr. Scot, a missionary, now heads the case management unit, while the two isolation units have each got seven personnel.

In Fort Portal, a district task force has been set up comprising the top district officials, medical personnel and some NGOs to handle the Ebola emergency.



In addition, two isolation centres have been set up, one at Buhinga in Fort-Portal town, the other at Bukuku, about 10km on Fort-Portal Bundibugyo road.

The RDC, Kakonge Kambarage, said they suspected that there could be more infected people who are still in the incubation period.

An official from the US Centre for Disease Control in Atlanta is set to collect samples from the patients in Fort-Portal today for testing.

The Minister of Defence, Dr. Crispus Kiyonga is also in Fort-Portal and Kasese to sensitise the population about the virus.

Kiyonga on Saturday asked local leaders to start public awareness campaigns.
�Once infected with Ebola, chances of survival are 50&#37;,� the former health minister told sub-county and town council leaders at Virina Gardens in Kasese town.

He advised that Ebola victims be buried in fluid-proof bags soon after they die. He asked the public to look out for such symptoms as headache, high fever, a rash, red eyes, bleeding, diarrhoea and vomiting.

Participants expressed fear that the virus could be incubating in Kasese and Kabarole among people who have been going Bundibugyo to bury their relatives since the disease outbreak in August.

Meanwhile, the UN Children�s Fund (UNICEF) has given sh45m to Bundibugyo district to fight the disease, the chief administrative officer, Elias Byamungu, said on Saturday. Byamungu said other agencies, including Oxfam, had agreed to offer more support.

Uganda was last hit by an Ebola epidemic in 2000, when 425 people caught it and just over half of them died, including Dr. Mathew Lukwiya. An outbreak in neighbouring Congo this year infected up to 264 people, killing 187.
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[Treyfish]

Re: New Ebola Strain in Uganda May Be Spreading

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New Strain of Ebola Virus Kills 16 People in Uganda, WHO Says

By Simeon Bennett
<!-- 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. 2 (Bloomberg) -- Ebola hemorrhagic fever has killed at least 16 people and may have infected another 35 in Uganda, the World Health Organization said.
An outbreak of the disease in the east African nation's Bundibugyo district may have infected 51 people, including three health-care workers, one of whom died, the WHO said in a statement on its Web site. Samples of the virus analyzed at the Centers for Disease Control and Prevention in Atlanta show the strain responsible for the outbreak is a ``new species'' of the virus, the WHO said.
The animal-borne virus killed 1,301 of the 1,880 people known to be infected between 1976, when the disease was first seen on the Sudan-Congo border, and 2005, during an outbreak in Congo. Ebola causes high fevers, diarrhea, vomiting and often leads to severe internal bleeding. The virus probably resides in animals in the rainforests of the African continent and in areas of the Western Pacific region, the WHO said.
The outbreak may have started in September, the WHO said in a Nov. 30 statement. Two more people have died of the virus, bringing the total death count to 18, Agence France-Presse reported today, citing Sam Zaramba, the nation's top government physician.
The disease, named after a river near where it was first recognized, is often passed from contact with contaminated blood or body fluids. Outbreaks have been found in Africa, where some diets include primates.
There's no treatment or vaccine for the disease

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http://www.bloomberg.com/apps/news?pid=20601202&sid=azF9yZOiE4hE&refer=healthcare

[Laidback Al]

Re: New Ebola Strain in Uganda May Be Spreading

General location of <?xml:namespace prefix = st1 ns = "urn:schemas-microsoft-com:office:smarttags" /><st1:country-region w:st="on">Uganda</st1:country-region> in Africa and a map showing the locations of the four Districts in western <st1:country-region w:st="on"><st1:place w:st="on">Uganda</st1:place></st1:country-region> where Ebola has been identified or suspected as noted in post #31 above. <?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" /><o:p></o:p>
Bundibugyo<o:p></o:p>
Kyenjojo<o:p></o:p>
Mbarara<o:p></o:p>
Karbarole (Virika and <st1:place w:st="on"><st1:PlaceType w:st="on">Fort</st1:PlaceType> <st1:PlaceName w:st="on">Portal</st1:PlaceName></st1:place>)<o:p></o:p>

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[HenryN]

Re: New Ebola Strain in Uganda May Be Spreading

Source: Xinhua News Agency
Date: 03 Dec 2007

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<!--toolbar--><!--firstLine-->Ebola death toll rises to 18 in Uganda


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KAMPALA, Dec3, 2007 (Xinhua via COMTEX) -- Two more people have died of the deadly Ebola virus in an outbreak in the Uganda's southwestern district of Bundibugyo, bringing the death toll to 18, an official from the Health Ministry has said.
Sam Okware, the commissioner for Health Services, told Xinhua by telephone on Monday that in one week, with six more new cases recorded, the number of infection has risen to 58.
"We have had two more deaths in the last 24 hours, and the disease continues to spread. The six people were infected from a burial. This is because some people have not avoided crowds. We have restricted people from shaking hands when greeting and should avoid congestion in taxis," Sam Zaramba, the director general of health services, was quoted by Daily Monitor on Monday.
"The main challenge we are facing is detecting cases and following up who among those made contact with the patients," Zaramba said.
The Ugandan government last week dispatched a team of health officials from the Ministry of Health headquarters in Kampala, with over 10 other international health experts, to reinforce rapid response capability in the troubled district.
Zaramba said that the government has so far created two isolation centers one in Bundibugyo Hospital and the other at Kikyo Health Center with at least seven trained staff at each.
"We advise people to instantly report Ebola cases for early treatment and people should not be close to each other. We have not gotten any new case at Kikyo. All the six have come from Bundibugyo only," he said.
It has emerged that the Ebola outbreak in the district has created a state of panic in the larger part of western Uganda. This has consequently paralyzed businesses and social activities in the neighboring districts of Kasese, Fort Portal, and Kabarole as residents choose to confine themselves in their homes.
Zaramba advised people to bury the dead immediately, avoid feasting at funerals, and keep funeral services short.
The ministry of health last Thursday confirmed that the " strange" disease that hit parts of Bundibugyo district since August as Ebola.
The disease is characterized by very high fever, diarrhoea, vomiting associated with red eyes and a measles-like rash. It is spread by close contact with the body fluids of infected persons or people who have died of it.
Ebola is one of the most virulent viral diseases known to mankind, causing death in 50 to 90 percent of all clinically ill cases.
The Ebola virus was first identified in a western equatorial province of Sudan and in a nearby region of Zaire (now the Democratic Republic of Congo) in 1976 after significant epidemics in Yambuku, northern Democratic Republic of Congo, and Nzara, southern Sudan.
According to World Health Organization, Ebola strain identified in western Uganda is "completely different" from the four known sub types of the heamorrhagic fever namely, Ebola Sudan, Ebola Zaire, Ebola Reston (that only affects monkeys) and Ebola Tai ( Ivory Coast).
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. An outbreak in neighboring Congo this year infected up to 264 people, killing 187.

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

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[HenryN]

Re: New Ebola Strain in Uganda May Be Spreading

Source: United Nations Office for the Coordination of Humanitarian Affairs - Integrated Regional Information Networks (IRIN)
Date: 03 Dec 2007

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<!--toolbar--><!--firstLine-->Uganda: Fears of Ebola spread as more cases reported


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KAMPALA, 3 December 2007 (IRIN) - Medical authorities in Uganda have expressed concern over the possible spread of the deadly Ebola disease in the western region after suspected cases were reported in two neighbouring districts.
Sam Zaramba, the director of medical services in the health ministry, told IRIN on 3 December that a patient with symptoms similar to those reported in Bundibugyo district, the epicentre of the outbreak, died on 2 December at Mbarara hospital, farther southwest, causing fears that the disease was spreading out of Bundibugyo.
Another suspected case had also been isolated at Virika hospital in Fort Portal district, next to Bundibugyo, Zaramba said.
"We are waiting for the results of the samples for the two suspected victims," he told IRIN by telephone.
Another medical official, who requested anonymity, said: "There is cause to worry when we start getting these cases overshooting and appearing in other areas because this complicates contact surveillance. One medical officer who worked on the first cases but moved to Kampala [the capital] to attend to personal issues has also fallen sick and was admitted to Mulago [the main hospital in Kampala]; we are trying to follow his contacts."
Several dozen medics and support staff have fled western Uganda after their co-workers became infected with the virus in an outbreak that has already killed 16 people and infected at least 58 others.
A government official in Bundibugyo, Samuel Kazinga, said a quarantine had been declared in all homes in the district that had registered a case in order to control contacts and ease monitoring.
"We are mobilising the public to take precautionary measures through public announcements on the radio and talking to people through community [leaders]," Kazinga said.
He said Bundibugyo had appealed for help but efforts to contain the outbreak, which began in September although it was only identified as Ebola last week, have been hampered by lack of medical personnel.
"We have a shortage of health workers and we need more because those who were there on the ground have been infected: two doctors, a medical officer and a nurse. We are trying to get more medical workers to go to the region and help in the fight," said Zaramba.
Zaramba had initially said two more patients succumbed to the virus on 1 December, bringing the toll to 18. But the health ministry on 3 December revised the number back to 16, saying the two deaths had since been confirmed as due to other causes.
"Cumulatively, we now have 16 deaths and 58 cases," he said.
Patients were quarantined in Bundibugyo hospital's isolation ward near the border with the Democratic Republic of Congo (DRC), which has had outbreaks of the virulent disease in the past.
"Those admitted are mainly health workers and those who attended to the patients," Zaramba said.
Previous Ebola fatalities among medical workers have been blamed on poor sanitation and hygiene in health centres that lack protective suits, masks, latex gloves and other equipment.
Ebola spreads through body fluids, particularly blood, putting health workers without protective gear at risk. Ebola sub-types usually attack capillaries and blood vessel linings, so patients lose blood rapidly, and die of shock, doctors say.
The new Uganda subtype kills patients by provoking high fever, but without much loss of blood. There is no vaccine or cure for Ebola.
"The situation is not yet under control," Zaramba said. "The main challenge we are facing is detecting cases and following up on those who had contact with the patients."
A team of epidemiologists and virologists arrived in the region on 1 December to try to retrace the source of the virus as part of a campaign to avoid future epidemics.
Authorities said a team of pathogen experts from the Centers for Disease Control in the US were expected in the country on 4 December to beef up the local response to the disease, including bringing laboratory facilities to detect infections more easily.
An outbreak killed at least 170 people in Uganda's northern Gulu district in 2000. Another recent outbreak killed at least 26 people in DRC's West Kasai region.
The Ebola virus was first identified in 1976 in Sudan and in a nearby region of DRC, then Zaire. Outbreaks of Ebola have also occurred in the Ivory Coast and Gabon.
vm/mw
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A selection of IRIN reports are posted on ReliefWeb. Find more IRIN news and analysis at http://www.irinnews.org
Une s?lection d'articles d'IRIN sont publi?s sur ReliefWeb. Trouvez d'autres articles et analyses d'IRIN sur http://www.irinnews.org
This article does not necessarily reflect the views of the United Nations or its agencies. Refer to the IRIN copyright page for conditions of use.
Cet article ne refl?te pas n?cessairement les vues des Nations Unies. Voir IRIN droits d'auteur pour les conditions d'utilisation.

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http://www.reliefweb.int/rw/RWB.NSF/db900SID/LRON-79JKF6?OpenDocument

[scottmcpherson]

Re: New Ebola Strain in Uganda May Be Spreading

Dr. Niman,
If you are finding multiple genetic points of similarity between Ebola and H5 avian influenza, is there a concern that Ebola may be able to recombine and present an airborne face?

[HenryN]

Re: New Ebola Strain in Uganda May Be Spreading

Dr. Niman,
If you are finding multiple genetic points of similarity between Ebola and H5 avian influenza, is there a concern that Ebola may be able to recombine and present an airborne face?

There are not many Ebola sequences available. The 18 BP match has been present for some time (it was in the first H5N1, isolates in 1959) as well as the original Zaire sequence (from 1976).

Sequences from the recent outbreak have not yet been released.

[HenryN]

Re: New Ebola Strain in Uganda May Be Spreading

<TABLE id=topTools cellSpacing=0 cellPadding=0 border=0><TBODY><TR><TD>Ebola death toll rises to 19 in Uganda</TD></TR></TBODY></TABLE>
KAMPALA, Uganda (AP) ? Three more people have died from a new strain of the Ebola virus in Uganda, bringing the death toll to 19, health officials said Monday. Health workers in the area were fleeing in fear.
The disease has now been detected in five districts in western Uganda, said Dr. Sam Zaramba, director general of Uganda's health service.
The first case was reported on Nov. 10 in Bundibugyo district, on the Congolese border and about 200 miles west of the Ugandan capital, Kampala.
Simon Atuhe, a local official in Bundibugyo, said health workers were abandoning their jobs in fear.
"There is a shortage of manpower because some health workers have fled," he said. "We are in a crisis."

Tests conducted on some of the samples by a national lab in Uganda and confirmed by the U.S. Centers for Disease Control and Prevention indicate that the virus belongs to a different subtype than the four already known, the World Health Organization said.
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.
The last previous outbreak of Ebola in Uganda occurred in October 2000 when 173 people died and a total of 426 people were diagnosed with it in the north of the country.
WHO says more than 1,000 people have died of Ebola since the virus was first identified in 1976 in Sudan and Congo. Primates, hunted by many central Africans for food, can carry the virus.

http://usatoday.printthis.clickability.com/pt/cpt?action=cpt&title=Ebola+death+toll+rises+to+19+in+Uganda+-+USATODAY.com&expire=&urlID=25226076&fb=Y&url=http%3A%2F%2Fwww.usatoday.com%2Fnews%2Fworld%2F2007-12-03-uganda-ebola-deaths_N.htm&partnerID=1660

[mordan]

Re: New Ebola Strain in Uganda May Be Spreading

Interesting

http://www.paradoxuganda.blogspot.com/

[hawkeye]

Re: New Ebola Strain in Uganda May Be Spreading

News source in Cuba reporting 20

Ebola Virus Kills 20 in Uganda

Kampala, Dec 03 (Prensa Latina) A new variant of Ebola virus is hitting the Uganda population with about 20 deaths and 50 new cases reported in the last few hours, noted sources from the Health Ministry

Uganda's director of medical services Sam Zaramba said that the epidemic outbreak appeared first in Bundibugyo region, bordering with Congo Democratic Republic.

Zaramba noted that measures have been taken to isolate the locality and keep sick people in quarantine.

The genetic analysis of the victims revealed that it is a new type of virus, asserted the official.

This haemorrhagic fever is incurable until now and is lethal in 80 percent of the cases.

The disease is transmitted by contact with sick people's fluid or infected animals.

The symptoms are visible bleeding, fever, diarrhoea containing blood, muscle pain and sickness.

hr abo arc mf

[Niko]

Re: New Ebola Strain in Uganda May Be Spreading

Interesting

http://www.paradoxuganda.blogspot.com/

What a great find. Thank you mordan!

[HenryN]

Re: New Ebola Strain in Uganda May Be Spreading

Interesting

http://www.paradoxuganda.blogspot.com/

Running log on admissions:

Monday:

16 admissions at BGO hospital, still 8 in Kikyo

Sunday:

Admitted at Bundibugyo: 15, including Dr. Sessanga whose sister just came to our house looking for Scott because he’s no longer responsive; the matron (head nurse); the nurse who was working in the isolation unit Fred; a clinical officer named Joshua Kule; and an ophthalmic assistant. Among the other patients are six direct contacts (mother, brother, wife, daughter and two friends) of Muhindo Jeremiah who died just over a week ago.

Admitted at Kikyo: 8 as of yesterday, haven’t heard today.

[sharon sanders]

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

Thanks Mordan - very interesting.

[HenryN]

Re: New Ebola Strain in Uganda May Be Spreading

Running log on admissions:

Monday:

16 admissions at BGO hospital, still 8 in Kikyo

Sunday:

Admitted at Bundibugyo: 15, including Dr. Sessanga whose sister just came to our house looking for Scott because he?s no longer responsive; the matron (head nurse); the nurse who was working in the isolation unit Fred; a clinical officer named Joshua Kule; and an ophthalmic assistant. Among the other patients are six direct contacts (mother, brother, wife, daughter and two friends) of Muhindo Jeremiah who died just over a week ago.

Admitted at Kikyo: 8 as of yesterday, haven?t heard today.

Monday night:

The official case count has gone up from 51 to 79 since the initial numbers were released four days ago. We now have 21 admitted in Bundibugyo (up from 16 yesterday) while only one more patient came to Kikyo (10 total).

[HenryN]

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

The MSF team is impressive and fascinating, they are tracking numbers and plotting maps and have already concluded from interviews that besides patient care in the hospital, the greatest risk factor is the handling of dead bodies at burial.

http://paradoxuganda.blogspot.com/2007/12/ebola-in-bundibugyo-monday-night-still.html