Ebola in Uganda: November 30 - December 17, 2007

[HenryN]

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

Ebola spreads in western Uganda: officials

32 minutes ago
KAMPALA (AFP) ? Three people with suspected Ebola were Monday admitted to hospital in western Uganda, where the virus has killed 18 people and is spreading from village to village, government officials said.
"Three cases were admitted today, bringing the total to 64," said Samuel Kazinga, the district commissioner for Bundibugyo, the epicentre of the new outbreak.
With experts from the Atlanta-based Centre for Disease Control (CDC) expected on Tuesday, efforts to isolate and intern patients in Bundibugyo, near the Democratic Republic of Congo (DRC), appeared to suffer setbacks.
"Some people refuse to come of their home to seek treatment, but our social mobilisation team is trying to convince them to come out," Kazinga said, describing the phenomenon as "psychological."
Meanwhile, a patient who had been isolated in neighbouring Port Portale district died, but his sample -- alongside with another of patient who died in the southern Mbarara region -- were still lying in Uganda Virus Research Institute awaiting screening.
A health ministry official said more pathogen experts were expected later this week.
"By Thursday, we shall have 30 international health experts on the ground and by the end of the week, we expect more experienced Ugandan doctors there," said the official.
Spread primarily by blood contact, Ebola was identified last week by the CDC pathogen branch after simmering unnoticed in the impoverished region since September.
The World Health Organisation said the new outbreak was a previously unknown strain that provokes high fever before killing its victims without much blood haemorrhage.
This is unlike the known Ebola subtypes, which rupture blood vessels, killing their patients in shock after non-stop bleeding through body orifices, doctors said.
The disease killed at least 170 people in northern Uganda in 2000.
The Ebola virus has remained rare and mystifying since it was first discovered in DR Congo and Sudan in 1976 and other outbreaks have since hit Ivory Coast and Gabon.
Experts have said the disease, which strikes with an initial ferocity but fades away in months, is usually containable because it kills its victims faster that it can spread to new ones.

http://afp.google.com/article/ALeqM5gkG0Me4fDvwY6NWX96Poab29jrPw

[hawkeye]

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

official numbers of infected seem to be lower than those in the blog.

[Gert van der Hoek]

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

Source: The Monitor-Uganda

Date: 03 Dec 2007

Uganda: Mulago gets Ebola case

TABU BUTAGIRA, HUSSEIN BOGERE & JOSEPH MUGISHA

Experts believe infection originated from dead goat

KAMPALA/BUNDIBUGYO - UGANDA's main referral hospital, Mulago has received its first Ebola patient since the deadly viral disease broke out in Bundibugyo District in August.

Dr Yonah Kule, an employee of the International Air Ambulance (IAA), who contracted the highly communicable hemorrhagic fever while treating patients at Bundibugyo hospital last week, was admitted at Mulago at the weekend.

"Yes, he (Kule) is in our isolation unit and he is fair now," Dr Edward Ddumba, the director of Mulago hospital told Daily Monitor yesterday; disapproving local press reports - a day earlier - that the infected medic had been secluded in a room at the Ministry of Health headquarters.

Dr Ddumba said precautionary measures had been taken by placing the doctor in an "Isolation Unit" so that he would not get in contact with other people. The virus has so far killed 18 people, with six more new cases recorded and some medical workers placed under quarantine.

In one week, the rate of infection has risen to 58, an increment attributed to free human movement and people's ignorance of the disease since September.

Most staff and patients at Mulago were unaware of an Ebola case in their midst although Dr Ddumba said they had prepared for any eventuality.

"We have sufficient capacity to handle that (Ebola emergencies)," he said by telephone. But in Bundibugyo, the epicenter of the contagion, under-resourced and overstretched health workers at the district hospital and Kikyo health centre IV were grappling with the increasing number of Ebola cases.

Dr Sam Zaramba, the commissioner for health services said that by 1:30pm yesterday, the cumulative number of Ebola infections registered since August had risen to 62 while deaths from the epidemic had remained at 16.

But a source within the ministry said the number of fatalities, including those in communities that are not recorded at health units was 31 and that epidemiologists had so far confirmed 62 out of 80 suspected Ebola cases as positive.

Bundibugyo RDC Samuel Kazinga, who heads the district Ebola Taskforce, said yesterday eight health workers - two doctors and six senior clinical officers - had contracted Ebola, causing acute shortage of medical personnel, especially for other general medical services since medics available are pre-occupied with managing Ebola cases.

However, seven doctors from international bodies like WHO, Unicef, Afrinet and MSF-France were reported to have arrived in Bundibugyo to strengthen the teams there.

Yesterday, the African Field Epidemiology Network Scientists (Afenet) meeting at the second scientific conference in Kampala announced that they were dispatching a team of experts to the Ebola trouble spots but did not specify the number.

"We intend to keep our team there for about two weeks for a start," said Dr David Makanga, the executive director adding, "But this will depend on the situation on the ground. They could even stay longer".

And the UPDF last Thursday sent a medical team to Bundibugyo to bolster the response operations.

The Defence and Army Spokesman, Maj. Felix Kulayigye, said yesterday the team headed by Col. Apollo Musinguzi, the director of Public Health in the army comprises of doctors and nurses.

However, one of the army medics is said to be down with Ebola.

Eighty expatriates, seconded by various global institutions and foundations are expected to arrive in the country this week to trace the details of the unique Ebola strain, Dr Zaramba said yesterday.

No sex

Dr Zaramba cautioned that apart from coming into contact with infected people, infected people should refrain from having sex for their own safety.

"We encourage those (people) who have got symptoms of Ebola, not to engage in sex and if they have to, they must use condoms and we are sending more condoms to Bundibugyo," he said.

Health experts say the incubation period for Ebola virus ranges from two to 21 days, depending on the strain and this could mean that it is only safer for people living in affected regions not to have unprotected sex since infected persons, may in the early days of infection, not show the known Ebola symptoms of measles-like body rash, high fever, red eye, vomiting and bleeding through body orifices.

Goat origin

Dr Zaramba said a group of epidemiologists who have pitched camp in Bundibugyo are investigating clues that the first person to contract Ebola in the district or index case as is called in medical jargons, consumed meat of a dead goat and conclusive findings of this inquiry are not expected to be ready immediately due to strict onerous laboratory test rules.

"It is true the index case ate a dead goat but we do not know what killed the goat," Dr Zaramba said. "The suspicion is that the goat could have been bitten by a Columbus Monkey or other such wild animals".

It emerged yesterday that frightened urban dwellers in Bundibugyo town many of who do not have palm gloves, have stopped receiving bank notes for fear of contracting Ebola.

http://www.reliefweb.int/rw/RWB.NSF/db900SID/EMAE-79JRRE?OpenDocument

[Gert van der Hoek]

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

Ebola strikes more nurses

Monday, 3rd December, 2007


By Vision Reporters

THIRTEEN-YEAR-OLD Katusabe from Kyenjojo district, who had been admitted at Virika Hospital in Fort Portal with suspected Ebola, died yesterday afternoon. If confirmed, his demise would bring to 17 the number of people who have died since the outbreak of the epidemic in August.

The team, that visited Bundibugyo Hospital yesterday, also learnt that four more medical workers were suspected to be infected.

They were among the nine patients treated at one of the two isolation units in the hospital. All of them were health workers, including the matron, Peluce Tabiita, and a nursing assistant of the UPDF, Pte Fred Lubwama.

The unit, formerly an anti-natal ward, seen by The New Vision, was poorly equipped and understaffed. There was only one male nurse, who was wearing gloves and a mask, but no protective over-all.

The doors were not locked and there was no sign that this was an isolation ward. About five attendants walked in and out, some were wearing either gloves or masks, while others were not protected at all.

One attendant, dressed in white, was touching a patient with her bare hands, as if she was not aware of the danger.
No doctors were seen at the hospital. The super-intendent was still admitted in a private wing of the hospital. His condition was said to have improved.

Though foreign experts were reported to have come in to help with the treatment, none were seen by The New Vision team at Bundibugyo Hospital. Contrary to findings by The New Vision, the Ministry of Health said only six new cases of Ebola had been reported over the last week, including one health worker.

?All the other six health care workers who had been put under quarantine because of Ebola-related complaints are still under observation,? said a statement by Dr. Sam Zaramba, the Director General of Health Services.

According to Zaramba, experts from the World Health Organisation, Medecins sans Frontieres and the Centres for Disease Control had arrived in the country to help with laboratory diagnosis, case research and management.

A permanent laboratory will be set up this week at the Uganda Virus Research Institute Entebbe to speed up the diagnosis of Ebola and other viral haemorrhagic fevers, while equipment for the laboratory is expected to arrive today, the statement added. Currently, samples have to be taken to South Africa or the Centres for Disease Control in Atlanta, USA.

Meanwhile, the UPDF has deployed a team of medical officers and health educators to Bundibugyo. They will assist in the management of Ebola patients and sensitising the public.

UPDF 2nd Division spokesperson, Lt. Tabaro Kiconco, said more personnel from the UPDF Medical Department would be deployed in Bundibugyo today, while emergency supplies would be delivered to Kabarole.

No new cases have been reported in Kabarole. Two patients with Ebola symptoms have so far been admitted in Buhinga Hospital in Fort-Portal, of which one died.

Following the Ebola outbreak, the five districts of the Rwenzori region have postponed their joint education week celebrations, which were slated to start today in Kasese.

Other reports from Bundibugyo say elders have resorted to consulting their oracles and sacrificing to their ancestors to appease the gods.

http://www.newvision.co.ug/D/8/12/600344

[HenryN]

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

Source: The Monitor-Uganda

Date: 03 Dec 2007



Dr Yonah Kule, an employee of the International Air Ambulance (IAA), who contracted the highly communicable hemorrhagic fever while treating patients at Bundibugyo hospital last week, was admitted at Mulago at the weekend.

"Yes, he (Kule) is in our isolation unit and he is fair now," Dr Edward Ddumba, the director of Mulago hospital told Daily Monitor yesterday; disapproving local press reports - a day earlier - that the infected medic had been secluded in a room at the Ministry of Health headquarters.

Dr Ddumba said precautionary measures had been taken by placing the doctor in an "Isolation Unit" so that he would not get in contact with other people. The virus has so far killed 18 people, with six more new cases recorded and some medical workers placed under quarantine.

http://www.reliefweb.int/rw/RWB.NSF/...E?OpenDocument

I just got off the phone with Dr. Jonah. He had gone to Kampala on personal business a few days ago. Yesterday he had a headache, and today a bit of fever, so he admitted himself to Mulago Hospital’s isolation ward. We are hoping that his illness is not related, but I think he was wise to put himself there, so that he does not infect others.

http://paradoxuganda.blogspot.com/2007/11/update-friday-mid-day.html

[vinny]

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

what are the chances of this getting out of africa and becoming a problem for all of us..........?

[sharon sanders]

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

Journal of Virology, June 2007, p. 6379-6388, Vol. 81, No. 12
0022-538X/07/$08.00+0 doi:10.1128/JVI.00105-07
Copyright © 2007, American Society for Microbiology. All Rights Reserved.
Successful Topical Respiratory Tract Immunization of Primates against Ebola Virus

Alexander Bukreyev,¹^* Pierre E. Rollin,² Mallory K. Tate,² Lijuan Yang,¹ Sherif R. Zaki,² Wun-Ju Shieh,² Brian R. Murphy,¹ Peter L. Collins,¹ and Anthony Sanchez² Laboratory of Infectious Disease, National Institute of Allergy and Infectious Diseases, National Institutes of Health, 50 South Dr., Bethesda, Maryland 20892,¹ Special Pathogens Branch, Division of Viral and Rickettsial Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road MS G-14, Atlanta, Georgia 30329²
Received 16 January 2007/ Accepted 26 March 2007
<!-- ABS --> Ebola virus causes outbreaks of severe viral hemorrhagic feverwith high mortality in humans. The virus is highly contagiousand can be transmitted by contact and by the aerosol route.



Therefore, a vaccine that induces bothsystemic and local immune responses in the respiratory tractwould be highly beneficial. We evaluated a common pediatricrespiratory pathogen, human parainfluenza virus type 3 (HPIV3),as a vaccine vector against Ebola virus.



HPIV3 recombinantsexpressing the Ebola virus (Zaire species) surface glycoprotein(GP) alone or in combination with the nucleocapsid protein NPor with the cytokine adjuvant granulocyte-macrophage colony-stimulatingfactor were administered by the respiratory route to rhesusmonkeys—in which HPIV3 infection is mild and asymptomatic—andwere evaluated for immunogenicity and protective efficacy againsta highly lethal intraperitoneal challenge with Ebola virus.

A single immunization with any construct expressing GP was moderatelyimmunogenic against Ebola virus and protected 88&#37; of the animalsagainst severe hemorrhagic fever and death caused by Ebola virus.Two doses were highly immunogenic, and all of the animals survivedchallenge and were free of signs of disease and of detectableEbola virus challenge virus. These data illustrate the feasibilityof immunization via the respiratory tract against the hemorrhagicfever caused by Ebola virus. To our knowledge, this is the firststudy in which topical immunization through respiratory tractachieved prevention of a viral hemorrhagic fever infection ina primate model.

<hr align="left" width="50%"><!-- null --> * Corresponding author. Mailing address: Building 50, Room 6505, NIAID, NIH, 50 South Dr. MSC 8007, Bethesda, MD 20892-8007. Phone: (301) 594-1854. Fax: (301) 496-8312. E-mail: AB176v@nih.gov <!-- null --> Published ahead of print on 11 April 2007.<script type="text/javascript"><!-- var u = "AB176v", d = "nih.gov"; document.getElementById("em0").innerHTML = '<a href="mailto:' + u + '@' + d + '">' + u + '@' + d + '<\/a>'//--></script> <!-- FN -->

[Treyfish]

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

Uganda: Country Moves Ebola Patient to Capital

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The Nation (Nairobi)
4 December 2007
Posted to the web 3 December 2007
Tabu Butagira
Kampala
Uganda's main referral hospital, Mulago has received its first Ebola patient since the deadly virus broke out in the country's southwestern district of Bundibugyo.
Dr Yonah Kule, an employee of the International Air Ambulance (IAA) who contracted the highly communicable haemorrhagic fever while treating patients at Bundibugyo hospital last week, was admitted to the top most government medical centre in Kampala at the weekend.

<TABLE cellSpacing=0 cellPadding=5 align=right border=0><TBODY><TR><TD align=right><!-- Display Google AdManager Ad for 'AllAfrica_Story_Inset'--><SCRIPT language=JavaScript> GA_googleFillSlot("AllAfrica_Story_Inset");</SCRIPT><SCRIPT src="http://partner.googleadservices.com/gampad/ads?correlator=1196727081937&output=json_html&call back=_GA_googleAdEngine.setAdContentsBySlotForSync &impl=s&prev_afc=0&client=ca-pub-2420009840005975&slotname=AllAfrica_Story_Inset&pa ge_slots=AllAfrica_Story_BannerBottom%2CAllAfrica_ Story_BannerMid%2CAllAfrica_Story_BannerSubbody%2C AllAfrica_Story_Inset%2CAllAfrica_Story_Leaderboar d%2CAllAfrica_Story_LeftA%2CAllAfrica_Story_LeftB% 2CAllAfrica_Story_RightA%2CAllAfrica_Story_RightB% 2CAllAfrica_Story_RightC&cust_params=language%3Den glish%26Topics%3Dhealth%26Countries%3Deastafrica%2 52Cuganda&cookie=ID%3Dbe1f03850f55c79a%3AT%3D11936 07090%3AS%3DALNI_Mb2u1szov4SzPzfRy65R8q54nxoAg&ga_ vid=1289186491.1188621188&ga_sid=1196727088&ga_hid =33584360&ga_fc=true&url=http%3A%2F%2Fallafrica.co m%2Fstories%2F200712032204.html&ref=&lmt=119672319 3&dt=1196727087625&cc=49&u_h=600&u_w=800&u_ah=600& u_aw=800&u_cd=24&u_tz=-300&u_his=0&u_java=true&u_nplug=0&u_nmime=0"></SCRIPT><SCRIPT type=text/javascript><!--google_ad_client = "pub-2420009840005975";google_ad_width = 160;google_ad_height = 90;google_ad_format = "160x90_0ads_al_s";//2007-11-16: Link Unit (5) 160x90google_color_border = "000000";google_color_bg = "F0F0F0";google_color_link = "0000FF";google_color_text = "000000";google_color_url = "008000";//--></SCRIPT><SCRIPT src="http://pagead2.googlesyndication.com/pagead/show_ads.js" type=text/javascript></SCRIPT>
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"Yes, he (Kule) is in our isolation unit and he is fair now," Dr Edward Ddumba, the director of Mulago hospital told Daily Monitor yesterday; disapproving local press reports - a day earlier - that the infected medic had been secluded in a room at the ministry of health headquarters.
Asked if the admission of Dr Kule to Mulago, which is always brimming with In and Out-patients patients would not result in possible cross infections, Dr Ddumba said precautionary measures had been taken by placing the doctor in an "Isolation Unit" so that he would not get in contact with other people.
The deadly virus has so far killed 18 people, with six more new cases recorded and four medical workers placed under quarantine.
In one week, the rate of infection has risen to 58, an increment attributed to free human movement and people's ignorance of the disease since September, this year.
As it turned out yesterday, most staff and patients at Mulago were unaware of an Ebola case in their midst although Dr Ddumba said they had prepared for any eventuality.
Sufficient capacity
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"We have sufficient capacity to handle that (Ebola emergencies)," he said by telephone.
But in Bundibugyo, the epicentre of the contagion, under-resourced and overstretched health workers at the district hospital and Kikyo health centre IV were grappling with the increasing number of Ebola cases.
Dr Sam Zaramba, the commissioner for health services in the ministry of health said that by 1:30 pm yesterday, the cumulative number of Ebola infections registered at health facilities since August had risen to 62 while deaths from the epidemic had stagnated at 18. But a source within the ministry said the number of fatalities, including those in communities was 31. http://allafrica.com/stories/200712032204.html

[hawkeye]

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

Ebola Kills 19 Ugandans


Article Tools Sponsored By
By THE ASSOCIATED PRESS
Published: December 4, 2007

KAMPALA, Uganda, Dec. 3 (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.

Officials said health workers in the area were fleeing their jobs.

The disease has been detected in five districts in western Uganda, said Dr. Sam Zaramba, director general of Uganda?s health service.

Tests showed the virus belongs to a different subtype than the four already known, the World Health Organization said.

[hawkeye]

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

Uganda gets Ebola testing laboratory


APA-Kampala (Uganda) Uganda?s Ministry of Health has secured a laboratory to be used in the diagnosis of Ebola and other viral hemorrhagic fevers in the country.

The procurement of the laboratory comes in the wake of a new Ebola outbreak in the western Uganda district of Bundibugyo bordering the Democratic Republic of Congo (DRC).

So far 16 people have been killed in the Ebola epidemic and about 60 are being treated for the disease.

In a statement released on Monday evening, the director general of Health Services, Dr. Sam Zaramba, said the laboratory equipment was donated by the United States Centers for Disease Control.

He said that the equipment that arrives in the country on Tuesday will be set up at the Uganda Virus Research Institute in Entebbe.

All tests for viral fevers have in the past been done in South Africa and in the United States.

Dr. Alex Opio, the acting chairperson of the National Task Force against Epidemics, said the Ministry of Health may open more Ebola isolation units in the country if the need arises over the next few days.

He however said the epidemic is under control and only six new cases have been reported.

He said six health workers who were quarantined after displaying Ebola-like symptoms are being held for observation.

The Ebola hemorrhagic fever is a potentially lethal disease that manifests as fever, vomiting, diarrhoea, general pain and sometimes internal and external bleeding.

According to the Centers for Disease Control, mortality rates are extremely high, with fatality rates ranging between 50 and 89 percent.

The Ebola virus first emerged in 1976 in simultaneous outbreaks in the Sudan and DRC.

Scientists believe a new strain of Ebola has been identified in Uganda in the Bundibugyo outbreak because it does not match any of the four Ebola subtypes previously identified by scientists.

JM/pm/APA
03-12-2007

[hawkeye]

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

Posted on: Monday, 3 December 2007, 06:00 CST
Two More Ugandan Towns Put on Ebola Alert

Excerpt from report by Anne Mugisa, John Thawite, Matthias Mugisha and Bizimungu Kisakye entitled "Ebola: Mbarara, Fort Portal put on high alert" published by Ugandan newspaper The New Vision website on 3 December

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 Sam Okware, said the 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. [Passage omitted]

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 10 km on Fort-Portal Bundibugyo road.

The RDC [resident district commissioner], 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 sensitize the population about the virus.

Kiyonga on Saturday [1 December] asked local leaders to start public awareness campaigns. "Once infected with Ebola, chances of survival are 50 per cent," 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 45m shillings 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 DRCongo this year infected up to 264 people, killing 187.

Originally published by The New Vision website, Kampala, in English 3 Dec 07.

[HenryN]

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

EBOLA HEMORRHAGIC FEVER - UGANDA (04): (BUNDIBUGYO)
***********************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: Mon 3 Dec 2007
Source: AllAfrica.com, UN Integrated Regional Information Networks
(IRIN) [edited]
<http://allafrica.com/stories/200712031382.html>


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 2 neighbouring districts. Sam
Zaramba, the director of medical services in the health ministry,
told IRIN on Mon 3 Dec 2007 that a patient with symptoms similar to
those reported in Bundibugyo district, the epicentre of the outbreak,
died on Sun 2 Dec 2007 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 2 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 1st 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 2007, 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: 2
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 2 more patients succumbed to the virus on
Sat 1 Dec 2007, bringing the toll to 18. But the health ministry on
Mon 3 Dec 2007 revised the number back to 16, saying the 2 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 Sat 1 Dec 2007 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 Tue 4 Dec 2007 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 1st 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.

--
Communicated by:
ProMED-mail <promed@promedmail.org>

[The significant new feature of this most recent report is that the
death toll in the outbreak has been reduced from 18 back to 16 -- the
2 most recent cases having failed to be confirmed. The number of
confirmed cases has been revised down to 58.

Dr C.H. Calisher has raised the interesting question of the taxonomic
status of the virus responsible for this new outbreak. Preliminary
reports have suggested that the outbreak virus is significantly
different from previously isolated Ebola viruses. Should the current
Uganda virus be designated a new strain, a new subtype or a new virus
species? Some guidance from those involved in determination of the
genome sequence of this new Ebola virus would be appreciated. - Mod.CP]

[see also:
Ebola hemorrhagic fever - Uganda (03): (Bundibugyo) 20071202.3885
Hemorrhagic fever - Uganda (04): (Bundibugyo), Ebola confirmed 20071130.3859
Hemorrhagic fever - Uganda (03): (Bundibugyo) 20071121.3775
Hemorrhagic fever - Uganda (02): (Bundibugyo), Marburg NOT 20071116.3718
Hemorrhagic fever - Uganda (Bundibugyo): Marburg susp., RFI 20071114.3697
Marburg hemorrhagic fever - Uganda (06): new case 20071002.3257
Marburg hemorrhagic fever - Uganda (05) 20070817.2697
Marburg hemorrhagic fever - Uganda (04), WHO 20070814.2656
Marburg hemorrhagic fever - Uganda (03) 20070810.2609
Marburg hemorrhagic fever - Uganda (02) 20070804.2533
Marburg hemorrhagic fever - Uganda 20070803.2514
Viral hemorrhagic fever - Uganda (Kamwenge): Marburg conf. 20070801.2490
Viral hemorrhagic fever - Uganda (Kamwenge): Marburg susp., RFI 20070801.2475
2001
----
Ebola hemorrhagic fever - Uganda: postscript 20011019.2576]
..................................cp/msp/mpp

[HenryN]

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

Uganda says suspected Ebola cases rise to 75

Tue 4 Dec 2007, 13:22 GMT
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By Tim Cocks
KAMPALA (Reuters) - At least 75 Ugandans are now suspected to have contracted a previously unknown strain of the lethal Ebola virus, although the death toll in the east African country remains at 18, an officials said on Tuesday.
Uganda confirmed on Sunday it had 58 cases. The extra infections included medical staff looking after Ebola patients, deputy health minister Dr. Emmanuel Otaala said.
"Since the outbreak started back in August, we have registered 75 suspected cases," he told reporters.
Otaala said all patients were in Uganda's western Bundibugyo district, bordering Democratic Republic of Congo, except one nurse being treated in the Ugandan capital Kampala, after contracting it in Bundibugyo before heading out.
Otaala denied claims in the local press that the government knew of the Ebola outbreak but concealed it to avoid putting off the 53 heads of government and thousands of delegates who arrived in Kampala 11 days ago for a Commonwealth summit.
Britain's Queen Elizabeth II, who heads the group of mostly former British colonies, was among the leaders at the Commonwealth Heads of Government Meeting (CHOGM).
The government announced the outbreak four days after the summit ended, fuelling speculation of a cover-up.
"We did not keep quiet after learning that we were dealing with Ebola. The medical fraternity would not go to the expense of leaving people to die...because we are hosting CHOGM," Otaala said.
Genetic analysis of samples taken from some victims shows this virus is a previously unrecorded type of Ebola, making it the fifth strain, U.S. and Ugandan health officials say.
The World Health Organisation says it is concerned about the way the virus keeps mutating.
Ebola -- known to infect humans, chimpanzees and gorillas -- causes symptoms including fever, vomiting, diarrhoea and bleeding through various orifices.
Victims often die of blood loss, but the fever and dehydration can also kill. Otaala said this strain was less lethal than previous ones identified, which normally kill 50 to 90 percent of those infected.
"We have so far registered 18 deaths ... this is a 25 percent (death rate). That means we are dealing with a milder form of Ebola," he said.
Uganda was last hit by an epidemic of Ebola in 2000, when 425 people caught it and just over half died.
This year, an outbreak in Congo -- where some of the first recorded cases in 1976 gave the virus its name after the country's Ebola river -- infected up to 264 people, killing 187.

http://africa.reuters.com/wire/news/usnL04719213.html

[HenryN]

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

http://paradoxuganda.blogspot.com/2007/12/ebola-in-bundibugyo-tues-day-6.html

Jonah: still with fever, not terribly high, still with diarrhea, no bleeding, up and talking and walking and drinking in Mulago Isolation unit. Day 5 of illness.
Sessanga: Refused to unlock door for Scott to enter his house this morning, but answered the phone. Diarrha and vomiting better, but complaining of headache.
BGO Isolation ward: one death this morning 5 am, another contact of Jeremiah Muhindo, who seems to have been very infectious. 2 new admissions, so total caseload 22. Scott says they are finally getting up the mesh fence and controlling the access a bit better.
Kikyo: no news yet today.
The rest of Uganda: Panic mode.

[tropical]

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

what are the chances of this getting out of africa and becoming a problem for all of us..........?

Quote:
<TABLE cellSpacing=0 cellPadding=6 width="100&#37;" border=0><TBODY><TR><TD class=alt2 style="BORDER-RIGHT: 1px inset; BORDER-TOP: 1px inset; BORDER-LEFT: 1px inset; BORDER-BOTTOM: 1px inset">Originally Posted by scottmcpherson
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?



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

Dr. Niman answered, but the CDC scientific text nominate "aerosol route".
Aerosol means not airborne, but stil:
from the scientific text, Ebola seems airborne faced ?

The propagation (if starting in September) seems it is not.

If we will see near country sanitar border closures, and denying airplain flyings from the source country, than it have the potential to getting out of Africa.

_____
"Re: New Ebola Strain in Uganda Spreading - Death toll rising
<HR style="COLOR: #cccccc" SIZE=1><!-- / icon and title --><!-- message -->Journal of Virology, June 2007, p. 6379-6388, Vol. 81, No. 12

0022-538X/07/$08.00+0 doi:10.1128/JVI.00105-07
Copyright &#169; 2007, American Society for Microbiology. All Rights Reserved.
Successful Topical Respiratory Tract Immunization of Primates against Ebola<SUP></SUP> Virus
... Bethesda, Maryland 20892,<SUP>1</SUP> Special Pathogens Branch, Division of Viral and Rickettsial Diseases, Centers for Disease Control and Prevention, ...
Received 16 January 2007/ Accepted 26 March 2007

<!-- ABS -->Ebola virus causes outbreaks of severe viral hemorrhagic fever<SUP> </SUP>with high mortality in humans. The virus is highly contagious<SUP> </SUP>and
can be transmitted by contact and by the aerosol route.<SUP> </SUP>
...
We evaluated a common pediatric<SUP> </SUP>respiratory pathogen, human parainfluenza virus type 3 (HPIV3),<SUP> </SUP>as a vaccine vector against Ebola virus. ..."
__________________________________________________ __________

(?) Questions about the scientific study interpretation:

- If "aerosol route" means "aerosol droplets in a very close proximity - 1m?", than Ebola can be transmited like an respiratory virus ?
- It is airborne but with "very low infect. eficiency" ?
- The "evaluated HPIV3" as an "against Ebola vaccine vector" (by exp. vaccination) can (at the exp. field) produce recombinants of mixed Ebola/respiratory pathogen virus ?

Have the CDC Special Pathogens Branch scientists, or anybody else the exact answers ?
Thank you all.