Uganda: Hemorrhagic fever outbreak- Yellow Fever

[sharon sanders]

Re: Uganda: Hemorrhagic fever outbreak- 16 dead

A friend of FT sent this to me via email tonight for consideration:

Detection of Novel Sequences Related to African Swine Fever Virus in Human Serum and Sewage ^†
Joy Loh,¹ Guoyan Zhao,¹ Rachel M. Presti,² Lori R. Holtz,³ Stacy R. Finkbeiner,¹ Lindsay Droit,¹ Zoilmar Villasana,¹ Collin Todd,¹ James M. Pipas,⁴ Byron Calgua,⁵ Rosina Girones,⁵ David Wang,¹ and Herbert W. Virgin¹^*

snip

We report here the discovery of novel viral sequences in human serum and sewage which are clearly related to the asfarvirus family but highly divergent from ASFV. Detection of these sequences suggests that greater genetic diversity may exist among asfarviruses than previously thought and raises the possibility that human infection by asfarviruses may occur.

snip

ASFV infection of wild swine typically causes persistent infection with few symptoms (9, 17, 24, 25), but domesticated pigs can develop severe disease including acute hemorrhagic fever with nearly 100% mortality. As there is no vaccine and disease is contained by animal quarantine and slaughter, ASFV outbreaks can decimate pig populations and have significant economic impact. A 2007 outbreak in the former Soviet republic of Georgia resulted in the death and slaughter of over 80,000 pigs (20).

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2786824/

----------------------
In Uganda -

<table width="480" border="0" cellpadding="4" cellspacing="0"><tbody><tr><td colspan="2" class="headline1">Gulu district imposes quarantine on pigs </td> </tr> <tr> <td>Sunday, 28th November, 2010</td> <td align="right"> <table style="border-collapse: collapse; margin-left: auto; margin-right: 0px;"> <tbody><tr> <td style="vertical-align: middle;">
</td> <td style="vertical-align: middle;">
</td> <td style="vertical-align: middle;">
</td> <td style="vertical-align: middle;">
</td> <td style="vertical-align: middle;">
</td> </tr> </tbody></table> </td> </tr> <tr> <td colspan="2"> By Chris Ocowun

GULU has imposed a quarantine on pigs and restricted their movement in the district.This was after over 150 pigs died of African swine fever in Odek, Lakwana, Koro and Bardege sub-counties in the last five months.
</td></tr></tbody></table>
more..

http://www.newvision.co.ug/D/8/16/739568

--------------------------------------

In Uganda -

Suspected Swine Flu Kills 100 Pigs - (edit from Alert - fever, not flu)

9 August 2010

Kampala — Over 140 pigs have died in Binya and Ora-Pwoyo in Odek sub-counties in Gulu district in the last one week following an outbreak of African swine fever.

more...

http://www.flutrackers.com/forum/showthread.php?t=150776

[alert]

Re: Uganda: Hemorrhagic fever outbreak- 16 dead

http://www.promedmail.org/pls/apex/f?p=2400:1001:2788775254718678::NO::F2400_P1001_BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,86046

Archive Number 20101130.4302
Published Date 30-NOV-2010
Subject PRO/EDR> Undiagnosed disease - Uganda (02): (TG)


UNDIAGNOSED DISEASE - UGANDA (02): (KITGUM)
*******************************************
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 29 Nov 2310
Source: AllAfrica, The New Vision (Uganda) report [edited]
<http://allafrica.com/stories/201011300096.html>


Uganda: strange disease spreads to Kitgum
-----------------------------------------
The mysterious disease affecting Agago and Abim districts has
reportedly spread to Kitgum. The [Ugandan] Health Ministry yesterday
[28 Nov 2010] said the disease had not been identified yet, but
medical officers had been giving people "supportive treatment". Dr
Issa Makumbi, the Ministry's head of disease surveillance, said the
Entebbe-based Centre for Disease Control was today [29 Nov 2010]
expected to release results from samples received last week.

In the middle of this month [November 2010], Ministry officials,
quoting preliminary laboratory results, identified the disease as
amoebic dysentery. Yesterday [28 Nov 2010], the ministry put the
death toll in Kitgum at 5. But Sr Grace Ogwang, the Kitgum district
disease surveillance officer, said 8 people died of the disease in
Kitgum. This brings the death toll in the 3 districts to 36. The
disease has also reportedly spread to Pader.

The Kitgum victims included a mechanic who was hurriedly buried at
the Kitgum Hospital cemetery on [Sun 28 Nov 2010] under the strict
supervision of medical personnel from the World Health Organisation.
Ogwang said [the deceased] had travelled to Wol in Agago district a
week before his death. He is suspected to have contracted the disease
there. Ogwang warned people against getting into contact with the
bodies of victims and to avoid handshakes, communal handwashing, and
sharing of food.

[Byline: Anne Mugisa, David Labeja]

--
Communicated by:
Thomas James Allen

[Since the previous press report from the region, the outbreak of
this unidentified disease has spread to include Kitgum and the
overall death toll has in creased from 32 to 36. 8 of the fatalities
have occurred in Kitgum. No further information is available yet
regarding the nature of the disease, other than that initially
amoebic dysentery was suspected, rather than any form of haemorrhagic
disease as rumoured previously. A precise diagnosis is awaited.

The districts of Kitgum, Abim, and Agago in the Northern Region of
Uganda can be located on the map at
<http://en.wikipedia.org/wiki/Districts_of_Uganda>.
The HealthMap/ProMED-mail interactive map of Uganda can be accessed at
<http://healthmap.org/r/0089>. - Mod.CP]

[alert]

Re: Uganda: Hemorrhagic fever outbreak- 16 dead

Ouch. Bad timing. This is from today's ProMED cholera, diarrhea, and dysentery report, and was published before yesterday's articles. There has been transmission to an HCW, and the fatality rate seems far too high.

http://www.promedmail.org/pls/apex/f?p=2400:1001:7824413581896399::NO::F2400_P1001_BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,86055

[1] Dysentery, amoebic - Uganda (northeast)
Date: Wed 24 Nov 2010
Source: The New Vision (Uganda) [edited]
<http: www.newvision.co.ug="" d="" 8="" 16="" 739215="">


Two more people in Agago district have died of [amoebic] dysentery.
This brings the number of people who have died of the disease since
the outbreak begun in October 2010 to 15. 3 other people have been
quarantined at Kalongo after presenting symptoms of the disease.

The district health officer, Dr Emmanuel Otto, said the 2 people, who
had been quarantined at Dr Ambrossoli Hospital in Kalongo town
council, died over the weekend [20-21 Nov 2010]. "All the 5 victims
are from Paimol sub-county, which borders Abim district," Otto said.

Last week [week of 15 Nov 2010], 13 people died of the disease, 5
from Paimol and Omiya P'Chua sub-counties in Agago district and 8
from the neighbouring Abim district, where the disease is said to
have originated.

The health ministry spokesman, Paul Kaggwa, recently said preliminary
laboratory tests revealed that the disease was [amoebic] dysentery.

[Byline: David Labeja]

--
Communicated by:
HealthMap Alerts via ProMED-mail



[Although not specifically stated in this report, the previous report
stated that the outbreak was due to amoebiasis rather than
shigellosis. - Mod.LL]</promed@promedmail.org></http:>

[alert]

Re: Uganda: Hemorrhagic fever outbreak- 16 dead - Novel ebolavirus suspected

edit

There is a map at the link; this outbreak is actually nowhere near the Tanzanian border. The RSOE update for this article errantly puts this outbreak in Tanzania.

This is the second report (#24 was the first) that refers to a WHO report on this outbreak, one that I cannot find.

This report of eight cases with four deaths in Kitgum differs slightly from the above reports of eight deaths.

http://www.africareview.com/News/Medics%20on%20alert%20over%20ebola%20scare/-/979180/1063770/-/k3txcl/-/

By THE CITIZEN REPORTER (email the author)

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Posted Wednesday, December 1 2010 at 15:16
The Government of Tanzania is sending a team of medical experts to Kagera region in the north to investigate reports of an outbreak of a deadly disease suspected to be ebola in border villages in neighbouring Uganda.
The deputy minister for Health and Social Welfare, Dr Lucy Nkya, said in Dar es Salaam Wednesday that the team will comprise medical experts from her ministry, the National Institute for Medical Research (NIMR) and the Muhimbili National Hospital (MNH).

“You are just breaking the news (on the outbreak of the disease in Uganda) to me. Thanks, and I will make sure that a medical team is dispatched to Kagera region as soon as possible,” she told Tanzania's The Citizen daily in a telephone interview.

Reports from Uganda quoted health officials as saying that a disease that has been killing people in Kitgum, Abim and Agago districts could be a new strain of ebola.

Frontal headache

The situation report of November 26 indicated a cumulative figure of 32 cases, with fatality rate of 25 per cent since its outbreak in Balang village in Mutu parish in Paimol Sub-County, Agago district early this month.

A National Professional Officer with the World Health Organisation in Gulu, Dr Emmanuel Tenywa, said a total of 19 people were currently admitted at an isolation ward in Kalongo Hospital with acute signs and symptoms of diarrhoea, vomiting, and severe frontal headache, sometimes associated with pain in the eye without conjunctivitis and blood stains on their stool.

He said already one of the health workers in the hospital had developed the disease symptoms after she accidentally came into contact with vomit of a patient.

The Kitgum district Surveillance Officer, Ms Grace Ogwang, said four people had so far died of the disease from their homes, while four others were still admitted at St. Joseph’s Hospital.

[alert]

Re: Uganda: Hemorrhagic fever outbreak- 16 dead

This is a similar article to the one above it, but this description also includes the following phrase;

For comparison, I have posted the wikipedia description of typhoid below.

http://www.nation.co.ke/News/africa/Tanzania%20sends%20team%20to%20border%20amid%20fea rs%20of%20Ebola%20in%20Uganda%20/-/1066/1064086/-/gu1idqz/-/

[snip]

“The illness thus progresses with patients reporting abdominal pain localized in the epigastrium and as it progresses, patients develop restlessness and mental confusion, aggressive behaviuor and eventually results into coma and death” he said.

----------

http://en.wikipedia.org/wiki/Typhoid

Signs and symptoms
Typhoid fever is characterized by a slowly progressive fever as high as 40 &#176;C (104 &#176;F), profuse sweating, gastroenteritis, and nonbloody diarrhea. Less commonly, a rash of flat, rose-colored spots may appear.[4]

Classically, the course of untreated typhoid fever is divided into four individual stages, each lasting approximately one week. In the first week, there is a slowly rising temperature with relative bradycardia, malaise, headache and cough. A bloody nose (epistaxis) is seen in a quarter of cases and abdominal pain is also possible. There is leukopenia, a decrease in the number of circulating white blood cells, with eosinopenia and relative lymphocytosis, a positive diazo reaction and blood cultures are positive for Salmonella typhi or paratyphi. The classic Widal test is negative in the first week.

In the second week of the infection, the patient lies prostrate with high fever in plateau around 40 &#176;C (104 &#176;F) and bradycardia (sphygmothermic dissociation), classically with a dicrotic pulse wave. Delirium is frequent, frequently calm, but sometimes agitated. This delirium gives to typhoid the nickname of "nervous fever". Rose spots appear on the lower chest and abdomen in around a third of patients. There are rhonchi in lung bases. The abdomen is distended and painful in the right lower quadrant where borborygmi can be heard. Diarrhea can occur in this stage: six to eight stools in a day, green with a characteristic smell, comparable to pea soup. However, constipation is also frequent. The spleen and liver are enlarged (hepatosplenomegaly) and tender, and there is elevation of liver transaminases. The Widal reaction is strongly positive with antiO and antiH antibodies. Blood cultures are sometimes still positive at this stage. (The major symptom of this fever is the fever usually rises in the afternoon up to the first and second week.)

In the third week of typhoid fever, a number of complications can occur:

Intestinal hemorrhage due to bleeding in congested Peyer's patches; this can be very serious but is usually not fatal.
Intestinal perforation in the distal ileum: this is a very serious complication and is frequently fatal. It may occur without alarming symptoms until septicaemia or diffuse peritonitis sets in.
Encephalitis
Metastatic abscesses, cholecystitis, endocarditis and osteitis
The fever is still very high and oscillates very little over 24 hours. Dehydration ensues and the patient is delirious (typhoid state). By the end of third week the fever has started reducing this (defervescence). This carries on into the fourth and final week.

[alert]

Re: Uganda: Hemorrhagic fever outbreak- 16 dead

Another variation on the above articles, but with the mention of no new admissions in the past two days, and the mention of the donation of food to the isolation unit (and the fact that is even necessary).

http://thecitizen.co.tz/general-elections-news/6028-tanzania-on-alert-as-ebola-hits-uganda.html

Tanzania on alert as ebola hits Uganda Send to a friend
Wednesday, 01 December 2010 23:17
digg
By The Citizen Reporter
Dar es Salaam. The government has moved to assess the situation following reports of outbreak of a deadly disease suspected to be Ebola in some districts in Uganda.

Reports from Uganda quoted health officials as saying that has been killing people Kitgum, Abim and Agago districts could be a new strain of Ebola. However, the three districts do no border Kagera region.

But the deputy Minister for Healthm, Dr Lucy Nkya, said yesterday that they were not going to take and chances ahe she she would ensure that a team of medical experts is dispatched to Kagera region to investigate the reports and assess the situation.

Dr Nkya, said in Dar es Salaam yesterday that the team will comprise medical experts from her ministry, the National Institute for Medical Research (NIMR) and the Muhimbili National Hospital (MNH).

“You are just breaking the news (on the outbreak of the disease in Uganda) to me. Thanks and I will make sure that a medical team is dispatched to Kagera region as soon as possible,” she told The Citizen in a telephone interview.

She said they will summon his senior lieutenants at the ministry and make immediate arrangements to send the medical team to Kagera region.

The situation report of November 26 indicates a cumulative figure of 32 cases with fatality rate of 25 percent since its outbreak in Balang village in Mutu parish in Paimol Sub County, Agago district early this month.

A National Professional Officer with World Health Organization in Gulu, Dr Emmanuel Tenywa said a total of 19 people are currently admitted at an isolation ward in Kalongo Hospital with acute signs and symptoms of diarrhea, vomiting, and severe frontal headache sometimes associated with pain in the eye without conjunctivitis and blood stained on their stool.

He said already one of the health workers in the hospital has developed the disease after she accidentally came into contact with a vomit of a patient suffering from the disease.

“The illness thus progress with patients reporting abdominal pain localized in the epigastrium and as it progresses, patients develop restlessness and mental confusion, aggressive behavior and eventually results into coma and death” he said.

The Kitgum district Surveillance Officer, Ms Grace Ogwang said in her district four people have so far died of the disease from their homes while four others were still admitted in St. Joseph’s hospital.

“Some of them die from their homes although we have not registered any admission over the last two days yet,” Ms Ogwang said.

Meanwhile World Food Program has already donated maize, beans and cooking oil to support those in the isolation ward at Kalongo Hospital.

In October 2000, Ebola killed hundreds of people including a medical officer, Doctor Lukwiya Mathew of St. Mary’s Hospital Lacor.

[Treyfish]

Re: Uganda: Hemorrhagic fever outbreak- 16 dead

<TABLE id=apex_layout_271110100662109808 class=formlayout border=0 summary=""><TBODY><TR><TD noWrap align=left>02-DEC-2010</TD></TR><TR><TD noWrap align=right>Subject</TD><TD noWrap align=left>PRO/EDR> Undiagnosed disease - Uganda (03)</TD></TR></TBODY></TABLE>

UNDIAGNOSED DISEASE - UGANDA (03)***********************************A ProMED-mail post<http://www.promedmail.org>ProMED-mail is a program of theInternational Society for Infectious Diseases<http://www.isid.org>Date: Wed 1 Dec 2010Source: Daily Nation [edited]<http://www.nation.co.ke/News/africa/Tanzania%20sends%20team%20to%20border%20amid%20fea rs%20of%20Ebola%20in%20Uganda%20/-/1066/1064086/-/gu1idqz/-/>The government [of] Tanzania is sending a team of medical experts to Kagera region to investigate reports of an outbreak of a deadly disease suspected to be Ebola [haemorrhagic fever] in border villages in neighbouring Uganda. The Deputy Minister for Health and Social Welfare, Dr Lucy Nkya, said in Dar es Salaam on Wednesday [1 Dec 2010] that the team will comprise medical experts from her Ministry, the National Institute for Medical Research (NIMR) and the Muhimbili National Hospital (MNH)."You are just breaking the news (on the outbreak of the disease in Uganda) to me. Thanks, and I will make sure that a medical team is dispatched to Kagera region as soon as possible," she told The Citizen in a telephone interview. She said they will summon his senior lieutenants at the ministry and make immediate arrangements to send the medical team to Kagera region.Reports from Uganda quoted health officials as saying that a disease that has been killing people [in] Kitgum, Abim and Agago districts could be a new strain of Ebola [haemorrhagic fever].The situation report of 26 Nov 2010 indicates a cumulative figure of 32 cases with a fatality rate of 25 per cent since its outbreak in Balang village in Mutu parish in Paimol Sub County, Agago district early this month [November 2010].A National Professional Officer with World Health Organization in Gulu, Dr Emmanuel Tenywa, said a total of 19 people are currently admitted at an isolation ward in Kalongo Hospital with acute signs and symptoms of diarrhoea, vomiting, and severe frontal headache, sometimes associated with pain in the eye without conjunctivitis and blood in their stool. He said already one of the health workers in the hospital has developed the disease after she accidentally came into contact with vomit of a patient suffering from the disease."The illness thus progresses, with patients reporting abdominal pain localized in the epigastrium, and as it progresses, patients develop restlessness, mental confusion, and aggressive behavior which eventually results in coma and death," he said.--Communicated by:ProMED-mail <promed@promedmail.org>[This press report provides a more detailed description of the condition of the patients in the Ugandan outbreak and states that the cumulative number of cases is now 32 with a fatality rate of 25 percent. The symptoms of the patients do not resemble those associated with haemorrhagic fever, and the outcomes are more severe than expected for a diagnosis of amoebic dysentery currently favoured in Uganda. Clarification is awaited.The districts of Kitgum, Abim, and Agago in the Northern Region of Uganda where the outbreak is located can found in the map at <http://en.wikipedia.org/wiki/Districts_of_Uganda>. The HealthMap/ProMED-mail interactive map of Uganda can be accessed at <http://healthmap.org/r/0089>. - Mod.CP]http://www.promedmail.org/pls/otn/f?..._ID:1000,86086</PRE>

[Treyfish]

Re: Uganda: Hemorrhagic fever outbreak- 16 dead

<TABLE border=0 cellSpacing=0 cellPadding=4 width=480><TBODY><TR><TD class=headline1>20 gutoo</TD></TR><TR><TD align=middle> YIK: Wadi pa lutoo ma pe guruke pi yik man gitye ka konyo dano adek ma guruke pi yiko kom lyel pa Charles Otto, 26 i limo
</TD></TR><TR><TD>Justin Moro & Wokorach Oboi
DANO aboro i Kitgum ki Lamwo distrik dong gutyeko too ki two ma pud pe ki niang ikome maber kun oneko dano mukene i Agago ki Abim distrik ni.

Man dong kelo wel dano ma gutoo wa i 24 ocake ma two man ocop Agago cabit aryo angec pi man oweko kityeko juko moto cing woko ikin lwak pien bye tye ni two man kobo ka dano ogudu lawote ma
tye ki two.

Ladit maloyo lok me ngiyo two i Kitgum, mego Sister Grace Ogwang otito ki Rupiny ni lamony UPDF, latin Orom ma nyinge onongo pud pe ononge i kare me coc man tye i kin jo ma gutoo i cabit ma okato ni.

Anywali acel me Luwero, Kigozi Robert Ssalongo ma onongo tye mekanika bot Aquatech, ma tye ka tucu pii i Kitgum bene oto i ceng abic ki io yat St Jospeh?s ka kiyike cut i limo me otyat meno i ceng abicel.

En onongo bedo i Gangdyan i but taun Kitgum. Daktar Ogwang owaco i gin gibyeko ni Kigozi nen calo onongo two man ki i Wol matye i Agago kama
en onongo ocito kayubu mutoka ma obale.

?Wabyeko ni en onongo two man ki i Wol pien ikine ka cabit acel inge dwgo ne en ocako winyo arem ,? en owaco.
</TD></TR></TBODY></TABLE>
http://www.rupiny.co.ug/detail.php?m...&newsId=739807

[sharon sanders]

Re: Uganda: Hemorrhagic fever outbreak- 16 dead

<http: www.newvision.co.ug="" d="" 8="" 16="" 739215="">Two more people in Agago district have died of [amoebic] dysentery. This brings the number of people who have died of the disease since the outbreak begun in October 2010 to 15. 3 other people have been quarantined at Kalongo after presenting symptoms of the disease.

The numbers are all over the place. The above quote says 15 fatalities in post #33.

The latest ProMed quotes 32 total cases and a 25&#37; fatality rate which would be 8 deaths.



</http:>

[sharon sanders]

Re: Uganda: Hemorrhagic fever outbreak- 13 dead

The medical workers say victims pass blood stool, vomiting, high temperatures and blood discharge from the nose and other parts of the body and over 16 people have so far been killed by this disease.
But the Ministry of health is yet to confirm the nature of the disease outbreak.

This article in post #20 says 16 deaths which is reflected in the title of this thread.

[Shiloh]

Re: Uganda: Hemorrhagic fever outbreak- 16 dead

Source: http://www.reliefweb.int/rw/rwb.nsf/...A?OpenDocument

ACT Alliance Alert: Outbreak of Unidentified Disease in Uganda - No. 42/2010

Source: ACT Alliance
Date: 03 Dec 2010


1. Brief description of the emergency...

...2. Impact

The death rates so far are 25 percent in Agago district (ie one in four people with symptoms have died), and in Abim, the death rate has also been about 25%. However, in Kitgum district, eight out of the 10 patients admitted to St. Joseph's Hospital have died. Some connection with animal (domestic and wild) illness and death has been suggested. In Agago especially, links between sick animals and human cases have been examined. It seems to be established that the disease can be spread from human-to-human most likely through body fluids.

Two major factors for spreading the disease at the moment include people trying to move away from affected areas, spreading the disease further, and scared health staff who, without protective clothing, refuse to care for patients. There is need for mobilisation by agencies, sensitisation of population, patient care, patient isolation and proper and safe handling of bodies...

[alert]

Re: Uganda: Hemorrhagic fever outbreak- 16 dead

Tons of information here. It seems possible that a new hemorrhagic fever may have been discovered.

http://www.reliefweb.int/rw/rwb.nsf/db900sid/JALR-8BSEPA?OpenDocument

ACT Alliance Alert: Outbreak of Unidentified Disease in Uganda - No. 42/2010
Source: ACT Alliance

Date: 03 Dec 2010


1. Brief description of the emergency

An unidentified deadly disease broke out in Abim village located in the Karamoja region in northeastern Uganda in late October 2010. Several cases of the disease were reported and several deaths have resulted. The disease then spread from Karamoja to neighbouring districts. On December 1, some cases were also reported in Gulu. The signs and symptoms of the disease indicate that it is most likely not dysentery, as it is sometimes thought to be in the absence of a clear diagnosis. Symptoms point to Ebola but authorities have been unable to confirm that disease. The most common symptoms are headache, fever and vomiting large quantities of blood. Tests have been done in Entebbe (Uganda) and in Atlanta (USA).

Unequipped medical staff are fearful of being infected, leaving their duty stations because they lack personal protective gear. Some refuse to take care of patients. Kitgum district also lacks transport, including ambulances to transport patients. Pader district had one ambulance which no longer functions. People refuse to transport patients for fear of being infected. In villages, residents do not know what to do or how to protect themselves. Some have tried to move out of affected areas, potentially spreading the diseases to new areas. The spread is fairly slow but follows common "travel routes" throughout the region.

The number of affected people is unknown. About 60 cases are known, with at least 20 deaths reported. However, there could be many more cases and deaths that are unreported, and many more carriers. The first six fatalities in Kitgum were one woman, three men, and two male youths. None had any serious previous medical history. One had malaria at the time of death. Death usually occurred within three days of the first symptom. (Sources: Dr. Alex Layoo, Medical Superintendent Kitgum Government Hospital, Dr. Tenywa (World Health Organisation), Medicin Sans Frontiers, Uganda Ministry of Health, and Agago District Local Government).

2. Impact

The death rates so far are 25 percent in Agago district (ie one in four people with symptoms have died), and in Abim, the death rate has also been about 25&#37;. However, in Kitgum district, eight out of the 10 patients admitted to St. Joseph's Hospital have died. Some connection with animal (domestic and wild) illness and death has been suggested. In Agago especially, links between sick animals and human cases have been examined. It seems to be established that the disease can be spread from human-to-human most likely through body fluids.

Two major factors for spreading the disease at the moment include people trying to move away from affected areas, spreading the disease further, and scared health staff who, without protective clothing, refuse to care for patients. There is need for mobilisation by agencies, sensitisation of population, patient care, patient isolation and proper and safe handling of bodies.

3. National and international response

An emergency meeting was held in Kitgum on September 1 bringing together local and international NGOs, governmental institutions, UN agencies and ACT Alliance member LWF. It was agreed that all actors participate in the following coordinated response:

&#183; DHO, KDLF, AVSI, URCS and IRC will work in the surveillance of cases and with epidemiology.

&#183; District Hospitals, MSF and IRC will work on case management.

&#183; CAO, DHO and UNOCHA will work with finances and logistics.

&#183; The District Chairperson and UNOCHA will work with coordination.

&#183; DHE, UNICEF, Care International, CRS, CARITAS, LWF, URCS, IRC, Mercy Corps and WHO will focus on social mobilisation and sensitisation.

The Ministry of Health has responded, together with WHO and NGOs. So far, the focus has been identifying the disease and therefore the appropriate response.

4. ACT Alliance response

ICCO, DanChurchAid, Church of Uganda/PDR (the active members of the Uganda ACT Forum) have approved the Lutheran World Federation proposal to apply for ACT Rapid Response Funds. LWF's primary role at this stage will be community mobilisation and sensitisation to prevent further spread of the disease. Provision of protective gear to village health teams can also be considered so health care workers can move patients and bodies without being exposed to the disease.

5. Planned activities

LWF Uganda, with approval from the ACT Uganda Forum, intends to apply for RRF, with focus on mobilisation/sensitisation of communities and possibly to provide protective gear for village health teams, in order to stop the outbreak and save lives. Discussions in working groups and coordination committees in Kitgum continues. More precise priorities will be set on December 2. Funds will be needed for (preliminary estimates):

&#183; Radio spot messages/production and airing.

&#183; Transport/travel costs.

&#183; Posters, Information, Education and Communication (IEC) material.

&#183; Possibly purchasing protective gear for village health teams.

The level of funding is estimated at between 40,000 – US$ 50,000 but this will be confirmed after

coordination meetings when a detailed budget has been worked out.

Any funding indication or pledge should be communicated to Jean-Daniel Birmele, ACT Chief

Finance Officer (jbi@actalliance.org).

Thank you for your attention.

For further information please contact:

ACT Regional Programme Officer, Katherine Ireri (phone +41 22 791 6040)

[alert]

Re: Uganda: Hemorrhagic fever outbreak- 16 dead

http://www.coastweek.com/3349-32.htm

Strange disease worries northern Uganda

GULU, Uganda (Xinhua) -- A growing concern is spreading in parts of northern Uganda as an Ebola-like disease claimed 26 lives in three districts in the region though the country?s health ministry has ruled out an deadly Ebola outbreak.

According to a medical situation report obtained by Xinhua on Tuesday, eight people have been confirmed dead of the strange disease in Kitgum district, another eight in Agago district and 10 in Abim district.

The health ministry earlier this month said the strange disease was dysentery.

Health workers on the ground, however, said there was no conclusion yet.

The Agago district health officer Emmanuel Otto called for caution among locals saying there was still investigation going on to establish the cause.

"The ministry of health has taken samples from the victims of the disease for analysis and we are yet to get the disease," he noted.

Local leaders revealed that the number of people died of the disease could be higher as some people were not hospitalized and could have died in the village unreported.

The poor sanitation in homesteads of the returning former Internally Displaced Persons (IDPs) remains worrying with a number of homes living with no toilets, local leaders said.

It is reported that a number of animals also died of a strange disease in one village hit by the unknown epidemic.

Residents contracted with the disease commonly present with severe frontal headache that in some cases is associated with pain in the eyes without conjunctivitis.

Some patients have reported dizziness.

This may or may not be followed by low grade fever and general body weakness.

The illness then progresses with patients reporting abdominal pain.

Diarrhea and vomiting that are initially watery and eventually blood-streaked have been reported.

In the near terminal stages, the patient condition changes and is characterized by restlessness, disorientation and mental confusion, aggressive behavior, convulsions, and eventually coma and death.

The duration of illness varies from two to 10 days.

[alert]

Re: Uganda: Hemorrhagic fever outbreak- 16 dead

I think they mean pneumonic plague, not mnemonic plague, confirmed not conformed, and fleas not flees....

I have posted this article as it is, without any edits. I can't find confirmation of this in any other source.

http://www.ugpulse.com/articles/daily/news.asp?about=Mnemonic+plague+conformed+in+the+Acholi+sub-region++&ID=16924

A previous un identified disease spreading through the Acholi sub-region has been conformed to be the mnemonic plague.
More than ten cases have been reported in Abim, Pader and Kitgum districts.

Bloods samples of the patients were tested at the Uganda virus research institute in Entebbe and come up positive for mnemonic plague.

The ministry of health today said the disease that was earlier feared to be Ebola has been confirmed as mnemonic plague.

Mnemonic plague is contagious disease spread by contact with flees, characterised by coughing fever, headache general body, shortness of breathing and chest pain.

[alert]

Re: Uganda: Hemorrhagic fever outbreak- 16 dead

And another HCW infected, this time in Gulu.

http://www.newvision.co.ug/D/8/16/740073

Three catch strange disease
Friday, 3rd December, 2010 E-mail article Print article

THREE new cases of the mysterious disease that is affecting parts of Acholi sub-region have been registered in the district, bringing the total number to 13.

The district disease surveillance officer, Grace Ogwang, said two of the cases were recorded in Orom sub-county, while another is admitted to St. Joseph’s Hospital.

Evelyn Ayoo and Okeny Denis were admitted to Orom health centre III, while Benon Ogwech was admitted to Kitgum mission hospital.

Medical sources noted that a staff member of Aquatech, Francis Kilama, suspected to be infected by the unknown disease, was also admitted to Lacor Hospital in Gulu.