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Uganda: Ebola Sudan identified in 17 deaths, all monitoring completed, outbreak declared over
Re: Uganda: Ebola Sudan identified in 13-17 deaths including Healthcare worker in Kibaale out of 20 total suspected cases
Alert - the health facility in Kiballe appears to be called Kagadi hospital. I have checked on the maps and there isnt another medical facility, so Mulago hospital references must apply to the one in Kampala.
So I think post #41 indicating the infant died in Mulago Hospital is in error. As to the case in post #38, we still don't know enough of his contact history to know whether he ould have contracted Ebola. I don't know whether they would risk medically transferring a suspected case to Kampala; it seems the case in #38 is reported to have travelled to Kampala (from where?) on his own before taking ill.
It is normal from previous Ebola outbreaks to have reports of quite a few suspected cases that are not actually infected. They cast a wide net in looking to isolate suspects to avoid missing a case and allowing a new cluster to occur.
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Apparently, Mulago Hospital is being used as a base for co-ordinating the response:
...At this time, the cases appear to be centered in Nyamarunda Sub County, Kibaale district, although one suspected victim is reported to have traveled to Kampala for treatment at Mulago Hospital where he subsequently died on July 22, 2012.
killed 13 family members and a clinical officer in Kagadi Hospital who was attending to the patients. World Health Organisation, Centers for Disease Control, Mulago and Laco hospitals, mainly those who handle Ebola outbreaks has already camped in Kibaale District http://www.flutrackers.com/forum/showpost.php?p=462297&postcount=26
so they got people from a few different hospitals. 1 person suspected went to Kampala, prolly on his own. They would know who they were and where they came from, but didn't know it was Ebola till yesterday.
Last edited by Laidback Al; July 29, 2012, 09:24 PM.
Reason: typo
Kibaale district was last week hit by a strange disease which the health experts from World Health Organization (WHO) have confirmed to be Ebola. The disease has spread to most areas in the district and reports indicate that it has so far killed 18 people out of the 20 admitted at Kagadi hospital. More patients are being admitted each day and among them include a health worker identified as Margret Asaba who was working at Muhorro Health Centre III.
Most of the patients admitted have signs which include fever, vomiting, diarrhea, abdominal pain, headache, rash, red eyes and bleeding.http://www.ugandapicks.com/2012/07/e...ict-49991.html
Re: Uganda: Ebola Sudan identified in 13-17 deaths including Healthcare worker in Kibaale out of 20 total suspected cases
Monday 30 July 2012 South Sudan alert after Ebola outbreak in Uganda
July 30, 2012 (JUBA) - The Republic of South Sudan remains alert after a confirmed Ebola outbreak in neighbouring Uganda reportedly killed 13 people, with at least 20 cases reported by the country?s health officials.
An outbreak of the deadly disease, according to local media reports, were confirmed in the Western Ugandan district of Kibaale, located about 200km from the country?s capital, Kampala. The district reportedly has a total population of about 646,700 people.
An official from South Sudan health ministry, speaking on condition of anonymity, told Sudan Tribune on Monday that the new nation, being a neighbour to Uganda, will ?not take chances? at all on the disease.
?Ebola, as you know is a deadly disease and the rate at which it spreads from one person to another is very rapid. We need to take precaution as a country especially with the massive influx of Ugandans coming into South Sudan,? the official warned... http://www.sudantribune.com/South-Su...er-Ebola,43398
Re: Uganda: Ebola Sudan identified in 13-17 deaths including Healthcare worker in Kibaale out of 20 total suspected cases
The HCW infections are the most difficult/worrying as these individuals will have been infectious during the incubation period (anything from 2 - 21 days). Contact with skin secretions of an infected person is a potential mode of transmission, which means that an infected HCW may have seen many patients before becoming symptomatic themselves. This is especially true of a health centre as opposed to a hospital; these centers carry out routine anti-natal work, immunisations etc.
Given that this outbreak has become quite well established before being identified [as it did not present with the 'usual' disease pattern] suggests that WHO and health authorities have an enormous contact tracing mission ahead of them over a wide geographical area.
If cases start appearing at random in the Kampala area [which has an international airport at Entebbe, 45 kms out of Kampala ] should the authorities be considering immediate movement bans out of Uganda now to prevent international spread?
Re: Uganda: Ebola Sudan identified in 13-17 deaths including Healthcare worker in Kibaale out of 20 total suspected cases
Uganda Red Cross responding to Ebola outbreak in Western Uganda Report
Nairobi/Geneva - 29 July 2012 - A deadly outbreak of hemorrhagic fever Ebola has been confirmed in Kibaale district, Western Uganda by the Ministry of Health of Uganda. So far, 13 people have died and 7 more cases have been diagnosed. Kibaale district has a total population of about 646,700 people and is located at around 200 kilometres west of the Ugandan capital Kampala, and around 50 kilometres from the border with Democratic Republic of Congo.
The Uganda Red Cross is part of the National Emergency Taskforce that has been set up by the Ministry of Health to stop the disease from spreading more widely. The Red Cross has mobilized volunteers and staff who are ready to support with case tracking and community awareness.
'This outbreak is occurring in the same area where the Red Cross is already responding to the growing crisis caused by the influx of Congolese refugees fleeing violence in their country? said Charlie Musoka, Regional Operations Coordinator in Nairobi for the International Federation of the Red Cross who is preparing to travel to the affected region.
There is no treatment or vaccine against Ebola, one of the most virulent viral diseases known to humankind. It is transmitted by close personal contact and, depending on the strain, kills up to 90 percent of those who contract the virus.
There have been several Ebola outbreaks recorded in Uganda since the first one in 2000, leaving many people killed and much more traumatized. Symptoms include sudden onset of fever, headache, joint and muscle aches, sore throat, and weakness, followed by diarrhea, vomiting, and stomach pain. The government of Uganda is coordinating needs assessments and response efforts aimed at containing the outbreak. A team composed of a medical doctor and a Disaster Management specialist from the International Federation of Red Cross is being dispatched from Nairobi to immediately support Uganda Red Cross efforts.
For further information, please contact:
Catherine Ntabadde , Uganda Red Cross Head of Communication, Kampala: + 256 772629567
It seems that a typical infection runs its course over 14 - 21 days but I am not clear if this time range is from the date of onset of symptoms, but I would guess it must be.
As the incubation period is anything from 2 - 21 days, it would suggest that the monitoring period will need to be 6 weeks clear from the last detection of a case before this can be declared contained or 'over'.
The HCW infections are the most difficult/worrying as these individuals will have been infectious during the incubation period (anything from 2 - 21 days). Contact with skin secretions of an infected person is a potential mode of transmission, which means that an infected HCW may have seen many patients before becoming symptomatic themselves. This is especially true of a health centre as opposed to a hospital; these centers carry out routine anti-natal work, immunisations etc.
Given that this outbreak has become quite well established before being identified [as it did not present with the 'usual' disease pattern] suggests that WHO and health authorities have an enormous contact tracing mission ahead of them over a wide geographical area.
If cases start appearing at random in the Kampala area [which has an international airport at Entebbe, 45 kms out of Kampala ] should the authorities be considering immediate movement bans out of Uganda now to prevent international spread?
WHO said in its statement specifically that does not recommend any travel or trade restrictions to Uganda.
Any suspected case has to be quarantined in hospital as happened in the past. For example in Italy several nuns were put into isolation for three weeks after being exposed to infected people in a hospital (it was 1995 Kikwit Ebola outbreak. A story about the nuns who died in Zaire is available in Italian at http://www.istitutopalazzolo.it/site/?page_id=21 . For the survivors, another story is here: http://archiviostorico.corriere.it/1...05224759.shtml ).
Re: Uganda: Ebola Sudan identified in 13-17 deaths including Healthcare worker in Kibaale out of 20 total suspected cases
It is typical in the reporting to get a lot of suspect cases that are not actually infected with Ebola, and have no contact history, but whose symptoms look enough like Ebola that they must be isolated as a precaution.
We know that someone died on the 22nd in Mulago Hospital in Kampala of a hemorrhagic illness. We do NOT know that he had any contact with any confirmed/probable Ebola case, and we do NOT even know for sure that he had been in Kibaale (all we know is that he travelled to Kampala; we do not know his origin).
We also know that a woman named Margaret Asaba who worked in Muhorro Health Center (which I think is in Kibaale, at least according to http://allafrica.com/stories/201109281268.html) has been isolated and is ill. She certainly could have had contact with a missed case as she is in the right area, but we don't have any report of any suspected cases at Muhorro other than her.
Both of these remain in the "suspected" category for now.
We also have one unconfirmed report that the four-month-old infant son of the first HCW at Kagadi (who we know has died) was transferred to Mulago Hospital in Kampala. Personally, that seems unlikely, but we will see. If other HCW at Mulago start taking ill, then we have a problem.
Sponsored LinksKAMPALA, Uganda (AP) ? A Ugandan health official says six more patients suspected to have Ebola have been admitted to the hospital days after investigators confirmed an outbreak of the highly infectious disease in a remote corner of western Uganda.
Stephen Bayaruhanga, health secretary of the affected Kibaale district, said Monday that possible cases of Ebola, at first concentrated in a single village, are now being reported in more villages.
But many sick people with suspected Ebola are unwilling to be taken to the hospital, he said, because they are terrified of contracting the disease if Ebola is not what they have.
If the six new cases are confirmed as Ebola, it would bring to 26 the number of Ugandans infected with the virus this month. At least 14 people have died.
Ebola virus reported in Kampala
July 30 2012 at 12:52pm
AFP
Uganda's president on Monday banned all physical contact after a victim of a deadly outbreak of the Ebola virus was reported in the capital Kampala for the first time.
“The Ministry of Health are tracing all the people who have had contact with the victims,” Yoweri Museveni said in a state broadcast, adding that 14 people had died in total since Ebola broke out in western Uganda three weeks ago.
Two cases have since been reported in the capital, with one victim reported dead in Kampala's Mulago Hospital, he said, calling on people not to shake hands to avoid the spread of the killer virus.
“Ebola spreads by contact when you contact each other physically... avoid shaking of hands that can cause contact through sweat, which can cause problems,” Museveni said.
“Do not take on burying somebody who has died from symptoms that look like Ebola -- instead call health workers because they know how to do it...avoid promiscuity because this sickness can also go through sex,” he added.
Seven doctors and 13 health workers at Mulago hospital are in quarantine after “at least one or two cases” were taken there, with one later dying from the virus.
The latest outbreak started in Uganda's western Kibaale district, around 200 kilometres west of the Kampala, and around 50 kilometres from the border with Democratic Republic of Congo.
The rare haemorrhagic disease, named after a small river in DR Congo, killed 37 people in western Uganda in 2007 and claimed the lives of at least 170 people in the north of the country in 2000.
“I wish you good luck, and may God rest the souls of those who died in eternal peace,” Museveni added. - AFP
Re: Uganda: Ebola Sudan identified in 13-17 deaths including Healthcare worker in Kibaale out of 20 total suspected cases
What we are missing here are timelines.
Dates of cofirmed cases presenting to health facilities, dates of disease onset etc. i.e how long a gap was there between presentation for treatment and confirmation this was Ebola?
The second factor we dont know is the onset and progression of symptoms - given that reports have already stated that at least some cases were atypical and therefore could be missed/ misdiagnosed.
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