Announcement

**Treyfish** · December 12, 2007, 08:11 PM

Re: Ebola in Uganda Spreading - Death toll rising

<TABLE cellSpacing=0 cellPadding=4 width=480 border=0><TBODY><TR><TD class=headline1 colSpan=2>Ebola scares varsities</TD></TR><TR><TD>Wednesday, 12th December, 2007</TD><TD align=right><TABLE style="MARGIN-LEFT: auto; MARGIN-RIGHT: 0px; BORDER-COLLAPSE: collapse"><TBODY><TR><TD style="VERTICAL-ALIGN: middle"></TD><TD style="VERTICAL-ALIGN: middle">E-mail article</TD><TD style="VERTICAL-ALIGN: middle"> </TD><TD style="VERTICAL-ALIGN: middle"></TD><TD style="VERTICAL-ALIGN: middle">Print article</TD></TR></TBODY></TABLE></TD></TR><TR><TD colSpan=2>By Samson Opus

THE Inter-University Games that were due to tart this weekend in Mukono have been postponed indefinitely because of the ongoing Ebola scare.

The cancellation of the annual championship was announced yesterday in a communication from hosts, Uganda Christian University (UCU).

UCU vice chancellor Prof. Stephen Noll said: ?It is with real regret that UCU chose to cancel all invitations to teams.?

?I decided that the risk of bringing so many thousands of athletes and spectators together in the present climate of fear and danger (of the Ebola disease) outweighed the pleasure we anticipated in hosting the games.?

The universities that had entered are Makerere, Mbarara, IUIU, KIU, Nkumba, Kampala University, Kyambogo, MUBS, Busoga, Nkozi, Gulu, Busitema, Bugema, Ndejje, Kumi and UCU.

http://www.newvision.co.ug/D/8/30/601782

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**Treyfish** · December 12, 2007, 08:50 PM

Re: Ebola in Uganda Spreading - Death toll rising

Tuesday, Dec. 11:

<< GO BACK <<

Today?s big event was the visit of the Minister of Health, the Honorable Dr. Stephen Mallinga, along with the Commissioner of Community Health Services, Sam Okware.
We were running a training for NHC staff but the RDC and the temporary medical superintendent from MOH stopped Scott on his way back from discharging Dr. Sessanga (cured!!) this morning and told him that they had assigned the training to one of their own doctors, instead he should come greet the minister. He turned back to Bundibugyo, and Scott Will and I went to Nyahuka to meet with about 40 staff, along with a doctor finishing his Masters in Epidemiology at Makerere and a senior nurse who survived the 2000 epidemic in Gulu. The doctor lectured on the basic facts of Ebola, and both he and the nurse provided a lot of confidence, a boost in morale, an appeal to get back to work.

Meanwhile Scott met the Minister, Dr. Mallinga. This was very confidence boosting, an upsurge on the roller coaster. Another lesson of this crisis is that there are some brilliant and dedicated doctors in this country. The Minister is one of them. Scott said he addressed the issues of witchcraft and discrimination that have arisen by saying that we are like full glasses of water, when trouble comes we are shaken and whatever is inside spills over, the trouble of life merely reveals the heart. It sounds a bit like what Jesus said to the Pharisees . . .For some that means the evil just below the surface comes out. For others that means the charity and self-sacrifice are called forth. He appealed for the latter.
The government has now allocated 6 BILLION shillings to the response, which is 6 billion more than they had last week. . . . The crisis has also pointed out the problem of medical staffing. The Minister said <?XML:NAMESPACE PREFIX = ST1 /><ST1:COUNTRY-REGION w:st="on">Uganda</ST1:COUNTRY-REGION> has lost about 200 doctors to <ST1:COUNTRY-REGION w:st="on">South Africa</ST1:COUNTRY-REGION>, 3 anesthesiologists to <ST1:COUNTRY-REGION w:st="on">Rwanda</ST1:COUNTRY-REGION>, countless nurses to <ST1:COUNTRY-REGION w:st="on">Kenya</ST1:COUNTRY-REGION>, more new grads to <ST1:COUNTRY-REGION w:st="on"><ST1:PLACE w:st="on">Sudan</ST1:PLACE></ST1:COUNTRY-REGION> where NGO?s are paying huge salaries. Even here in <ST1:COUNTRY-REGION w:st="on"><ST1:PLACE w:st="on">Uganda</ST1:PLACE></ST1:COUNTRY-REGION> some of the best minds and hearts we?ve seen responding to the crisis are Ugandan doctors who have left Ministry of Health to work for the WHO. I can already see that some of these hard working and helpful men are going to be gone in the next few weeks, and we?ll be left with the same hobbling health system we had before, minus Jonah.

It is a week today since Jonah died. Though Melen and I had a little cry together this morning, I can see some signs that she is emerging, thinking a little bit into the future beyond the 21 day contact isolation period, she even smiled once this morning at her daughter Sarah?s antics. Thanks for praying for her.

http://www.whm.org/news/ebolainugand...CjXi_AP8kNuYIA

**Treyfish** · December 12, 2007, 09:38 PM

Re: Ebola in Uganda Spreading - Death toll rising

<TABLE cellSpacing=0 cellPadding=0 width=570 border=0><TBODY><TR><TD class=arial13 align=middle colSpan=3 height=50></TD></TR><TR><TD align=middle bgColor=#000000 colSpan=3></TD></TR><TR><TD align=middle colSpan=3></TD></TR><TR bgColor=#c0d4fe><TD class=arial12 align=middle width=188 height=20> </TD><TD class=arial12 align=middle width=224 height=20>2007-12-13 07:50:39 </TD><TD class=arial12 align=middle width=188 height=20> </TD></TR></TBODY></TABLE>

Uganda: Ebola is still two deaths in the west

2007-12-13 07:50:39

KAMPALA, Dec. 12 (XINHUA) -- Two more people have died of Ebola haemorrhagic fever in Uganda, bringing the total number of victims to 32 deaths since the epidemic began in August, according to a press release issued by the Department of Health Wednesday.

"The Ministry of Health wishes to the public aware of the situation of Ebola in the country. The new report dated December 12, 2007 reveals that the total number of cases is 120 and the death toll is 32" , said the statement.

According to the press release, 28 cases of Ebola are being treated at the health center of Kikyo and at the hospital in Bundibugyo, in the district of Bundibugyo in western Uganda.

The ministry called on the population to avoid unnecessary movements and gatherings, particularly in the districts surrounding Bundibugyo.

Last week, the gouvernemnt Uganda has refused to declare a state of emergency, claiming to have set up a reliable mechanism.

The government has approved a budget of 6 billion Ugandan shillings (3.5 million USD) to contain the epidemic.

This is the second time that Uganda is faced with the Ebola virus, which this time is caused by a new strain of virus that appears to be more b?gnine that the other four identified.

http://www.french.xinhuanet.com/fren...ent_542746.htm

**Niko** · December 13, 2007, 12:00 AM

Re: Ebola in Uganda Spreading - Death toll rising

Wednesday, December 12, 2007

Ebola Bundibugyo--Wednesday Night Numbers

We flew home at dusk on Scott?s motorcycle, the sky pinking westward and mist shrouded mountains silhouetted eastward. I saw a young girl dancing with abandon as we passed, and many people greeting, talking, walking, carrying their burdens and cooking their food, smoke rising from fires, just like any other day. Yes, Ebola is here, but for the vast majority of people it is only a shadowy fear, and their real life continues. I lose sight of that sometimes. A week ago we were stumbling through our tears and anticipating illness, wondering if we would leave this place alive, and if we did could we ever come back? Now a week later hope surfaces again. Even Melen is smiling more readily, her shorn head a final sign of her mourning coming to completion. This place breaks my heart and demands my all. But in God?s economy, that draws out love. I have thought often this week that the pain which was introduced into childbirth by the Fall had a redemptive consequence: that which we labor for with such cost becomes dear to our hearts. In the paradox of the Kingdom, a difficult child becomes the one that we love. And a place so steeped in death becomes a place that we deeply care for.

Today?s numbers also carry seeds of hope:

Cumulative cases remain at 115. There was a story of a contact with fever who had not been reeled in quite yet, so it will likely increase tomorrow, but for tonight we?re stable.
Cumulative deaths: 32. One more in the last 24 hours. (CFR 27.8%)
Inpatients: Bundibugyo 11with 5 discharges, 0 deaths, no admissions. Kikyo 10 with 1 discharge, 1 death, no admissions.
LABS: still in process, but there have been 31 confirmed positive samples, all from Bundibugyo district. All samples from suspected cases in other districts have proven negative to date.
Spread: As above, all Bundibugyo so far, but Bundibugyo contacts have been dispersing themselves. They want to get away from Kikyo, away from the disease, and have been turning up in neighboring districts. So it is very possible that true cases will arise elsewhere.
Contacts: 265 of 368 followed up today. Jonah?s family has six more days to make it to 21 and all are well. I have five more.
Issues: there was a call for projections in order to plan the budget. Will this go on for a month? Two? More? The epidemiologists are supposed to bring us their best guess tomorrow. I did talk to the CDC and MSF about the impact on resuming Christ School. The official policy from the outsiders is that contacts should be able to continue their normal activities until they have a fever. They are not supposed to be very infectious the first day of illness, which gives time for isolation. I do wonder if the teachers or students will be willing to return even if we give the medical all clear. Anyway this should be more clear by early January when we?ll know the trend of cases better. Half the time I feel like life will go back to normal; half the time I feel like the stress of evaluating every fever or whiff of illness in everyone we know as a potentially fatal disease will be unbelievably stressful.
Medical Care in General: Scott and Scott worked at NHC today. Scott W saw all the HIV positive people and even saved a child?s life by putting in a more complicated IV line for a blood transfusion. Every day that we don?t have Ebola cases at Nyahuka makes us more comfortable with expanding services there once again. We wish we had better mortality data for the district in general. I spoke with a family today whose baby had died the day after the Ebola announcement. I?m sure there are many dying at home, of malaria and anemia and sepsis and everything else, afraid to come for care.

Luke should have landed by now, we?re waiting for his call. Pat plans to drive back in tomorrow.
See the posts below for a Christmas meditation, and the reminder of links for donating to help Jonah?s family and other needs. Scott will take food tomorrow to two widows (Joshua Kule?s , the clinical officer, and Anansio Maate?s, the eye assistant, as well as two children whose mother is in the isolation unit, and visiting to check on Melen, one of the ways we as a smaller organization can fill some gaps).

**Giuseppe** · December 13, 2007, 11:50 AM

Re: Ebola in Uganda Spreading - Death toll rising

3) [EBOLA, UGANDA, CONGO DR] DRC-UGANDA: Ebola outbreak leads to border closure

KINSHASA, 13 December 2007 (IRIN) -

Health authorities in the Democratic Republic of Congo (DRC) have closed the lake and land border with Uganda and shut down two markets as a precautionary measure to prevent the spread of Ebola from its neighbour.

Several dozen traders in the areas of Beni and Butembo in DRC's North Kivu province have been placed under quarantine after visiting Uganda.

The Ebola virus has an incubation period of 21 days.

"We closed the border five days ago and also shut two markets - Kasindi and Watakingi - where traders coming from Uganda sell their merchandise," said Marcel Katembo, the officer in charge of public health in Beni and Butembo.

An outbreak of Ebola in the western Ugandan district of Bundibugyo has claimed the lives of 28 out of 112 people infected since September, and sparked fear among the population.

Katembo said checkpoints had also been set up along the roads to DRC towns and villages.

The measures have led to the blocking of about 30 lorries carrying food and other supplies, and there are fears the prices of essential supplies could rise as a result, according to a report on Radio Okapi, which is supported by the UN Mission in Congo (MONUC).

Local civil and health authorities, as well as radio and television services, are conducting an Ebola awareness campaign in the border areas.

An Ebola outbreak that claimed the lives of nearly 20 of the 26 people infected in the Kasai Occidental province of DRC was declared to have ended in November.

Ebola is characterised by fever, diarrhoea, severe blood loss and intense fatigue.

It is transmitted through direct contact with the bodily fluids of infected persons or primates.

There is no cure, and health experts say between 50 and 90 percent of victims die.

The best way of halting its spread is through prevention, prompt detection and the isolation of suspected cases.

The DRC experienced Ebola epidemics in 1976 in Yambuku, Orientale province, in Kikwit, Bandundu, in 1995, where at least 250 deaths were reported, and in Watsa, Orientale, in 1999.

In Uganda, an outbreak killed at least 170 people in the northern Gulu district in 2000.

The Ebola virus was first identified in 1976 in Sudan and in a nearby region of DRC, then Zaire. Outbreaks have also occurred in C?te d'Ivoire and Gabon.

-
LINK (IRIN)

**Niko** · December 13, 2007, 01:08 PM

Re: Ebola in Uganda Spreading - Death toll rising

?You Don?t Want This Going Places?

Doctors are investigating a new strain of Ebola that has erupted in Uganda, killing 22 people and raising fears of infections farther afield.

By Fred Guterl
Newsweek Web Exclusive

Updated: 12:21 PM ET Dec 10, 2007
Few things in life are scarier than Ebola. The virus has killed 9 of 10 victims in some outbreaks, and the effects are particularly gruesome?the bug causes massive bleeding. Ever since the first outbreaks in 1976, which erupted simultaneously in Zaire (now the Democratic Republic of the Congo) and Sudan, scientists had identified a total of four strains. Now there's a fifth. The outbreak earlier this month in Uganda has claimed 22 lives, including a doctor in Kampala, raising fears of an urban outbreak and causing rumors that the virus is a milder type that could spread more easily beyond Uganda and the African continent. Tom Ksiazek, chief of the pathogen branch of the Centers for Disease Control in Atlanta spoke with NEWSWEEK's Fred Guterl about how dangerous the outbreak may be and what scientists are doing to investigate. Excerpts:
NEWSWEEK: How is this virus different from the four other known strains of Ebola?
Tom Ksiazek: This virus is not like any of the four other ones. It's about as different from the other four as they are from each other.
How do you know?
That's based on preliminary information about the [genetic] sequence of the virus itself. These are RNA viruses, so we're looking at the [nucleotide] base composition of small pieces of the virus. We've managed to isolate the virus and are growing it in cell cultures. We're still working on getting more sequencing.
What have you learned about this particular strain?
There's been a lot of speculation in press reports about it being less pathogenic, or perhaps not causing as much bleeding [as other strains]. I've seen other people speculating that this will make it more difficult to control. Our perspective is, you need data to say those things. Specifically when you're dealing with a new virus. You have to develop your data as you go along. You want to probably limit your data to those who you can demonstrate are really patients who have been infected with the virus. It's very early in the process now. We've diagnosed a few patients in our lab, and those are the only patients we really know are Ebola patients.
You mean many people reported as victims of this Ebola outbreak may be sick with some other disease?
You're seeing reports from Uganda that there's?you name a number?79 patients and 22 deaths. How many of those patients are really known to [have the] Ebola virus? There's a case definition that's developed that says, "This guy's got a headache and four or five other symptoms." There are a lot of other things that will give you symptoms like that.
Like what?
If you've ever had a serious case of flu, you'd be included in that group. Or early malaria, for that matter.

So you're saying that we still don't have a true picture of the mortality of this particular strain?
It could be higher, it could be lower [than what's been reported]. It really has to be based on patients that you're doing some rigorous diagnosis on. If you cast a wide net, you end up with a lot of fish in the net that you're not really after.
What are you doing to get better data?
We've sent a team to establish a lab in Entebbe, south of Kampala. We'd like to get samples from suspected patients and have them tested, and they'd either be called confirmed cases or put in some other category. And here [in Atlanta] we're working to get assays that are targeted for the new virus, [which would enable us to] test for presence of the virus.
What will more complete sequencing of the virus tell you?
It may tell us something about its evolutionary relationship with the other viruses, but not how pathogenic it will be. That has to come from the field. At this point we're waiting to get more sequence [of genetic data] so we can have a better perspective on it.
When will that happen?
Within a week we'll have more [sequencing] information and make some sort of announcement to the government of Uganda. To find out how pathogenic it's going to be, that has to come from the field. We need to know how many patients die and how many of them live. That really defines the mortality.
Is this a milder strain than those you've seen in the past?
That has to be based on data. As far as we're concerned, there's not a lot [of data] suggesting that this is all that different from other strains. It's premature to say that it's milder or not milder.
Would a milder strain be worrying because it would be more likely to spread?
I would say that if it's milder, it's less likely to be shed in huge quantities, so people who've come in contact with patients are probably less likely to transmit the disease than [if it were] a severe strain.
How does this virus spread?
Through very close contact with patients. A lot of misinformation that's being spread is that it's transmitted through the air, but generally you have to have pretty close contact with somebody who's pretty seriously ill.
What about the doctor who traveled from the outbreak area to Kampala and died there? Are you concerned that he might have taken the outbreak to Kampala?
If he was relatively well when he traveled to Kampala, it's unlikely that the people he had casual contact with resulted in any infection. We'll check to see if he's had any unusual exposure to individuals after that. There's always concern. There tends to be a lot of reaction and misinformation that can border on panic. What we attempt to do is refamiliarize people with past outbreaks rather than speculating on what might happen.
So you're not worried too much about a wider transmission of the virus than in the past?
There's always some concern. Let's be clear: this is a disease you don't want to get. But the outbreaks generally occur in underresourced areas where it's necessary to get folks in and help them with things like infection control practices and protective gear, so the outbreak stops. There's a lot of concern?you don't want this going places. But in a developed country transmission probably wouldn't get started.
Should travelers avoid Uganda?
There's been some stuff in newspapers that might tend to make people overly concerned. We don't advise people not to travel to Uganda. If you were a medical missionary and were treating patients in these areas, that would be cause for concern. But if you're traveling to see animals, you don't need to worry too much.

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URL: http://www.newsweek.com/id/74942

**FrenchieGirl** · December 13, 2007, 02:24 PM

Re: Ebola in Uganda Spreading - Death toll rising

http://paradoxuganda.blogspot.com/20...ht-living.html

Thursday, December 13, 2007
Ebola Bundibugyo: Thursday Night, Living on the Edge

The facts:

Cumulative cases: 118
Laboratory confirmed cases: 32, all still from Bundibugyo
Cumulative deaths: 34 (28.8%CFR)
Contacts: 368, with 264 seen today (71.7%) This is the heart of containment, having surveillance teams face to face daily with contacts to monitor any who become ill, and encourage them to come in for isolation and care.
Admitted in Bundibugyo: 8 (!), with 5 discharges, 3 new admissions, and 1 death.
Admitted in Kikyo: 9, with 0 new admissions, 0 discharges, and 1 death. We learned today that two of these are women who are breast feeding babies (age 3-4 months), and since the virus is highly transmissible in breast milk we are providing formula tomorrow so that the babies can be watched in isolation for symptoms but separated from their mothers . . . Another sinister aspect of this disease and the way it insinuates into the very relationships that should bring comfort and support.
Stories: well, there were a couple of sad ones. First, a pastor died, a man who had prayed for Ebola patients before we knew it was Ebola. In my view it is just like the health workers dying. This man laid down his life by caring for others. He probably laid his hands on Jeremiah Muhindo as he prayed for him. So did Scott. That always sobers us, though each day we move further and further from the common incubation period, and closer to the 21 day safety zone. The clinical officer Joshua Kule?s son is another problem story?it came out in the meeting that a surveillance team visited him and determined that the fever he had was improving on antimalarials so he did not have Ebola. At that point our MSF nurse spoke with obvious conviction and care: it is DANGEROUS, she said, for the surveillance team to think they can make that judgment. Any contact with fever has to be evaluated by a medical person and tested!!!! This man was the primary caretaker for his father, who died, and is exactly in the incubation period for symptoms. Cases like this make it clear that we are not yet out of the woods. Because people fear the isolation ward, they will try to hide or minimize symptoms, and thereby put their families and communities at risk.
High of the day: Scott was able to visit four of the five families of health workers who died, taking them some food and comfort and words of Scripture about God?s care for the orphan and widow. I think it was a touch of kindness and contact in a disease that is otherwise frightening and isolating. And a way to show extra respect for the lives of these men and women. He also tracked down the children of a woman admitted now, who is not dead, but whose children have been reported to be fending for themselves.
Low of the day: Well, several really. One is that the voices of reason and wisdom and experience may be thinning out as we end our second week of crisis response. We hear rumblings that the CDC team is narrowing down to one (a really nice guy, but still only one of him) and our trusted WHO doctors and epidemiologists are also hinting they won?t stay much longer. An experienced person warned us today to expect things to temporarily deteriorate again between Christmas and New Year as people slack off .. . Which makes us feel like we should be here then. I miss my kids a lot tonight, more than usual, maybe hearing about them first-hand from Pat. It was a discouraging meeting tonight, focused on money, and while I respect the hard work and leadership of most people involved, I feel the cross-cultural tension of distaste for the fact that the biggest budget items are extra allowances for most of the politicians. My American viewpoint is that they are doing their job, so why should UNICEF money go to their pocket? But I know the African view would be that they are underpaid, and that they are putting in extra hours, and that it is only right that their work be valued in this way. But I have to confess it still grates on me.
Unlikely heroes: MAF. Mission Aviation Fellowship flies people in and out almost daily, ferries blood samples to the lab, brings supplies here. They also have found our team a house to stay in in Kampala, and helped them with everything from a generator to groceries. We are a small mission, and in many ways MAF functions as our support base. The pilot today even took an extra hour on the ground just to visit us and pray for us. We are so grateful.

I?m wearing a shirt tonight in honor of Pat returning, a shirt that she gave me after buying it right off the back of a man in the market who was wearing it, during the ADF years. It says: If you aren?t living on the edge, you?re taking up too much room. Here we are on the edge, hanging on.

**FrenchieGirl** · December 13, 2007, 02:27 PM

Re: Ebola in Uganda Spreading - Death toll rising

http://paradoxuganda.blogspot.com/20...yo-health.html

Thursday, December 13, 2007
Ebola Survivors - 2 Bundibugyo Health Workers

Dr. Steven Sessanga, the Medical Superintendent of Bundibugyo Hospital, was formally discharged as an Ebola survivor yesterday. President of Uganda, Yoweri Museveni, called him on the phone yesterday to congratulate him on his recovery. His illness lasted for nearly two weeks. His exposure occurred during his care for Mr. Muhindo Jeremiah, the same patient from which Dr. Jonah contracted the Ebola virus.

Issac, a nursing assistant at the Kikyo Health Unit also recovered from a prolonged illness due to Ebola infection. His severe vomiting and diarrhea resulted in his need for 61 bottles of IV fluid. He's currently back on the job, effectively immunized and safe from any infection from the Ebola-Bundibugyo strain (the title of the strain has not yet been determined).

District officials would like to capitalize on the fact that some patients--even health workers--are surviving Ebola. There's a tremendous resistance to admission to either Isolation Ward, as it is perceived as a death sentence. The experience of these two heroes challenges that fear.

**Gert van der Hoek** · December 13, 2007, 04:48 PM

Re: Ebola in Uganda Spreading - Death toll rising

Uganda Ebola epidemic claims four more lives

KAMPALA (AFP) — An Ebola epidemic in western Uganda has claimed four more lives, health officials said Thursday, bringing to 34 the number of deaths since the virulent virus first appeared in September.

Bundibugyo deputy district commissioner Patrick Kawamala told AFP that two patients died on Thursday and two more the previous day.

A total of 116 people are known to have been infected but many more are under observation after coming in close contact with Ebola patients.

However health ministry spokesman Paul Kaggwa said that no new hospital admissions had been recorded since Tuesday, suggesting that the deadly virus may soon be contained.

Spread by body fluids, the blood-borne disease was named after a small river in the Democratic Republic of Congo, where it was discovered in 1976. It re-emerged in Sudan later the same year.

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http://afp.google.com/article/ALeqM5gzNxYwUWdioxkBYt3ftIDxE26H4w

**hawkeye** · December 14, 2007, 09:33 AM

Uganda: First Ebola Victims Ate Monkey - Govt

Uganda: First Ebola Victims Ate Monkey - Govt

13 December 2007
Posted to the web 14 December 2007

Richard M. Kavuma
Kampala

Four months since the deadly Ebola fever broke out in western Uganda, there is still no clear explanation of where the original victim contracted the virus from. But government now believes the outbreak may have come as a result of people eating monkey meat.

Officials in Bundibugyo district were by press-time still noncommittal about what sparked off the current outbreak. Chief Administrative Officer (CAO) Elias Byamungu, said that investigations were continuing, while Resident District Commissioner (RDC) Samuel Kazinga, who chairs the district's Ebola Task Force, promised to make the information public once investigations were complete.

Tracing this "index case" is important to scientists trying to understand exactly where the Ebola virus hides between outbreaks. Knowing this natural reservoir would help the country cope better with any future outbreaks.

Initial reports said that the first victims had eaten a dead goat suspected to have been bitten by a monkey. But speaking in Kampala last week, President Yoweri Museveni cast doubts at monkey-goat theory, suggesting instead that the initial victims might have eaten a monkey.

This appears to be the official view. The minister of State for Health, Emmanuel Otaala, said early this week that investigators had failed to find any trace of the goat suspected to have been bitten by the monkey.

"We tried to trace for the skin of the said goat but in vain," Otaala said by telephone. "So we think the victims actually ate the monkey. And you see Ebola is not known to stay in goats but it can affect primates like monkeys."

The Ministry of Health says the strain of Ebola in Bundibugyo and Kabarole is different from previous types identified in Zaire, Ebola Sudan, Ebola Ivory Coast and Ebola Reston (USA). Medical authorities suggest that this latest strain of Ebola may not be as lethal as previous ones and should not be hard to contain.

Ebola is a highly infectious viral disease without a cure - characterised by fever, joint pains, vomiting and bleeding, among other symptoms. In most outbreaks, up to 70 percent of those infected die.

Health workers try to contain Ebola by isolating patients and sensitising the public to bury the dead immediately and observe higher levels of personal hygiene. By press time, the Ebola death toll stood at 29 out of 113 cases.

Minister Otaala said volunteers had contacted at least 200 people who had come into contact with confirmed Ebola cases. Such people are being advised to stay in their homes for three weeks, after which they can be cleared.

Otaala said the next three weeks would be critical; if the contacts co-operate, then the outbreak should be tamed within this period.

Changing lifestyle

The second coming of Ebola has thrown much of the country into a state of panic. The first case of the current outbreak has been traced back to August 20 this year, while confirmation of Ebola only came three months later. This has given the impression that in that period the disease could have spread far and wide, making many more people vulnerable.

During the just concluded Commonwealth summit (CHOGM), many guests spoke fondly of the kindness and warmth of the Ugandan people. They were not exaggerating. In a country where greetings tend to be elaborate, handshakes abundant and the dead are seen off with body-washing, outpouring of grief and communal meals, Ebola is threatening to shake up Ugandans' way of life.

Here is why. The guide book the public is reading on how to avoid Ebola reads like this: Avoid handshakes - just wave. Avoid contact with (even suspected) Ebola patients. Avoid burials where the deceased's clan and friends cry and dine. And from junior Health Minister Emmanuel Otaala: Avoid washing bodies before burial. Some people even suspect you can get Ebola by visiting a public toilet used by someone carrying the Ebola virus.

According to Dr. Chris Baryomunsi, a medical doctor and MP for Kinkiizi East in Kanungu district, there is a risk in each of the above practices, even if sometimes it is remote. Part of the problem is that the person you shake hands with on the street may appear healthy when in fact he or she is carrying the Ebola virus.

Baryomunsi says you may contract the virus if you come into contact with body fluids of such a person incubating Ebola. (Other medics however say that only a person with full-blown Ebola can spread the disease - Ed) So while a 'dry handshake' with an old friend on Kampala Road may pose no risk, you cannot be sure it will be dry; you cannot be sure if they came into contact with Ebola the day before; so you leave out handshakes altogether.

The same goes for other measures, like avoiding congested public transport and communal burials. You just can't be sure.

"The incubation period of Ebola is between two and 21 days, and even if one does not show overt Ebola symptoms, they can still pass on the disease if there is contact with body fluids," Baryomunsi said....

**Gert van der Hoek** · December 14, 2007, 10:06 AM

Re: Ebola in Uganda Spreading - Death toll rising

Uganda confirms 119 Ebola cases, 35 deaths

Reuters

Friday, December 14, 2007; 7:43 AM

NAIROBI (Reuters) - Uganda has had 119 cases of a new strain of Ebola fever that has killed 35 people, the east African country's Health Ministry said on Friday.

All the cases since the outbreak began in August have been in remote western Bundibugyo district, which borders Democratic Republic of the Congo (DRC), except for a doctor who died in the capital Kampala after returning from that area.

"The Ministry of Health continues to urge the public to avoid unnecessary movements and gatherings especially in the districts around Bundibugyo," the ministry said in a statement.

It urged all local health officers to remain on alert and called on the public to bring to their attention anyone suffering symptoms including very high fever, diarrhea or vomiting associated with red eyes and a measles-like rash.

The last Ebola outbreak in Uganda was in 2000, when 425 people caught it and more than half died.

(Writing by Daniel Wallis; Editing by Stephen Weeks)

http://www.washingtonpost.com/wp-dyn/content/article/2007/12/14/AR2007121400640.html

**FrenchieGirl** · December 14, 2007, 01:43 PM

Re: Ebola in Uganda Spreading - Death toll rising

http://paradoxuganda.blogspot.com/20...t-numbers.html

Friday, December 14, 2007
Ebola Bundibugyo: Friday Night Numbers

Two weeks and one day since the diagnosis of Ebola was made public. Two weeks since the MSF preparation team came, 12 days since the first real medical staff, and 10 days since the overall organized response took shape. In that time it is good to think about what has NOT happened. Ebola has NOT been confirmed anywhere outside of Bundibugyo. Hundreds of new cases have NOT materialized. Health centers in addition to the two primary foci have NOT been swamped with cases. It has been a stressful and uncertain two weeks, and a time of great loss and sorrow. There were many points at which it seemed we might be reaching the potential beginning of the end of life as we know it, with diffuse spread of the infection and overwhelming fatalities. Thankfully that has not happened, but now the weariness of grief is beginning to catch up with us, the change in pace to the long-haul. And with that shift comes the district and ministry wrangling over money, power, and control. Scott spoke up in tonight’s meeting on behalf of compensation for health workers who were infected and recovered, as well as the families of those who died, concerned that these people were getting lost in the scramble for the money flowing in. He was immediately attacked by at least three people who sensed a threat or challenge to the proposal of huge allowances for all numbers of people, some of whom are quite peripherally involved. Sigh. I think it is a small reflection of the kind of pressure Jonah faced. If we aren’t a threat to the way things are, we shouldn’t be here. And so it goes.

Cumulative Cases: 120.
Cumulative Deaths: 34 (CFR 28.4&#37

Admitted: Bundibgugyo 8, 1 new admission, 1 discharge, 0 deaths. Kikyo 10, 1 new admission (a health worker sadly), 0 discharges, 0 deaths.
Confirmed cases by lab: 32 still, but now we got the information that 11 have died, 7 are still admitted, and 14 have recovered. If those 11 are the only ones to die then the CFR among laboratory confirmed cases will be slightly higher than the overall, at 34%. The numbers are small, and this CFR could be falsely lowered by the fact that the sickest patients did not survive to get their labs drawn, or falsely elevated if we go back and test lots of people for antibodies since we’ll only find the survivors. Still it is the best number we have, and would suggest this strain is less lethal than other strains of Ebola.
Contacts: 345 (17 were removed from the list for reaching their 21 day limit, a milestone we look forward to next week!). Over 90% were followed up today.
Interesting stories: the two biggest clusters of related cases have been mapped out. There do not appear to be multiple sources of this infection crossing from the supposed animal reservoir to humans. This is excellent news, since it was certainly possible that Bundibugyo might have had lots of little mini-epidemics all cropping up in this time period. Most cases seem to be directly related to each other. However not all are testing positive, which may mean that we are looking at not just another strain of Ebola but something else as well. We continue to be thankful for the excellent and inquisitive minds who are focusing their energies on this.
Sad news: there was a massive turn over in staff today, especially WHO, including three of the men whom we have grown to really trust and respect over the last ten days. They will be missed. Dr. Yoti promised to come back. Other sad news was that a mission house was broken into, the thieves dragging a safe a long distance and then sledgehammering it to pieces. They were probably disappointed to find it was pretty much empty. Sad for all of us that people would use this time to take advantage of others.
Happy news: The UPDF nurse Fred, whom we met in the Bundibugyo isolation unit the first time we went to investigate patients, recovered.

**Niko** · December 16, 2007, 02:50 AM

Re: Ebola in Uganda Spreading - Death toll rising

Saturday, December 15, 2007

Ebola Bundibugyo: Saturday numbers

Encouraging statistics from today:

Cumulative cases: 122
Cumulative deaths: 34 (same as yesterday, no new ones!)
Admitted on isolation wards: Bundibugyo 4 . . . 0 admissions, 4 discharges, 0 deaths. Kikyo 8 . . . .2 admissions, 4 discharges, 0 deaths.
Contacts: 423 identified, 327 being followed, 286 seen today (87%). 42 people moved off the list at the end of their 21 days.
Surgeries Scott performed today: 3. He was called this morning by the police surgeon from Fort Portal who said he needed to go home for the weekend, so could Scott be on call. . And a few minutes later the first emergency C-section call came. So Scott and Scott spent the whole day at Bundibugyo hospital, once again the only people seeing non-Ebola patients. This pinch-hitting is very stretching for them, dealing with cases that come very late and very sick . . . Thankfully a healthy baby boy was delivered by C section, an 18 year old bleeding excessively from a miscarriage had a d and c, and another lady?s life was saved when she came with a retained placenta. Before and after all that Scott was dealing with airstrip maintenance. It?s a lot of work to be here these days.

Best comment of the day: Dr. Sessanga?s son. It is a privilege to be a source of information even for Ebola patients? family members in Uganda, to encourage prayer and hope. A small way in which this crisis bridges cultural barriers and connects us all.
Posted by DrsMyhre at <a class="timestamp-link" href="http://paradoxuganda.blogspot.com/2007/12/ebola-bundibugyo-saturday-numbers.html" rel="bookmark" title="permanent link"><abbr class="published" title="2007-12-15T09:43:00-08:00">9:43 AM</abbr>

Ebola Bundibugyo: Saturday numbers

http://paradoxuganda.blogspot.com/2007/12/ebola-bundibugyo-saturday-numbers.html

Encouraging statistics from today: Cumulative cases: 122 Cumulative deaths: 34 (same as yesterday, no new ones!) Admitted on isolation war...

**Sally Furniss** · December 16, 2007, 07:30 AM

Re: Ebola in Uganda Spreading - Death toll rising

Inside Ebola's zone of death

It is a country where the president has asked people to stop shaking hands, where MPs have called for an end to public gatherings, market vendors wear gloves and Roman Catholic priests no longer give the communion wafers and wine by hand. Uganda is gripped by terror over a new strain of one of the world's most deadly diseases. Ebola haemorrhagic fever, which is spread by touch, kills between 50% and 90% of victims.

Thirty-two people have died and 120 people have the virus -- in a nation where malaria kills 300 people a day -- but it is the nature of the illness that has caused such panic. After an incubation period of up to 21 days, Ebola patients develop terrible symptoms: high fever, headache and joint pains, then vomiting and diarrhoea, and in some cases bleeding from the mouth, nose, eyes and ears. In most cases, multiple organ failure, haemorrhaging or shock brings death.

This new strain is feared to kill more slowly than previously, leaving more time for the disease to spread. There is no vaccine and no cure. The only hope is to contain the lethal virus, but Ebola moves fast and is hard to track. If just one infected person boards a plane, this could become a global outbreak.

Buses heading west from the capital, Kampala, to the affected region of Bundibugyo normally have standing room only. Now they leave half empty, and anyone crossing into neighbouring Rwanda and Kenya is screened. "For the time being people should resort to jambo [waving]. If I don't shake your hand, it doesn't mean I don't like you," President Yoweri Museveni told his people.

"One of the fears with Ebola is that it can move very quickly to different parts of the world," said Dave Daigle, of America's Centres for Disease Control and Prevention (CDC) in Atlanta, Georgia, where the virus was confirmed as Ebola last month. The date of the announcement, three months after the first deaths had been reported, aroused suspicion, falling just after the Commonwealth heads of government meeting, attended by the Queen, ended in Kampala.

Ugandan newspapers accused ministers of suppressing the news to ensure the meeting went ahead, and claimed the delay may have cost lives.

A team of CDC scientists has travelled to the epicentre of the outbreak. The focus, said Daigle, is on containment. He described how experts mapped out the movements of sufferers and tracked those they came into contact with. Hundreds have been confined to their homes over fears that they may have come into contact with infectious people or corpses.

The most senior politician in the affected area, Jackson Bambalira, the Bundibugyo district chairperson, fears the worst: "I am greatly worried that a bigger Ebola bomb could explode, claiming many more lives."

Among those most at risk are doctors and nurses. The first time Ebola came to Uganda, in 2000, 14 nurses and one doctor died. This time eight medical workers have died and many doctors and nurses are in isolation units after testing positive for the virus. Nurses have threatened to strike, angry about the lack of protective clothing and any risk allowance, and the Uganda Medical Workers' Union has instructed health workers without proper protection to flee the Ebola zone after reports of medics treating patients with bare hands.

It began in late summer in Kikyo, a village hidden away on a mountainside of western Uganda. At the edge of a beautiful game reserve, villagers who spend their lives farming the cocoa crop began to fall ill. There were headaches, fevers, vomiting, diarrhoea and the painful bleeding. Relatives washed the bodies of their loved ones before burying them, unaware of a deadly disease at its most contagious. Although news spread of a strange sickness, the word Ebola was not mentioned.

Local doctor Jonah Kule decided he wanted to help. He drove his motorbike to the district's government offices to see his friend, Elias Byamungu, the region's chief administrative officer. It was a warm day and sunlight was streaming through the windows of Byamungu's office when Kule walked in. "He told me he was going to find out what the disease was that was infecting his people," said Byamungu. "I questioned him; I said it could be deadly." But Kule insisted he was prepared to die to help Ugandans. "He was the first person who dared to go and see," said Byamungu. A few weeks afterwards Kule left Bundibugyo to pick up his children from school in Kampala. While there he fell sick and was admitted to the isolation ward at the city's largest hospital. Eight days later he died. A matron, Rose Bulimpikya, died within 24 hours of Kule.

Dr William Sikyewunda, director of health services in Bundibugyo, said health workers were petrified. "We are trying to reassure them," he said. "It was Rose Bulimpikya's kindness and diligence that put her at risk," he said.

Bulimpikya was the most senior nurse in the district and next year would have celebrated her 60th birthday. Her devastated family were in disbelief as she was buried. She had fallen ill less than a week earlier.

"She has left a very large family with six children," said her husband, Hassan Bhatungi Kabho (60). "I have lost a beloved wife. We have been working hand in hand to look after the family. I don't know how I will manage. I am very afraid." Her son Francis said Rose died a heroine. "She wanted to help people. I feel proud because she died doing her job and she behaved with professionalism."

Now officials are focusing on who Bulimpikya and the other victims have come into contact with. The early symptoms of Ebola are similar to those of malaria, said Dr Susan Wandera, head of programmes for the African Medical and Research Foundation. "Ebola is a very big risk for doctors and nurses. Usually sweat is taken as harmless, but it is not in this case."

Ebola first appeared in two simultaneous outbreaks in Zaire and Sudan in 1976, killing 90% and 50% of sufferers respectively. It was believed to have come from monkeys, perhaps through eating "bush meat", but scientists remain at a loss. Kule died a day before the anniversary of the death of Dr Matthew Lukwiya, the first doctor to die of Ebola in the last outbreak here, in 2000, which killed 224 people.

Lukwiya has become an international hero, described in the New York Times as a "fearless commander at the centre of a biological war that threatened everyone in the country". Called to his hospital in Gulu, northern Uganda, after a mystery virus began to kill student nurses, he suspected Ebola and set up restrictive safety measures that prevented the further spread of the virus.

For his widow, Margaret, this month has been difficult. "I started recalling how I felt when Matthew was sick and died," she said. "I am imagining that poor widow now," she said of Kule's wife.

Then, as now, the nurses threatened to strike. Lukwiya brought them together and told them: "Whoever wants to leave can leave. As for me, I will not betray my profession. Even if I am on the ward alone, I will continue."

More than a month after he returned to the hospital, Margaret gathered her five children around the phone to sing him happy birthday. Six days later she received the call she had dreaded. Margaret rushed to the hospital. She wore protective gear, including six gloves, but was still told not to touch him. In those final days she ignored his own rules, taking his hand and bathing him.

She has not celebrated Christmas since and fought for six years to persuade the government to give families of health workers compensation.

"He went too fast," she said. "At first I was bitter. But then I think, suppose it was me that was sick and needed a doctor -- if a doctor refused to come to my aid, how would I feel? He died for the right cause." - Guardian Unlimited ? Guardian Newspapers Limited 2007

Page not found - The Mail & Guardian

http://www.mg.co.za/articlepage.aspx?area=/breaking_news/breaking_news__africa/&articleid=327848&referrer=RSS

**Treyfish** · December 17, 2007, 05:15 PM

Re: Ebola in Uganda Spreading - Death toll rising

<TABLE cellSpacing=0 cellPadding=4 width=480 border=0><TBODY><TR><TD class=headline1 colSpan=2>6 new Ebola suspects in Bundibugyo</TD></TR><TR><TD>Monday, 17th December, 2007</TD><TD align=right><TABLE style="MARGIN-LEFT: auto; MARGIN-RIGHT: 0px; BORDER-COLLAPSE: collapse"><TBODY><TR><TD style="VERTICAL-ALIGN: middle"></TD><TD style="VERTICAL-ALIGN: middle">E-mail article</TD><TD style="VERTICAL-ALIGN: middle"> </TD><TD style="VERTICAL-ALIGN: middle"></TD><TD style="VERTICAL-ALIGN: middle">Print article</TD></TR></TBODY></TABLE></TD></TR><TR><TD colSpan=2>By Vision Reporters

SIX more people were admitted to Bundibugyo Hospital and Kikyo health centre with suspected Ebola haemorrhagic fever. Doctors said the patients, three of them children aged 6 to 12 were admitted to Bundibugyo Hospital, while two were admitted at Kikyo health centre.

The admissions push the number of suspected Ebola admissions to 125 from 119 last week, but according to the health ministry, no new deaths have occurred.

Eight patients are in Kikyo, up from six and seven in Bundibugyo , increasing from threereported last week. The authorities in Bundibugyo, however, said the new cases were not confirmed patients and it could be something else.
They vomited, had fever and diarrhoea but were said not to be very sick.

The health ministry said the fifth and sixth lot of blood samples taken earlier from alert cases were found negative at the Virus Research Institute.

http://www.newvision.co.ug/D/8/13/602563
</TD></TR></TBODY></TABLE>

Announcement

Ebola in Uganda: November 30 - December 17, 2007

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