Ebola in Uganda: November 30 - December 17, 2007

[Treyfish]

Re: WHO concerned at new Ebola strain in Uganda

Ebola drives medical help Uganda on the run
ANP, AFP
Published on 02 December 2007 09:32, modified on December 2, 2007 10:07

KAMPALA - Dozens of doctors and nurses are the extreme west of Uganda escaped after the outbreak of ebola fever. The authorities have this Saturday in the capital Kampala. The outbreak has already claimed eighteen lives in the affected region Bundibugyo.

The disease off since around September, but it was only last week established that it is the highly contagious and dangerous ebolakoorts.

That caused panic at the very poorly equipped and poorly protected medical personnel.

There are currently 43 ebola pati?nten in the area counted, in addition to the deceased eighteen patients.

Ebola is the name for a group of dangerous viruses in 1976 in the then Zaire to the river Ebola is discovered. There is no way of combating found. The outbreak is usually very local, and between half and 90 percent of patients dies in short time. It is allegedly so earlier by the United States and the then Soviet Union tested for the usefulness as a biological weapon. http://www.volkskrant.nl/buitenland/...a_op_de_vlucht

[HenryN]

Re: WHO concerned at new Ebola strain in Uganda

CDC scientists find new Ebola virus strain

Published: Dec. 1, 2007 at 7:11 PM

ATLANTA, Dec. 1 (UPI) -- Centers for Disease Control and Prevention scientists in Atlanta say they believe they have found a new strain of the deadly Ebola virus.

After testing samples sent from an Ebola outbreak in Uganda, CBC scientists said they may have found a fifth strain of the extremely dangerous virus, The Atlanta Journal-Constitution said Saturday.

The outbreak in Uganda has claimed at least 16 lives and has contaminated 51 people to date.

Dr. Eileen Farnon, an epidemiologist with the CDC, said investigators would soon be on site to determine the scope of the spread of the virus and how best to contain the outbreak.

"The most important consideration is to have a sense of what's been going on with the outbreak: How many people are affected, where and when the outbreak is moving, and trying to stop transmission," she said.

The Ebola virus can affect both humans and non-human primates, causing internal and external bleeding.

http://www.upi.com/NewsTrack/Health/2007/12/01/cdc_scientists_find_new_ebola_virus_strain/1930/print_view/

[HenryN]

Re: WHO concerned at new Ebola strain in Uganda

Ebola: Bundibugyo medics abandon patients
By John Thawite, Bizimungu
Kisakye and agencies

MEDICAL workers in Bundibugyo District have fled their workplaces in fear of contracting the deadly Ebola virus. Elias Byamungu, the Chief Administrative Officer, on Friday said medical workers had abandoned patients in health units, for fear of being infected.

?The health workers are terribly afraid,? he said. Byamungu put the death toll at 28. Health authorities, however, last night put the toll at 18, up from 16 registered by Thursday.

?We have had two more deaths in the last 24 hours and the disease continues to spread,? Dr. Sam Zaramba, the Director General of Health Services, told Reuters. He said World Health Organisation (WHO) officials had teamed up with local experts to draw up a strategy to contain the outbreak. More than 50 people are also infected.

District health officials said five new cases were admitted to Bundibugyo Hospital yesterday.

?We have set up isolation wards where all those who have been diagnosed with Ebola have been quarantined, and are being monitored closely,? Zaramba said.

The first victim died in August, but the cause of death was referred to as a ?mysterious illness?.

Until Wednesday when the health ministry and the WHO confirmed it as being Ebola, the disease, which has ravaged 14 villages in the district, was being described as ?mysterious? and ?strange?.

Zaramba said the illness was confirmed as being Ebola following tests at the Centers for Disease Control and Prevention in Atlanta, US.

Speaking on phone, Byamungu said among the infected are three medical workers including a doctor, whom he identified only as Ssesanga, who he said was critically ill. He said the disease started in Kikyo Parish, Kasitu Sub-county and later spread to Ngamba Parish, Bundibugyo Town Council and Bubukwanga Sub-county.
The first death occurred after a group of residents of Kikyo feasted on a goat in August.

?There were accusations and counter-accusations of witchcraft. Some people were even arrested until we discovered that the problem was medical,? Byamungu said.

He expressed fear that the disease could be incubating in the neighbouring districts of Kabarole and Kasese, where infected people could have travelled.

Residents of Kabarole are in a state of panic, with many avoiding handshakes or being in crowed places. Taxi drivers plying the Fort Portal-Bundibugyo route said they were taking extra precautions. ?We are not overloading our vehicles so as to reduce body contact among passengers. We also do not accept to transport visibly ill people,? said one driver.

Ebola is spread through contact with the body fluids of infected persons. This is the second major Ebola outbreak in Uganda. The last one occurred in 2000 in Bunyoro and in the north, killing over 140 people.

Published on: Saturday, 1st December, 2007

http://www.sundayvision.co.ug/detail.php?mainNewsCategoryId=7&newsCategoryId=123&newsId=600030

[Treyfish]

Re: WHO concerned at new Ebola strain in Uganda

Officials Say Ebola Outbreak Spreading In Uganda - AFP

KAMPALA, Uganda (AFP)--The Ebola outbreak that has killed 18 people in western Uganda appears to be spreading, officials said Sunday, as authorities examined a sample taken from a dead patient in the south of the country.
Government officials told AFP that the disease, which flared up in September, had spread to three new zones in the impoverished Bundibugyo district near the border with the Democratic Republic of Congo.
Virologists were meanwhile examining a sample taken from a suspected victim who died overnight in Mbarara region, 160 kilometers southeast of the affected district.
Health officials said several dozen medics and support staff had fled Bundibugyo when their co-workers became infected with the virus in an outbreak that has already killed 18 people and infected 61.
Virologists were also investigating an isolated patient in the neighboring Port Portale district as well as the fatality in Mbarara.
"There are fears that the disease has spread," said a top health ministry official, who requested to remain unnamed.
"We are waiting for the results from the samples," he said of the two cases that have spread panic in the east African nation.
The disease, which is fatal in 90% of cases, is spread by contact of body fluids, primarily contamination of blood.
Epidemiologists and virologists are in Bundibugyo district to try to trace backwards the source of the virus as part of a campaign to avoid future outbreaks.
Authorities say the outbreak was an unknown strain after analysis was done on tissue samples at the laboratories of the Atlanta-based Center for Disease Control.
An outbreak killed at least 170 people in Uganda's northern Gulu district in 2000. Another in recent weeks killed at least 26 people in DR Congo's West Kasai region.

http://www.nasdaq.com/aspxcontent/Ne...ternational.na</PRE>

[HenryN]

Re: New Ebola Strain in Uganda May Be Spreading

Commentary at

http://www.recombinomics.com/News/12020701/Ebola_Recombination_Uganda.html

[Treyfish]

Re: WHO concerned at new Ebola strain in Uganda

Outbreak of rare Ebola virus in Uganda worsens

Sun 2 Dec 2007, 15:24 GMT

KAMPALA (Reuters) - The number of Ugandans infected by a
new strain of the deadly Ebola virus has risen to 58, raising fears the death toll of 18 will also increase from the outbreak in a remote area near Democratic Republic of Congo.
The half dozen extra infections in recent days include some medical staff who were treating victims of the haemorrhagic fever which has swept the western Bundibugyo region since August.
"Four of our medical personnel, including a doctor and three nurses, have been isolated in Bundibugyo Hospital after catching the virus," said Dr. Sam Okware, head of Uganda's national hemorrhagic fever task force.
"We now have a team of experts on the ground to try and contain further spreading of the virus."
Genetic analysis of samples taken from some of the victims shows it is a previously unknown type of Ebola, making it the fifth strain, U.S. and Ugandan health officials say.
Ebola can cause internal and external bleeding.
Victims often die of shock, but symptoms can be vague, including fever, muscle pain and nausea. It is known to infect humans, chimpanzees and gorillas.
Uganda was last hit by an epidemic of Ebola in 2000, when 425 people caught it and just over half of them died, including a doctor treating victims.
An outbreak in neighbouring Congo this year infected up to 264 http://africa.reuters.com/top/news/u...7.html?rpc=401&

[Treyfish]

Re: New Ebola Strain in Uganda May Be Spreading

<TABLE xmlns:fo="http://www.w3.org/1999/XSL/Format"><TBODY><TR><TD class=ArticleHead colSpan=2>Medics flee Uganda<!--head0--></TD></TR><TR><TD class=Byline><!--byline1-->By Vincent Mayanja, AFP<!--byline0--></TD><TD class=Published align=right>Published:<!--date1-->Dec 02, 2007<!--date0--></TD></TR><TR><TD class=ArticleHead colSpan=2><HR class=ArticleLine width="100%" SIZE=1></TD></TR><TR><TD colSpan=2><TABLE cellSpacing=0 cellPadding=5 width=200 align=right border=0><TBODY><TR><TD><TABLE cellSpacing=0 cellPadding=0 width=200 border=0><TBODY><TR><TD class=ArticleImg>

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<!--par1-->KAMPALA - Several dozen medics and support staff have fled western Uganda after their co-workers became infected with the Ebola virus in an outbreak that has already killed 18 people, officials said on Saturday.<!--par0-->
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<!--par1--><!--par0-->
<!--par1-->Ugandan officials clamped a quarantine on the Bundibugyo region and appealed for help in dealing with the outbreak of Ebola, a contagious disease that kills up to 90 percent of those infected.<!--par0-->
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<!--par1-->However efforts to contain the outbreak, which began in September but was definitively identified as Ebola only last week, have been hampered by medical personnel becoming infected and others fleeing.<!--par0-->
<!--par1--><!--par0-->
<!--par1-->"We have a shortage of health workers and we need more because those who were there on the ground have been infected: two doctors, a medical officer and a nurse," said Sam Zaramba, the country?s top government physician.<!--par0-->
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<!--par1-->"Health workers are terribly afraid. They have abandoned patients in health units for fear of being infected," a government official told the state-owned New Vision newspaper.<!--par0-->
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<!--par1-->A health official for the Bundibugyo region, who asked not to be named, estimated the number of health and support staff to have abandoned their posts to be several dozen.<!--par0-->
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<!--par1-->Zaramba said earlier that two more patients had succumbed to the virus in the region, bringing the toll to 18.<!--par0-->
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<!--par1-->"Cumulatively, there are 18 deaths and 61 cases," he said.<!--par0-->
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<!--par1-->A total of 19 patients were quarantined in Bundibugyo hospital near the border with the Democratic Republic of Congo, which itself has had harrowing experience with the virulent disease.<!--par0-->
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<!--par1-->"Those admitted are mainly health workers and those who attended to the patients," Zaramba told AFP.<!--par0-->
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<!--par1-->Previous Ebola fatalities among medical workers have been blamed on poor sanitation and hygiene in health centres that lack protective suits, respirator masks, latex gloves and other necessary safety gear.<!--par0-->
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<!--par1-->Ebola spreads through contact of body fluids, particularly blood, putting health workers who lack protective gear at risk.<!--par0-->
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<!--par1-->"The situation is not yet under control. The main challenge we are facing is detecting cases and following up on those who made contacts with the patients," Zaramba added.<!--par0-->
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<!--par1-->A team of epidemiologists and virologists arrived in the region on Saturday to try to retrace backwards the source of the virus as part of a campaign to avoid future epidemics.<!--par0-->
<!--par1--><!--par0-->
<!--par1-->Authorities on Friday said the outbreak was an unknown strain after analysis was done on tissue samples at the laboratories of the Atlanta-based Centre for Disease Control.<!--par0-->
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<!--par1-->Known Ebola subtypes usually attack capillaries and blood vessel linings, draining the body of blood through openings, leaving the patient to die in shock, doctors say.<!--par0-->
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<!--par1-->But the new Uganda subtype kills patients by provoking high fever, but without much loss of blood.<!--par0-->
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<!--par1-->There is no vaccine or cure for Ebola.<!--par0-->
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<!--par1-->On Saturday, Rwandan authorities announced they had tightened border health controls to prevent if from travelling across the frontier from western Uganda.<!--par0-->
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<!--par1-->Experts say the disease is usually containable because it kills its victims faster that it can spread to new ones.<!--par0-->
<!--par1--><!--par0-->
<!--par1-->An outbreak killed at least 170 people in Uganda?s northern Gulu district in 2000. Another in recent weeks killed at least 26 people in DR Congo?s West Kasai region.<!--par0-->
<!--par1--><!--par0-->
<!--par1-->The Ebola virus was first identified in 1976 in Sudan and in a nearby region of DRC, then Zaire. Outbreaks of Ebola have also occurred in the Ivory Coast and Gabon. http://www.thetimes.co.za/News/Article.aspx?id=647609
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[HenryN]

Re: New Ebola Strain in Uganda May Be Spreading

Commentary at

http://www.recombinomics.com/News/12020702/Ebola_Uganda_HCW.html

[Treyfish]

Re: New Ebola Strain in Uganda May Be Spreading

Rwanda reinforces border health controls<TABLE style="WIDTH: 405px; HEIGHT: 44px; BACKGROUND-COLOR: #ffffff" cellSpacing=0 cellPadding=0><TBODY><TR><TD class=caption style="WIDTH: 360px">
December 01 2007 at 12:05PM </TD></TR><TR><TD style="HEIGHT: 1px; BACKGROUND-COLOR: #cccccc" colSpan=2></TD></TR></TBODY></TABLE><TABLE cellSpacing=0 cellPadding=23 border=0><TBODY><TR><TD class=svarticletext>Kigali - Rwanda's authorities announced on Saturday they had reinforced border health controls to prevent a previously unknown strain of the lethal Ebola virus from travelling across the frontier from western Uganda.

"We are extremely worried since this region isn't very far away from us and commercial and social exchanges are considerable," Innocent Nyaruhirira, Rwanda's secretary for HIV/Aids and other epidemics, told the government-controlled Radio Rwanda.

So far no Ebola cases have been detected in Rwanda, he said.

The Atlanta-based Centres for Disease Control announced on Friday a new strain of Ebola with new characteristics from the classic virus had been detected in western Uganda's Bundibugyo region.

Virologists say previous strains destroyed the linings of blood capillaries and vessels, prompting fluids to drain out of the circulatory system through the body's orifices and pores, killing the victim through shock.

But there is not much bleeding in the new strain that appears to kill its victims after provoking a high fever, they say.

So far 16 people have died out of the 51 Ebola cases detected in Uganda since September.

A similar outbreak has killed at least 26 people in DR Congo's West Kasai region in recent weeks, officials there report.
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http://www.int.iol.co.za/index.php?set_id=1&click_id=3045&art_id=nw20071201120157173C288597

[HenryN]

Re: New Ebola Strain in Uganda May Be Spreading

Ebola outbreak spreading
02/12/2007 15:58 - (SA

Kampala - The Ebola outbreak that has killed 18 people in western Uganda appears to be spreading, officials said on Sunday, as authorities examined a sample taken from a dead patient in the south of the country.
Government officials told AFP that the disease, which flared in September, had spread to three new zones in the impoverished Bundibugyo district near the border with the Democratic Republic of Congo.
Virologists were meanwhile examining a sample taken from a suspected victim who died overnight in Mbarara region, 160km southeast of the affected district.
Medics flee
Health officials said several dozen medics and support staff had fled the Bundibugyo when their co-workers became infected with the virus in an outbreak that has already killed 18 people and infected 61.
Virologists were also investigating an isolated patient in the neighbouring Port Portale district as well as the fatality in Mbarara.
"There are fears that the disease has spread," said a top health ministry official, who requested to remain unnamed.
"We are waiting for the results from the samples," he said of the two cases that have spread panic in the east African nation.
The disease, which is fatal in 90&#37; of cases, is spread by contact of body fluids, primarily contamination of blood.
Unknown strain
Meanwhile, epidemiologists and virologists are in Bundibugyo district to try to trace backwards the source of the virus as part of a campaign to avoid future outbreaks.
Authorities say the outbreak was an unknown strain after analysis was done on tissue samples at the laboratories of the Atlanta-based Centre for Disease Control.
Known Ebola sub-types usually attack capillaries and blood vessel linings, draining the body of blood through openings, leaving the patient to die in shock, doctors say.
But the new Uganda subtype, which provokes high fever, kills victims without much loss of blood.

http://www.news24.com/News24/Africa/News/0,,2-11-1447_2231444,00.html

[sharon sanders]

Re: New Ebola Strain in Uganda May Be Spreading

Spread may be exacerbated by asymptomatic carriers - this from the Lancet

The Lancet 2000; 355:2210-2215
DOI:10.1016/S0140-6736(00)02405-3

Human asymptomatic Ebola infection and strong inflammatory responseDr EM Leroy DVM a , S Baize PhD a, VE Volchkov PhD b, SP Fisher-Hoch MD c, M-C Georges-Courbot MD a, J Lansoud-Soukate PhD a, M Capron PhD d, P Debr&#233; MD e, JB McCormick and AJ Georges MD a

SummaryBackground

Ebola virus is one of the most virulent pathogens, killing a very high proportion of patients within 5–7 days. Two outbreaks of fulminating haemorrhagic fever occurred in northern Gabon in 1996, with a 70% case-fatality rate. During both outbreaks we identified some individuals in direct contact with sick patients who never developed symptoms. We aimed to determine whether these individuals were indeed infected with Ebola virus, and how they maintained asymptomatic status.
MethodsBlood was collected from 24 close contacts of symptomatic patients. These asymptomatic individuals were sampled 2, 3, or 4 times during a 1-month period after the first exposure to symptomatic patients. Serum samples were analysed for the presence of Ebola antigens, virus-specific IgM and IgG (by ELISA and western blot), and different cytokines and chemokines. RNA was extracted from peripheral blood mononuclear cells, and reverse-transcriptase-PCR assays were done to amplify RNA of Ebola virus. PCR products were then sequenced.

Findings
11 of 24 asymptomatic individuals developed both IgM and IgG responses to Ebola antigens, indicating viral infection. Western-blot analysis showed that IgG responses were directed to nucleoprotein and viral protein of 40 kDa. The glycoprotein and viral protein of 24 kDa genes showed no nucleotide differences between symptomatic and asymptomatic individuals. Asymptomatic individuals had a strong inflammatory response characterised by high circulating concentrations of cytokines and chemokines.

Interpretation
This study showed that asymptomatic, replicative Ebola infection can and does occur in human beings. The lack of genetic differences between symptomatic and asymptomatic individuals suggest that asymptomatic Ebola infection did not result from viral mutations.

Elucidation of the factors related to the genesis of the strong inflammatory response occurring early during the infectious process in these asymptomatic individuals could increase our understanding of the disease.

[HenryN]

Re: New Ebola Strain in Uganda May Be Spreading

Commentary at

http://www.recombinomics.com/News/12020703/Ebola_Uganda_Spread.html

[Treyfish]

Re: New Ebola Strain in Uganda May Be Spreading

Doctor, 3 nurses catch Ebola
JOSEPH MUGISHA & AL-MAHDI SSENKABIRWA
BUNDIBUGYO/KAMPALA
AS the unusual Ebola strain identified in the southwestern district of Bundibugyo continues to take its toll, four health workers were reported to have been taken ill yesterday.
The District Ebola Task Force Chairman, Mr Samuel Kazinga, told Sunday Monitor yesterday that the four health workers include three nurses and a doctor, all attached to Bundibugyo Hospital. He said four other new cases had been recorded at Kikyo Health Centre IV.
?It is really unfortunate that those admitted at the hospital include our medical superintendent, Dr Stephen Ssesanga,? he said.
Sixteen people have so far been reported dead and 51 others infected, according to Mr Kazinga. However, unofficial reports continue to place the number of the dead at 30 while new recorded cases are seven.
Mr Kazinga, who is also the Bundibugyo RDC, said the task force had set up two patient isolation centres: one at Kikyo Health Centre IV and the other at Bundibugyo Hospital.
On Friday morning, the International Emergency Response Team arrived in the district to trace contacts of the deadly Ebola patients. More perplexing is that the Ebola type in Bundibugyo is ?completely different? from the four known subtypes of the haemorrhagic fever namely; Ebola Sudan, Ebola Zaire, Ebola Reston (that only affects monkeys) and Ebola Tai (Ivory Coast), according to medical experts.
Ebola has since spread to at least 14 villages. They include Kabango, Ntandi , Butolya, Kikyo, Kizufo, Bugharama, Butantagua , Bulhambago, Bundimwali I, Buyaya, Bugharama II and Bulhambaghiri.
Asked whether they would consider quarantining the district, Mr Kazinga said the situation was still controllable.
Ebola National Task Force Chairman, Dr Sam Okware, said on Friday that the Ministry of Health had dispatched an ambulance and a consignment of personnel protection equipment (PPE) like gloves and disinfectants to help the response team.
He said part of the response team led by Dr Jackson Amone was expected back on Friday. ?The team went for among other things to search for the index case which would help us establish the origin of this breed of Ebola,? said Dr Okware, a veteran of many public medical emergencies in Uganda.
Ebola last struck Uganda in October 2000 in the north and parts of Bunyoro region killing 224 people.

http://www.monitor.co.ug/artman/publish/sun_news/Doctor_3_nurses_catch_Ebola.shtml

[Treyfish]

Re: New Ebola Strain in Uganda May Be Spreading

<TABLE cellSpacing=0 cellPadding=4 width=480 border=0><TBODY><TR><TD class=headline1 colSpan=2>Ebola: Red Cross sends team to Bundibugyo </TD></TR><TR><TD>Sunday, 2nd December, 2007</TD><TD align=right><!-- E-mail and Print Article --></TD></TR><TR><TD colSpan=2>By Raymond Baguma

THE Uganda Red Cross Society has sent an assessment team to Bundibugyo district to support the Ministry of Health in containing the deadly Ebola hemorrhagic disease.

A total of 100 volunteers, who participated in containing Ebola in Gulu district in 2000, were also sent to the area following the death of 16 people.
The Red Cross will sensitise the community about the disease through door-to-door sessions as part of the preventive measures.

They also identify suspected Ebola cases and report them to the Ministry of Health, according to a statement issued by the secretary-general, Alice Uwase Anukur.
?As part of our operations, re-integration in the communities will be done to ensure that households with suspected cases are not discriminated within the communities as this causes stigma and psychological torture,? she said.

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http://www.newvision.co.ug/D/8/13/600188

[HenryN]

Re: New Ebola Strain in Uganda May Be Spreading

Ebola haemorrhagic fever in Uganda

30 November 2007
The Ministry of Health (MoH), Uganda, has confirmed an outbreak of Ebola haemorrhagic fever, in Bundibugyo District, western Uganda. As of 28 November, 51 suspected cases, including 16 deaths have been reported. Among the reported cases, 3 health care workers were also infected, including one fatality. Cases are being hospitalized at Kikyo and Bundibugyo.
Laboratory analysis undertaken at the National Reference Laboratories and the Centres for Disease Control and Prevention (CDC), Atlanta, USA has confirmed the presence of a new species of Ebola virus in samples taken from cases associated with the outbreak.
Based on initial field investigations, the MoH/WHO Country office has reported that the outbreak might have been ongoing since Sept 2007. A national task force comprising MoH, WHO and other international partners in the field, is coordinating the response to this outbreak. WHO Country office is assisting the MOH national field team and the District health officials.

http://www.who.int/csr/don/2007_11_30a/en/index.html