Uganda: Hemorrhagic fever outbreak- Yellow Fever

[alert]

Re: Uganda: Yellow fever outbreak- 45 dead

http://www.newvision.co.ug/D/8/12/742071

Yellow fever kills 45 in Northern Uganda
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By Anne Mugisa

AT least 2.5 million people will be vaccinated in northern Uganda against yellow fever that has so far killed 45 people and infected 178.

According to the Ministry of Health, 2.5 million vials of the the yellow fever vaccine will be urgently imported to protect the people from the deadly viral disease, which is spread by mosquitoes.

The disease has been reported in nine northern Uganda districts of Abim, Agago, Lamwo, Kitgum, Pader, Gulu, Arua, Kaabong and Lira.

The deadly disease, which doctors say can kill in one week, is recurring in Uganda after almost 40 years. It was last in Uganda in 1972, according to officials from the health ministry.

A statement from the Ministry of Health said they had instituted measures to fight the disease in collaboration with the World Health Organisation and the Centres for Disease Control.

National and district task-forces have been reactivated, and an epidemic containment plan developed.

The process of procuring the yellow fever vaccine has been initiated, case surveillance is being carried out and guidelines on supportive management of patients have been disseminated to the affected districts, according to the statement.

“The most cost-effective intervention now is mass immunisation in the nine districts plus the districts nearby because the disease could have spread there too,” said the director general of health services, Dr. Kenya Mugisha.

The disease that broke out around November had puzzled medical officers and residents.

Yellow fever patients experience fever, muscle and back pain, headache, shivering, loss of appetite and vomiting. Some of the patients develop yellow eyes, abdominal pain and bleeding from the mouth, nose, eyes and stomach.

According to Mugisha, yellow fever affects humans and animals, especially monkeys. He said the first victims were around forest areas, where they had cut bamboo trees.

The ministry has appealed to the people to take precautions by avoiding mosquito bites, especially during the day.

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Re: Uganda: Hemorrhagic fever outbreak- 45 dead, 127 ill- yellow fever?

The case counts seem to be much higher now, perhaps as a result of recognizing milder cases.

Assuming the diagnosis of yellow fever is correct, the actual number of human infections may exceed 1000.

http://www.bbc.co.uk/news/world-africa-12084028

27 December 2010 Last updated at 13:09 ET

Uganda yellow fever outbreak kills more than 40

Yellow fever is transmitted by a type of mosquito that is active only during the day Continue reading the main story

Yellow fever vaccines are being imported for the north of Uganda to inoculate people against the disease which has killed about 45 people.

People began falling ill about a month ago in nine northern districts, the country's health ministry says.

A health official in Kitgum told the BBC the outbreak was confirmed as yellow fever on Christmas Eve.

The disease, transmitted by infected mosquitoes, was last recorded in Uganda almost 40 years ago, officials say.

Task forces have been put in place in the affected districts and isolation units set up.

Bosco Ochola, chairman of the Kitgum task force, said his staff were treating about 65 infected patients.

"This morning we got a phone call from the Ministry of Health that arrangements are being made from WHO (World Health Organization) to bring vaccines to cover the population," he told the BBC's Focus on Africa programme

Yellow fever, unlike malaria, is transmitted by a type of mosquito which is active only during the day.

Radio talk shows and dramas were trying to inform people of this, he said.

The health ministry says at least 2.5 million people will be vaccinated when the vials arrive, Uganda's state-owned New Vision newspaper reports.

The disease has a wide array of symptoms from nausea and vomiting to kidney failure, jaundice and bleeding.

About half of those who develop severe symptoms and are untreated die from the disease.

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Re: Uganda: Yellow fever outbreak- 45 dead

Case counts are meaningless at this point, as milder cases earlier were not detected.

I think I have seen enough to rename and move this thread now.

http://www.newvision.co.ug/D/8/12/742163

Yellow fever spreads to 10 districts
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By Anne Mugisa

THE Ministry of Health wants $35m (about sh80b) to purchase the yellow fever vaccine for 10 districts in the north to stop the spread of deadly viral disease.

The disease, which recurred after about 40 years, has spread to the 10th district of Kotido and cases climbed to 183 from 178, the Director General of Health Services, Dr. Kenya Mugisha, said yesterday.

He, however, said the death toll remained at 45.

Other districts where the disease has been found are Abim, Agago, Lamwo, Kitgum, Pader, Gulu, Arua, Kaabong and Lira.

According to Mugisha, most of the patients were discharged from hospital, but 23 were still being treated at different health centres.

He, however, said if the ministry got $10m (sh23b), it would immunise everybody, which he said is not possible now.

The vaccine, he added, was not available at the ministry because it was not part of the routine immunisations.

Mugisha said the vaccine is available in Kampala City Council clinics and others in Kampala, where people intending to travel abroad have been undergoing immunisation.

Travellers are required to be immunised at least 10 days before travelling. The vaccine protects one for 10 years.

With the latest outbreak, at least 2.5 million people will be vaccinated against the disease in northern Uganda.

According to Mugisha, 2.5 million vials of the yellow fever vaccine will be urgently imported to protect the people from the deadly disease, which is spread by mosquitoes.

The disease, which has a high fatality rate, can kill in a week, according to medical officers.

The ministry, in collaboration with the World Health Organisation, the Centres for Disease Control and other partners, is working on the importation of the vaccine, which is expected in the country in January.

Meanwhile, the ministry has asked people to observe precautionary measures to avoid contracting the disease.

These include avoiding mosquito bites, especially during the day, sleeping under insecticide-treated mosquito nets and destroying breeding grounds of mosquitoes, including draining stagnant water and clearing bushes around residences.

The ministry also advises anybody who gets symptoms like fever, muscle and back pain, headache, shivering, loss of appetite and vomiting to immediately report to the nearest health facility for treatment.

[alert]

Re: Uganda: Hemorrhagic fever outbreak- 45 dead, 127 ill- yellow fever?

http://www.newvision.co.ug/D/8/14/742118

Yellow fever: Ring vaccination not enough
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AT least 2.5 million people will be vaccinated in northern Uganda against yellow fever that had by the weekend killed 45 people and infected 178 others.

The disease, whose fatality rate ranges between 15% and 50%, is taken so seriously that just one confirmed case is considered an outbreak by the World Health Organisation.

While the health ministry has instituted measures to contain the disease, a mass rather than ring-vaccination would be a more effective control mechanism. Diseases know no borders. With increased travel within the region the disease could have been transmitted far beyond the surrounding districts. Therefore, a mass vaccination, as was done in the Gambia in the 1970s, is the best approach in the long run. Yellow fever vaccination could also be added to the expanded programme for immunisation that currently covers the six killer diseases ? tetanus, diptheria, whooping cough, polio, TB and measles.

Global statistics show that yellow fever cases are on the increase with 90% of the 200,000 cases registered annually being in Africa. Uganda is therefore, likely to experience a resurgence of yellow fever, just like polio a few years ago.

Since most Ugandan health units are not equipped to test for yellow fever, the medical workers should be highly suspicious and investigate all cases with yellow fever symptoms like high fever, chills, headache, muscle aches, vomiting, and backache. Anybody who presents these symptoms should immediately take a medical check-up.

Uganda should be more vigilant since all factors responsible for the resurgence of yellow fever are prevalent here ? reduced immunisation against the disease; deforestation bringing people in closer contact with monkeys and population movements making it easier to transport the disease far and wide.

Therefore, unless stringent measures like mass immunisation are taken in collaboration with neighbouring countries, Uganda is likely to register more yellow fever outbreaks in other places with its attendant costs.

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Re: Uganda: Hemorrhagic fever outbreak- 45 dead, 127 ill- yellow fever?

http://www.promedmail.org/pls/apex/f?p=2400:1001:70776471214555::NO::F2400_P1001_BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,86390

Archive Number 20101228.4572
Published Date 28-DEC-2010
Subject PRO/AH/EDR> Undiagnosed disease - Uganda (09): yellow fever vaccination

UNDIAGNOSED DISEASE - UGANDA (09): YELLOW FEVER VACCINATION
************************************************** *********
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: Tue 28 Dec 2010
Source: The New Vision (Uganda) [edited]
<http://www.newvision.co.ug/D/8/14/742118>

Yellow fever: ring vaccination not enough
-----------------------------------------
At least 2.5 million people will be vaccinated in northern Uganda
against the yellow fever [outbreak] that had by the weekend [25-26
Dec 2010] killed 45 people and infected 178 others.

The disease [yellow fever], whose fatality rate ranges between 15
percent and 50 percent, is taken so seriously that just one confirmed
case is considered an outbreak by the World Health Organisation.
While the health ministry has instituted measures to contain the
disease, a mass rather than ring-vaccination would be a more
effective control mechanism. Diseases know no borders. With increased
travel within the region the disease could have been transmitted far
beyond the surrounding districts. Therefore, a mass vaccination
[campaign], as was done in the Gambia in the 1970s, is the best
approach in the long run. Yellow fever vaccination could also be
added to the expanded programme for immunisation that currently
covers the 6 killer diseases (tetanus, diphtheria, whooping cough,
polio, tuberculosis, and measles).

Global statistics show that yellow fever cases are on the increase
with 90 percent of the 200 000 cases registered annually being in
Africa. Uganda is therefore, likely to experience a resurgence of
yellow fever, just like polio a few years ago.

Since most Ugandan health units are not equipped to test for yellow
fever, the medical workers should be highly suspicious and
investigate all cases with yellow fever symptoms like high fever,
chills, headache, muscle aches, vomiting, and backache. Anybody who
presents [with] these symptoms should immediately take a medical check-up.

Uganda should be more vigilant since all factors responsible for the
resurgence of yellow fever are prevalent here -- reduced immunisation
against the disease; deforestation bringing people in closer contact
with monkeys; and population movements making it easier to transport
the disease far and wide.

Therefore, unless stringent measures like mass immunisation are taken
in collaboration with neighbouring countries, Uganda is likely to
register more yellow fever outbreaks in other places with its attendant costs.

--
Communicated by:
Thomas James Allen
<tjallen@pipeline.com>

[The following commentary is predicated on the assumption that the
outbreak of undiagnosed disease affecting several villages in
northern Uganda has been unequivocally identified as an outbreak of
yellow fever virus infection. This remains to be confirmed
unequivocally by laboratory testing.

Yellow fever is an acute viral haemorrhagic disease transmitted by
infected mosquitoes. Several different species of the _Aedes_ and
_Haemagogus_ mosquitoes transmit the virus. The mosquitoes either
breed around houses (domestic), in the jungle (wild), or in both
habitats (semi-domestic).

The following information is taken from the WHO fact sheet at
<http://www.who.int/mediacentre/factsheets/fs100/en/>:
There are 3 types of transmission cycles.
- Sylvatic (or jungle) yellow fever: in tropical rainforests, yellow
fever occurs in monkeys that are infected by wild mosquitoes. The
infected monkeys then pass the virus to other mosquitoes that feed on
them. The infected mosquitoes bite humans entering the forest,
resulting in occasional cases of yellow fever. The majority of
infections occur in young men working in the forest (such as for logging).
- Intermediate yellow fever: in humid or semi-humid parts of Africa,
small-scale epidemics occur. Semi-domestic mosquitoes (that breed in
the wild and around households) infect both monkeys and humans.
Increased contact between people and infected mosquitoes leads to
transmission. Many separate villages in an area can suffer cases
simultaneously. This is the most common type of outbreak in Africa.
An outbreak can become a more severe epidemic if the infection is
carried into an area populated with both domestic mosquitoes and
unvaccinated people.
- Urban yellow fever: large epidemics occur when infected people
introduce the virus into densely populated areas with a high number
of non-immune people and _Aedes_ mosquitoes. Infected mosquitoes
transmit the virus from person to person.

There is no specific treatment for yellow fever, only supportive care
to treat dehydration and fever. Associated bacterial infections can
be treated with antibiotics. Supportive care may improve outcomes for
seriously ill patients, but it is rarely available in poorer areas.
Vaccination is the single most important measure for preventing
yellow fever. In high risk areas where vaccination coverage is low,
prompt recognition and control of outbreaks through immunization is
critical to prevent epidemics.

To prevent outbreaks throughout affected regions, vaccination
coverage must reach at least 60 percent to 80 percent of a population
at risk. Preventive vaccination can be offered through routine infant
immunization and one-time mass campaigns to increase vaccination
coverage in countries at risk. WHO strongly recommends routine yellow
fever vaccination for children in areas at risk for the disease.

The yellow fever vaccine is safe and affordable, providing effective
immunity against yellow fever within one week for 95 percent of those
vaccinated. A single dose provides protection for 30-35 years or
more, and probably for life.

The HealthMap/ProMED-mail interactive map of Uganda can be accessed
at <http://healthmap.org/r/0089>. - Mod.CP]

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Re: Uganda: Hemorrhagic fever outbreak- 45 dead, 127 ill- yellow fever?

http://www.reliefweb.int/rw/rwb.nsf/db900sid/MCOI-8CKJLZ?OpenDocument

UGANDA: YELLOW FEVER BACK AFTER 40 YEARS, EPIDEMIC HITS NORTH
Source: Missionary International Service News Agency (MISNA)

Date: 28 Dec 2010


Forty-five people have died and 183 are reported infected in a Yellow Fever epidemic underway for about a month in Uganda's northern districts. The announcement was made by Director General of Health Services, Dr. Kenya Mugisha, updating on the spread of the epidemic, the first in Uganda since 1970. Based on the update, the epidemic has spread to 10 districts of the nation, mainly in the north, after cases were confirmed also in the Kotido district adding to the nine so far (Abim, Agago, Lamwo, Kitgum, Pader, Gulu, Arua, Kaabong and Lira), where the Yellow Fever broke out already a few weeks ago. The government has announced a mass vaccination campaign, conducted by Kampala's Health ministry and the World Health Organisation (WHO), which should include 2.5-million people. The WHO and Kampala in fact reached an accord to import the necessary quantity of vaccines as soon as possible. Due to the absence of the disease for 40 years, the vaccine was in fact not in stocks. Also any foreigners visiting Uganda will be required to be vaccinated for Yellow Fever at least ten days ahead of arrival.

[BO]

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Re: Uganda: Hemorrhagic fever outbreak- 45 dead, Yellow Fever

This is a confusing post. I'm not aware of any reports that this illness was hepatitis, although obviously yellow fever would cause jaundice.

This may be the first report of someone disputing the yellow fever diagnosis, though. It is difficult to imagine on what grounds the HCW (NOT the CDC lab) would dispute this diagnosis, given that none of them have likely seen yellow fever before. Perhaps it is based on the idea that since this looks a little like Ebola, it "must" be.

I am not that familiar with this source.

http://www.wbs-tv.co.ug/index.php?option=com_content&view=article&id=424:disease-outbreak-disputed&catid=1:current-affairs&Itemid=77

Disease outbreak disputed
Monday, 27 December 2010 06:48 Sadab Kitatta Health officials in Kitgum district have downplayed a report by the Ministry of Health that had identified the strange disease that has so far claimed 11 lives in the district as Yellow Fever.

After a month of investigations, the Ministry of Health announced a few days back that the strange epidemic that is ravaging a number of districts in Northern Uganda was yellow fever and not a type of hepatitis as had been earlier suspected.

The emergency response unit at Kitgum General Hospital had by Christmas day received about 42 patients, 11 of whom lost their lives while some have been discharged after successfully receiving medication.

The strange infection had proven difficult to identify for a joint team of investigators from the World Health Organization, Ministry of Health and the Veterinary department.

It is reported to have begun in Abim district before spreading to the neighbouring districts of Agago, Lamwo, Pader, Gulu and Kitgum.
After a series of investigations, the Health Ministry announced on Christmas eve, that the infection was yellow fever which is being contested by health workers in Kitgum district.

As a contingency measure, a special team that was instituted to manage the outbreak is advising people here to stop embracing each other and shaking of hands.

Management of the epidemic at the hospital has received a major boost from an International NGO; Medicin sans Frontier which has provided an assortment of protective gear for the health workers.

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Re: Uganda: Hemorrhagic fever outbreak- 45 dead, Yellow Fever

Apparently, they are sure enough of the diagnosis to let those evacuated from Kitgum back in.

http://marikelley.blogspot.com/2010/12/merry-christmas-and-happy-new-year.html

[snip]

The Ebola outbreak was actually Yellow Fever, according to the CDC. So the PCV that had been evacuated from Kitgum and Padre were able to go back home.

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Re: Uganda: Hemorrhagic fever outbreak- 45 dead, Yellow Fever

http://edition.cnn.com/2010/WORLD/africa/12/28/uganda.yellow.fever/index.html?eref=edition_africa&utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+rss%2Fedition_africa+%28RSS%3A+Africa%29

(CNN) -- Uganda is planning to inoculate 2.5 million residents in the East African nation's northern districts, where a yellow fever outbreak has killed 45 people and sickened another 183.

The outbreak began in early November but was not confirmed as yellow fever until December 23 by the U.S. Centers for Disease Control and Prevention, Dr. Nathan Kenya-Mugisha, director general of the Ugandan Health Ministry, said Tuesday.

He said the cause of the outbreak was not known but that it could have originated in animals.

"We are doing all we can to contain the disease," Kenya-Mugisha said. "We are working with our partners to mobilize our resources to vaccinate (in) the affected areas."

Yellow fever is a viral disease transmitted to human beings through the bite of infected mosquitoes. It can lead to severe hepatitis and hemorrhaging, according to the CDC.

There is no specific treatment for yellow fever, and care is based on symptoms that include fever, backache, nausea and vomiting. People can pass on the illness without ever having its symptoms.

The World Health Organization estimates there are 200,000 cases of yellow fever and 30,000 deaths worldwide each year. Uganda's last outbreak of yellow fever, a disease endemic to tropical regions, was in the early 1970s, Kenya-Mugisha said.

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Re: Uganda: Hemorrhagic fever outbreak- 48 dead, Yellow Fever

http://www.monitor.co.ug/News/National/-/688334/1080214/-/cjfkbnz/-/index.html

HomeNewsNational National

Yellow fever deaths reach 48

By Flavia Nalubega (email the author)

Posted Wednesday, December 29 2010 at 00:00

Kampala

The number of people killed by yellow fever in northern Uganda has reached 48 and 187 are hospitalised, an official has confirmed. Dr Isa Makumbi, a commissioner in the health ministry, made the revelations last night.

Earlier, Junior health minister James Kakooza had told Daily Monitor on phone that the viral disease has been confirmed in Abim, Agago, Lamwo, Kitgum, Pader, Gulu, Arua, Kaabong and Lira districts.

“The infection was in place as early as two months ago. Since then, we have been doing investigations to ascertain the disease. It is only two weeks ago that we confirmed the viral infection as yellow fever,” Mr Kakooza said. He said the disease has taken a new string of infection where patients suffer severe vomiting of blood, diarrhoea and swollen eyes.

Signs
“The common signs of this fever are yellow eyes and urine as well as vomiting but this time around the symptoms are severe. This explains why investigations have taken long,” he explained.
Dr Kenya Mugisha, the director general, said the fever is transmitted by mosquitos. “The signs are fever, muscle pain and backache, headache, fever, shivering, loss of appetite and vomiting.”

[Treyfish]

Re: Uganda: Hemorrhagic fever outbreak- 45 dead, Yellow Fever

Warden Message

<!--Start If Image-->
U.S. Embassy Kampala, Uganda
Warden Message - December 28, 2010
Outbreak of Unidentified Illness Now Confirmed as Yellow Fever in Northern Uganda

After discussions with the Ugandan Ministry of Health and WHO, the U.S. Centers for Disease Control and Prevention (CDC) now confirms that the unknown severe illness reported in Mission Kampala?s November 30 Warden Message is an outbreak of Yellow Fever.
Although as many as seven districts are now reporting occurrences - including two possible cases from southern Sudan- almost all of the reported severe cases (characterized by fever, vomiting and bleeding) continue to be concentrated in three districts of Northern Uganda, namely Abim (specifically Morulem sub-county), Agago (Omiya P?Chua, Adilang and Paimoi sub-counties) and Kitgum (Orum, Namokora and Kitgum Town Council).
In light of these findings, the U.S. Mission in Kampala recommends that U.S. citizens residing and traveling in Uganda avoid travel to Northern Uganda unless they have been vaccinated against Yellow Fever within the past 10 years. If vaccinated recently, do not travel to Northern Uganda for at least 10 days after receiving the vaccination. (Yellow Fever vaccinations do not take effect for 10 days.) Only U.S. government officials with Yellow Fever vaccinations are permitted to travel to the affected areas.

For more background on yellow fever, please visit the following websites:
General information:
http://www.cdc.gov/ncidod/dvbid/yellowfever/

Detailed information:
http://wwwnc.cdc.gov/travel/yellowbook/2010/chapter-2/yellow-fever.aspx

International response:
http://www.who.int/topics/yellow_fever/en/
The U.S. Embassy in Kampala also encourages U.S. citizens to enroll in the Department of State?s Smart Traveler Enrollment Program (STEP) at https://travelregistration.state.gov/ibrs/ui/. By enrolling in this program, you will receive important safety and security announcements. It will also help your friends and family get in touch with you in case of an emergency. You should remember to keep all of your information in STEP up-to-date. Please note that it is important during enrollment, or updating of information, to include your current phone number and current email address where you can be reached in case of an emergency.
The U.S. Embassy is located at Plot 1577 Ggaba Road. For after-hour emergencies, please call (256) (414) 306-001 or (256) (414) 259-791, fax (256) (414) 258-451, or email KampalaUSCitizen@state.gov.http://kampala.usembassy.gov/warden_..._10282010.html

[Treyfish]

Re: Uganda: Hemorrhagic fever outbreak- 45 dead, Yellow Fever

27 December 2010 Last updated at 13:09 ET
Uganda yellow fever outbreak kills more than 40
Yellow fever is transmitted by a type of mosquito that is active only during the day
Yellow fever vaccines are being imported for the north of Uganda to inoculate people against the disease which has killed about 45 people.
People began falling ill about a month ago in nine northern districts, the country's health ministry says.
A health official in Kitgum told the BBC the outbreak was confirmed as yellow fever on Christmas Eve.
The disease, transmitted by infected mosquitoes, was last recorded in Uganda almost 40 years ago, officials say.
Task forces have been put in place in the affected districts and isolation units set up.
Bosco Ochola, chairman of the Kitgum task force, said his staff were treating about 65 infected patients.
"This morning we got a phone call from the Ministry of Health that arrangements are being made from WHO (World Health Organization) to bring vaccines to cover the population," he told the BBC's Focus on Africa programme
Yellow fever, unlike malaria, is transmitted by a type of mosquito which is active only during the day.
Radio talk shows and dramas were trying to inform people of this, he said.
The health ministry says at least 2.5 million people will be vaccinated when the vials arrive, Uganda's state-owned New Vision newspaper reports.
The disease has a wide array of symptoms from nausea and vomiting to kidney failure, jaundice and bleeding.
About half of those who develop severe symptoms and are untreated die from the disease.http://www.bbc.co.uk/news/world-africa-12084028

[Treyfish]

Re: Uganda: Hemorrhagic fever outbreak- 45 dead, Yellow Fever

Yellow Fever Spreads to Ten Districts
Anne Mugisa
27 December 2010


<!-- share box -->

• THE Ministry of Health wants $35m (about sh80b) to purchase the yellow fever vaccine for 10 districts in the north to stop the spread of deadly viral disease.

The disease, which recurred after about 40 years, has spread to the 10th district of Kotido and cases climbed to 183 from 178, the Director General of Health Services, Dr. Kenya Mugisha, said yesterday.
He, however, said the death toll remained at 45.
<!-- open google_inset_a div ---><!-- Display Google AdManager Ad for 'AllAfrica_Story_InsetA'--><SCRIPT language=JavaScript type=text/javascript> GA_googleFillSlot( "AllAfrica_Story_InsetA" );</SCRIPT><SCRIPT src="http://pubads.g.doubleclick.net/gampad/ads?correlator=1293571648153&output=json_html&call back=GA_googleSetAdContentsBySlotForSync&impl=s&a2 ids=_r3w&cids=ROMXL8&pstok=yxXpX3NM0lAKDgoKCN_XPxC _ubGcERAA&client=ca-pub-2420009840005975&slotname=AllAfrica_Story_InsetA&p age_slots=AllAfrica_Story_BannerMid%2CAllAfrica_St ory_InsetA&cust_params=Language%3Denglish%26PageTy pe%3Dstory%26Topics%3Dhealth%26Countries%3Deastafr ica%252Cuganda&cookie=ID%3D5c2cff1ed9695656%3AT%3D 1290192439%3AS%3DALNI_MZc3BSmu9qKK_L_YTkbHzcuLuB2p g&ga_vid=1216092112.1290192446&ga_sid=1293571648&g a_hid=1931554866&ga_fc=true&ga_wpids=UA-230539-1&url=http%3A%2F%2Fallafrica.com%2Fstories%2F20101 2280039.html&ref=http%3A%2F%2Fwww.newsnow.co.uk%2F A%2F466152817%3F-18049&lmt=1293566519&dt=1293571648462&biw=758&bih= 322&ifi=2&adk=3096498150&oe=iso-8859-1&u_tz=-300&u_his=1&u_java=true&u_h=614&u_w=1093&u_ah=614& u_aw=1093&u_cd=32&flash=10.1.85.3"></SCRIPT>

<!-- close google_inset_a div --->Other districts where the disease has been found are Abim, Agago, Lamwo, Kitgum, Pader, Gulu, Arua, Kaabong and Lira.
According to Mugisha, most of the patients were discharged from hospital, but 23 were still being treated at different health centres.
He, however, said if the ministry got $10m (sh23b), it would immunise everybody, which he said is not possible now.
The vaccine, he added, was not available at the ministry because it was not part of the routine immunisations.
Mugisha said the vaccine is available in Kampala City Council clinics and others in Kampala, where people intending to travel abroad have been undergoing immunisation.

Travellers are required to be immunised at least 10 days before travelling. The vaccine protects one for 10 years.
With the latest outbreak, at least 2.5 million people will be vaccinated against the disease in northern Uganda.
According to Mugisha, 2.5 million vials of the yellow fever vaccine will be urgently imported to protect the people from the deadly disease, which is spread by mosquitoes.
The disease, which has a high fatality rate, can kill in a week, according to medical officers.

The ministry, in collaboration with the World Health Organisation, the Centres for Disease Control and other partners, is working on the importation of the vaccine, which is expected in the country in January.
Meanwhile, the ministry has asked people to observe precautionary measures to avoid contracting the disease.
These include avoiding mosquito bites, especially during the day, sleeping under insecticide-treated mosquito nets and destroying breeding grounds of mosquitoes, including draining stagnant water and clearing bushes around residences.
The ministry also advises anybody who gets symptoms like fever, muscle and back pain, headache, shivering, loss of appetite and vomiting to immediately report to the nearest health facility for treatment.http://allafrica.com/stories/201012280039.html

[Treyfish]

Re: Uganda: Hemorrhagic fever outbreak- 45 dead, Yellow Fever

Yellow Fever

Mark Gershman, Betsy Schroeder, J. Erin Staples


Infectious Agent

Yellow fever virus (YFV) is a single-stranded RNA virus that belongs to the genus Flavivirus.


Mode of Transmission

• Vector-borne transmission occurs via the bite of an infected mosquito, primarily Aedes or Haemagogus spp.
• Nonhuman and human primates are the main reservoirs of the virus, with anthroponotic (human-to-vector-to-human) transmission occurring.
• There are three transmission cycles for yellow fever: sylvatic (jungle), intermediate (savannah), and urban.
  • The sylvatic (jungle) transmission cycle involves transmission of the virus between nonhuman primates and mosquito species found in the forest canopy. The virus is transmitted via mosquitoes from monkeys to humans when the humans encroach into the jungle during occupational or recreational activities.
  • In Africa, an intermediate (savannah) cycle involves transmission of YFV from tree hole-breeding Aedes spp. to humans living or working in jungle border areas. In this cycle, the virus may be transmitted from monkeys to humans or from human to human via these mosquitoes.
  • The urban transmission cycle involves transmission of the virus between humans and urban mosquitoes, primarily Ae. aegypti.
• Humans infected with YFV experience the highest levels of viremia and can transmit the virus to mosquitoes shortly before onset of fever and for the first 3?5 days of illness.
• Given the high level of viremia attained in humans, bloodborne transmission can also occur (via transfusion, needlestick, and intravenous drug abuse).

Occurrence

• Yellow fever occurs in sub-Saharan Africa and tropical South America (Maps 2-3 and 2-4), where it is endemic and intermittently epidemic (see Table 2-12 for a list of countries with risk of yellow fever transmission).
• In Africa, natural immunity accumulates with age, and thus infants and children are at greatest risk for disease.
• In South America, yellow fever occurs most frequently in unimmunized young men who are exposed to mosquito vectors through their work in forested or transitional areas.
• Most yellow fever disease in humans is due to sylvatic or intermediate transmission cycles. However, urban yellow fever does occur periodically in Africa and sporadically in the Americas.http://wwwnc.cdc.gov/travel/yellowbo...low-fever.aspx

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Re: Uganda: Hemorrhagic fever outbreak- 45 dead, Yellow Fever

Warden Message

<!--Start If Image-->
U.S. Embassy Kampala, Uganda
Warden Message - December 28, 2010
Outbreak of Unidentified Illness Now Confirmed as Yellow Fever in Northern Uganda

After discussions with the Ugandan Ministry of Health and WHO, the U.S. Centers for Disease Control and Prevention (CDC) now confirms that the unknown severe illness reported in Mission Kampala?s November 30 Warden Message is an outbreak of Yellow Fever.
Although as many as seven districts are now reporting occurrences - including two possible cases from southern Sudan- almost all of the reported severe cases (characterized by fever, vomiting and bleeding) continue to be concentrated in three districts of Northern Uganda, namely Abim (specifically Morulem sub-county), Agago (Omiya P?Chua, Adilang and Paimoi sub-counties) and Kitgum (Orum, Namokora and Kitgum Town Council).
In light of these findings, the U.S. Mission in Kampala recommends that U.S. citizens residing and traveling in Uganda avoid travel to Northern Uganda unless they have been vaccinated against Yellow Fever within the past 10 years. If vaccinated recently, do not travel to Northern Uganda for at least 10 days after receiving the vaccination. (Yellow Fever vaccinations do not take effect for 10 days.) Only U.S. government officials with Yellow Fever vaccinations are permitted to travel to the affected areas.

For more background on yellow fever, please visit the following websites:
General information:
http://www.cdc.gov/ncidod/dvbid/yellowfever/

Detailed information:
http://wwwnc.cdc.gov/travel/yellowbook/2010/chapter-2/yellow-fever.aspx

International response:
http://www.who.int/topics/yellow_fever/en/
The U.S. Embassy in Kampala also encourages U.S. citizens to enroll in the Department of State?s Smart Traveler Enrollment Program (STEP) at https://travelregistration.state.gov/ibrs/ui/. By enrolling in this program, you will receive important safety and security announcements. It will also help your friends and family get in touch with you in case of an emergency. You should remember to keep all of your information in STEP up-to-date. Please note that it is important during enrollment, or updating of information, to include your current phone number and current email address where you can be reached in case of an emergency.
The U.S. Embassy is located at Plot 1577 Ggaba Road. For after-hour emergencies, please call (256) (414) 306-001 or (256) (414) 259-791, fax (256) (414) 258-451, or email KampalaUSCitizen@state.gov.http://kampala.usembassy.gov/warden_..._10282010.html

Excellent find, Treyfish. This is the first report coming from the US government, and not the Ugandan media, and should remove all doubt.

Note also the two possible cases in Sudan.