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Ebola in Uganda: November 30 - December 17, 2007

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Re: New Ebola Strain in Uganda Spreading - Death toll rising

Re: New Ebola Strain in Uganda Spreading - Death toll rising

Suspected cases rise as new Ebola strain stalks Uganda

Dec 6, 2007 (CIDRAP News) ? The number of people in Uganda suspected of being infected with a new strain of the Ebola hemorrhagic fever virus has grown to 93, and 22 have died, including four healthcare workers, according to news reports.
The outbreak was first reported on Nov 30 by the World Health Organization (WHO), which said a new subtype of the virus was found to be sickening people in Bundibugyo district in western Uganda. Four Ebola subtypes have previously been identified: Zaire, Sudan, Cote d'Ivoire, and Reston.
Uganda's health ministry said 58 cases have been confirmed in laboratory tests so far, Reuters reported today.
Dr Sam Zaramba, Uganda's director of health services, said one of the healthcare workers was a doctor who died in Kampala's Mulago Hospital after treating a patient in an isolation ward, the Reuters report said.
A report from the BBC today, citing other media reports, said the medical workers became infected with the Ebola virus because they lacked safety equipment. However, Zaramba told Reuters, "All medical staff dealing with Ebola have been issued with protective gear."
Some healthcare workers have threatened to strike unless they receive risk pay and adequate protective equipment, the BBC report said.
Health officials in Uganda say the new Ebola strain seems to have a low death rate when compared with other lethal Ebola strains, according to Reuters. The new strain has a 22%death rate compared with 50% to 90% for the other deadly strains.
However, Tom Ksiazek, MD, chief of the special pathogens branch at the US Centers for Disease Control and Prevention (CDC), said it's too early to say if the new Ebola strain in milder, the Associated Press (AP) reported yesterday.
Asiya Odugleh-Kolev, a W HO communications official who has worked on several Ebola outbreaks, said a milder Ebola strain might be problematic, because it could spread unnoticed and be confused with other diseases, the AP reported.
Patients have had some unusual initial symptoms, such as vomiting, with the new Ebola strain, WHO spokesperson Gregory Hartl said in a previous AP report. For the other known strains, initial symptoms include fever, headache, joint and muscle aches, sore throat, and weakness, followed by diarrhea, vomiting, and stomach pain, according to the CDC. Some patients have internal and external bleeding. There is no vaccine or specific treatment for the disease.
Meanwhile, members of parliament in Uganda today calledon the government to declare a state of emergency and quarantine areas affected by the Ebola outbreak, All Africa News reported today.
"We need to take radical measures if we are to save our people from this deadly virus," said Theodore Ssekikubo, who represents Rwemiyaga in Ssembabule district, during the parliament session today, according to the All Africa report.
Prime Minister Apollo Nsibambi told members of parliament that a state-of-emergency is an urgent matter that will be discussed at a cabinet meeting tomorrow, All Africa reported.
On Uganda's border with Kenya, health officials from Kenya are screening people entering the country, Dr James Nyikal, the country's head of medical services, told the BBC today.
See also:
Nov 30 CIDRAP News story "WHO reports new Ebola virus subtype in Uganda"
CDCinformation about Ebola

http://www.cidrap.umn.edu/cidrap/content/bt/vhf/news/dec0607ebola2.html
 
Re: New Ebola Strain in Uganda Spreading - Death toll rising

Re: New Ebola Strain in Uganda Spreading - Death toll rising

<TABLE cellSpacing=0 cellPadding=0 width="100%" border=0><TBODY><TR><TD class=lead_title colSpan=2>Ebola: Gov?t to set up hotline</TD></TR><TR><TD class=lead_title colSpan=2>
1371-ebola.jpg

Graphic illustration of the virus that causes ebola
</TD></TR><TR><TD class=lead_title colSpan=2>BY EDWIN MUSONI</TD></TR><TR><TD class=lead_body colSpan=2>KIGALI - The government has come up with new mechanisms, including a hotline, in a bid to prevent the spread of the deadly Ebola virus from neighbouring countries. Ebola has killed 20 people, including three medics, in the latest outbreak in Uganda, which shares borders with Rwanda.
There was also an earlier outbreak in the DR Congo.
The Ministry of Health issued a statement yesterday announcing new measures put in place to prevent any spread of Ebola into Rwanda. Among the new measures, the ministry said it?s soon going to set up a free telephone hotline that will be operating nationwide for information sharing on Ebola.
On Tuesday, ministry of health officials met with local and international health partners and epidemic experts to review and devise more precaution measures. ?An Ebola hotline will be put in place to ease the communication with the public and all stakeholders,? the statement indicated.
The government also has set up isolation facilities in all medical centers the border posts with Uganda and DRC. ?Isolation facilities at all medical centers close to the border posts are being set up and whoever will be suspected to be carrying the virus will be put in those isolation cubicles,? it said.
The ministry has also trained a mobile medical team that will be in charge of emergency intervention in case the outbreak spills over to Rwanda.
The team will be on alert 24 hours and would also be in charge of offering timely treatment, in case of a spill over.
During Tuesday?s meeting, local and international health partners including epidemic experts agreed to work together in implementing vital preventive measures. They all concurred that TRAC Plus, the Center for Infectious Diseases, should coordinate the preparedness plan, provide training to health professionals and strengthen communication to the public and health professionals.
The State Minister in charge of HIV/Aids and other Epidemics Dr Innocent Nyaruhirira who chaired the meeting called for strong collaborative efforts and information sharing among all the stakeholders.
Partners that attended the meeting include representatives of TRAC Plus, National Referral Laboratory, the Office of Immigration, World Health Organisation (WHO) the Center for Disease Control (CDC), Great Lakes Initiative on Aids (GLIA) and UNHCR.
Ends:tiphat:
http://www.newtimes.co.rw/index.php?issue=1371&article=2789
</TD></TR></TBODY></TABLE>
 
Re: New Ebola Strain in Uganda Spreading - Death toll rising

Re: New Ebola Strain in Uganda Spreading - Death toll rising

niman said:
Commentary at

http://www.recombinomics.com/News/12060702/Ebola_Uganda_Spread_Confirmed.html
Click to expand...
Commentary

Uganda Ebola Spread Confirmed
Recombinomics Commentary
December 6, 2007

Government of Uganda and U.S. Centers for Disease Control and Prevention have confirmed 51 cases of suspected hemorrhagic fever, reported in Bundibugyo, Kabarole and Mbarara Districts since September 2007, as Ebola.

The most recently reported three cases, of whom one has died, were recorded in Kabarole’s Fort Portal and Mbarara, and referred to the Ebola Isolation Unit in Bundibugyo.

Health authorities have identified three clusters of infection, each originating from different sites by relative proximity. However, as the most recently identified case was not from the original areas of contamination, investigations are ongoing to determine if there has been an additional outbreak. Two isolation units have been established in Bundibugyo’s Kikywa Health Centre IV (8 cases) and district hospital (9 cases), managed with MSF Switzerland's support. A third centre was established in Kampala's Mulago Hospital (2 cases), managed with MSF Spain support.

The above comments, from a UNICEF report dated December 5, 2007 indicate there has been significant spread of Ebola in Uganda. Earlier reports had described the death of Dr Jonah Kule, 41M, in Mulago Hospital in Kampala, but the above report indicates there are two confirmed cases in the capital. Similarly, there are also confirmed cases in Fort Portal and Mbarara, also signaling significant spread from the epicenter in Bundibugyo.

Media reports indicate the number of suspected cases has now topped 100, but patients are avoiding admission into hospitals, in part because of the number of fatal infections in health care workers. Therefore, the number of patients silently infected with Ebola may be increasing and the virus may be spreading via fleeing patients.

These complications will impact the number of confirmed or suspect patients and hamper contact tracing. Media reports indicate the number of contacts under observation has increased to 330.


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Re: New Ebola Strain in Uganda Spreading - Death toll rising

Re: New Ebola Strain in Uganda Spreading - Death toll rising

niman said:
Commentary at

http://www.recombinomics.com/News/12060703/Ebola_Uganda_Spread_East.html
Click to expand...
Commentary

Ebola Spread to Uganda Eastern Border?
Recombinomics Commentary
December 6, 2007

a team of epidemiologists from Kampala was reported to be heading to eastern Uganda to investigate reports that Ms Olive Mukite, the district information officer of Sironko died yesterday of suspected Ebola infection at Mbale referral hospital.

This follows reports of alert cases in Mbarara, Kabarole, Mubende and Kanungu; where 20-year-old Ivan Asimwe died yesterday.

The above comments raise concerns that Ebola has spread across the southern Uganda. The list represents most of the major cities in southern Uganda and extends from the western to eastern borders. The deaths of two of the suspect cases increases the likelihood these cases will be confirmed Ebola infections. Confirmed cases have already been reported in Kampala. The neighboring countries of the Democratic Republic of the Congo, Rwanda, Tanzania, and Kenya have announced monitoring of border crossings.

Earlier reports confirmed that the suspect cases in south western Uganda were infected with Ebola and raised concerns that the spread had been extensive. The species involved is new and symptoms are not typical of earlier Ebola outbreaks.

The expanded geographical reach compounds problems linked to the high number of fatal infections in health care workers. Some workers had left because of compensation issues, and more may leave because of safety concerns due to lack of PPE?s. Similarly, patients are being discharged from hospitals and suspect cases are fleeing.

More detail on these suspect cases would be useful.


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Re: New Ebola Strain in Uganda Spreading - Death toll rising

Re: New Ebola Strain in Uganda Spreading - Death toll rising

Populations:

Bundibugyo - 175,000
Kabarole - 386,000
Mubende - 706,000
Kampala area - about 1 million
Sironko - 292,000

Uganda - 28 million

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Re: New Ebola Strain in Uganda Spreading - Death toll rising

Re: New Ebola Strain in Uganda Spreading - Death toll rising

Ebola Rising

A new strain of the deadly virus has doctors scrambling to contain the disease.

By Andrew Ehrenkranz
Newsweek Web Exclusive
Updated: 7:45 PM ET Dec 6, 2007
Dr. Stephen Ssesanga thought he was doing just another routine check on a newly admitted patient at the hospital in Bundabigyo, in western Uganda. The man was unable to hold food down, had a very high fever and was having problems breathing and talking. "It seemed to me to be a textbook case of Ebola," says Ssesanga, the hospital's chief medical superintendent, "but I couldn't tell for sure." The man died a few days later, on Nov. 27. Last Friday health officials confirmed the reason for Ssesanga's doubt: a new strain of the deadly Ebola virus is spreading through Uganda. Ssesanga's patient, it seems, had contracted the disease, and the symptoms didn't exactly correspond to known forms of Ebola that caused trouble in the past. By then Ssesabga had a bigger problem: he had contracted the new Ebola virus.
Ssesanga, who's been battling the disease for the past week, has almost regained his strength and appetite. Of eight other medical staff members in his hospital who have become infected with the virus, three have died. "They were all buried today," Ssesanga said, though was unable able leave his quarantine to pay his respects. Funerals, Ssesanga says, are too dangerous in western Uganda right now.
In the last week an outbreak of a new strain of the Ebola virus has ravaged villages across the rural districts of western Uganda. As it has spread, the outbreak has plunged Uganda into a health crisis and put the entire Great Lakes region, from Rwanda to Kenya, on high alert. Ebola II is the fifth strain of the virus since its discovery near the Ebola River in the Democratic Republic Congo, in 1976. Some scientists think the new strain of Ebola may be a milder form than earlier strains, which is not necessarily good news—the high mortality rate has previously helped keep transmission levels low, as infected people got sick and died before they could infect too many others. A mild version of Ebola could, in theory, spread more effectively through populations—though health officials are quick to say that there's no solid evidence that this strain is spreading more quickly than past outbreaks.
The current outbreak was first reported in western Uganda in late August, but because of a variety of logistical and clinical difficulties, not the least being that many locals consult herbalists and traditional healers rather than medical practitioners, confirmation was slow in coming. As of now, with 33 reported dead out of a total of nearly 71 infections in the epicenter Bundabigyo district, the virus appears to have a considerably higher survival rate than the four prior strains. Officials from the U.S. Centers for Disease Control emphasize that the data are not conclusive. To confirm the mortality rate, doctors must make further study of patients in the field. Only when that work is done, weeks from now, will they be able to characterize the new strain.
Ugandan officials have refused to comment on how the current outbreak got started, and epidemiologists from the CDC and World Health Organization are actively working to pin down the source. According to a number of other Ugandan and foreign doctors with clinical knowledge of the outbreak, the present consensus is that this strain originated in a monkey killed and eaten by a Ugandan man and his family in the highland village of Kyiko, near the Congolese border. The hunter and four of his 14 family members, battling high fevers and extreme nausea, sought care at a government-run hospital, where medical workers, puzzled by their symptoms, treated them for food poisoning.
The eating of monkey and "bushmeat" is an accepted tradition throughout the eastern Congo—monkeys, dead and alive, are sold in markets for consumption. But because the practice is prohibited in Uganda, people tend to deny it. The hunter's claim that he had become sick from consuming infected goat meat, which is considered to be an unlikely carrier for Ebola, certainly didn't help health workers identify the disease.
Like other cases, this Ebola II strain has an incubation period of up to 21 days before an infected person experiences symptoms. Earlier Ugandan health ministry inquiries into a so-called "mystery" virus in western Uganda spawned speculative diagnoses of leporetosis and the Marburg virus, a feared hemorrhagic fever similar to Ebola that was successfully contained after an outbreak among Ugandan mine workers last July. Ebola is not airborne, but rather passes through contact with bodily fluids or skin. Studies have shown that in the past it has spread to humans from contact with wild chimpanzees, antelope and gorillas, according to analyses of cases in the Congo, Gabon, and Sierra Leone. And with 13 different primate species, the Bundabigyo region of Uganda has the most variation of primates on earth.
Allegations that the government intentionally concealed the outbreak have swirled through newly beautified Kampala since the announcement of the new Ebola strain last week. Today the state-run New Vision newspaper lashed out against the ministry of health for mishandling the situation, blaming the deaths and new infections of medical staff on the lack of readily available protective gear and underfunded hospitals in the outbreak region.
Dr. Jakson Amone, a senior health ministry official in Bundadisgyo, is concerned about the possibility of the new strain of Ebola spreading across the rest of Uganda and into its relatively populous capital, Kampala. "It's hard to treat something you've never seen before," he says. A task force of local doctors and specialists from the CDC, the World Heath Organization and Doctors Without Borders as well as local and international NGOs are working around the clock to contain the outbreak. "We have plenty of manpower on the ground now. We are going village to village looking to find and isolate new cases," says Amone. A dramatic rise in the number of reported infections in the coming days, he suggests, could be the result of better surveillance and monitoring.
For Dr. Ssesanga, who's anxious to get back to his hospital when he's fully recovered from his bout with the disease, fear and panic are the greatest enemies to containing the outbreak. With more cases confirmed each day, doctors and civilians are staying away from the hospital. As of this morning the usually crowded maternity ward at Bundadigybo was empty. Dr. Scott Mehyre, an American missionary doctor who runs a health clinic in a neighboring village, is down to only three doctors working in shifts clad in isolation suits. "This virus is spreading by the foot of the hills," Ssesanga says, referring to the many people who may be affected but are trying to flee the region. "Running away is the worst thing people can do now."
<!-- Omniture --><SCRIPT language=javascript type=text/javascript> <!-- var nw_page_name = "nw - article - 74101 - Ebola Rising "; var nw_content_type = "article"; var nw_source = "newsweek.com"; var nw_content_id = "74101"; var nw_headline = "Ebola Rising "; var nw_author = "andrew ehrenkranz"; var nw_page_num = "print format"; var nw_application = "gutenberg"; var nw_hierarchy = "health|articles"; --> </SCRIPT>
URL: http://www.newsweek.com/id/74101
 
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Re: New Ebola Strain in Uganda Spreading - Death toll rising

Re: New Ebola Strain in Uganda Spreading - Death toll rising

http://ugandaninsomniac.wordpress.com/2007/12/06/mbale-records-first-ebola-death/

The first suspected Ebola death outside Kampala City and the Rwenzori Mountains region has been recorded at Mbale Hospital. Olive Esther Mukite, the Sironko District Information Officer, died this evening at about 5 p.m.
Olive Mukite was admitted at Mbale Hospital this morning after displaying symptoms of Ebola and was quickly placed in an isolation ward. Henry Luigale, the Mbale Hospital Medical Superintendent, says Mukite and 65 councilors from Sironko returned from a study tour of Kisoro district on Friday last week. He cannot say for sure that Mukite died of the disease and is awaiting a post mortem report from a team of medical experts from Kampala who will travel to Mbale tomorrow. No case of the hemorrhagic fever has been reported in either Kisoro districts.
The staff at Mbale Hospital were completely unprepared for Ebola in their neck of the woods and several medical officers, including a nurse who was by Mukite?s side throughout her ordeal, have been put in isolation for observation.

~ by tumwijuke on December 6, 2007.

<!-- You can start editing here. -->
 
Re: New Ebola Strain in Uganda Spreading - Death toll rising

Re: New Ebola Strain in Uganda Spreading - Death toll rising

niman said:
Commentary at

http://www.recombinomics.com/News/12070701/Ebola_Uganda_Emergency.html
Click to expand...
Commentary

State of Emergency Call Linked To Uganda Ebola Spread
Recombinomics Commentary
December 7, 2007

MPs yesterday unanimously asked the government to immediately declare a State-of-emergency over the rapidly spreading Ebola epidemic and impose quarantine on already affected areas in western Uganda.

"We need to take radical measures if we are to save our people from this deadly virus," Theodore Ssekikubo, the MP for Rwemiyaga constituency in Ssembabule district, said.

In the afternoon plenary session dominated by the Ebola debate, most MPs called on the government not to drag its feet when people are dying in the countryside.

"Ebola is a serious disease and the government must declare all affected areas a no-go area.

The above comments call for a state of emergency in western Uganda, but recent reports suggest the disease may have already spread to the eastern border and cover most of southern Uganda (see satellite map).

Most of the cases are in and around Bundibugyo, but the confirmed and suspect cases have led to monitoring of border crossings by the Democratic Republic of the Congo, Rwanda, Tanzania, and Kenya.

The recent deats of health care workers have emptied the hospitals of both patients and health care workers. The fleeing patients could spread the virus, which appears to be readily transmitted. Over 330 contacts are being monitored, but patient avoidance of hospitals will create additional contact tracing problems.

More information on the sequence of the new strain, which is likely a recombinant, and further confirmation of suspect cases will be useful.


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Re: New Ebola Strain in Uganda Spreading - Death toll rising

Re: New Ebola Strain in Uganda Spreading - Death toll rising

<TABLE cellSpacing=0 cellPadding=0 width="99%" border=0><TBODY><TR><TD><TABLE cellSpacing=0 cellPadding=0 width="100%" border=0><TBODY><TR><TD class=DetaildTitleGolden id=tdMainHeader width="100%">Ebola outbreak kills many in Uganda</TD><TD vAlign=center></TD><TD vAlign=center align=left></TD></TR><TR><TD id=tdbyLine width="100%" colSpan=3></TD></TR><TR><TD colSpan=3></TD></TR></TBODY></TABLE></TD></TR><TR><TD style="PADDING-RIGHT: 5px"><TABLE height=350 cellSpacing=0 cellPadding=0 width="100%" border=0><TBODY><TR><TD colSpan=2 height=1></TD></TR><TR><TD class=PaddingTop10 id=tdSubHeader vAlign=top colSpan=2 height=60><TABLE cellSpacing=0 cellPadding=0 width="100%" border=0><TBODY><TR><TD vAlign=top><TABLE style="DISPLAY: inline" cellSpacing=0 cellPadding=0 width=309 align=right border=0><TBODY><TR><TD align=right width="100%"><TABLE borderColor=#c0c0c0 cellSpacing=0 cellPadding=0 width=0% border=0 imageTableTakeCare><TBODY><!-- TOKEN --><TR><TD>
1_234993_1_5.jpg
</TD></TR><TR><TD style="FONT-WEIGHT: bold; FONT-SIZE: 8pt; COLOR: #000000; FONT-FAMILY: Verdana" align=middle>The World Health Organisation is concerned about the way the Ebola virus keeps mutating [EPA]</TD></TR><!-- /TOKEN --></TBODY></TABLE>



















<TABLE border=0><TBODY><TR></TR></TBODY></TABLE></TD></TR></TBODY></TABLE>At least 22 people have died and 94 thought to be infected by a new strain of the Ebola virus in Uganda, reports say.

Some 330 people are being monitored for possible infection in western Uganda, health officials said on Thursday.

<TABLE border=0><TBODY><TR><TD></TD></TR></TBODY></TABLE><TABLE style="DISPLAY: none" border=0><TBODY><TR><TD><SCRIPT language=javascript>bodyVariable350="Htmlphcontrol1_lblError";</SCRIPT></TD><TD></TD></TR></TBODY></TABLE><TABLE height=10><TBODY><TR><TD></TD></TR></TBODY></TABLE>The outbreak started in August and 58 cases have so far been confirmed by laboratory tests.

Authorities are facing problems investigating the extent of the outbreak in the Bundibugyo district, bordering the Democratic Republic of Congo (DRC).

<TABLE border=0><TBODY><TR><TD></TD></TR></TBODY></TABLE><TABLE style="DISPLAY: none" border=0><TBODY><TR><TD><SCRIPT language=javascript>bodyVariable300="Htmlphcontrol2_lblError";</SCRIPT></TD><TD></TD></TR></TBODY></TABLE><TABLE height=10><TBODY><TR><TD></TD></TR></TBODY></TABLE><TABLE id=ServicesList style="DISPLAY: inline" cellSpacing=0 cellPadding=0 align=right border=0><TBODY><TR><TD align=middle></TD></TR><TR><TD id=tdRelated align=middle></TD></TR><TR><TD height=5></TD></TR></TBODY></TABLE>The area is home to an estimated 250,000 people and considered the epicentre of the disease.

Many villagers are reportedly unwilling to co-operate with medical authorities.

Sam Zaramba, Uganda's director of health services, told Reuters news agency that a doctor had died in the Mulago hospital in Kampala, the capital, after looking after a patient in its isolation ward.

Three other medical staff died after treating infected patients.

According to Zaramba, all other cases and deaths had occurred where the outbreak started.

Zaramba said: "We've had one more admission today, someone in Bundibugyo. It is 94 now."

"Twenty-two have died. Out of them, four [are] health workers, one a doctor. He died in Mulago."

Kenyan alert

Kenya has been screening travellers entering from Uganda at the Busia crossing - on the main road out of Kenya's western region, into east and central Africa - since last week, health officials said.

James Nyikal, the head of medical services, said: "Screening is going on at Busia. People are being asked questions about where they have travelled and their health."

Ugandan health officials say that the genetic analysis of samples taken from victims shows the virus as a previously unrecorded type of Ebola, making it a fifth strain.

They also said that the low death rate of this type - at roughly 22 per cent, when the virus normally kills between half and 90 per cent of those infected - shows it is less lethal than previous epidemics.

Uganda was last hit by an Ebola outbreak in 2000, when 425 people were infected and over half died.

Some of the first recorded cases of Ebola were found in the DRC in 1976.

It killed 280 people and infected up to 380.:tiphat:

<TABLE border=0><TBODY><TR><TD></TD></TR></TBODY></TABLE>http://english.aljazeera.net/NR/exeres/521BC67B-BD18-4464-A1C6-42B5713C3A28.htm</TD></TR></TBODY></TABLE></TD></TR></TBODY></TABLE></TD></TR></TBODY></TABLE>
 
Re: New Ebola Strain in Uganda Spreading - Death toll rising

Re: New Ebola Strain in Uganda Spreading - Death toll rising

Uganda has over 100 Ebola cases, 350 more at risk

Fri 7 Dec 2007, 9:55 GMT
<INPUT id=CurrentSize type=hidden value=13 name=CurrentSize>
[-] Text [+]

By Tim Cocks
KAMPALA, Dec 7 (Reuters) - Uganda now has more than 100 suspected cases of the lethal Ebola virus and 350 more people are being closely monitored because they were in contact with those infected, the Health Ministry said on Friday.
There were no new deaths from the virulent haemorrhagic fever, which usually causes victims to die of bleeding through various orifices, Health Ministry Spokesman Paul Kabwa said.
Twenty two people have so far died of the fever.
"Cumulatively, we have got 101 cases of Ebola -- those who fit the case definition," Kabwa said, adding that all were in western Uganda's Bundibugyo district, except for two in Kampala, including a doctor who died.
He said 39 had been admitted to hospital in serious condition and 350 others suspected of having been exposed to the virus were being urged to stay at home.
"They are being observed because they are possible contacts with Ebola cases," Kabwa said. "They are not being confined."
The outbreak, which started in August, has sparked panic amongst officials, health workers and the public.
"A bigger Ebola bomb could explode, claiming many more lives," Bundibugyo district chairman Jackson Bambalira was quoted as saying in the state-owned New Vision daily on Friday.
Bundibugyo borders Democratic Republic of the Congo, whose Ebola river gave the virus its name after some of the first cases of Ebola were recorded in its valley in 1976.
The independent Daily Monitor reported on Friday that Congo had sealed the border with the district. Congolese officials were not immediately available for comment.
Neighbours Kenya and Rwanda, to the east and southwest, respectively, are screening travellers entering from Uganda.
The four-month delay between the start of the outbreak and confirmation last week that it was Ebola has raised suspicions the government covered it up so as not to scare delegates -- Britain's Queen Elizabeth and 53 heads of government -- who met in Kampala two weeks ago for a Commonwealth summit.
The government denies it withheld information. It says it took time for test results to come back from the Centres for Disease Control and Prevention in the United States.
Commentators have criticised the government's response as sluggish and say Uganda should have learned from an Ebola outbreak in 2000, when 425 people caught it and over half died.
"When Ebola first struck in 2000 in northern Uganda, we were plunged into panic. Seven years later when we should have been better prepared ... we are ill-equipped as before," read an editorial in the Monitor on Friday.
Uganda's medical workers union have called on staff to refuse to care for patients unless they have proper protective gear, following the death of four medical staff.
The government says all those treating Ebola cases are protected. "We are distributing protective gear. We don't want to risk our own staff," Kabwa said.
(Editing by Sophie Walker)

http://africa.reuters.com/wire/news/usnL07590270.html
 
Re: New Ebola Strain in Uganda Spreading - Death toll rising

Re: New Ebola Strain in Uganda Spreading - Death toll rising

<TABLE cellSpacing=4 cellPadding=0 width="100%" border=0><TBODY><TR><TD colSpan=2>UGANDA: Medical staff bore the brunt of "sly" new Ebola virus

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Photo: Stuart Price/IRIN </TD></TR><TR><TD class=ImgCreditCaption style="FONT-SIZE: 7pt; FONT-FAMILY: Tahoma">Authorities are monitoring hundreds of people</TD></TR></TBODY></TABLE>KAMPALA, 7 December 2007 (IRIN) - As Uganda's western district of Bundibugyo grapples with the consequences of an outbreak of the Ebola virus, which has killed 22 people in three months, medical officials have blamed what they term the "slyness" of the virus for the high death toll among medical staff.

"It has taken us three months to diagnose that this was Ebola," Sam Zaramba, the director-general of health services, told IRIN on 6 December. "It presented itself differently from the known haemorrhagic fevers. Instead of patients passing blood from body openings, it was characterised by high fever, abdominal pain, diarrhoea, vomiting and headaches."

When the disease broke out in September, health workers in Bundibugyo thought it was one of the many common ailments prevalent among the 250,000 population, mainly farmers of cocoa, rice and vanilla and small-scale cattle-raisers.

Zaramba said the disease could have spread unnoticed in the ensuing medical confusion, with its characteristic haemorrhaging obscured by companion ailments, only to emerge when cases were tested at hospital. This presentation, he said, made health workers think the disease was a ?normal" ailment.

"This was the main reason why many [medical personnel] have fallen victim and four of them have since died," Zaramba said. Three of these medical workers died on 5 December; one was the head of a health centre in Bundibugyo.

"They did not use any protection when attending to patients," Zaramba said. "However, we have now supplied enough protective gear to all health units in the affected district and we have asked them to treat every patient with caution."

Sam Okware, the chairman of the National Ebola Taskforce, said the Ebola strain identified in Bundibugyo was "completely different" from the four known sub-types of the highly contagious haemorrhagic fever - Ebola Sudan, Ebola Zaire, Ebola Reston, which only affects monkeys, and Ebola Tai, recorded in C?te d'Ivoire.

Ebola last struck Uganda in 2000 in the northern district of Gulu, and killed at least 170 people, including Matthew Lukwiya, then medical superintendent of Lacor hospital, who spearheaded the fight against the disease.

Several other medical workers also lost their lives during the 2000 epidemic, suspected to have struck soon after the return of Ugandan soldiers from the Democratic Republic of Congo (DRC) where the national army fought alongside rebels against the government of then president Laurent Kabila. <TABLE style="BORDER-RIGHT: #336699 1px solid; PADDING-RIGHT: 5px; BORDER-TOP: #336699 1px solid; PADDING-LEFT: 5px; PADDING-BOTTOM: 5px; MARGIN: 2px 8px 8px; BORDER-LEFT: #336699 1px solid; WIDTH: 160px; PADDING-TOP: 5px; BORDER-BOTTOM: #336699 1px solid; BACKGROUND-COLOR: #aabbdc" cellSpacing=0 cellPadding=0 align=right><TBODY><TR><TD style="COLOR: #ffffff; FONT-FAMILY: tahoma; size: 12px" align=left bgColor=#aabbdc>
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It presented itself differently from the known haemorrhagic fevers. Instead of patients passing blood from body openings, it was characterised by high fever, abdominal pains, diarrhoea, vomiting and headaches
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</TD></TR></TBODY></TABLE>

Monitoring patients

Zaramba said the authorities were monitoring hundreds of people believed to have had contact with some of those infected. "We are monitoring 330 people in the community," Zaramba said. "These are the people who had contact or had been near Ebola patients."

Zaramba said of the 330, 93 fitted the diagnosis of Ebola and 38 were admitted to health centres in Bundibugyo where isolation units had been erected. The death toll in this outbreak is 22 so far.

Samuel Kazinga, resident district commissioner for Bundibugyo, said some patients had gone into hiding for fear of possible contamination in hospitals. This, he said, had complicated the drive to isolate cases.

"The Congolese have also closed their border at Busunga and installed customs officers, who are not allowing the movement of people between the two nations," he said.

At the same time as the Ebola outbreak spread to districts neighbouring Bundibugyo, the health ministry was swamped with outbreaks of plague, meningitis, hepatitis and cholera that have killed 33 people.

The ministry reported 569 cases of cholera in western and northwestern Uganda with 12 deaths; 121 plague cases in Arua with 10 deaths and 39 cases in Nebbi, with nine deaths.

At least 255 cases of meningitis have been reported in Arua district and 32 cases of viral hepatitis with two deaths in northern Kitgum district.

According to the ministry, the main victims of plague are women because they sleep on the ground while men sleep on beds; fleas that spread plague can only jump six inches from the ground.

"They feast on those sleeping on the ground and these are mainly women," Emmanuel Otaala, the state minister for health, said. "We are encouraging men to allow women sleep on beds also."

vm/js/mw
</TD></TR><TR><TD colSpan=2>
Themes: (IRIN) Health & Nutrition</TD></TR><TR><TD colSpan=2>
[ENDS] </TD></TR><TR><TD colSpan=2>Report can be found online at:
http://www.irnnews.org/Report.aspx?ReportId=75738 </TD></TR></TBODY></TABLE>
 
Re: New Ebola Strain in Uganda Spreading - Death toll rising

Re: New Ebola Strain in Uganda Spreading - Death toll rising

D<SUP class=typo_exposants>r</SUP>. Jonah Kule, a first son of World Harvest Mission, succombs to Ebola Virus

<SMALL>vendredi 7 d?cembre 2007</SMALL>
<TABLE align=left border=0><TBODY><TR><TD><SCRIPT type=text/javascript><!--google_ad_client = "pub-8126303992385778";google_ad_width = 250;google_ad_height = 250;google_ad_format = "250x250_as";google_ad_type = "text";//2007-08-21: Finance, M?dias, Voyage, cash for structured settlement, faire de l argent sur internetgoogle_ad_channel = "1955222947+9431141123+9432790818+3653009034+7755964615";//--></SCRIPT><SCRIPT src="http://pagead2.googlesyndication.com/pagead/show_ads.js" type=text/javascript></SCRIPT></SCRIPT></TD></TR></TBODY></TABLE>
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By Michael Ireland
D<SUP class=typo_exposants>r</SUP>. Jonah Kule was in many ways a first son of World Harvest Mission?s (www.whm.org) work in Uganda.
WHM?s Dan Herron writes : ? We were shocked learn of Jonah?s death after he had been up walking around. ?
World Harvest sent out this note yesterday :
? It is with deep sadness that I share the news of the death of D<SUP class=typo_exposants>r</SUP>. Jonah Kule ? in many ways a ?first son? of World Harvest, having learned about Jesus many years ago through Isingoma Edward Amooti, Dan Herron and Robert Carr. ?D<SUP class=typo_exposants>r</SUP>. Jonah, an integral part of the community health effort in Bundigbugyo for many years, quite literally laid down his life to proclaim the Kingdom of Christ through healing," says WHM?s Dan Herron.
Herron writes of the current Ebola Virus outbreak in Uganda : ? I know that many of you have already received this news and are caring for the Myhres and the entire Uganda team through your ongoing prayer and support of them. Thank you. Don?t grow weary in doing this good and important work. ?
Dan and Gini Herron are on their way from Spain heading to Uganda to help with spiritual care for the WHM folks coming out of the Ebola zone.
? It will include caring for the children of the two missionary doctors who are remaining there. Both have been exposed and have been asked to remain in the district. The Ugandan government is sending in other doctors since the two Ugandan doctors are in isolation sick with Ebola. Some of our missionaries seem quite concerned and rightly so. That is why Gini and I are going to meet them in Kampala. We will be there for at least a month. Pray for safety, compassion, and wisdom. ?
Earlier, WHM?s Bob Osborne began his December 3 update with the news that D<SUP class=typo_exposants>r</SUP>. Jonah and D<SUP class=typo_exposants>r</SUP>. Sessanga were ? also very pleased (though cautiously optimistic) to report that D<SUP class=typo_exposants>r</SUP>. Jonah seems to be showing signs of healing. Yesterday he was strong enough to walk around and interact with the medical staff caring for him. D<SUP class=typo_exposants>r</SUP>. Sessanga also appears to have turned a corner in his recovery. ?
Please pray in particular for Jonah?s widow Melen and their five children. ? Melen is also pregnant ? this tragedy truly knows no bounds, ? saya Herron.
Dan and his wife Gini are currently en route to Uganda.
They write : ? We are at the airport in Madrid on our way to Kampala. Please pray for us to have wisdom in comforting those who are grieving and who may fear for their own lives. We are so appreciative of your emails and expressions of standing with us. ?
Dan Herron adds that their access to email may be limited for some days.
If you want to read more go to the World Harvest website ([->www.whm.org] ) or the Myhres? blog ([->www.paradoxuganda.blogspot.com
]) .
http://www.spcm.org/Journal/spip.php?breve4525
 
Re: New Ebola Strain in Uganda Spreading - Death toll rising

Re: New Ebola Strain in Uganda Spreading - Death toll rising

350 confined over Ebola outbreak
Thursday, 6th December, 2007

http://www.newvision.co.ug/D/8/12/600844

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Margaret Lukwiya at the requiem mass of her husband in Gulu yesterday
By Vision Reporters

ABOUT 350 people who have had contact with Ebola victims have been confined to their homes for monitoring in Bundibugyo and Kasese districts. About 253,000 people in the five sub-counties of Bundibugyo district are at risk of contracting the deadly haemorrhagic fever, the World Health Organisation and the Ministry of Health said yesterday.

They added that Bundibugyo town council was the most affected.

?We have established that 335 such people participated in burying some of the cases, either as relatives or sympathisers,? the Bundibugyo district chairman, Jackson Bambalira, said.

The National Task Force put the figure of the people being followed at 327.

?I am greatly worried that a bigger Ebola bomb could explode, claiming many more lives,? Bambalira said.

He added that another 20 people in Kasese had also been confined at home. The suspects were tracked down by local and international experts this week.

Since August when the killer disease broke out, ninety-three were confirmed infected, 24 of whom have died among them Dr Jonah Kule, and four health workers. Kasese, Mbarara and Kabarole districts have been put on high alert.

Blood specimens are being collected for testing at the newly-established Ebola lab, which begins to work this weekend. Results will now be out within 24 hours unlike in the past when the samples would be taken to the US.

Community leaders in Bundibugyo and Kasese have also been registering suspected cases and deaths. LCs have been ordered to restrict movement into homesteads where cases are suspected.

UPDF doctors have also joined the local and international experts in Bundibugyo to combat Ebola, including sensitising the population. Dr. Kule and the other health workers who died of Ebola were buried yesterday at Bundibugyo Hospital.

Dr. Richard Kaddu Ssessanga, the medical superintendent, who until the time of the burial had not learnt of his colleague?s death, forced himself out of bed to attend the burial. ?He looked really hard-hit by Dr. Kule?s death,? an official said. Ssessanga barred his relatives who had travelled from Kampala from entering the room where he is confined.

Meanwhile, in Gulu, a memorial service was held on Wednesday for the victims who died of Ebola in Gulu in the 2000 outbreak, the first ever in Uganda. Dr. Matthew Lukwiya, the head of Lacor Hospital, was one the victims.

Kabarole
In neighbouring Kabarole district, residents of Kichwamba have threatened to flee if an isolation centre for Ebola cases is set up in their village.

?People fear to risk their lives and those of their children and are relocating,? resident Evanice Manyireho said.

?We are worried. Some of our elderly people and drunkards may stray into the isolation centres and get infected. We ask the Government to identify another place far away from human settlement,? Manyireho pleaded. The concerns were raised during a meeting called by the district disaster preparedness committee at Bukuku sub-county hall.

Kichwamba Health Centre III has been made an isolation centre after two unconfirmed cases were admitted in Buhinga and Virika hospitals in Fort-Portal.

The World Health Organisation (WHO) has provided gloves, gowns, gumboots and jik for use at the centre. The Ministry of Health advised people with other ailments to seek help at the Bukuku health centre and Buhinga Hospital.

Kabale
Meanwhile, Kabale authorities have set up a task force as a precautionary measure to handle any cases.

The head of health services, Dr. Patrick Tumusime, was afraid that the disease could be carried to the district by unsuspecting infected people. He advised that suspicious illnesses be immediately reported.

(By Anne Mugisa, John B. Thawite, Bizimungu Kisakye, Colombus Tumusiime, Dennis Ojwee, Bwogi Buyera)
 
Re: New Ebola Strain in Uganda Spreading - Death toll rising

Re: New Ebola Strain in Uganda Spreading - Death toll rising

I don't understand why the WHO don't wan't to restrict even partialy (for turists) the traveling through Uganda if that's an maybe H5 addition recombinant new Ebola virus with diferent symptoms (vomiting, maybe no bleeding) similar with starting of many other diseases - how will an esigue staff of doctors control all the international passengers through Uganda succesfuly?

______
"Recommendations for U.S. Travelers
The World Health Organization (WHO) has reported that there is no need for any travel restrictions to Uganda. Generally, the risk of contracting Ebola virus is low for travelers." ...
 
Re: New Ebola Strain in Uganda Spreading - Death toll rising

Re: New Ebola Strain in Uganda Spreading - Death toll rising

Kemri to investigate suspected Ebola samples
Written By:Judith Akolo , Posted: Fri, Dec 07, 2007



The Kenya Medical Research Institute -Kemri has been mandated as the sole recipient of samples of any suspected cases of Ebola.

Director of Medical Services Dr James Nyikal says that Kemri has the capacity to diagnose any form of haemorrhagic fever including the dreaded Ebola.

In a statement to media houses, Nyikal said the government has reactivated its surveillance systems countrywide to detect and respond to any possible threat.

A rapid response team has been established at the Ministry headquarters to support any districts that might report suspected cases of Ebola.

Nyikal however maintained that the public are free to travel to and from Uganda.

Over 350 people in Bundibugyo and Kasese districts of Uganda who had contact with Ebola victims have been quarantined in their homes for monitoring.

Since August when the killer disease broke out, ninety-three people, have been infected while 24 have already succumbed to the deadly fever.

Nyikal and Health Minister Paul Sang were quick to reassure the Kenyan public that the government is on high alert and monitoring the situation in Uganda.

Nyikal advised those traveling to Uganda to ensure that they avoid any contact with Ebola patients or their body fluids, including needles or medical waste.

They should also avoid contact with wild animals or consuming bush meat.

They should report to the nearest health facility any person with symptoms suggestive of malaria or typhoid if they have visited the Western parts of Uganda or the DRC.
 
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