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Ebola: December 18+ 2007, is getting contained; no new case confirmed since jan 3

HenryN

Retired
Ebola Under Control But Experts Fear Re-Emergence in Congo


UN Integrated Regional Information Networks

NEWS
18 December 2007 </B>
Posted to the web 18 December 2007
Kampala

Ugandan health officials said they had an outbreak of a rare Ebola strain under control in their country but expressed concerns that the disease could resurface in the neighbouring Democratic Republic of Congo (DRC).
At a news conference in the capital Kampala on 18 December, the Ministry of Health said a person "with the appropriate clinical case definition of Ebola" had been identified in an area in DRC near the border.
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They said Uganda had contacted the UN World Health Organization (WHO) over the current threat.
"We have asked our people in Bundibugyo [the epicentre of the latest outbreak in Uganda] to encourage them to come over for treatment because these diseases know no boundaries," Emmanuel Otaala, the minister in charge of primary health care, said. "We are in touch with Kinshasa [DRC's capital] through the World Health Organization and we have also contacted our foreign ministry to handle it through the diplomatic channels."
Some 127 cases of suspected Ebola have been reported in Uganda, 35 of whom have died, including five health workers. Another 39 patients, including six health workers, have been discharged from hospital after making a full recovery.
Otaala said there had been a general decline in the number of new Ebola cases, with only three cases reported in the past four days - an indication that the outbreak was now under control.
Tests on other suspected cases reported outside Bundibugyo district were negative, while the capacity of all referral hospitals to handle contagious infections had been improved, he said.
Health official Sam Okware told IRIN a taskforce set up to fight the outbreak has been tasked with convincing the public in the affected region to abandon traditional circumcision rituals, due to start shortly, until the epidemic clears.
He also said that those people discharged from hospital had been asked to abstain from sex for three months or use condoms as the virus could be carried in semen.
Virologists are investigating what triggered the latest epidemic and are specifically exploring reports that it could have started when a family of 10 people feasted on a dead goat that had been bitten by a wild animal. The 10 later fell sick.
"We have tried to look for the skin of the goat but it is not there and we are suspecting that these people might have eaten the real wild animal, but we have not made any conclusions yet," Okware said.
An outbreak of the highly contagious disease, which can have fatality rates as high as 90 percent, killed at least 170 people in northern Uganda in 2000.
A similar Ebola outbreak killed at least 26 people in DRC's West Kasai region, in a country where the disease was first discovered in 1976.
[ This report does not necessarily reflect the views of the United Nations ]
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http://allafrica.com/stories/200712180801.html
 
Re: Ebola: December 18+, Under Control But Experts Fear Re-Emergence in Congo

Re: Ebola: December 18+, Under Control But Experts Fear Re-Emergence in Congo

Uganda: Bundibugyo Residents Shun Ebola Survivors

The Monitor (Kampala)

21 December 2007


Residents of Bundibugyo District, already terrified by the highly communicable killer Ebola in their midst are shunning survivors of the haemorrhagic fever discharged from nearby medical facilities.

The Medicines Sans Frontiers, a Swiss NGO that has been the lead agency in setting up and stocking isolation centres for treating the Ebola patients at both Bundibugyo Hospital and Kikyo Health Centre IV, says community resistance is heightening public stigma against the survivors.

"When we take the survivors home, people only accept them (temporarily) in our presence," Dr Esther Sterk, who has been involved in Ebola management at Bundibugyo Hospital since December 5, told a press conference in Kampala on Wednesday.

"But our follow up shows that people have been rejecting them (survivors)."

She said only relatives of one, Mr Swaibu readily accommodated him after recovering from Bundibugyo Hospital.

Dr Sam Okware, the commissioner of community services in the Ministry of Health said the government had dispatched a Makerere University professor of Psychology to undertake research in various villages in Bundibugyo and advise government on how best to sort out the increasing stigma against Ebola survivors.

http://allafrica.com/stories/200712210454.html
 
Re: Ebola: December 18+, Under Control But Experts Fear Re-Emergence in Congo

Re: Ebola: December 18+, Under Control But Experts Fear Re-Emergence in Congo

Tuesday, December 18, 2007

Tuesday Night Numbers-Still in Bundibugyo


Dueling posts? Jennifer has posted this evening from Kampala because she flew out of Bundibugyo with MAF this afternoon to re-join our kids, capitalizing on her first opportunity in 14 years to sit in the co-pilot's seat. Flight protocol states the plane must be loaded heaviest in front, so Jennifer has always been relegated to the rear with the small kids. As the only passenger on today's return leg to Kampala, she had no competition for the premium seat.

This evening's District Ebola Task Force Meeting revealed a continuing tapering of the epidemic...

- Cumulative Cases: 128
- Cumulative Deaths: 34 (CFR = 26.6%)
- Current Admissions: Bundibugyo Hospital 4 ; with no new admissions, 1 discharge, and no deaths. Kikyo also with 4 inpatients; 2 new admissions, 3 discharges and no deaths. Of the 8 currently admitted to the Isolation Wards, they hope that 6 might be discharged tomorrow.
- Contacts: 535 have been listed with 426 actively followed (the remainder finished their 21 day waiting period--the Jonah family will hit their 21 day goal tomorrow). 85.2% of the contact list were visited today, a huge and punishing task in the unrelenting sunshine today.

The most intense discussion of the evening again revolved around the issue of "traditional healers" , also known as "herbalists", "traditional herbalists", "alternative practitioners","witch doctors" or "jujus". The lines between these practitioners seem indistinct, and in fact, they appear to jump back and forth between the roles depending on circumstances. Hundreds of these healers prescribe their concoctions of locally gathered substances (77 different tree sources) in drinkable teas, smearable pastes, or otherwise unspeakably applied mixtures for all sorts of common illnesses...and now they are taking credit for the successful treatment of Ebola patients.

Where does the Task Force draw the line between challenging engagement versus tacit endorsement? Clearly, this group is out in the community on the front line of caring for people with illness and cannot be ignored. However, their practices and pharmaceuticals have not been scientifically studied and cannot be endorsed. They commonly make small incisions to "let bad blood out" and to promote the absorption of their smeared herbs, a practice that could put them at extremely high risk of contracting Ebola themselves or promoting the transmission of the virus to others. Thankfully, reason prevailed and the Task Force unanimously agreed today that this group should be strongly discouraged from treating any Ebola patients. Whether they can be convinced is an entirely different question.

Posted by DrsMyhre at <a class="timestamp-link" href="http://paradoxuganda.blogspot.com/2007/12/tuesday-night-numbers-still-in.html" rel="bookmark" title="permanent link"><abbr class="published" title="2007-12-18T10:23:00-08:00">10:23 AM</abbr> 1 comments



In Kampala

I flew to Kampala today, and am now with my four children after two weeks and one day of separation. Thanks to the many who prayed. Now Scott will be updating the blog from Bundibugyo. It was amazing to fly out over the epicenter today, seeing the white MSF isolation tents like mushrooms sprouting around the Kikyo health center. Smoke rose from forest-clearing fires, the ridges shone with the diamond glitter of tin roofs reflecting the afternoon sun, and the line of the forest where the elusive viral reservoir hides was clearly visible. All so orderly and peaceful from the air . . .

Posted by DrsMyhre at <a class="timestamp-link" href="http://paradoxuganda.blogspot.com/2007/12/in-kampala.html" rel="bookmark" title="permanent link"><abbr class="published" title="2007-12-18T07:02:00-08:00">7:02 AM</abbr> 8 comments

http://www.paradoxuganda.blogspot.com/
 
Re: Ebola: December 18+, Under Control But Experts Fear Re-Emergence in Congo

Re: Ebola: December 18+, Under Control But Experts Fear Re-Emergence in Congo

Wednesday, December 19, 2007

Ebola Bundibugyo, Wednesday numbers




One of the World Health Organization experts told us that in the best case scenario we would see the number of cases cut in half each week. The admitted caseload peaked at 40 about 2 weeks ago, so with the current admissions numbering 6, things are looking pretty good.

Today's numbers:
- Cumulative cases: 130
- Cumulative deaths: 34 (CFR = 26.2%)
- Current admissions: Bundibugyo Hospital 1, with no new admissions, 3 discharged, and no deaths. Kikyo has 5 current, with 2 new cases (both identified from the pool of contacts who are being visited daily), 1 discharge and no deaths.
-Contacts: 571 total of which 450 are being actively followed (77 have finished their 21 day incubation monitoring and the remainder were lost to follow-up). 86.4% of the contacts were visited today.
-Lab confirmations: of the 108 samples sent for testing in the CDC/UVRI lab in Entebbe, 32 have been positive (29.6%). Of the 32 positive samples, 11 died (CFR = ~34%, slightly higher than the overall clinical CFR mentioned above)...probably closer to the "true" CFR of the Ebola-Bundibugyo strain (Btw, still waiting on that name to be officialized).

The District Task Force meeting continues to chase administrative details rather than medical or epidemiological questions. Today's issues related to the number of individuals of a village health team who could receive renumeration for assisting the surveillance teams and who would distribute food donated by the World Food Programme. Every confirmed Ebola case will receive a month's worth of food for a family of six.

My favorite anecdote of the meeting came out in the Surveillance Committee report. When a patient is discharged from either of the two MSF Isolation Units, they are asked to surrender all of their properties for incineration. Their mattress, their clothes, their toiletries...up in smoke -- along with any residual virus. Well, one patient was asked to surrender his cell phone (any studies out there on the duration of Ebola virus viability in a cell phone?)...which he relinquished without complaint. However, he did follow-up over the next couple of days with a couple of calls...and found that his phone is still in use! The surveillance committee is pointing the finger at the Isolation Ward staff for poaching the infected cell phone.

"Burn it or give it back," the patient has asked (he's not afraid...he's immune now).

Posted by DrsMyhre at <a class="timestamp-link" href="http://paradoxuganda.blogspot.com/2007/12/ebola-bundibugyo-tuesday-numbers.html" rel="bookmark" title="permanent link"><abbr class="published" title="2007-12-19T10:44:00-08:00">10:44 AM</abbr> 1 comments

http://www.paradoxuganda.blogspot.com/
 
Re: Ebola: December 18+, Under Control But Experts Fear Re-Emergence in Congo

Re: Ebola: December 18+, Under Control But Experts Fear Re-Emergence in Congo

Thursday, December 20, 2007

Ebola Bundibugyo, Thursday numbers


A small milestone. The last death occurred one week ago, 13th December. The beauty of the line graph above is the flattening of that slope on the right. A whole week without an Ebola death...that's a cause for celebration.

Today's numbers:
-Cumulative cases: 131
-Cumulative deaths: 34 (CFR=25.9%)
-Current admissions: Bundibugyo Hospital 2, with 1 new admission, no discharges and no deaths. Kikyo Health Unit has 4 inpatients, with no new admissions, 1 discharge and no deaths.
Contacts: 571 of which 432 are being followed-up. 94 have completed their 21 day incubation count-down. 89% of contacts were seen today.

Issues discussed in the evening briefing:
-World Food Programme will be giving a generous package to the families of all Ebola patients: 75 kg of corn meal, 11 kg of dry peas, 3.7 kg (one can) of vegetable oil, 14 kg of corn-soya blend, and 3 kg of sugar.
- The Batwa (a.k.a., the pygmies) have appealed to the LC5 Chairman because they are "bad off" because of Ebola. They claim that they depend on the income generated from tourists who have stopped coming to Bundibugyo because of Ebola and that they are starving. In fact, the Queen Pygmy has deserted her husband, the King, because he is not providing for her. Abdicating the throne because of hunger...things are bad in Bundibugyo. The Task Force requested that their request be redirected to other donors so as not to confuse our mandate which is to treat and prevent Ebola infection.
-The Democratic Republic of Congo has closed the border to incoming traffic. Congolese citizens may enter Uganda freely, but not re-enter the DRC. Congolese nationals who want to re-enter their country from Uganda are being admitted to Isolation Tents whether they are sick or not. Unnecesary, extreme, mis-informed.

Jonah's wife, Melen, and her family returned from their outlying farm to their small concrete home in Nyahuka last night. Melen, Sofia and Jonah's mother wept all evening. Pat slept with them and read Scripture to them all morning until the stream of visitors began which lasted all day.

Posted by DrsMyhre at <a class="timestamp-link" href="http://paradoxuganda.blogspot.com/2007/12/ebola-bundibugyo-thursday-numbers.html" rel="bookmark" title="permanent link"><abbr class="published" title="2007-12-20T10:33:00-08:00">10:33 AM</abbr> 5 comments
 
Re: Ebola: December 18+, Under Control But Experts Fear Re-Emergence in Congo

Re: Ebola: December 18+, Under Control But Experts Fear Re-Emergence in Congo

Friday, December 21, 2007

Ebola Bundibugyo, Friday Night Numbers




Today's numbers...
-Cumulative cases: 132
-Cumulative deaths: 34 (CFR 25.8%)
-Current Admissions: Bundibugyo Hospital 3, of which 1 is a new admission, no discharges and no deaths. Kikyo Health Unit has 2 inpatients, with no new admissions, 1 discharge and no deaths.
-Contacts: 577 total, 124 completed their 21 day follow-up, and 379 (94%) were followed up today.

Issues of the evening briefing (see the picture of the Task Force meeting above):
- 5 dogs were found dead in Bundibugyo Township today causing general panic due to fear that the dog deaths could be caused by Ebola. CDC experts assured everyone that Ebola has never been known to be found in dogs (collective sigh of relief).
-70 herbalists were sensitized/trained today. Not sure exactly what that means or how effective the training will be.

The pictures above...
-The Bundibugyo District Ebola Task Force meets in a Unicef tent every evening from 5:30-7pm (avg attendance ~ 50).
-The Kikyo Health Unit MSF Isolation Unit is now a finely tuned machine, terraced and complete with brick-lined crushed stone sidewalks.

The RDC reminded everyone to be vigilant as we approach the Christmas celebrations.
Vigilant...watchful, observant, attentive, alert, eagle-eyed, hawk-eyed, on the lookout, on one's toes, on the qui vive; wide awake, wakeful, unwinking, on one's guard, cautious, wary, circumspect, heedful, mindful.

A biblical reminder for sure...

Posted by DrsMyhre at <a class="timestamp-link" href="http://paradoxuganda.blogspot.com/2007/12/ebola-bundibugyo-friday-night-numbers_21.html" rel="bookmark" title="permanent link"><abbr class="published" title="2007-12-21T09:59:00-08:00">9:59 AM</abbr> 2 comments
 
Re: Ebola: December 18+, Under Control But Experts Fear Re-Emergence in Congo

Re: Ebola: December 18+, Under Control But Experts Fear Re-Emergence in Congo

Ebola Bundibugyo, the Sunday night numbers

Two steps forward, one step backward?the first Ebola death since December 13th.

Cumulative cases: 134
Cumulative deaths: 35 (Case Fatality Rate, CFR = 26.1%)
Case Fatality Rate among Laboratory confirmed cases = 12/34 = 35.3%

Current admissions: Bundibugyo Hospital 5, with no new admissions, no discharges, no deaths. Kikyo 2, with no new admissions or discharges, but one death.

Contacts: 587 of which 148 have finished their 21 day follow-up period. 321 were visited today.

Tomorrow, I will fly out with Pat and three others from MSF to spend Christmas with my wife, my kids, and my Team. As much as I am bursting to see my kids again?I also don?t want to go, to leave behind my fellow soldiers fighting the war against Ebola, against death.

As Jennifer mentions below, our Net access is limited at best in Kampala. Funny, but we are better connected to the world in rural Bundibugyo than in Uganda?s capital.

May your Christmas celebrations be filled with the Life and Light of the World.



http://paradoxuganda.blogspot.com/2007/12/ebola-bundibugyo-sunday-night-numbers.html
 
Re: Ebola: December 18+, Under Control But Experts Fear Re-Emergence in Congo

Re: Ebola: December 18+, Under Control But Experts Fear Re-Emergence in Congo

Uganda: New Ebola Case in Bundibugyo

New Vision (Kampala)

27 December 2007


Bundibugyo Hospital has registered a new case of the Ebola haemorrhagic fever just after discharging the last seven patients.

The confirmation that the woman (identity has been concealed) had Ebola sent the medical staff and other patients she had interacted with in panic.

She had been admitted to the hospital for five days.

The patient spent two days in the general ward being treated for malaria before she developed signs of Ebola.

She was taken to the isolation ward and the blood samples showed that she had the Ebola virus.

In Kabarole, the two patients, who were put in an isolation ward at Buhinga Hospital, tested negative for the Ebola virus.

According to results from the Uganda Virus Research Institute in Entebbe, the two do not have the virus although they participated in the burial of Ebola suspects.

However, another patient was taken to the isolation ward.

The Ministry of Health yesterday noted that a cumulative figure of 55 Ebola patients had been discharged from hospital.

It added that 279 contacts of the victims are out of danger.

The incubation period for Ebola is up to 21 days after exposure to the virus that causes the disease.

According to the ministry, the disease is getting contained.

It, however, warned people to stay vigilant.

It cautioned that the public, especially in the districts surrounding Bundibugyo, should avoid unnecessary movements and gatherings.

The districts are Kabarole, Kasese, Hoima, Kibaale, Kyenjojo, Kamwenge, Ibanda, Bushenyi and Mbarara.

Ebola kills within a short period of time if not treated urgently.

The Bundibugyo outbreak claimed five medical workers, including the medical superintendent ofKikyo Health Centre, Dr. Jonah Kule.

http://allafrica.com/stories/200712280092.html
 
Re: Ebola: December 18+, is getting contained; however new case confirmed

Re: Ebola: December 18+, is getting contained; however new case confirmed

Ebola cases up again

Friday, 28th December, 2007

By Vision Reporters

The deadly Ebola epidemic, which has been declining, is on the rise again.

One woman died on Thursday evening.

Shortly after, six more people were admitted exhibiting signs of Ebola.

Three of the suspected cases were admitted to Bundibugyo Hospital and three in Kikyo Health Centre.

The dead woman was identified as Goretti Kabugho from Butwaka near Kikyo. Medics in Bundibugyo said they had sent a team to verify other suspected cases reported in the community and bring them to hospital.

Blood samples from the medical workers, who treated Kabugho in the female ward before she was discovered to have Ebola, will also be called in for testing.

Samples would also be collected from patients who shared facilities with her in the ward before she was isolated.

?The health workers are so scared after they handled the patient without adequate protective gear and their morale is low. Apart from the isolation ward, the other wards do not have the heavy protective gear,? a medical worker said.

Neighbouring Kabarole district is reactivating the village health teams which were initially set up to carry out primary health care at the LC level.

Dr. Musa Walakira said the village health teams would be used to pass on information to combat the Ebola threat.

http://www.newvision.co.ug/D/8/13/603993
 
Re: Ebola: December 18+, is getting contained; however new case confirmed

Re: Ebola: December 18+, is getting contained; however new case confirmed

Friday, December 28, 2007

Ebola Bundibugyo, Friday Night Numbers

The Ebola Task Force daily briefing was tense and long. The death of a patient who was errantly admitted to the Female Ward of the Bundibugyo Hospital, later recognized as a Ebola supect, later confirmed and then died...after having exposed at least six health workers to the virus--has left the hospital and district anxious and angry.

Current Cases: Bundibugyo Hospital, 5 - of which 3 are new admissions (no discharges, no deaths). Kikyo Health Unit, 4 - of which 1 is a new admission (no discharges, no deaths).


Total Cumulative cases: 143
Total Deaths: 36
Case Fatality Rate: 25.2%

Contacts: 667.
362 finished their 21 day follow-up.
240 visited today.

Please continue to pray for an end to this scourge.

http://paradoxuganda.blogspot.com/
 
Re: Ebola: December 18+, is getting contained; however new case confirmed

Re: Ebola: December 18+, is getting contained; however new case confirmed

3 more cases

Sunday, December 30, 2007


Ebola Bundibugyo, Not Going Away


The Sunday night numbers while not huge continue to cause concern...

I failed to reach the Task Force Meeting due to mechanical motorcycle problems, but got the report second-hand from a very reliable CDC source...

Current Admissions: Bundibugyo Hospital, 5; of which there were three new admissions.

All of the new admissions managed to somehow filter through the Triage System and were admitted to the Bundibuygo Hospital General Wards.

After displaying symptoms suggestive of Ebola (high fever, vomiting and diarrhea) each of the three were subsequently transferred to the Isolation Ward.

Patients seem to be hiding their symptoms and/or history of contact with cases because of fear of admission to the Isolation Ward. Consequently, more health workers are being inadvertantly exposed to Ebola. This is a huge problem that has eluded a definitive solution.

Kikyo has 2 current cases.

Total Cumulative: 146
Deaths, Cumulative: 36

http://paradoxuganda.blogspot.com/
 
Re: Ebola: December 18+, is getting contained; however new cases confirmed

Re: Ebola: December 18+, is getting contained; however new cases confirmed

Source: Government of Uganda

Date: 02 Jan 2007

Ebola outbreak in Uganda: National Task Force situation report no. 17 - as at 10.00 hrs;

02 Jan 2008

Seen and cleared by Dr. Sam Okware/Chairman/NTF & Dr Melville George, WR/Uganda/Co chair/NTF


1. Situation in the Field:


- No new case and no death reported at the beginning of the year.

- To date a cumulative total of 147 cases with 37 deaths have been reported (Case Fatality rate of 25.3%) while 35 were laboratory confirmed.

- The total number of inpatients in both isolation units is 5 cases as of yesterday evening.

- All teams both International and local are still in the field and worked through out the festive season and are continuing to ensure the epidemic stops.

- There are still adequate supplies for case management and infection control in both Kikyo and Bundibugyo

- Social mobilization and psycho social support are still on going.

- Alerts from Kabale, Kabarole and Kisoro reported over the weekend are all negative.

- The outbreak is still confined in Bundibugyo district, No confirmed cases in any other part of the country.

2. Laboratory and Surveillance:


- Contact tracing is still on going, with a cumulative total of 772 contacts, and 414 contacts completed a 21 day follow up yesterday. 321 are still under follow up. Total contacts followed up to date are 83.8%, they are all in good health.

- Laboratory results from the earlier collected samples are still awaited. The cumulative laboratory samples collected to date is now 130.

3. Case Management and Infection Control:

- There were 5 Alert cases in Bundibugyo which turned out to be non cases.

- There are no new admissions in Bundibugyo while in Kikyo there was one patient re-admitted.

- No discharges in both Bundibugyo and Kikyo in last 12 hours.

- The total number of patients in both Kikyo and Bundibugyo isolation units is 5.

- No death was recorded by yesterday evening.

- Two Clinicians from IRC will be leaving the field today

4. Coordination ? Collaboration:

- The DTF compiled a field report to be discussed in the next NTF meeting to be held on 3rd January 2008, issues raised by the field team included; Strengthening Ebola laboratory services to reduce on the turn around time to confirm the diagnosis of Ebola, need to improve the quality of contact tracing, difficulty in accessing the population in mountainous areas, motivation of staff in all the health units in the district, and the need to strengthen surveillance in Bundibugyo district

- The district task force continues to meet every evening.

5. Logistics:

- There is ongoing provision of discharge kits to patients

- The World Harvest Mission pledged to take care of all the educational needs of the children of the Late Dr. Kule Jonah

- WCO is in final process of procuring Handheld radios to assist communication up in the mountains

6. Social mobilization, media and psycho social support:


- The social mobilization teams were deployed to sensitize 15 churches on Ebola over the New Year?s Day.

- The field psychosocial intervention group has reached out to 49 families and 146 individuals. The main problems noted include, stigma, lack of school fees to support the orphans,

7. Travel advice:

- There is no travel restriction to the affected district or Western Uganda in general as this disease is transmitted through direct contact with an Ebola patient or contact with body fluids from an infected person.

8. Challenges:

- There is a looming shortage of diesel and petrol in Bundibugyo district that is likely to affect follow up of contacts and social mobilization activities.

- Pace of distribution of food and non food items to affected families is slow due to terrain.

http://www.reliefweb.int/rw/RWB.NSF/db900SID/LSGZ-7AGK8Z?OpenDocument
 
Re: Ebola: December 18+, is getting contained; however new cases confirmed

Re: Ebola: December 18+, is getting contained; however new cases confirmed

Museveni Cautions on Ebola


New Vision (Kampala)


3 January 2008

Posted to the web 4 January 2008

Kampala

PEOPLE should not relax on the Ebola haemorrhagic fever because it is still posing a threat, President Yoweri Museveni has said , reports Anne Mugisa.

The warning comes amidst fears of a resurgence in the epidemic. Just as it was thought the last patient had been discharged, nine people were readmitted to hospital this week.


According to a State House statement, Museveni said Ebola was found in monkeys and cautioned people against eating monkey meat and that of other wild game. He made the statement during the New Year service at St. Luke's Nshwerenkye Church in Nyabushozi, Kiruhura district.

He also warned people against shaking hands to stem the risk of spreading the disease through sweat.

Medical workers in Bundibugyo and Kabarole have said the current fuel crisis, sparked by the election violence in Kenya, is hampering Ebola surveillance work.

The epidemic, which recently hit Bundibugyo district in western Uganda, claimed 37 lives, including the medical superintendent of Kikyo Health Centre, Dr Jonah Kule and five health workers.

http://allafrica.com/stories/200801040063.html
 
Re: Ebola: December 18+, is getting contained; however new cases confirmed

Re: Ebola: December 18+, is getting contained; however new cases confirmed

Source: Government of Uganda

Date: 04 Jan 2008

Uganda: Ebola outbreak press statement - 04 Jan 2008

The Ministry of Health wishes to update the general public on the Ebola situation in the country. The cumulative total is 149 patients with 37 deaths.

In Bundibugyo District, 5 people are currently admitted, 1 in Kikyo Health Centre and 4 in Bundibugyo Hospital. Of these, 1 new suspected case has been registered and is admitted in Bundibugyo hospital in the last 24 hours. One patient was discharged from Kikyo Health Centre.

On a good note, 441 out of 771 contacts have completed 21 days of follow up and are considered safe.

The Ministry of Health continues to urge the public to avoid unnecessary movements and gatherings especially in the districts around Bundibugyo i.e. Kabarole, Kasese, Hoima, Kibaale, Kyenjojo, Kamwenge, Ibanda, Bushenyi and Mbarara.

As we end the festive season, all District Health Officers, In charges of Health Units and the general public should not relax but continue being on alert and immediately report any suspected cases. Similarly, the public is reminded to report to Health Facilities any persons who present with the following symptoms: Very high fever of sudden onset, diarrhoea, vomiting associated with red eyes and a measles-like rash.

Ebola is spread by close contact with body fluids of infected persons or people who have died of Ebola. Anybody handling suspected cases must use appropriate protective wear and must wash his/her hands thoroughly with soap and water or JIK and water.

The Ministry assures the general public that the epidemic is still confined in Bundibugyo district and is getting contained. The public is urged to be compassionate and provide care and support to persons that have been discharged. I wish to thank all those who have provided support to the discharged patients. Let us continue. These people are not infectious and therefore should not be discriminated against.

The public should continue to be vigilant but without creating unnecessary fear and panic. The Central Alert Team will continue to respond to all alert cases brought to our attention. The numbers to contact remain the same as; Police Mobile 111 or 999 Police control room, Ministry of Health, 0772 587567, 0414 345108.

Dr. Sam Zaramba
DIRECTOR GENERAL OF HEALTH SERVICES

http://www.reliefweb.int/rw/RWB.NSF/db900SID/EDIS-7AJL5L?OpenDocument
 
Re: Ebola: December 18+, is getting contained; however new cases confirmed

Re: Ebola: December 18+, is getting contained; however new cases confirmed

Uganda: Ebola Scare As Dead Monkeys Found in Bundibugyo

The discovery of eight dead monkeys in the Rwenzori National Park in Bundibugyo District has again caused more fears and tension among locals who are just coming to terms with the Ebola outbreak that ravaged the area and is said to have been brought to the area by infected monkeys.

District leaders and the health workers are suspecting that the monkeys may have been suffering from another virus but are all the same carrying out investigations.

In a meeting of medical experts with the district leaders held on Thursday at the district headquarters that was aimed at assessing and fighting the Ebola epidemic who epicenter has been here, it was noted that the monkeys and chimpanzees have certain blood viruses similar to those detected in human blood samples.

The investigations, however, will take congnisance of the fact that illegal hunting and killing of monkeys in the Mt Rwenzori ranges is going on uninterrupted.

It was resolved that the district authorities of Bundibugyo with immediate effect and alert the Uganda Wildlife Authority to intervene since a good number of families living in the mountains are feeding monkey meat and putting their lives at risk.

Meanwhile, on January 4 the Director General of Health Services, Dr Sam Zaramba issued a statement saying that the cumulative total of Ebola patients stands at 149 with 37 deaths.

"In Bundibugyo District, five people are currently admitted, one in Kikyo Health Centre and four in Bundibugyo Hospital. Of these, one new suspected case has been registered and is admitted in Bundibugyo Hospital in the last 24 hours. One patient was discharged from Kikyo Health Centre," the statement said.

The statement had positive news too saying that 441 out of 771 contacts have completed 21 days of follow-up and are considered safe.

Dr Zaramba, however, cautioned against "creating unnecessary panic."

http://allafrica.com/stories/200801060023.html
 
Re: Ebola: December 18+, is getting contained; however new cases confirmed

Re: Ebola: December 18+, is getting contained; however new cases confirmed

Uganda: Last Bundibugyo Ebola Patient to Be Discharged

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The Monitor (Kampala)
8 January 2008
Posted to the web 7 January 2008
Tabu Butagira & Joseph Mugisa
Kampala/Bundibugyo
THE last Ebola patient at Bundibugyo Hospital was due to be discharged yesterday amid rising hope that the new strain of the haemorrhagic fever that struck in August last year, could soon be wiped out.
Dr William Sikyewunda, the Bundibugyo District Health Officer said yesterday that they had not registered any case of the virulent disease since Friday.
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But the Director General of health services, Dr Sam Zaramba said whereas the current lull in admissions shows Ebola infections are getting "fewer and fewer" in the western enclave, the disease could still erupt - as is characteristic with epidemics.
"It is still too early to celebrate (an end to Ebola). We shall only declare the country Ebola-free forty-two days after the last Ebola patient is discharged," he said yesterday.
It emerged yesterday that health officials in eastern Uganda on Sunday isolated two patients with Ebola-like symptoms at Obalanga Health Centre in Amuria District throwing the rural community into panic.
Dr Bernard Odu, the coordinator of Ebola Management in Teso sub region said they secluded the two individuals, who were taken ill with bleeding "as a precautionary measure. We do not want to take any chances".
Earlier, Dr Zaramba said following the weekend reports of mass deaths of monkeys in Bundibugyo, the Health Ministry had sent a team of experts to ascertain if it was Ebola killing the primates.
Daily Monitor has learnt that the group, led by Dr Kaboyo Winyi, the Public Health Veterinary Officer in the ministry comprises epidemiologists from the US-based Centres for Disease Control Prevention and specialist zoologists from Uganda wildlife authority and the ministry of agriculture.
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The disease, which was confirmed in the country on November 24, has since claimed 37 lives, including that of eight health workers out of 149 cumulative infections.
Even when containment of what is thought to be a milder form of the Ebola becomes manifest, the ministry of health is still urging the public to avoid unnecessary movement to Bundibugyo and its neighbouring nine districts.:tiphat: http://allafrica.com/stories/200801071655.html
 
Re: Ebola: December 18+, is getting contained; however new cases confirmed

Re: Ebola: December 18+, is getting contained; however new cases confirmed

FOCUS-Ebola causes more panic than other infections in Uganda
Sunday, 6 nero of 2008 12:41 GYT Print | Page One [-] text [+]
By Tim Cocks

KAMPALA (Reuters) - Few diseases cause much panic as an outbreak of Ebola fever.

In Uganda, where 100,000 people die each year from malaria, an epidemic of a new strain of Ebola has left only 36 dead and 135 infected, but it is spreading panic.

Apart from a doctor who died in Kampala after attending an affected area, all cases have occurred in the district of Bundibugyio, west of Uganda. Doctors say that the epidemic in the remote region along the border with Congo could be contained in months.

But tell that to Thomas Ssema, craftsman Kampala.

"This is not yet finished," said Ssema.

"It could spread everywhere. Just need that one of those people arriving in Kampala in a bus. Terrified I am," said Ssema.

The teller of banks have donated gloves to handle the money and the president of Uganda, Yoweri Museveni said the people who raise their hands to salute estrecharlas rather than with another person. But experts say that much of the panic is an exaggeration.

A doctor in Kampala, a notice entitled "Ebola" called for calm, assuring that although the virus spreads easily through body fluids such as blood, saliva and sweat, the victims are not contagious until they show symptoms.

"As usual, panic is out of proportion with the threat," said one of the general practitioners, who preferred anonymity.

LESS LETAL


The symptoms of Ebola begins with fever, vomiting and diarrhea. The victims are deteriorating rapidly. Most died quickly by shock or multiple organ failure, unless their immune system is able to contain the virus. Some people bleed for the eyes, mouth, nose and other orifices.

The disease was identified for the first time in the Democratic Republic of Congo and Sudan in 1976, where there were simultaneous outbreaks of different varieties miles away.

In Congo, the mutation of the most lethal Ebola, the Zaire strain, left 280 dead and was so named by the Ebola River, where the epidemic was identified for the first time.

The last time Uganda was affected, the strain of Sudan, mid-level, 425 infected persons. Slightly more than half of them died. Other types of ebola, as Reston and the Ivory Coast, do not cause human epidemics.

The current outbreak in Uganda represents a fifth strain and the World Health Organization (WHO) said he was concerned because the initial symptoms are softer, making it difficult diagnosis.

"By the way it is presented, can be confused with malaria, in its initial phase, high fever and headache. Variety That put us on alert," said Dr. Andrew Bakinaga of WHO Uganda.

The organization Doctors Without Borders said it was concerned because the eve of Christmas could have given an opportunity to spread Ebola, as the disease can reach with large family groups that meet in the towns of Uganda. Government authorities prefer to look at the positive side, saying that the death rate of 25 per cent of the total infected ago that the epidemic is less lethal than the variety of Zaire, which has between 80 and 90 percent mortality. Some even speculated that the virus might have been adapted.

"We believe that something is happening with the virus is mutating into a form less lethal," said Dr. Sam Zaramba, director of health services in Uganda.

But Dr. Pierre Rollin, a specialist in haemorrhagic fevers of the Center for Disease Control and Prevention in the United States, does not agree with these speculations.

"It is still lethal," said Rollin Reuters during a visit to Uganda.

"HIV is fantastic from (this) point of view. People survive for ten years and (...) it spreads. Adaptation is perfect. Ebola not adapted to humans," said Rollin.

It is even more lethal to monkeys and other primates as chimpamc?s, meaning they can not be their main source of storage, either.
http://lta.reuters.com/article/topNews/idLTAN0320698220080106?rpc=401&&pageNumber=1&virtualBrandChannel=0
 
Re: Ebola: December 18+, is getting contained; however new cases confirmed

Re: Ebola: December 18+, is getting contained; however new cases confirmed

Source: Government of Uganda

Date: 08 Jan 2008

Ebola outbreak in Uganda: National Task Force situation

report no. 19 - 08 Jan 2008

Seen and cleared by Dr. Sam Okware/Chairman/NTF & Dr Melville George, WR/Uganda/Co chair/NTF

1. Situation in the Field:

The Ebola outbreak is on the decline and still confined in Bundibugyo district, No confirmed cases in any other part of the country.

No new case has been reported since 3rd January 2008, the last confirmed case was on 22nd December 2007 and died on 27th December 2007(this was the last death reported).

On the 6th of January 2008, 2 Ebola suspected cases wife and husband in Amuria district with history of epistaxis, vomiting and diarrhea, were found to be non Ebola cases after investigations by the district rapid response team.

To date a cumulative total of 149 cases with 37 deaths have been reported (Case Fatality rate of 24.8%) while 37 were laboratory confirmed. 14 of the confirmed cases died.

The teams started support supervision of peripheral health facilities to ensure adequate supplies and infection control techniques.

Social mobilization and psycho social support are still on going.

Important to note that the suspected case of Ebola in OICHA, DR Congo Health zone (Health district) bordering Bundibugyo district was isolated and managed in a health facility in OICHA District and is recovering. Samples have been taken and sent to the national reference laboratory in Kinshasa (INRB).

2. Laboratory and Surveillance:

Contact tracing is still on going, with a cumulative total of 804 contacts, and 504 contacts completed a 21 day follow up yesterday. 236 are still under follow up. Total contacts followed up to date are 182/236 (77%), they are all in good health.

The expected date of completing contact follow up is 24/01/2008.

No laboratory samples were collected yesterday. The cumulative laboratory samples collected to date is still 134.

No Laboratory confirmed case is still admitted in the isolation unit.

A team constituting the DVO, DISO CDC experts and MoH was constituted to investigate the earlier reports of 8 monkeys that died in the National park.

3. Case Management and Infection Control:

Two alerts were responded to yesterday andt hey were all negative.

There were no new admissions in both Isolation units in Bundibugyo and Kikyo.

The total number of inpatients in Bundibugyo isolation unit is 2 cases as of yesterday evening. since 4th January 2008 there has been no case in Kikyo Isolation unit

There was one discharge in Bundibugyo isolation unit yesterday.

4. Coordination ? Collaboration:

The NTF meeting was held on 3rd January 2007 some issues agreed on included, maintain the current Ebola epidemiological case definition, and disseminate Sitrep twice a week, every Tuesday and Thursday.

The NTF visited Bundibugyo on the 4th January 2008. The Team included WCO Ebola team, the MoH Commissioner for Nursing. A meeting was held with the field team and later visited Bundibugyo Isolation unit and 2 other peripheral health facilities.

The District task force continues to hold meetings on a daily basis.

The NTF will hold a meeting today 8th January 2008.

http://www.reliefweb.int/rw/RWB.NSF/db900SID/KHII-7AP8DM?OpenDocument
 
Re: Ebola: December 18+, is getting contained; no new case confirmed since jan 3

Re: Ebola: December 18+, is getting contained; no new case confirmed since jan 3

Outbreak Notice
Updated: Ebola Outbreak in the District of Bundibugyo, Uganda

This information is current as of today, January 10, 2008 at 19:12
Updated: January 08, 2008

The U.S. CDC and the Ministry of Health of Uganda have reported an Ebola hemorrhagic fever outbreak in the Bundibugyo district located in the Western part of the country. The outbreak may have begun as early as August 2007. As of January 3, 2008, 148 people have become ill and 37 people have died. Genetic analysis of samples from case-patients indicated that this is a new virus strain distinct from the four known strains of Ebola virus. However, further studies will be needed before this can be verified.
Ebola hemorrhagic fever is a rare, serious viral disease which develops suddenly, with common symptoms of fever, headache, joint and muscle aches, sore throat, and weakness. Diarrhea, vomiting, and stomach pain start after the first symptoms. A skin rash may develop. By the third or fourth day of illness some people with Ebola hemorrhagic fever may develop internal and external bleeding, shock and organ failure.
Ebola is spread through direct contact with blood or other body fluids (e.g., saliva, urine) of infected persons or objects that have been contaminated with infected body fluids. People who have close contact with a nonhuman primate infected with the virus are also at risk.
Recommendations for U.S. Travelers

The World Health Organization (WHO) has reported that there is no need for any travel restrictions to Uganda.:rolleyes: Generally, the risk of contracting Ebola virus is low for travelers. CDC recommends that anyone traveling to Uganda take the following steps to prevent Ebola virus infection:
  • Avoid contact with Ebola patients and their body fluids.
  • Avoid touching used needles or other medical waste.
  • Avoid contact with wild animals and bushmeat, including primates.
More Information

For information about the current situation, see the WHO report at www.who.int.
For additional information on Ebola hemorrhagic fever, please see http://www.cdc.gov/ncidod/dvrd/spb/mnpages/dispages/ebola.htm.
To learn more about traveling to areas with hemorrhagic fevers, see the Viral Hemorrhagic Fevers section of CDC Health Information for International Travel 2008.:tiphat: http://wwwn.cdc.gov/travel/contentEbolaUganda.aspx

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