Re: New Ebola Strain in Uganda Spreading - Death toll rising
Re: New Ebola Strain in Uganda Spreading - Death toll rising
EBOLA HEMORRHAGIC FEVER - UGANDA (06): (BUNDIBUGYO)
***********************************************
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: Thu 6 Dec 2007
Source: New Vision online [edited]
<
http://www.newvision.co.ug/D/8/12/600646>
A medical doctor and 4 health workers, who treated the 1st Ebola
patients in Bundibugyo, have died of the disease. Dr. Jonah Kule, the
medical superintendent of Kikyo Health Centre, succumbed on Tuesday
night [4 Dec 2007]. He had been quarantined at Mulago Hospital.
Senior clinical officer Joshua Kule, senior nursing officer Rose
Bulimpikya, matron Peluce Tabiita and another nurse not yet
identified died yesterday [5 Dec 2007] in Bundibugyo Hospital,
according to senior clinical officer James Agaba.
In a statement yesterday [Wed 5 Dec 2007], the health ministry said
the number of Ebola cases had shot up to 91, after 7 new cases had
been recorded. The death toll has risen to 24. This includes a
Bundibugyo businessman who died on Tuesday [4 Dec 2007]. Eight of the
Ebola cases are health workers.
Contrary to guidelines by the health ministry to immediately bury the
victims, Kule's remains will be taken to his home in Bundibugyo today
[6 Dec 2007] and buried there. The Director of Mulago Hospital, Dr.
Edward Ddumba, said precautionary measures had been taken and there
was no risk of infection from the body.
Bundibugyo chief administrative officer, Elias Byamungu, said Kule
could have been infected when he went to investigate deaths which
locals had attributed to witchcraft. The Bakonjo had accused the
Bamba of bewitching them. "I warned Dr. Kule, but he insisted,
saying: 'Let come what may. I must go down and investigate what is
killing the people.' He investigated, and he wrote a report. That
report is helping the authorities," said Byamungu.
Kule becomes the 2nd medical doctor to die from Ebola in Uganda
through contact with patients. The 1st, Dr. Matthew Lukwiya, died in
Lacor Hospital in 2000 during the 1st ever outbreak of the disease in
Uganda. In Kasese, a teacher who works in Bundibugyo, has been
admitted at Bwera Hospital in Kasese with suspected Ebola. "We have
not yet confirmed if it is Ebola, but he complains of headache, joint
pain, fever, chest pain and bleeding from the nostrils. We have
isolated him," the hospital's medical superintendent, Dr. Yusuf
Baseke, said. He appealed for protective gear for the hospital staff
to be able to handle Ebola cases.
Meanwhile, health ministry sources said yesterday [5 Dec 2007]
experts from the US-based Centers for Disease Control and Prevention
(CDC) and the Ministry of Health were assembling the Ebola-testing
machine at the Uganda Virus Research Institute in Entebbe. Eight
pathogen experts from the CDC also arrived in the country on Tuesday
[4 Dec 20007]. The equipment was brought this week and is expected to
be operational by the beginning of next week. The machine will make
testing for Ebola and other haemorrhagic viruses faster and
intervention quicker. Currently, samples have to be sent to
laboratories in South Africa and the US, causing delays. The Ebola
outbreak in Bundibugyo was only confirmed on 29 Nov 2007 after
initial tests turned out to be negative, according to the health
minister, Dr. Stephen Mallinga. The Bundibugyo Ebola strain is said
to be different from any other known strain [see comment below]. It
is characterised by high fever, abdominal pain and diarrhoea and not
so much internal and external bleeding.
The authorities at Buhinga Regional Hospital in Kabarole district
said some patients had fled, fearing to contract Ebola. One of the
patients who fled was a woman who had been put in isolation at the
hospital after she vomited blood. She was classified as an alert
case, though the results of her test had not yet come back. Radio
stations in Fort Portal ran announcements for anybody who spots the
woman to alert the authorities.
The Fort Portal Catholic Diocese, where a 13-year-old boy died from
suspected Ebola on Sunday [2 Dec 2007], has warned people to stop
self-medication. The health coordinator, Sr. Euphrasia Masika,
advised people to seek help from the nearest health units as soon as
they suspect they may have contracted the disease. She warned that
concealing the disease minimised their chances of getting cured.
Residents of Mbarara town have stopped their traditional culture of
greeting with a hug and a handshake, fearing to contract Ebola. They
have resorted to waving at each other. This followed the death of a
woman who was vomiting blood at Mbarara University Hospital. The
woman was from areas near the hospital. The Ministry of Health took
samples of her blood for testing and buried her body immediately as a
precautionary measure. The management of all the banks in the town
have instructed their staff to wear protective gloves before handling
money from clients. At Stanbic Bank, manager Enid Natukunda said it
was the bank's obligation to protect its staff. "They are all
supplied with gloves. We cannot take chances," Natukunda said.
Make-shift eating places have been hit hardest by the scare as
patrons abandoned them, fearing contact with other people. Two Ebola
taskforces have been set up at Mbarara Hospital.
[Byline: Anne Mugisa, Bizimungu Kisakye, Kyomuhendo Muhanga, John
Thawite and Matthias Mugisha]
--
Communicated by:
ProMED-mail <
promed@promedmail.org>
[This report records a dramatic upsurge in cases from 58 (3 Dec 2007)
to 91, and the number of fatalities has increased from 17 (5 Dec 2007) to 24.
This report also states that the outbreak virus is distinct from
known strains of Ebola virus. Provisional sequencing of the genome of
this new virus suggests that it is sufficiently different from
previously isolated Ebola viruses to rank as a 5th species alongside
the existing 4 species: _Ivory Coast ebolavirus_, _Reston
ebolavirus_, _Sudan ebolavirus_, and _Zaire ebolavirus_. However,
this will not be clear until the full genome sequence has been determined.
A ProMED-mail correspondent, Debora MacKenzie, has drawn my attention
to a recent paper describing the involvement of recombination in the
emergence of novel Ebola viruses. Wittmann et al. (Proc Natl Acad Sci
U S A. 2007 Oct 23;104(43):17123-7; <
http://www.ncbi.nlm.nih.gov/
sites/entre>), which analysed viruses obtained from great apes in the
Democratic Republic of Congo and identified 2 distinct lineages,
suggesting that virus spillover from a reservoir had occurred more
than once, consistent with a multiple emergence hypothesis. However,
the spatial and temporal sequence of the outbreaks conflicted with
this hypothesis. Further analysis demonstrated the existence of
recombinants This 1st demonstration of recombination in the family
_Filoviridae_ adds an additional level of complexity to unraveling
the relationships between viruses within this taxonomic group.
For this reason, a decision on the taxonomic status of the virus
responsible for the current outbreak in Uganda must await further
analysis. - Mod.CP]
The Ebola virus is one of the world's most deadly
