Re: Uganda: Hemorrhagic fever outbreak- 38 dead, 91 ill- officials say pneumonic plague or pneumonia
Re: Uganda: Hemorrhagic fever outbreak- 38 dead, 91 ill- officials say pneumonic plague or pneumonia
http://www.promedmail.org/pls/apex/..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,86157
Archive Number 20101208.4382
Published Date 08-DEC-2010
Subject PRO/EDR> Undiagnosed disease - Uganda (07): plague suspected
UNDIAGNOSED DISEASE - UGANDA (07): PLAGUE SUSPECTED
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[1]
Date: Tue 7 Dec 2010
Source: Reuters Africa [edited]
<http://af.reuters.com/article/topNews/idAFJOE6B60HX20101207>
Pneumonic plague has broken out in northern Uganda, killing 38 people
and putting dozens in hospital, a senior health official said on
Tuesday, 7 Dec 2010.
Issa Makumbi, assistant commissioner in charge of disease
surveillance, said investigations into a disease that struck the
region in November [2010] were continuing but that tentative tests
had confirmed it was pneumonic plague.
Health services in the impoverished east African nation are patchy
and it can take weeks before diseases are identified and response
teams and medical supplies are sent to affected areas.
"So far (pneumonic plague) has been detected in 5 districts in
northern Uganda where a total of about 38 people have died," Makumbi
said.
Medical personnel had been sent from the capital Kampala and were
battling to contain the outbreak. Northern Uganda is recovering from
2 decades of civil war waged by the Lord's Resistance Army. Poverty
and poor sanitary conditions makes the region vulnerable to diseases.
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[But read further below in [3] and [4] Mod.LM]
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[2]
Date: Mon 6 Dec 2010
Source: AllAfrica, The New Vision (Uganda) report [edited]
<http://allafrica.com/stories/201012070114.html>
Plague, a disease that affects rodents but can be spread to humans
and other animals usually by infected fleas, has hit the northern
Ugandan district of Kitgum, the health ministry has confirmed. The
ministry said they had confirmed that the strange sickness was
plague, not a hemorrhagic fever as earlier thought.
The disease surveillance officer in Kitgum district, Sr Grace Agwang,
said preliminary results from the Centre for Disease Control in
Atlanta showed that it was plague.
The disease, according to the WHO report, hit Acholi sub-region on 3
Dec 2010. One person has been admitted in Kitgum at St Joseph
Hospital, 2 others at Kalongo Hospital in Pader. The report adds that
Kitgum district has so far had 18 cases, while one of the infected
people died at St Joseph Hospital on 3 Dec 2010. According to the
report, 9 other people have so far died.
Medical personnel in Kitgum have set up an isolation unit at Kitgum
Hospital. Health workers are also being trained by Medecins Sans
Frontieres from Holland to handle the disease. At Kalongo Hospital,
24 people had been admitted by 3 Dec 2010. The WHO suggested that a
community-based surveillance system needs to be reactivated in the
affected districts.
[Byline: Conan Businge, Chris Ocowun]
--
Communicated by:
Thomas James Allen
<tjallen@pipeline.com>
******
[3]
Date: 8 Dec 2010
Source: AFP [edited]
<http://www.google.com/hostednews/afp/article/ALeqM5hgmieXl3QCUDRkdH0Z12UD704bFg?docId=CNG.6a0a014a69f4ce1afd31a8eefff9f2b8.441>
Uganda scrambling to identify new deadly disease
----------------------------------------------------------
Uganda is working "around the clock" with international health
experts to identify an unprecedented illness that has killed 38
people in the north of the country, an official told AFP on Wednesday.
The unknown illness was first detected on November 10 in several
districts in the central part of northern Uganda, according to a
statement from the health ministry.
Local and foreign media reports had identified the illness as bubonic
plague, which has previously struck Uganda, most recently in 2008.
But an official from the ministry's Epidemiology and Surveillance
Division working closely on the outbreak said Wednesday that the
disease remained mysterious and evidence collected so far pointed
away from bubonic plague.
"The results we have received from Fort Collins are negative for
bubonic plague," the official, who requested anonymity, told AFP,
referring to a specialized laboratory in the US state of Colorado.
"If this was typical plague, we would have found that out by now. We
just haven't seen a disease like this before," he added.
The doctor explained that all previous incidents of plague in Uganda
were contained in the West Nile region, much further west than the
current outbreak.
The source added that plague victims suffer from inflammation in
specific body parts, including the armpits, which has not happened in
this case.
"The plague we've seen in the past also tends to cause fatalities
among women and children, but all the dead here are adult men," the
official also said.
The doctor said that while Uganda-based staff from the US Centers for
Disease Control (CDC) were already working on the case, specialists
from CDC headquarters in Atlanta were on their way to help identify
the illness.
Staff from the World's Health Organization's Africa regional office
in Brazzaville, Republic of Congo have also been sent to Uganda.
"We simply don't have the information to conclude what this disease
is yet, but we are working around the clock, literally 24 hours," the
official said.
Ugandan staff have developed a treatment that has so far halted the
death toll at 38, according to the source.
The 91 confirmed patients reported severe headaches, dizziness,
fever, diarrhoea and vomiting, according to the health ministry.
--
Communicated by:
Thomas James Allen
<tjallen@pipeline.com>
******
[4]
Date: 8 Dec 2010
Source: NewVision [edited]
<http://www.newvision.co.ug/D/8/13/740598>
Northern disease still a mystery
--------------------------------------
A new team of health experts from the US Centers for Disease Control
(CDC) is expected in Uganda tomorrow to intensify the fight against a
mysterious illness that has hit at least six districts in northern
and north-eastern Uganda.
The team is to carry out more tests to determine the cause of the
outbreak, which has claimed about 38 lives since it was first
reported in November.
CDC team leader, Jeffrey Miller yesterday said tests done at the CDC
and Uganda Virus Research Institute joint laboratory in Arua district
ruled out plague.
He said a series of preliminary tests done at the CDC laboratories in
Entebbe and Atlanta in the USA also proved negative for on Ebola,
Marburg and Congo Crimean haemorrhagic fever.
Patients complain of severe headache, dizziness, fever, diarrhoea and vomiting.
Earlier this week, the health ministry said the outbreak was plague.
But specialists from the World Health Organisation, ministry of
health, CDC and several non-governmental organisations, have now
revealed that there are no conclusive results proving this.
[Byline: Jimmy Wokorach-Oboiand Taddeo Bwambale]
--
Communicated by:
Thomas James Allen
<tjallen@pipeline.com>
[Primary pneumonic plague (one percent of natural plague
presentations) arises as a result of inhalation of plague bacilli in
infectious aerosols, such as would be produced when there are
secondary pneumonic complications in bubonic/septicemic plague.
Primary plague pneumonia has a short incubation period of 1-3 days,
after which there is sudden onset of flu-like symptoms including
fever, chills, headache, generalized body pains, weakness, and chest
discomfort. A cough develops with sputum production, which may be
bloody, and increasing chest pain and difficulty in breathing. As the
disease progresses, hypoxia (low oxygen concentration in the blood),
and hemoptysis (coughing up blood) are prominent. The disease is
invariably fatal unless antimicrobial therapy commences within 24
hours of exposure.
Patients with primary pneumonic plague generate large quantities of
infectious aerosols that pose a significant risk to close contacts.
CDC guidelines identify contacts within 2 meters (6.5 ft) as being at
greatest risk and do not consider the organism likely to be carried
through air ducts or vents. Persons who have been in contact with
pneumonic plague patients or handling potentially infectious body
fluids, or tissues without appropriate protection should receive
preventive antimicrobial therapy. The preferred antimicrobial agents
for prophylaxis include tetracyclines and fluoroquinolones.
It appears however, that the plague diagnosis may be less than
definitive, as indicated in the most recent news stories. The
clinical picture described in the outbreak is quite atypical for
pneumonic plague and the absence of any apparent accompanying bubonic
plague would be unusual, and may mean that another pathogen is
responsible or that multiple pathogens are causing disease in the
same region.
The involvement of teams including Ugandan public health
authorities, US CDC, WHO and NGOs indicate extensive international
attention has been given to this outbreak and that adequate
laboratory diagnostic testing should lead to identification of the
pathogen or pathogens responsible for this outbreak. We await
further results with interest.
The districts in the Northern Region of Uganda affected by the
outbreak can be located using the map at
<http://en.wikipedia.org/wiki/Districts_of_Uganda>.
The HealthMap/ProMED-mail interactive map of Uganda can be accessed at
<http://healthmap.org/r/0089>. - Mod.LL/LM]
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