Uganda: Hemorrhagic fever outbreak- Yellow Fever

[Treyfish]

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

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

Warden Message

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

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

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

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

International response:
http://www.who.int/topics/yellow_fever/en/
The U.S. Embassy in Kampala also encourages U.S. citizens to enroll in the Department of State?s Smart Traveler Enrollment Program (STEP) at https://travelregistration.state.gov/ibrs/ui/. By enrolling in this program, you will receive important safety and security announcements. It will also help your friends and family get in touch with you in case of an emergency. You should remember to keep all of your information in STEP up-to-date. Please note that it is important during enrollment, or updating of information, to include your current phone number and current email address where you can be reached in case of an emergency.
The U.S. Embassy is located at Plot 1577 Ggaba Road. For after-hour emergencies, please call (256) (414) 306-001 or (256) (414) 259-791, fax (256) (414) 258-451, or email KampalaUSCitizen@state.gov.:tiphat:http://kampala.usembassy.gov/warden_message_10282010.html

 

[Treyfish]

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

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

27 December 2010 Last updated at 13:09 ET
Uganda yellow fever outbreak kills more than 40

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

 

[Treyfish]

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

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

Yellow Fever Spreads to Ten Districts
Anne Mugisa
27 December 2010


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

The disease, which recurred after about 40 years, has spread to the 10th district of Kotido and cases climbed to 183 from 178, the Director General of Health Services, Dr. Kenya Mugisha, said yesterday.
He, however, said the death toll remained at 45.
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<!-- close google_inset_a div --->Other districts where the disease has been found are Abim, Agago, Lamwo, Kitgum, Pader, Gulu, Arua, Kaabong and Lira.
According to Mugisha, most of the patients were discharged from hospital, but 23 were still being treated at different health centres.
He, however, said if the ministry got $10m (sh23b), it would immunise everybody, which he said is not possible now.
The vaccine, he added, was not available at the ministry because it was not part of the routine immunisations.
Mugisha said the vaccine is available in Kampala City Council clinics and others in Kampala, where people intending to travel abroad have been undergoing immunisation.

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

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

 

[Treyfish]

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

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

Yellow Fever

Mark Gershman, Betsy Schroeder, J. Erin Staples


Infectious Agent

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


Mode of Transmission

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

Occurrence

• Yellow fever occurs in sub-Saharan Africa and tropical South America (Maps 2-3 and 2-4), where it is endemic and intermittently epidemic (see Table 2-12 for a list of countries with risk of yellow fever transmission).
• In Africa, natural immunity accumulates with age, and thus infants and children are at greatest risk for disease.
• In South America, yellow fever occurs most frequently in unimmunized young men who are exposed to mosquito vectors through their work in forested or transitional areas.
• Most yellow fever disease in humans is due to sylvatic or intermediate transmission cycles. However, urban yellow fever does occur periodically in Africa and sporadically in the Americas.:tiphat:http://wwwnc.cdc.gov/travel/yellowbook/2010/chapter-2/yellow-fever.aspx

 

[alert]

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

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

Warden Message

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

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

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

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

International response:
http://www.who.int/topics/yellow_fever/en/
The U.S. Embassy in Kampala also encourages U.S. citizens to enroll in the Department of State?s Smart Traveler Enrollment Program (STEP) at https://travelregistration.state.gov/ibrs/ui/. By enrolling in this program, you will receive important safety and security announcements. It will also help your friends and family get in touch with you in case of an emergency. You should remember to keep all of your information in STEP up-to-date. Please note that it is important during enrollment, or updating of information, to include your current phone number and current email address where you can be reached in case of an emergency.
The U.S. Embassy is located at Plot 1577 Ggaba Road. For after-hour emergencies, please call (256) (414) 306-001 or (256) (414) 259-791, fax (256) (414) 258-451, or email KampalaUSCitizen@state.gov.:tiphat:http://kampala.usembassy.gov/warden_message_10282010.html

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

Note also the two possible cases in Sudan.

 

[alert]

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

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

http://www.wbs-tv.co.ug/index.php?o...ellow-fever&catid=1:current-affairs&Itemid=77

Health Ministry in crisis meet over Yellow Fever
Wednesday, 29 December 2010 05:19 Harrison Thembo The ministry of Health has held a crisis meeting with development partners to try and raise funds to control the outbreak of yellow fever in northern Uganda.

The disease is reported to have spread to 10 districts but the ministry of health currently does not have sufficient funds to contain its spread
The mysterious disease which was eliminated 40 years ago has reoccurred in kitgum district and spread to about 10 other districts of northern Uganda,
Since its out break five weeks ago , over 2000 people [perhaps 200? - alert] have admitted in various hospitals in northern Uganda with a death toll of 36 people.

In an attempt to control the disease, the ministry of health and development partners have held a crisis meeting at the ministry headquarters on the control plan of the disease.

The infections are mild but the disease can cause severe life threatening illness such as high fever, chills, headache and backache. The symptoms appear between three to six days.

Yellow fever is treatable and the best intervention is immunization of which the ministry now lacks

 

[alert]

Re: Uganda: Hemorrhagic fever outbreak- 49 dead, Yellow Fever

Re: Uganda: Hemorrhagic fever outbreak- 49 dead, Yellow Fever

My interpretation is that the number of hospitalized patients (191) includes those that have already died or been discharged.

http://www.ugpulse.com/articles/dai...tinues+to+spread+in+northern+Uganda+&ID=17339

One more person has been confirmed dead and four others hospitalized as the viral yellow fever continues to spread in Northern Uganda.

The Ministry of Health last week put out an alert on yellow fever following a strange disease that had hit the 10 districts in the region last month.

The latest report put the death toll at 49 while 191 are hospitalized.

The Director General of Health Services, Dr. Nathan Kenya-Mugisha revealed that the death was registered in Kabong district.

Dr. Mugisha says 2 victims infected with the viral disease are from Kabong and the other 2 from Agago district.

He reveals that the ministry is working around the clock to mobilize resources internally to enable mass vaccination kick off as soon as possible before the disease spreads to neighboring districts.

Dr. Mugisha further says the ministry will hold another meeting with the development partners next week on Tuesday to discuss, among other things, financial support for the vaccination exercise.

Other districts affected by the disease include Gulu, Lira, Abim and Pader.

 

[alert]

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

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

And the international media (AFP here) picks up the diagnosis.

http://www.nation.co.ke/News/africa/-/1066/1080294/-/123g4xd/-/

By AFPPosted Wednesday, December 29 2010 at 11:39

KAMPALA

Uganda said Wednesday that a previously unidentified disease that has killed 48 people in the north of country is yellow fever.

Following the initial outbreak in November, health official were baffled by the illness, with many first believing it was a mutated version of bubonic plague.

Domestic and international lab tests have now confirmed that the disease, with 187 confirmed cases, and which spread across several northern districts is yellow fever, director of health services Kenya Mugisha told AFP.

"With yellow fever, it can take some time to identify positively. In other countries it has taken six months," he said.

He said the immediate priority was to secure funds to immunise everyone living in the outbreak area and that they had held talks with donors over financing of the programme.

"We have also asked government for supplementary funding."

Defences against the virus had relaxed since the last documented outbreak in Uganda in 1971-1972, Mugisha said.

Yellow fever is spread, like malaria, by mosquitoes and is a persistent problem in northern Uganda. There is no specific treatment and symptoms and severity vary from case to case.

Vaccination and other protective measures like bed nets, insect repellent and long clothing are considered the best methods to contain an outbreak.

 

[alert]

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

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

http://afludiary.blogspot.com/2010/12/ugandan-mystery-disease-identified-as.html

Wednesday, December 29, 2010
Ugandan Mystery Disease Identified As Yellow Fever

# 5185

More than two months after it began, we now appear to have an official cause of the mystery disease outbreak in northern Uganda; Yellow Fever.



My first blog on this outbreak came in mid-November (see Uganda: Unidentified Hemorrhagic Outbreak), and at that time a hemorrhagic fever like Ebola, Marburg, or Lujo virus was considered the likely cause.



Two weeks later, I reported that Health Ministry officials had stated that laboratory tests had come back negative for the usual suspects from that part of the world; Ebola, Marburg, Congo Crimean fever, Rift Valley fever and Typhoid.



On December 7th, it was widely reported that Plague (pneumonic and bubonic) had been identified as the cause of the outbreak, which I covered in Uganda Outbreak Identified As Plague: Officials.



Within a few days, the plague diagnoses began to look less and less likely, and in recent days Yellow Fever ? a disease not seen in Uganda in nearly 40 years ? has come to the forefront.



For a detailed history of this outbreak?s progression, FluTrackers has an extensive thread on this story, with more than 150 entries as of this morning.



Treyfish has been a particularly close follower of this story, and has posted many of these reports, although he is by no means alone in this effort.



Yesterday afternoon Treyfish posted a U.S. Embassy Warden Message that identifies the outbreak as Yellow Fever.



Warden Message
U.S. Embassy Kampala, Uganda
Warden Message - December 28, 2010

Outbreak of Unidentified Illness Now Confirmed as Yellow Fever in Northern Uganda

After discussions with the Ugandan Ministry of Health and WHO, the U.S. Centers for Disease Control and Prevention (CDC) now confirms that the unknown severe illness reported in Mission Kampala?s November 30 Warden Message is an outbreak of Yellow Fever.



Although as many as seven districts are now reporting occurrences - including two possible cases from southern Sudan- almost all of the reported severe cases (characterized by fever, vomiting and bleeding) continue to be concentrated in three districts of Northern Uganda, namely Abim (specifically Morulem sub-county), Agago (Omiya P?Chua, Adilang and Paimoi sub-counties) and Kitgum (Orum, Namokora and Kitgum Town Council).



In light of these findings, the U.S. Mission in Kampala recommends that U.S. citizens residing and traveling in Uganda avoid travel to Northern Uganda unless they have been vaccinated against Yellow Fever within the past 10 years. If vaccinated recently, do not travel to Northern Uganda for at least 10 days after receiving the vaccination. (Yellow Fever vaccinations do not take effect for 10 days.) Only U.S. government officials with Yellow Fever vaccinations are permitted to travel to the affected areas.



(Continue . . . )





Via newshound Alert we get this update from Uganda?s leading independent daily, The Daily Monitor.





National

Yellow fever deaths reach 48
By Flavia Nalubega

Posted Wednesday, December 29 2010 at 00:00


Kampala

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



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



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

(Continue . . . )





Yellow fever is a mosquito borne viral illness, that according to the World Health Organization, infects roughly 200,000 people each year and claims 30,000 lives.



Once the scourge of Africa, the Americas and Europe, Yellow fever is now endemic only to the tropical areas of South America and Africa.


In the 18th and 19th century, Yellow fever caused major epidemics in Europe and in the United States, up the Atlantic seaboard and as far north as New England (Boston was hard hit in 1780, and Philadelphia saw several thousand deaths in 1793).



Yellow Fever has been cited as one of the primary reasons why the French abandoned their attempt to build a Panama canal in the late 1800?s, as the combined burden of Yellow Fever and Malaria reportedly claimed the lives of more than 20,000 construction workers.



For more on the history of `Yellow Jack?, I would point you to Ian York?s excellent Mystery Rays blog, where he gives us some terrific background in:



Yellow fever, stasis, and diversification
The deadliest, most awe-inspiring of the plagues
The good old days




You can find more information on yellow fever at these websites:

http://www.cdc.gov/ncidod/dvbid/yellowfever/



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


http://www.who.int/topics/yellow_fever/en/

 

[alert]

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

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

http://www.promedmail.org/pls/apex/..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,86410

Archive Number 20101229.4588
Published Date 29-DEC-2010
Subject PRO/AH/EDR> Yellow fever - Uganda (10): North, alert


YELLOW FEVER - UGANDA (10): NORTH, ALERT
****************************************
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: 28 Dec 2010
Source: U.S. Embassy Kampala, Uganda Warden Message [edited]
<http://kampala.usembassy.gov/warden_message_10282010.html>

Outbreak of Unidentified Illness Now Confirmed as Yellow Fever in Northern
Uganda
---------------------------------------------------

After discussions with the Ugandan Ministry of Health and WHO, the U.S.
Centers for Disease Control and Prevention (CDC) now confirms that the
undiagnosed severe illness reported in Mission Kampala?&#128;&#153;s 30 Nov [2010] Warden
Message is an outbreak of yellow fever.

Although as many as 7 districts are now reporting cases -- including 2
possible cases from southern Sudan -- almost all of the reported
severe cases (characterized by fever, vomiting and bleeding) continue
to be concentrated in 3 districts of Northern Uganda, namely Abim
(specifically Morulem sub-county), Agago (Omiya P?&#128;&#153;Chua, Adilang and
Paimoi sub-counties) and Kitgum (Orum, Namokora and Kitgum Town
Council).

In light of these findings, the U.S. Mission in Kampala recommends that U.S.
citizens residing and traveling in Uganda avoid travel to Northern Uganda
unless they have been vaccinated against yellow fever within the past 10
years. If vaccinated recently, do not travel to Northern Uganda for at
least 10 days after receiving the vaccination. (yellow fever vaccinations
do not take effect [induce immunity] for 10 days.) Only U.S. government
officials with yellow fever vaccinations are permitted to travel to the
affected areas.

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

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

International response:
http://www.who.int/topics/yellow_fever/en/

--
Communicated by:
Irene Lai, MD" <irene.lai@internationalsos.com>


[At last there is laboratory confirmation that the outbreak is due to yellow
fever virus infection. Confirmation has taken over a month. The outbreak
initially was suspected to be Ebola hemorrhagic fever, then amoebic
dysentery and later plague. This situation illustrates the difficulty in
getting definitive diagnosis when outbreaks occur in remote areas with
logistical and health care challenges. With a reliable laboratory confirmed
diagnosis, health officials now can mount an aggressive vaccination
campaign, assuming that the finances for it are forthcoming quickly.

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

 

[alert]

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

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

http://www.newvision.co.ug/D/8/13/742428

Yellow fever death toll rises
E-mail article Print article

By Anne Mugisa

THE yellow fever death toll in Northern Uganda has risen to 48, the Director General of Health Services, Dr. Nathan Kenya Mugisha, has said.

The number of people infected by the disease has also escalated to 190, though the epidemic is still confined to the 10 districts of Northern Uganda, according to Mugisha.

The affected districts are Abim, Agago, Lamwo, Pader, Kitgum, Gulu, Arua, Kaabong, Kotido and Lira.

The ministry has instituted public awareness campaigns against the disease as they await the arrival of vaccines. They plan to vaccinate 2.5 million people.

The ministry has also deployed technical staff to monitor the disease.

 

[alert]

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

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

http://www.monitor.co.ug/News/National/-/688334/1081320/-/cjeu79z/-/index.html

Vaccine awaited as 12 more catch yellow fever

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Posted Friday, December 31 2010 at 00:00

Kampala

As the health ministry waits for vaccines to arrive, yellow fever, which has broken out in northern Uganda, continued to spread, affecting 12 more people?but with no new deaths recorded. The number of those infected now rises to 190, while the deaths stay at 48?two months after the disease broke out.

The Ministry of Health in a statement sent to Daily Monitor yesterday said the epidemic has remained confined in the 10 northern districts of Abim, Agago, Lawo, Pader, Kitgum, Gulu, Arua, Kabong, Kotido and Lira.

Junior health minister James Kakooza said the vaccine is scheduled to arrive in the country tomorrow?thereafter a vaccination exercise will commence. ?We cannot quantify how much vaccines will be arriving but what I can say is they will be enough to cover the 10 affected districts,? Mr Kakooza said. He also ruled out any possibilities of the disease spreading as the sick have been confined.

Signs of yellow fever are muscle pain and backache, headache, fever, shivering, loss of appetite and vomiting. This is in the earlier stages.
In the later stages, patients can develop yellow eyes, abdominal pain, bleeding from the mouth, nose, eyes and stomach. The epidemic, only confirmed two weeks ago, if not contained, can kill in 14 days.

The Ministry of health has advised people to destroy mosquito breeding places like stagnant water around homes and to sleep under insecticide-treated mosquito nets.

 

[alert]

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

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

http://www.promedmail.org/pls/apex/..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,86418


Archive Number 20101230.4595
Published Date 30-DEC-2010
Subject PRO/AH/EDR> Yellow fever - Uganda (11): (north)


YELLOW FEVER - UGANDA (11): (NORTH)
***********************************
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: Wed 29 Dec 2010
Source: Ultimate Media Consult (UMC), Uganda [edited]
<http://www.ugpulse.com/articles/daily/news.asp?about=Yellow+fever+continues+to+spread+in+northern+Uganda+&ID=17339>


One more person has been confirmed dead and 4 others hospitalized as
yellow fever continues to spread in Northern Uganda. The Ministry of
Health last week [week of 20 Dec 2010] put out an alert on yellow
fever following a strange disease that had hit the 10 districts in the
region last month [November 2010]. The latest report put the death
toll at 49 while 191 are hospitalized. The director general of Health
Services, Dr Nathan Kenya-Mugisha, revealed that the death was
registered in Kaabong district. Dr Mugisha says 2 victims infected
with the viral disease are from Kaabong and the other 2 from Agago
district.

He reveals that the ministry is working around the clock to mobilize
resources internally to enable mass vaccination kick off as soon as
possible before the disease spreads to neighboring districts. Dr
Mugisha further says the ministry will hold another meeting with the
development partners next week on Tuesday [4 Jan 2011] to discuss,
among other things, financial support for the vaccination exercise.

Other districts affected by the disease include Gulu, Lira, Abim, and Pader.

--
Communicated by:
ProMED-mail
<promed@promedmail.org>

[Initiating the vaccination campaign is urgent. Each passing day means
more cases and the risk of spread to new geographic areas. Since
Uganda has had no reported yellow fever cases for some 40 years,
pressure to maintain good herd immunity through ongoing YF vaccination
doubtless has been low, especially in more remote areas.

 

[alert]

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

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

Tying up loose ends, this is the EAFR confirmation from today, the first EAFR post at all in three weeks.

http://eafr.promedmail.org/

Published Date: 2010-12-30 23:34:59
Subject: PRO/EAFR> Undiagnosed disease - Uganda (07): yellow fever conf.
Archive Number: 20101231.216550

UNDIAGNOSED DISEASE - UGANDA (07) YELLOW FEVER CONFIRMED
********************************************


[ProMED-mail apologises for this late posting.]

[1]
Date: 23 Dec 2010
Source: Ultimate Media [edited]
http://www.ugpulse.com/articles/dai...w+fever+kills+40+in+northern+Uganda+&ID=17241


The Ministry of Health has confirmed that the disease that has killed over 40 people in Northern Uganda since last month [November 2010] is yellow fever.

The disease, which presents with fever, headache, abdominal pains, vomiting, and diarrhea, left 45 people dead and 127 people in serious condition in November 2010.

Districts that were affected by the disease include Abim, Agago, Lamwo, Kitgum, Pader, Gulu, Arua, Kaabong and Lira.

The Director General of Health Services, Dr Nathan Kenya-Mugisha, said that yellow fever is a viral disease that is transmitted by mosquito bites with symptoms, among others, of fever, muscle pains, shivering, yellow eyes, and vomiting.

Dr. Mugisha advised members of the public to destroy mosquito breeding places around their homes and to sleep under a mosquito net. He says maximum vaccination is going to be carried out in the affected areas and urged any person who experiences unfamiliar health symptoms to immediately report to the nearest health centre.

--
Communicated by:
ProMED-EAFR

***
[2]
Date: Fri 24 Dec 2010
Source: The Monitor [edited]
http://www.monitor.co.ug/News/National/-/688334/1078030/-/cjvl6uz/-/index


The Ministry of Health yesterday [23 Nov 2010] confirmed that the strange disease that has been devastating parts of northern Uganda is yellow fever. The disease that has plagued the region since November 2010 has so far killed 45 people. Most of its victims suffer fever, headache, abdominal pain, vomiting, and diarrhea.

Another 174 people have also been reported infected, according to the ministry of health.

Yellow fever is a viral disease that is transmitted by mosquito bites. Its symptoms are headache, fever, muscle and back pain, shivering, loss of appetite and vomiting. Some patients, according to health experts, also develop yellow eyes, abdominal pain, and bleeding from the eyes, ears and nose. Ministry of Health officials said experts from the Uganda Virus Research Institute, the US Centers for Disease Control, and the World Health Organisation have for the past one month been investigating the disease in the districts of Abim, Arua, Kaabong, Lira, Agago, Lamwo, Kitgum, Pader and Gulu.

Dr Kenya Mugisha, the acting director of health services, said mass vaccination will be carried out in the affected areas to control the spread of the disease. He, however, advised people in the affected areas to sleep under mosquito nets and destroy all mosquito breeding places, like stagnant water around their homes.

Uganda, particularly the northern region, is not new to epidemic outbreaks. In recent years, the region has been hit by a string of epidemics, including hepatitis E, Ebola, meningitis, cholera and bubonic plague in West Nile.

[Byline: Evelyn Lirri]

--
Communicated by:
ProMED-EAFR

[It is now confirmed that yellow fever is the causative agent for the undiagnosed deaths that have affected northern Uganda. This brings to rest the initial confusion which lead to different diagnoses made with devastating outcomes.

The following comment from Mod.CP is borrowed from ProMED-mail posting 20101224.4531:

"Yellow fever is an acute viral haemorrhagic disease transmitted by infected mosquitoes. The 1st, "acute," phase usually causes fever, muscle pain with prominent backache, headache, shivers, loss of appetite, and nausea or vomiting. Most patients improve, and their symptoms disappear after 3 to 4 days. However, 15 percent of patients enter a 2nd, more toxic phase within 24 hours of the initial remission. High fever returns, and several body systems are affected. The patient rapidly develops jaundice and complains of abdominal pain with vomiting. Bleeding can occur from the mouth, nose, eyes or stomach. Once this happens, blood appears in the vomit and faeces. Kidney function deteriorates. Half of the patients who enter the toxic phase die within 10 to 14 days, the rest recover without significant organ damage.

Yellow fever infection is difficult to diagnose, especially during the early stages. It can be confused with malaria, typhoid, dengue, hepatitis and other diseases, as well as poisoning. Blood tests can detect yellow fever antibodies produced in response to the infection. Several other techniques are used to identify the virus in blood specimens or liver tissue collected after death. These tests require highly trained laboratory staff and specialized equipment and materials (http://www.who.int/mediacentre/factsheets/fs100/en/index.html)." - Mod.BE]

 

[alert]

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

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

http://english.peopledaily.com.cn/90001/90776/90883/7247510.html

China suggests people traveling to Uganda take precautions against yellow fever

08:30, December 31, 2010

The Ministry of Commerce said Thursday that Chinese citizens who travel to Uganda should keep a close watch on the development of yellow fever, which has killed at least 40 people in the African nation.

Chinese-invested companies and citizens already in Uganda should also increase precautionary measures against the disease, the ministry said in a statement posted on its website.

The Ugandan health authorities recently confirmed the outbreak of yellow fever, almost 40 years after the disease was last recorded in the country.

Yellow fever is an acute infectious disease with symptoms including abrupt onset of headache, backache, fever, nausea, followed by higher fever, slow pulse, and vomiting of blood.

It is caused by a virus transmitted by several species of mosquitoes. Control of mosquitoes near cities and live-virus vaccines have made yellow fever completely preventable.

Source: Xinhua

 

[alert]

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

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

An inside look at some of the victims and survivors, and the first mention of "witchcraft", and intentional poisoning, both of which we (now) know are incorrect.

Although the first victim described below as having died in early November is described as the first victim in the outbreak, earlier posts indicate the first death occurred as early as October 7.

The early statement about a majority of victims being adult males seems to have been accurate (perhaps because they were more likely to travel into mosquito-infested areas?).

http://www.newvision.co.ug/D/8/13/742516

Yellow fever leaves trail of pain in northern Uganda
E-mail article Print article


Richard Oyo (2nd R) and his siblings. They lost their father to the disease


By Bonney Odongo

HALF-dressed and dehydrated children wave excitedly at us as we drive through the potholed path to Paimol sub-county, Agago district to the home of Alex Obonyo the first person to die of yellow fever in northern Uganda.

Obonyo, 38, a resident of Balang village, Mutu parish, died in the first week of November.
The Ministry of Health and the World Health Organisation have confirmed that the disease is yellow fever, however, a number of survivors still believe it is witchcraft.

“When my brother fell sick, his back bent within just few days and on the fourth day, he vomited blood. We rushed him to Kalongo Hospital, but he died on reaching there,” recounted Nimanoni Ongom, Obonyo’s elder brother. He added: “I believe it is witchcraft.”

Obonyo’s elder son, Richard Ayo, 15, said he is worried he will not go back to school. “Since our father was poisoned, nobody has bought us uniforms to go to school next year.”

Ayo, a P.5 pupil at Wipolo Soloti Primary School in Paimol sub-county, said their father left four orphans who are being taken care of by their mother.

James Okidi, 26 a resident of Soloti village, Mutu parish in Paimol sub-county, said those who died are people who escaped from the hospital for fear of stigma. “When we were isolated in one ward, nobody wanted to come near us and we started thinking that we were going to die. Some of our friends decided to escape and died from home,” Okidi said.

He said he spent 21 days in hospital although he started feeling better four days after treatment.

Linda Auma, 48, another survivor says the disease is scaring because it is spread by air. [This is obviously not true. - alert] “It is like flu! If not, then somebody is bewitching people,” she added.

The Agago district health educator, Bimenya Odong, noted that male adults were the most affected by yellow fever. He also said the number of people infected was reducing.

“Since December 24, only one case was registered in Abim, two in Agago and no death has occurred. These are in Kalongo Hospital. Since the outbreak, 12 people died in Abim, 15 in Agago and the rest in Kitgum, Lamwo and Pader, Lira and Gulu.”

Odong added that since the disease was confirmed as yellow fever, the standard yellow fever treatment is followed. Victims who seek treatment patients before the disease had progressed to the second stage, are recovering.

Agago district LC5 chairman, William Komakech, said the district is carrying out awareness campaigns. He added the disease disrupted Christmas celebrations in the district as residents were prevented from going to social gatherings.

The Ministry of Health says 2.5 million doses of the yellow fever vaccine are expected and as soon as they arrive, an immunisation campaign will be carried out in the affected districts.

The deadly disease, which can kill in six days, is reoccurring in Uganda after almost 40 years.

 

[alert]

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

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

http://www.monitor.co.ug/News/National/-/688334/1081556/-/cjesjiz/-/index.html

Government sends yellow fever task force team to north

AZdoctor displays yellow fever vaccine in Cameroon recently. There are only 1.5m dosages of the vaciine that have to be shared between the two countries. INTERNET PHOTO

By Flavia Lanyero (email the author)

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Posted Saturday, January 1 2011 at 00:00

To suppress any continued spread of the yellow fever, government has dispatched a national task force to the affected districts in the north to sensitise people and identify any new case of the disease.

Headed by the Minister of State for Health in-charge of General Duties, Dr Kenya Mugisha, the Permanent Secretary of the Ministry of Health, Dr Asuman Lukwago, said the task force that also has a village unit, will follow the will to sensitise the people on the importance of taking the vaccine to avoid resistance.

Cases of the disease have been cited in Abim, Agago, Lawo, Pader, Kitgum, Gulu, Arua, Kaboong, Kotido and Lira. The task force includes experts from the World Health Organisation and USAID among other health civil society organisations.

?The task force is monitoring and is engaged in active surveillance looking for any case of the disease. We are looking at the source and how to stop the source?, said Dr Lukwago.

However, out of the required 2.5 million doses of yellow fever vaccine required to immunise people in northern Uganda, it appears the government may only receive 750 [thousand?] dosages, an amount less than half of what is required.
Dr Lukwago told this newspaper yesterday that there are only 1.5m available dosages that have to be shared between Uganda and Cameroon, which has also had an outbreak of the disease.

Although the ministry has requested for Shs10 billion to procure the drug, vaccination may not start tomorrow as earlier scheduled because there is procedure to follow before the money is released.

However, Dr Lukwago said everything will be in place, including enough drugs to vaccinate the 2.5 million people by the end of next week. Despite the stringent measures to curb the disease, one other person succumbed to it on Thursday evening putting the total number of those dead at 49.

According to health officials at the ministry, the 190 infected people are in good shape but a massive vaccination exercise has to be done. The epidemic, only confirmed two weeks ago in Abim, if not contained, can kill in 14 days.
In Kitgum, for example, 17 people who were in isolation were on Wednesday discharged but monitoring continues.

The chairperson of the National Taskforce Kitgum, Mr John Komakech, said the situation is under control although the ministry is yet to communicate to them about the national vaccination exercise. According to Mr Komakech, the many outbreaks like hepatitis E and Cholera that hit northern Uganda are partly due to poor hygiene and he said the ministry should put more emphasis on hygiene.
The Ministry of Health said yesterday in a press statement that the epidemic has remained confined in the 10 northern Uganda districts and has not spread elsewhere.

An official from the Uganda Virus Research Institute, formally the Yellow fever Research Institute, explained that after four days when the mosquito bites, a person gets a high fever then the fever slows down for a day or two and returns with abdominal pain, vomiting and passing out urine which sometimes contains blood.

The disease last hit Uganda in 1972 of which not much has been documented.
Yellow fever is a viral hemorrhagic disease that is transmitted by the bite of the female Aedes aegypti--a kind of mosquito that is only active during the daytime.

 

[Ronan Kelly]

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

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

GoSS concern on Yellow Fever in Uganda
Thursday, 30 December 2010 20:47 Health >>> .The Southern Sudan Ministry of Health's Under Secretary, Olivia Lomoro, has said that the government is aware of the cases of Yellow Fever in Uganda's district bordering southern Sudan and confirmed that there is no reported case of the disease in southern Sudan.

Speaking to Radio Miraya she said that the government is concerned about the matter because of the porous border and free movement between the two countries.

...
continues at; http://www.mirayafm.org/index.php?o...of-yellow-fever-in-uganda&catid=87&Itemid=282

 

[alert]

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

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

The cost of vaccination here is given as one-tenth that previously reported.

http://www.newvision.co.ug/D/8/13/742523

Over 40 die of Yellow Fever
E-mail article Print article

By Anne Mugisa

THE yellow fever death toll in northern Uganda has risen to 48, the director general of Health Services, Dr. Nathan Mugisha, has said. He adds that the number of those infected by the deadly viral disease has also escalated to 190.

The epidemic is confined in the 10 northern Uganda districts. Mugisha names the affected districts as Abim, Agago, Lamwo, Pader, Kitgum, Gulu, Arua, Kaabong, Kotido and Lira.

The health ministry has instituted public awareness campaigns against the disease as they await the arrival of yellow fever vaccines, which are expected to arrive in the second week of January. About 2.5 million people will benefit from the vaccine, which is expected cost $3.5m (about sh8b).

In addition, the ministry says it has deployed technical staff to monitor the trend of the outbreak on a daily basis.

Dr. Mugisha urged the public to avoid being bitten by mosquitoes, especially during the day; destroy mosquito breeding places like stagnant water around the house and sleep under insecticide-treated mosquito nets.

Symptoms of yellow include fever, muscle pains, headache, shivering, loss of appetite and vomiting. Other signs are yellow eyes, abdominal pain, bleeding from the mouth, nose, eyes and stomach.

The ministry advises that people who have any of these symptoms to go to the nearest health centre.

Meanwhile, Conan Businge reports that the Government has allayed fears that yellow fever might easily spread to other parts of the country. ?It is containable. It will not easily spread to other parts of the country, much people are [not?] travelling to and from the affected districts,? the ministry?s publicist Paul Kagwa told Saturday Vision.

 

[alert]

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

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

And the blogger in Kitgum finally puts the pieces together as well.

http://briinuganda.blogspot.com/

[snip]

Second of all, so that everyone knows, the CDC has finally come out with an official notification on the sickness that had been plaguing Northern Uganda about a month ago. They are telling people now it is Yellow Fever (I have been vaccinated so I shouldn?t be in any danger) and advising people to get the shot for immunization if they haven?t had one in the last 10 years. So that mystery hopefully is solved and prayerfully no more people will die now that they know what it is.