Uganda, May 2011: Deadly Ebola Virus Confirmed Near Capital, 1 confirmed dead, other suspected cases including fatalities all test negative, monitorin

[Treyfish]

Re: Uganda: Deadly Ebola Virus Confirmed Near Capital, 1 confirmed dead, second possible fatality, other suspected cases under investigation, 25 monitored

Re: Uganda: Deadly Ebola Virus Confirmed Near Capital, 1 confirmed dead, second possible fatality, other suspected cases under investigation, 25 monitored

..-->>The ministry assures the general public that the outbreak is under
control as seen in the absence of new confirmed cases.

..-->>The ministry said that other suspected cases reported in the Western
District of Kasese and the epicenter [in] Luweero district [Central
Region] continue to be monitored.

..-->>This site, which had the 3 pdf reports I posted, has removed them from the site since 5 days ago and now has nothing on Ebola at all..They were listed under publications and are now gone.. Funny.. http://www.afenet.net/english/

..-->>Wednesday, May 25th, 2011 | Posted by The Razor Newspaper
<!-- /metas -->We need to get a hold on Ebola now

At least two people are officially known to have died from Ebola and 25 suspect cases traced since the deadly viral disease broke out last week in Nakisamata village in Luwero district.

Luweero District to Launch Sensitizing Campaign on how to fight Ebola

Large organizations like AMREF, Red cross and Tullow oil have joined the sensitizing campaign and for Tullow?s case it has donated 75 Million shillings so that it helps in sensitizing the people and buying medicine for the isolation unit in Bombo Military Hospital.
Ebola outbreak has so far claimed 3 lives including the 12 year old girl who was first diagnosed with the disease. In Bombo Military Hospital the Ministry of Health has set up an isolation unit where the Ebola patients are to be treated. 3 people who had the signs and symptoms of the disease where tested, the results where negative and they are waiting approval from the Ministry to be discharged.:tiphat:http://ugandapicks.com/2011/05/luwe...nsitizing-campaign-on-how-to-fight-ebola.html

..-->><TABLE border=0 cellSpacing=0 cellPadding=4 width=480><TBODY><TR><TD class=headline1 colSpan=2>Ebola: Health to issue update today </TD></TR><TR><TD>Friday, 27th May, 2011</TD><TD align=right><!-- E-mail and Print Article --><TABLE style="BORDER-COLLAPSE: collapse; MARGIN-LEFT: auto; MARGIN-RIGHT: 0px"><TBODY><TR><TD style="VERTICAL-ALIGN: middle"></TD><TD style="VERTICAL-ALIGN: middle">E-mail article</TD><TD style="VERTICAL-ALIGN: middle"> </TD><TD style="VERTICAL-ALIGN: middle"></TD><TD style="VERTICAL-ALIGN: middle">Print article</TD></TR></TBODY></TABLE></TD></TR><TR><TD colSpan=2>By VISION REPORTER

The Ministry of health is to update the country today (Thursday) about the Ebola outbreak.

Journalists are to be briefed at Bombo hospital where the first Ebola case was reported a fortnight ago.

The ministry officials are expected to give the latest update on how the scourge has been contained and to allay fear amongst the public that the virus could spread to other parts of the country.

Ministry officials yesterday said the Ebola outbreak in the country is under control. The head of the Ebola national task force, Dr. Anthony Mbonye, said there has been no confirmed case since May 6 when the index case was reported.

?The ministry assures the general public that the outbreak is under control as seen in the absence of new confirmed cases. The public is requested to report any suspected cases to the nearest health unit,? he said.

The ministry said that a total of 21 people have been tested at the Uganda Virus Institute in Entebbe and all prove negative. Mbonye said in a statement that experts were monitoring the 25 people who got in contact with the first victim.

?These contacts on Wednesday completed 18 days of follow up and have three more days to be declared Ebola free,? he said.

Yesterday, the United States Centres for Disease Control and Prevention (CDC) issued a travel warning advising US travellers to Uganda to take precaution following the outbreak.

?CDC advises that US citizens residing and travelling to Uganda should be aware of the disease situation and should take precautions,? the notice read
</TD></TR></TBODY></TABLE>
:tiphat:http://www.newvision.co.ug/D/8/12/755872

..-->> What took the CDC so long to issue an advisory and then the outbreak is considered contained and over?.. Malaria pot pie for you..mmm eat up.

 

[alert]

Re: Uganda: Deadly Ebola Virus Confirmed Near Capital, 1 confirmed dead, second possible fatality, other suspected cases under investigation, 25 monitored

Re: Uganda: Deadly Ebola Virus Confirmed Near Capital, 1 confirmed dead, second possible fatality, other suspected cases under investigation, 25 monitored

This is 21 days, so all monitoring of the girl's contacts is over.

I really am not sure whether there were any other infections or not. As is unfortunately common, the reporting mangled suspected, alert, and confirmed cases, and frequently reported the same individual with different descriptions.

http://www.irinnews.org/Report.aspx?ReportID=92826

UGANDA: Anatomy of an Ebola outbreak

Photo: AJC1/Flickr
Color-enhanced electron micrograph of Ebola virusKAMPALA, 27 May 2011 (IRIN) - A confirmed case of the deadly Ebola virus in eastern Uganda three weeks ago has been quickly contained, leading health experts in the country to believe the virus has not spread.

“According to the present report, it seems the virus didn’t pass to anybody,” said Issa Makumba, head of epidemiology and surveillance in the Ministry of Health, said on 25 May.

A 12-year-old girl died on 6 May in Luwero district, just 75km from the country's populous capital Kampala. Health officials said at the time that more cases were expected but to date, it remains the only confirmed case of the Sudan Ebola strain, which has a 50-60 percent fatality rate.

Ebola is a deadly disease characterized by fever, diarrhoea, severe blood loss and intense fatigue. It is transmitted through direct contact with the bodily fluids of infected persons.

Makumba said the speedy response of the National Task Force “has paid dividends” in the number of lives saved.

Uganda’s first outbreak in the northern Gulu district in 2000 killed 224 people, with 425 infected. It was the first time the Sudan strain had appeared in more than two decades, and remains the largest documented Ebola epidemic so far.

The second outbreak in 2007 that killed 37 people in the western Bundibugyo district took months for health officials to identify, according to Salim Wakabi, an Ebola researcher working with the Makerere University Walter Reed Project (MUWRP).

“It took about three months from the first dead up to the time the ministry said, ‘You know what, there is an Ebola outbreak’,” said Wakabi.

Makumba said the delay was due to it being a completely new strain – now coined the Bundibugyo strain. It presented less obviously than its Sudanese counterpart, and was easily mistaken for malaria.

This third outbreak of the contagious and incurable fever has now passed the halfway mark to 42 days, when officials will be able to declare the outbreak over, Makumba said.

Who does what
Outline of roles:

National Task Force
- led by government through the Ministry of Health
- coordinates national, district, sub-county, village health teams as well as local NGOs and outside partners;

Head of epidemiology and surveillance, Ministry of Health
- early detection and reporting of outbreaks
- heads coordination alongside Director General of Health Services;

WHO - provides technical support;

UNICEF - provides mass communication, public information;

Centre for Disease Control (CDC)
- laboratory support;
AFENET (religious non-profit), Uganda Red Cross Society
- assist with surveillance, community mobilization/information;

USAID - logistical supplies;

Tullow Oil - recently donated 75 million shillings (US$32600) to help with social sensitization and mobilization.

(Source: Head of epidemiology and surveillance, Ministry of Health)

He attributed the quick response to heightened awareness and ongoing surveillance by health officials, as well as the state-of-the-art Uganda Virus Research Institute (UVRI) laboratory in Entebbe that was able to quickly diagnose the disease.

Julius Lutwama, the head of laboratory activities at UVRI, has battled all three outbreaks in Uganda, and says this was the first time he had not had to go out into the field.

“More and more people are getting used to the infection, coming in and being brave enough to go and investigate the cases,” he said.

Working on a vaccine

The lab is one of only a handful on the continent able to test for Ebola – and Uganda the first African country working towards developing a vaccine.

The team at the helm, MUWRP, is not one of the primary response units, but behind a long-term effort to try to establish the root and a possible cure. It is also trying to establish the factors that allow some infected by Ebola to survive, as well as researching the long-term health effects of being infected by the virus.

“The turn-out was overwhelming when we started the vaccine trial because people appreciate and know the problem is with us,” Lutwama said.

Makumba said Ebola was an “emerging pandemic” [REALLY poor choice of words here - alert] in Uganda, which needed long-term commitment by coordinating partners to be able to trace the rarely found source. “It’s becoming like cholera, every now and then we get it,” he said.

While primates have been the most common source of infection for humans, their high mortality rate suggests they are not the natural reservoir for the virus.

According to the World Health Organization, the reservoir “seems to reside in the rain-forests on the African continent and in the Western Pacific” but is still unknown, despite extensive studies.

Wakabi said the vaccine being developed in Uganda, if successful, would not be ready before five years. Last year, an experimental vaccine developed in the United States was found to cure the virus, but only if it was administered within 30 minutes of being infected.

While this was seen to be unhelpful in curbing epidemics, it could potentially save the lives of health workers infected at work.

pc/am/mw

Theme (s): Early Warning, Health & Nutrition,

[This report does not necessarily reflect the views of the United Nations]

 

[Treyfish]

Re: Uganda: Deadly Ebola Virus Confirmed Near Capital, 1 confirmed dead, second possible fatality, other suspected cases under investigation, 25 monitored

Re: Uganda: Deadly Ebola Virus Confirmed Near Capital, 1 confirmed dead, second possible fatality, other suspected cases under investigation, 25 monitored

?According to the present report, it seems the virus didn?t pass to anybody,?

..-->>A mortuary attendant at Bombo Military Hospital who attended to the body of the 12 year girl (Died)
..-->>THE health ministry is investigating two deaths reported from Bowa-Kibira and Namaliga in Luweero district.

The two people died after suffering from high fever and unexplained bleeding, according to Dr. Dennis Lwamafa, the acting director general of health services.

..-->>The Ministry of Health is investigating two deaths in Luweero District suspected to be caused by Ebola. Health workers in Kasese District are also investigating a patient who was described to have signs of the disease. The patient is currently admitted to Kagando Hospital in Kasese.

In a press statement yesterday, the Acting Director General of Health Services, Dr Dennis Lwamafa, said the two died after suffering high fever and unexplained bleeding. ?Burial team was expeditiously sent to the sites to support the burial arrangements and avert any spread of the disease,? Dr Lwammafa said.

..-->>The last report 6 days ago..why were they removed and discontinued?
http://www.afenet.net/english/publications/Ebola_Sitrep_Luwero_19_May_2011_04.pdf

 

[alert]

Re: Uganda: Deadly Ebola Virus Confirmed Near Capital, 1 confirmed dead, second possible fatality, other suspected cases under investigation, 25 monitored

Re: Uganda: Deadly Ebola Virus Confirmed Near Capital, 1 confirmed dead, second possible fatality, other suspected cases under investigation, 25 monitored

This source is Kenyan.

Presumably, all monitoring has ended as 21 days have expired, but I have yet to see an article explicitly state that fact.

http://www.theeastafrican.co.ke/new...s+to+bats++monkeys/-/2558/1171200/-/92jobk/-/

Hunt for ebola host turns to bats, monkeys

By HALIMA ABDALLAH, Special Correspondent

Posted Sunday, May 29 2011 at 10:53

Ugandan medics are studying the transmission chain of an Ebola outbreak in the country focusing on the possibility that some of those afflicted could have eaten fruits touched by bats and monkeys carrying the disease, as the country battles yet another outbreak which has killed one person.

A team of experts from the US’s Centre for Disease Control (CDC), the World Health Organisation (WHO), PREDICT and Ugandan doctors is currently working on the case.

Although scientists cannot list all animals that are suspected to be ebola carriers, monkeys, bats and chimpanzees have been confirmed to carry the virus.

“We are now doing ecological studies looking at wild animals and bats. We have so far trapped 50 bats and some monkeys. Monkeys and bats are present in the Luwero where an infected girl died,” said Dr Issa Makumbi, the head of epidemiology at Uganda’s ministry of health.
An earlier study by the Wildlife Conservation Society in 2005 showed that the ebola outbreaks that occurred between 2001 and 2003 in DR Congo and Gabon were traced to handling of infected wild animal carcasses.

The study found that gorillas, chimpanzees and duiker produced positive ebola test results. The study also found direct links between the deadly disease in animal population and humans.

Luwero, where a five-year bush war was fought and won by the forces of President Yoweri Museveni 25 years ago, also still maintains the culture of game meat consumption. It is here where the single victim, a 12-year old girl was presented to a clinic with acute hemorrhagic fever on May 3.

Subsequent laboratory investigations at the Uganda Virus Research Institute in Entebbe confirmed ebola Sudan type on May 13. Blood samples were also taken to the CDC headquarters in the US for additional analysis and sequencing.

Although several cases have been reported from different parts of the country, no new case has been confirmed and monitoring of the 25 people who came in contact with the first victim has so far returned negative results for the virus and they were due to be declared free of the virus on May 28.

In all, 21 people have been tested and produced negative results except the dead girl. If no more positive tests show up by June 23, the country will be declared ebola free. By press time, four people were however in the isolation centre being monitored.

Ebola is spread through direct physical contact with body fluids of an infected person and consumption of animals carrying the virus. The survival rate of ebola is only at 10 per cent because of the acute nature of attacks characterised by high fever and loss of body liquids that leads to dehydration and blood shortage.

Ebola was first detected in 1976 in DR Congo. This year is the third time for the disease to erupt in Uganda. The first epidemic occurred in 2000/2001 in northern Uganda where 425 people were infected and over 200 died including a doctor who was treating them. In 2007, the disease claimed 37 lives after 149 people got infected in the western Uganda district of Bundibugyo, on the border with DR Congo.

 

[alert]

Re: Uganda: Deadly Ebola Virus Confirmed Near Capital, 1 confirmed dead, other suspected cases including fatalities all test negative, monitoring ended

Re: Uganda: Deadly Ebola Virus Confirmed Near Capital, 1 confirmed dead, other suspected cases including fatalities all test negative, monitoring ended

http://www.observer.ug/index.php?op...bola-success&catid=58:health-living&Itemid=89

How Uganda registered Ebola success

Written by Diana Nabiruma
Wednesday, 01 June 2011 19:37

On May 27 in Bombo, as outgoing minister of Health, Stephen Malinga, announced that the 25 people who had gotten in contact with the girl that died from Ebola were Ebola free, he also told the story of how the outbreak was contained.

Dr Joseph Okware, Luwero?s district health officer, says that on May 1, Kate Nakiguli, the lone victim of this year?s Ebola outbreak fell ill and her grandmother tried to treat her using modest means. She took her to a clinic and after three days of treatment without any signs of improvement, the deceased was referred to another clinic in Wobulenzi.

However, her caretakers instead took her to Bombo Military Hospital. Okware describes this as ?good luck? because if the deceased had been taken to the clinic in Wobulenzi, a bigger number of people could have gotten infected.

But because the manpower at Bombo Military Hospital was experienced in handling Ebola (they had worked with Ebola patients in Gulu and Bundibugyo), they quickly recognised the symptoms and took measures to curb its spread. Unfortunately, they were unable to save Nakiguli; she died five hours after getting to the hospital.

To determine whether the people who had gotten into contact with the girl had Ebola or not, they were monitored for symptoms of the disease and when they did not show after 21 days, they were declared Ebola free.

Even as Malinga congratulated the team at Bombo Military Hospital for stopping what could have been an epidemic, he called upon the public to remain vigilant.

?We should celebrate because we have been successful in controlling this outbreak but while we celebrate, we should remember that other cases could be reported,? Malinga said.

He called upon sick individuals to refrain from going to the Namugongo shrine to celebrate Martyrs Day on June 3, as these could have Ebola and spread it to the masses that turn up to celebrate. If there is anything this outbreak has shown, it is the fact that if patients seek treatment from properly trained personnel, epidemics can be averted.

Also, the fact that ordinary Ugandans can be lax about their health was highlighted during this outbreak. Maama Brenda, who runs a restaurant near Bombo Military Hospital, said people were not bothered about the disease. Instead, they simply went about their business, seemingly unbothered. Only one man expressed fear of the disease.

While it might be said that the people were right to be unbothered, after all the crisis had been declared over, Malinga called for vigilance. This means that individuals, especially those that are a mere 40km away from Zirobwe (Bombo Military Hospital and Zirobwe are 40km apart), cannot afford to relax.

 

[alert]

Re: Uganda: Deadly Ebola Virus Confirmed Near Capital, 1 confirmed dead, other suspected cases including fatalities all test negative, monitoring ended

Re: Uganda: Deadly Ebola Virus Confirmed Near Capital, 1 confirmed dead, other suspected cases including fatalities all test negative, monitoring ended

http://www.newvision.co.ug/D/8/13/756470

Namugongo Ebola free, says ministry
Thursday, 2nd June, 2011 E-mail article Print article

By Raymond Baguma

THE Health ministry has assured pilgrims to Namugongo for the Uganda Martyrs? Day commemoration today that there is no threat of spreading Ebola.

The head of the Ebola national taskforce, Dr. Anthony Mbonye, on Tuesday said: ?We are saying the risk of infection going to Namugongo is low and people are free to go there.?

Mbonye, however, cautioned sick people to stay in their homes and avoid causing panic at the venue.

He also asked the public to be cautious and on the lookout for sick people who may present with signs of fever and bleeding.

Mbonye also said the ministry was working with the Uganda Protestant Medical Bureau as well as the Catholic Medical Bureau and Wakiso district health officers to provide emergency services.

A 12-year-old girl died of Ebola on May 6 in Luwero district and remains the only confirmed case of the Sudan Ebola strain outbreak in the country.

Early this week, at least 25 people who got in contact with the first Ebola victim were declared free from the disease following the lapse of the 21-day incubation period.

The 25 were being monitored from their homes and Bombo Military Hospital for any signs and symptoms.
However, the ministry continues with Ebola surveillance countrywide and Kampala, Nakasongola, Nakaseke, Wakiso, Mukono and Luweero districts, remain on alert.
Ebola is a highly contagious disease with a high fatality rate.

The symptoms of the disease include fever, bleeding through body openings, fever, vomiting, diarrhoea, abdominal pain, headache, rash and red eyes.

Currently, there is no known cure for Ebola. It is transmitted through direct contact with bodily fluids of infected persons.

 

[alert]

Re: Uganda: Deadly Ebola Virus Confirmed Near Capital, 1 confirmed dead, other suspected cases including fatalities all test negative, monitoring ended

Re: Uganda: Deadly Ebola Virus Confirmed Near Capital, 1 confirmed dead, other suspected cases including fatalities all test negative, monitoring ended

http://www.promedmail.org/pls/apex/..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,88754

Archive Number 20110604.1711
Published Date 04-JUN-2011
Subject PRO/AH/EDR> Ebola hemorrhagic fever - Uganda (10): (LW)

EBOLA HEMORRHAGIC FEVER - UGANDA (10): (LUWERO)
***********************************************
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: Fri 3 Jun 2011
Source: TMCnet.com, (The Observer/All Africa Global Media via COMTEX)
[edited]
<http://www.tmcnet.com/usubmit/2011/06/03/5551994.htm>



How Uganda Registered Ebola Success
-----------------------------------
On 27 May 2011 in Bombo, as outgoing minister of health, Stephen
Malinga, announced that the 25 people who had been in contact with the
girl who died from Ebola [hemorrhagic fever] were Ebola free, he also
told the story of how the outbreak was contained.

Dr Joseph Okware, Luwero's district health officer, says that on 1
May 2011, the lone victim of this year's [2011] Ebola outbreak fell
ill and her grandmother tried to treat her using modest means. She
took her to a clinic and after 3 days of treatment without any signs
of improvement, the [patient] was referred to another clinic in
Wobulenzi. However, her caretaker instead took her to Bombo Military
Hospital. Okware describes this as "good luck" because if the
[patient] had been taken to the clinic in Wobulenzi, a bigger number
of people could have become infected.

But because the staff at Bombo Military Hospital was experienced in
handling Ebola [hemorrhagic fever cases] -- having worked with Ebola
patients in Gulu and Bundibugyo [previously] -- they quickly
recognised the symptoms and took measures to curb its spread.
Unfortunately, they were unable to save her; she died 5 hours after
admission to the hospital.

To determine whether the people who had been contact with the girl
had Ebola or not, they were monitored for symptoms of the disease and
when they did not show any after 21 days, they were declared Ebola
free.

Even as Malinga congratulated the team at Bombo Military Hospital for
stopping what could have been an epidemic, he called upon the public
to remain vigilant. "We should celebrate because we have been
successful in controlling this outbreak but while we celebrate, we
should remember that other cases could be reported," Malinga said.

He called upon sick individuals to refrain from going to the
Namugongo shrine to celebrate Martyrs Day on Fri 3 Jun 2011 as they
might have Ebola and spread it to the masses that turn up to
celebrate. If there is anything this outbreak has shown, it is the
fact that if patients seek treatment from properly trained personnel,
epidemics can be averted.

Also, the fact that ordinary Ugandans can be lax about their health
was highlighted during this outbreak. [A woman], who runs a restaurant
near Bombo Military Hospital, said people were not bothered about the
disease. Instead, they simply went about their business, seemingly
unperturbed. Only one man expressed fear of the disease.

While it might be said that the people were right to be unperturbed,
[since] the crisis had been declared over, Malinga called for
vigilance. This means that individuals, especially those that are a
mere 40km [25 miles] away from Zirobwe (Bombo Military Hospital and
Zirobwe are 40km apart), cannot afford to relax.

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

[This report highlights the efforts made to contain the Ebola
hemorrhagic fever outbreak in Central Uganda as the index case was the
only person confirmed to have the disease. Therefore, to date, there
is no evidence that any of her close contacts contracted the disease,
since she sought treatment early enough from trained health care
workers, who had experience from previous Ebola outbreaks in the
country. If no further cases are confirmed, the outbreak should be
declared over as of 17 Jun 2011, 2 incubation periods after the lone
case in this outbreak died.

A map of Uganda, can be accessed at
<http://en.wikipedia.org/wiki/Districts_of_Uganda>
and the HealthMap/ ProMED-mail interactive map of the country is
available at
<http://healthmap.org/r/0RSl>.
A map showing the geographic distribution of Ebola hemorrhagic fever
outbreaks (2009) can be seen at
<http://www.who.int/csr/disease/ebola/Global_EbolaOutbreakRisk_20090510.png
>. - Mod.JFW

The Ugandan health authorities certainly deserve commendation for the
successful containment of this most recent outbreak of Ebola
hemorrhagic fever, despite some initial confusion and release of
contradictory information. Some questions remain to be answered,
however, in particular the source of the infection of the index
patient and the genetic relationship of this new isolate of Sudan
ebolavirus to previously isolated strains that in general have been
responsibly for extensive outbreaks of hemorrhagic fever. No doubt
these questions will be addressed in time and in the meantime it is to
be hope that the deadline of 17 Jun 2011 for final closure of this
episode will pass without remark. - Mod.CP]

 

[alert]

Re: Uganda: Deadly Ebola Virus Confirmed Near Capital, 1 confirmed dead, other suspected cases including fatalities all test negative, monitoring ended

Re: Uganda: Deadly Ebola Virus Confirmed Near Capital, 1 confirmed dead, other suspected cases including fatalities all test negative, monitoring ended

Ouch. Pandemic is definitely the wrong word here....

http://www.monitor.co.ug/SpecialReports/-/688342/1174208/-/uuhtb3/-/

Is Ebola an emerging pandemic?

Posted Sunday, June 5 2011 at 00:00
In Summary

Uganda?s sharply declining death rate from its first Ebola outbreak to the next is no happy accident. The country is emerging as a leader on the continent in battling the fatal virus. But health officials say it is an ?emerging pandemic? Ugandans will not be rid of any time soon, writes Saturday Monitor?s Philippa Croome.


Uganda has made leaps and bounds in terms of its emergency response to the deadly Ebola virus. Dr Issa Makumbi, the head of epidemiology and surveillance with the Ministry of Health, says the third time around health workers simply knew what to do. Their speedy response saved lives thanks to ongoing surveillance, vastly improved local knowledge from epidemic?s past, and the top of the line Uganda Virus Research Institute (UVRI) laboratory in Entebbe ? one of only a handful on the continent able to perform rapid in-country testing.

?What is different from the outbreaks before is this time we were very prompt,? Dr Makumbi said. ?Immediately we took action, we even supervised the burial ? if we had not done that, it would have spread. Our immediate response has paid dividends.?

Hundreds to one
The Sudanese strain of the deadly Ebola virus first appeared in Gulu District in late 2000. It infected 425 people and killed 224, making it the largest-ever Ebola epidemic documented to date. In 2007, an entirely new strain emerged in the west. The Bundibugyo strain, named after the district where it was discovered, killed 37 people.

The current outbreak has already passed a crucial halfway point since the death of a 12-year-old girl in Luwero district on May 6. With no other confirmed cases by June 17, the Ministry of Health says the necessary 42 days will have passed after which they can declare the epidemic over.
Uganda?s unique position of having had three outbreaks within 11 years has also made it a valuable candidate for research. But while local knowledge has drastically improved on how to control the outbreak spreading, Ebola remains a mystery in more ways than one.

The Makerere University Walter Reed Project (MUWRP) is currently in the first phase of developing an Ebola vaccine. Dr Salim Wakabi, the Ebola researcher heading the vaccine?s development, said it will be at least five years before all necessary testing is through. ?If it is successful, if it goes through the three phases and we?ve seen that the vaccine works, then if there is an outbreak like now we can go ahead and administer the vaccine to the people that are prone,? Dr Wakabi said.

The project is looking into two anomalies of the virus that as of yet have not been able to be explained ? namely, why despite having such a high mortality rate, some still survive. Those survivors are the key to discovering how a vaccine can be developed. ?The turn up was overwhelming when we started the vaccine trial ? because people appreciate and know the problem is with us,? he said.

Though research is still ongoing, initial results in Bundibugyo have shown a number of survivors primarily complain of weakened hearing and vision. It demands a deeper look into the long-term implications of those infected by the virus, Dr Wakabi said.

The United States is the only other country trying to develop a vaccine. Last year, it successfully developed an experimental version was which was found to cure the virus ? but only if the shot was able to be administered within 30 minutes of someone being infected.

While this is an unlikely solution to epidemics, it could potentially save the lives of health workers too often infected on the job. Uganda has lost a number of health professionals to the Ebola ? including the renowned Dr Matthew Lukwiya. His quick response to Uganda?s first epidemic in 2000 was said to have saved hundreds of lives. About 1,850 cases with over 1,200 deaths have been documented since the Ebola virus was discovered in 1976.

Making way
It took more than two decades to make its way to Uganda from its roots in neighboring Congo ? and no one has yet been able to explain why. ?It?s becoming like cholera, every time now and then we get it,? said Dr Makumbi. ?You can see the frequency, you don?t know maybe in three years we could see it pop up again.?

Dr Makumbi suspects the virus has a lot to do with Uganda?s population pressures. ?We used to be further away from monkeys and wild animals, now we are a bit closer, sometimes we fight for the food, we fight for land ? all these come in,? he said. ?We are invading the ecosystem of the species.? He says the virus is in wild animals, but that non-human primates ? monkeys and gorillas ? are not likely host candidates, because of their high mortality rates as well. ?That?s actually the other thing we want the public to report ? if you see wild animals dying in masses, that is very suspicious,? he said.

According to the World Health Organisation, who provide much of the technical support in fighting Ebola epidemics, bats infected with the virus have not died, and may be a part of maintaining the virus? natural reservoir, which ?seems to reside in the rainforests on the African continent and in the Western Pacific?. Despite years of study, its roots of are still unknown.

Not yet there
Dr Makumbi says Uganda?s health system is not nearly as efficient well-equipped between emergencies as it is during...... ?If it is something that is a global, public good ? then everybody will come here, we can be overwhelmed by partners, everybody wants to lend a hand, everybody,? he says. ?But this general, routine, capacity-building strengthening ? they come, but not at full speed like the way they come for AIDS, Ebola, Yellow fever.?

Without emergency-sized budgets and personnel to help out, Uganda?s consistent shortages in health service delivery ? staff and drug shortages, equipment, wages and accessibility ? will likely prevent a more forward-looking approach to disease preparedness.

On top of that, despite the constant addition of districts has stretched the health budget thin, which has already remained at the same level for years. ?The population is increasing, the districts are increasing, so we need more people ? but wage bill is not enough,? Dr Makumbi said.

 

[alert]

Re: Uganda: Deadly Ebola Virus Confirmed Near Capital, 1 confirmed dead, other suspected cases including fatalities all test negative, monitoring ended

Re: Uganda: Deadly Ebola Virus Confirmed Near Capital, 1 confirmed dead, other suspected cases including fatalities all test negative, monitoring ended

http://allafrica.com/stories/201106071089.html

Kenya: No More Ebola Cases in Uganda - MOPHS
Diana Madegwa
7 June 2011

Border screening for people coming from Uganda will continue even after the government there announced that it has managed to bring the Ebola outbreak under control.

Head in the division of disease prevention and control Willis Akhwale says though they are not restricting cross border movement, they have intensified check ups to ensure the disease is not imported to the country.

Uganda authority say the deadly disease is now under control since there has been no confirmed case since May 6 when the first case was reported.

 

[Shiloh]

Re: Uganda: Deadly Ebola Virus Confirmed Near Capital, 1 confirmed dead, other suspected cases including fatalities all test negative, monitoring ended

Re: Uganda: Deadly Ebola Virus Confirmed Near Capital, 1 confirmed dead, other suspected cases including fatalities all test negative, monitoring ended

Source: http://www.theeastafrican.co.ke/news/-/2558/1179044/-/o1vvexz/-/

Critics say ?Ebola case? may have raised false alarm
Posted Sunday, June 12 2011 at 11:28

Speculation is rife in Uganda over whether the case of a 12-year-old girl who died from haemorrhage fever was correctly diagnosed as Ebola.
Critics say that given that all people who came into contact with the girl tested negative suggests laboratory tests could have returned false positive results for Ebola? a highly contagious viral disease.

The girl from Nakaseke district north of Kampala was early last month admitted to a local hospital after failing to respond to a multiple regimen for treating malaria.

Medics said they acted promptly in handling the suspicious case of high fever by isolating the patient who shortly began manifesting symptoms of haemorrhage fever that she later succumbed to...

 

[alert]

Re: Uganda: Deadly Ebola Virus Confirmed Near Capital, 1 confirmed dead, other suspected cases including fatalities all test negative, monitoring ended

Re: Uganda: Deadly Ebola Virus Confirmed Near Capital, 1 confirmed dead, other suspected cases including fatalities all test negative, monitoring ended

Source: http://www.theeastafrican.co.ke/news/-/2558/1179044/-/o1vvexz/-/

Critics say ‘Ebola case’ may have raised false alarm
Posted Sunday, June 12 2011 at 11:28

Speculation is rife in Uganda over whether the case of a 12-year-old girl who died from haemorrhage fever was correctly diagnosed as Ebola.
Critics say that given that all people who came into contact with the girl tested negative suggests laboratory tests could have returned false positive results for Ebola— a highly contagious viral disease.

The girl from Nakaseke district north of Kampala was early last month admitted to a local hospital after failing to respond to a multiple regimen for treating malaria.

Medics said they acted promptly in handling the suspicious case of high fever by isolating the patient who shortly began manifesting symptoms of haemorrhage fever that she later succumbed to...

I was wondering about that possibility myself. Could the Ebola test have been a false positive and the girl died of some other disease? Yellow fever in particular would be a good alternative explanation, as it is not spread person-to-person, but yellow fever is a flavivirus, whereas Ebola is a filovirus, so they should not cross-react.

But the article above does continue:

But Ugandan doctors are confident about their findings and conclusion. The medics say they conducted two highly sophisticated tests — the Polymerase Chain Reaction (PCR) which amplifies copies of the DNA so that they can be properly examined and antigen tests to confirm the PCR findings — which were also positive.

“We are capable of doing tests for Ebola, we even send the laboratory data to the Centre for Disease Control (CDC) in Atlanta, US and medics there are in agreement with our findings,” said Dr Makumbi.

 

[Shiloh]

Re: Uganda: Deadly Ebola Virus Confirmed Near Capital, 1 confirmed dead, other suspected cases including fatalities all test negative, monitoring ended

Re: Uganda: Deadly Ebola Virus Confirmed Near Capital, 1 confirmed dead, other suspected cases including fatalities all test negative, monitoring ended

Source: http://www.newvision.co.ug/D/8/12/757750

Uganda Ebola free
Thursday, 16th June, 2011
By Raymond Baguma

The ministry of health is set to announce an end of the Ebola outbreak in the country tomorrow (Friday).

Rukia Nakamatte, the ministry?s spokesperson said Friday would mark the end of 41 days, the required days designated to mark an end to such an epidemic.

The Ebola outbreak was confirmed on May 12 after a 12-year-old girl from Zirobwe Sub County in Luwero district died at Bombo Military Hospital.

The case remained the only confirmed case of the Sudan Ebola strain outbreak. All suspected cases were tested at the Uganda Virus Research Institute, Entebbe and proved negative.

 

[alert]

Re: Uganda: Deadly Ebola Virus Confirmed Near Capital, 1 confirmed dead, other suspected cases including fatalities all test negative, monitoring ended

Re: Uganda: Deadly Ebola Virus Confirmed Near Capital, 1 confirmed dead, other suspected cases including fatalities all test negative, monitoring ended

http://www.newvision.co.ug/D/8/13/757804

Uganda declared Ebola free
Thursday, 16th June, 2011 E-mail article Print article

By Raymond Baguma

THE health ministry is today set to announce an end of the Ebola outbreak in the country.

According to the ministry spokesperson Rukia Nakamatte today marks the end of 41 days required before marking an end to an epidemic at the magnitude of Ebola.

The disease is a contagious haemorrhagic fever with a high fatality rate.

Its symptoms include fever, bleeding through body openings, vomiting, diarrhoea, abdominal pain, headache, rash and red eyes.

However, the source of the outbreak, which was reported in Luwero district early last month, remains a mystery, according to the director general of health services, Dr. Nathan Kenya Mugisha.

The outbreak was confirmed on May 12, after a 12-year-old girl from Zirobwe sub-county in Luwero district died at Bombo Military Hospital.

This has remained the only confirmed case of the Sudan Ebola strain outbreak, and Mugisha said all the subsequent 25 suspected cases proved negative.

?Originally, we were also wondering whether it was Ebola. But further tests performed by the Centre for Disease Control and Prevention in Atlanta in the US, confirmed that it was Ebola,? Mugisha said.

Mugisha added that the Ebola isolation ward that was set up at the hospital would remain in place to handle any future cases of disease outbreaks.

 

[alert]

Re: Uganda: Deadly Ebola Virus Confirmed Near Capital, 1 confirmed dead, other suspected cases including fatalities all test negative, monitoring ended

Re: Uganda: Deadly Ebola Virus Confirmed Near Capital, 1 confirmed dead, other suspected cases including fatalities all test negative, monitoring ended

I believe the blue text is a misunderstanding on the part of Xinhua. The six people who died were probably the miscellaneous cases reported in this thread from all over Uganda. We know that there were only 33 or so contacts, so the 47 individuals likely includes these other cases.

If six contacts of the girl really had died (especially after testing negative), that would be a sign of a major problem.

http://news.xinhuanet.com/english2010/health/2011-06/17/c_13936124.htm


Uganda declared Ebola free

English.news.cn 2011-06-17 19:03:31 FeedbackPrintRSS


KAMPALA, June 17 (Xinhua) -- The World Health Organization (WHO) and Uganda's ministry of health on Friday declared the East African country Ebola free after an incubation period of 42 days without any new case registered.

Richard Nduhuura, minister of state for health in charge of general duties flanked by Joaquim Saweka, WHO representative here, told reporters that since the first case, a 12 year-old girl who died on May 6, no other case has been reported.

"We successfully managed to control the epidemic, recording no new cases, due to our previous experience in handling the disease. As you may recall, we were faced with the same epidemic in 2007 and 2001 in Bundibugyo and Gulu respectively," Nduhuura said.

According to the ministry, 47 people were monitored after they got into contact directly or indirectly with the 12 year-old girl in the central Ugandan district of Luweero, about 50km north of the capital Kampala.

Of the 47 people, six died but the cause of death was not related to Ebola, according to Anthony Mbonye, head of the National Task Force for Ebola.

He said surveillance and ecological studies in the affected area will continue.

Ebola is a contagious hemorrhagic fever with a high fatality rate.

Its symptoms include fever, bleeding through body openings, vomiting, diarrhea, abdominal pain, headache, rash and red eyes.

The outbreak in 2007 in the western district of Bundibugyo claimed 37 lives out of the 148 infected.

Editor: Fang Yang

 

[alert]

Re: Uganda: Deadly Ebola Virus Confirmed Near Capital, 1 confirmed dead, other suspected cases including fatalities all test negative, monitoring ended

Re: Uganda: Deadly Ebola Virus Confirmed Near Capital, 1 confirmed dead, other suspected cases including fatalities all test negative, monitoring ended

Note the location here, in the north-east of the country, so this was not one of the contact cases.

Still an interesting inside look at the containment effort.

http://www.theengineer.co.uk/blog/taking-no-chances-with-ebola/1009087.article


Taking no chances with Ebola
20 June 2011 | By Paul Jawor


You might not have heard of it, but mention the word Ebola in various parts of Uganda ? and indeed anywhere in rural Africa ? and the reaction is stark. At times, doctors refuse to see patients with suspected cases. All of a sudden, everyone worries they?ve got it. Queues outside the special clinics and health centres double, then triple. Panic ensues.

None of this is surprising when you learn that Ebola is a deadly and highly contagious virus. The disease it causes, alongside an acute hemorrhagic fever, kills people in a matter of days. The body shuts down from the inside as the symptoms ? vomiting, headache, joint pain, diarrhoea ? quickly take hold. The worst cases bleed from their nose, eyes, mouth. Of those diagnosed with the airborne strain, 80-90 percent typically succumb.


.Although Ebola ? possibly transmitted in the faeces of bats and by eating monkey meat ? is not common, a suspected case is still alarming for any village. It needs to be contained quickly, patients need to be identified and isolated and people need to be reassured.

As a humanitarian engineer specialising in water and sanitation for the medical charity M?decins Sans Fronti?res (MSF), Ebola has been my world for the last week. On a trip to north eastern Uganda to deal with a suspected case, I was reminded just how complex a challenge this disease is ? and how much we owe to engineering thinking and practice when it comes to containing it.

Initially, Ebola occurred just outside the Ugandan capital Kampala. A middle aged woman died and tests confirmed she had it. The government was very nervous because the disease is so virulent. They called MSF in to tackle a second suspected case in a place called Kabong.

As soon as we arrived we set to work, fully prepared for an Ebola outbreak. Our first hurdle involved ?line tracing? all the people the patient had come into contact with in recent hours and days. That meant finding out where the woman had gone as she travelled to the clinic to report her symptoms. We needed to know where she had had dinner, who she had spoken to and if she had stopped on her way.

It seems extreme, but it?s necessary. In typical cases of Ebola, the first people to die are usually the patient, anyone caring for them at home, their doctor and any nursing staff. Containment in the early stages is absolutely critical.

And containment is really what Ebola is all about. So we set about building an isolation ward.

In a rural Ugandan village with limited resources, our choice of building materials was slim. We settled initially for tents, reams of plastic sheeting, wooden poles and tarpaulin.



Inside the isolation ward: as well as the construction itself, care must be taken over controlling the flow of people into and out of the ward, as well as safely disinfecting or disposing of materials that might come into contact with the patients
In fact, the construction of the ward itself is the easy bit. The real conundrum comes when you consider the need to keep each section of the structure (suspected, infected and confirmed cases) isolated from one another.

It?s less to do with construction and more to do with flow; involving basic logistics, planning paths of movement from one room to the next and designing a pre-agreed ?circuit? for each health worker and patient to adhere to.

On top of that each family member, doctor, nurse and water and sanitation adviser is necessarily clad in protective clothing from head to toe. Anyone coming into contact with a patient needs to wear green scrub like underwear, overalls, an all-in-one paper suit, goggles, two pairs of gloves and a plastic apron.



Anyone entering the ward must wear full protective clothing, including a disposable paper suit, gloves and goggles
And each time you move from a high risk to a low risk area, you need to get undressed and redressed to stop potential spread of infection. At all stages you are sprayed with a chlorine solution, and each doorway has a chlorine footbath.

Disposing waste is just as challenging. How do you get rid of a bucket of infected fluid when there?s nowhere to put it? Where do you bin used and highly infectious clothing? What about contaminated water used to hose down the sections of the isolation ward? How do you get supplies into and out of the field camp ? or simply stop people wandering into the exclusion zone?

Each problem requires its own particular engineering solution. Often the answer involves chlorine ? and masses of it. And you quickly become obsessed with detail, constantly thinking about where you?ve been and where you?re going next.

Some solutions are simpler ? we used three layers of fencing to block the isolation ward off from passing villagers. Culturally, there are multiple challenges too. Just explaining what you are up to can be tricky enough!

Unfortunately, in this particular case, and despite all of our best efforts, we were unable to save the patient who sadly passed away after just two days. Only after we left did we discover that she had, in fact, not died of Ebola ? even though she showed all the symptoms. But we didn?t have the luxury of that knowledge until it was too late. And with Ebola you can?t take any chances.

On the plus side, we left the community with a permanent isolation ward for potential future cases, trained a number of local staff in procedures used to deal with an outbreak and helped protect the villagers of Kabong from what could have been a very deadly situation. Taken together, these measures will save more lives in the years to come. For me, it?s just one example of humanitarian engineering in action.



Read more: http://www.theengineer.co.uk/blog/taking-no-chances-with-ebola/1009087.article#ixzz1PphAvgsT

 

[alert]

Re: Uganda: Deadly Ebola Virus Confirmed Near Capital, 1 confirmed dead, other suspected cases including fatalities all test negative, monitoring ended

Re: Uganda: Deadly Ebola Virus Confirmed Near Capital, 1 confirmed dead, other suspected cases including fatalities all test negative, monitoring ended

Hat-tip IOH.

http://wwwnc.cdc.gov/eid/article/18/9/11-1536_article.htm

The Patient
On May 6, 2011, a 12-year-old girl from Nakisamata village, Luwero District, Uganda, was admitted to Bombo Military Hospital. She exhibited fever, jaundice, and hemorrhagic signs: epistaxis, hematemesis, hematuria, and conjunctival, gingival, and vaginal bleeding. The attending physician made a preliminary diagnosis of disseminated intravascular coagulopathy with a functional platelet disorder, along with viral hemorrhagic fever (VHF) as a possible cause. The patient was isolated from the general ward because of a high clinical suspicion of VHF. Hospital staff involved in her care and treatment implemented isolation precautions, including the use of personal protective equipment, such as gowns, gloves, and masks.

The patient?s condition worsened and despite tracheal intubation and supplemental oxygen, she died 3 hours after admission. Because the cause of death was unknown but suspicion of VHF was high, the body was disinfected by using a chlorine solution and then wrapped in plastic, taken to the hospital mortuary facility, and placed in a coffin, which was then sealed. The coffin was released to the girl?s relatives for burial, with instructions not to open the coffin or touch the body before burial.

A blood sample collected at the hospital before the patient?s death was transported to the US Centers for Disease Control/Uganda Virus Research Institute (CDC/UVRI) laboratory in Entebbe for diagnostic testing by reverse transcription PCR (RT-PCR), antigen-detection ELISA, and IgM for filoviruses as described (1?5). Evidence of infection with an Ebola virus of the genus and species Ebolavirus Sudan ebolavirus (SEBOV) was detected by RT-PCR and confirmed by antigen-detection ELISA. Results of ELISA IgM against Ebola viruses and all tests for Marburg virus were negative. SEBOV was also isolated from blood on Vero E6 cells at the Viral Special Pathogens Branch, CDC, Atlanta, Georgia, USA.

Figure 1


Figure 1. . Sudan Ebola virus in Uganda, 2011. A) Geographic locations of Nakisimata village and Bombo Military Hospital with the isolation facility established by M?decins Sans Fronti?res (MSF) relative to locations where...
Overlapping PCR fragment copies of the complete virus genome were amplified, and the nucleotide sequence was obtained as described (6). Maximum-likelihood phylogenetic analysis confirmed SEBOV and demonstrated that the isolate (Nakisamata isolate, JN638998) was closely related (99.3% identical) to the Gulu SEBOV strain obtained from northern Uganda in 2000 (Figure 1). A postmortem diagnosis indicated Ebola hemorrhagic fever (EHF) caused by SEBOV as the cause of the patient?s death.

An investigation team from the Kampala Ministry of Health, CDC Uganda, and UVRI traveled to Bombo Military Hospital and Nakisamata village, the home of the case-patient, on May 13, 2011. The village is located in Luwero District, ≈50 km north of Kampala. The investigation team established that the case-patient reported feeling ill on May 1. She had a mild headache and was given an over-the-counter analgesic. She had a fever with chills on May 4 and began vomiting on May 5. On May 6, she experienced intense fatigue and epistaxis. The patient?s grandmother then took her to a local health clinic where she received adrenaline nasal packs for her epistaxis and injections of quinine and vitamin K. The patient?s condition continued to worsen, and she experienced hematemesis and vaginal bleeding. She was then transported by motorcycle taxi to Bombo Military Hospital, ≈35 km north of Kampala, by her grandmother and father.

The investigation team identified 25 close contacts of the patient, comprising 13 persons who had physical contact after illness onset at her home and 12 hospital staff members. Four of the hospital contacts were classified as having a high risk for exposure to SEBOV because of possible exposure to the patient?s body fluids: 2 persons who performed tracheal intubation and 2 who handled the body after death. On May 15, a team from CDC Atlanta arrived in Uganda to provide assistance in laboratory diagnostics and epidemiological response. Also on this date, M?decins Sans Fronti?res, a nonprofit medical humanitarian organization, began establishment of an isolation ward at Bombo Military Hospital. During outbreak response and follow-up surveillance 21 days after the death of the case-patient, 24 sick persons (18 from Luwero District and 6 from other locations in Uganda) were identified. Testing at the CDC/UVRI laboratory ruled out EHF in this group.

Relatives reported that the girl did not travel outside Nakisamata village in the 3 months preceding her illness and did not attend any funerals or have contact with anyone visiting from another town or village before her illness. They recalled no unusual deaths in the area in recent months. They also reported that she had not been exposed to any sick or dead animals in the village or nearby forested area.

During follow-up investigation in Nakisamata village, several species of bats (tentatively identified as belonging to the genera Epomophorus, Hipposideros, Pipistrellus, and Chaerophon) were found roosting in unoccupied houses and several classrooms of the village schoolhouse where the girl attended classes, ≈400 meters from her home. Sixty-four bats were collected, and testing of these bats for Ebola virus (EBOV) is ongoing.

Samples from 4 family members, none of whom reported illness, were obtained and tested for EBOV by RT-PCR, antigen-detection ELISA, and IgM and IgG ELISAs. Test results for 3 of the family members were negative. One juvenile relative had positive IgG test results at a titer of 1,600 but was IgM negative, indicating past infection with EBOV. Since IgM antibodies can persist for as long as 2 months after infection (1,7), this person?s infection appears temporally unrelated to the case-patient, who had EHF attributed to SEBOV. No clinical information was available to determine whether the relative?s infection was symptomatic. Contact studies and serosurveys suggest that some EBOV infections can go unrecognized (1,8?10,11).

Conclusions
This case represents the second documented occurrence of an identified single-case EHF outbreak (12). We were unable to identify an epidemiologic link to any suspected EHF cases before the girl?s illness onset, or to conclusively identify a suspected environmental source of infection in and around the village in which she lived. This suggests that her exposure was zoonotic in nature and must have occurred in the vicinity of her residence, since her relatives reported that she did not travel. The fact that an additional family member had serologic evidence of an epidemiologically unrelated EBOV infection further supports the notion that zoonotic exposures have occurred in the vicinity of the case-patient?s village.

Rapid laboratory identification in this outbreak supported mobilization of an investigation team 1 day after initial laboratory detection and the rapid establishment of an isolation facility at Bombo Military Hospital. In this instance, the initial high suspicion of EHF by clinical staff, the appropriate use of personal protective equipment and barrier protection by hospital staff, and the rapid laboratory confirmation of EHF in-country likely contributed to limiting the size of this outbreak.

The timeliness of diagnostic confirmation and outbreak response was much improved over that during previous EHF outbreaks in Uganda (timeline shown in Figure 2), during which transmission of the virus occurred for multiple months before the outbreaks were detected (13?15). This improvement was possible mainly because of collaboration by the CDC Viral Special Pathogens Branch and the Uganda Virus Research Institute to establish a permanent high-containment laboratory that is capable of performing diagnostic testing for filoviruses and other causes of VHF in Uganda. The limited extent of this outbreak also demonstrates the powerful utility of a national VHF surveillance system, coupled with the ability to rapidly diagnose and respond to limit the spread of such high-hazard infections in the community and health care facilities. Continued efforts are needed to build and sustain VHF surveillance networks across Africa.

Mr Shoemaker is an epidemiologist in the Viral Special Pathogens Branch, CDC. His areas of interest and professional research include the epidemiology and surveillance of zoonotic viral pathogens.

Acknowledgment
We thank the staff at Bombo Military Hospital; the initial investigation team, which included members from the Ministry of Health Uganda, the World Health Organization, and CDC-Uganda for field and laboratory investigation of the outbreak; the National Task Force on Ebola; Tadesse Wuhib, John Lule, Herbert Kiyingi, Jeff Borchert, George Acire, and Betty Abang, Jonathon Towner, Brian Amman, Bobbie Rae Erickson, Lisa Wiggleton, Zach Reed, James A. Comer, Barbara Knust, and Julia Pierzchala for technical support; the CDC Motorpool for transportation; and M?decins Sans Fronti?res for their rapid establishment of an isolation ward at Bombo Military Hospital. We especially thank the Uganda Virus Research Institute for their support of the viral hemorrhagic surveillance program and diagnostic laboratory. We also thank all other participating organizations and development partners: United States Agency for International Development, Emerging Pandemic Threats, PREDICT and RESPOND, African Field Epidemiology Network, and United Nations Children?s Fund, that participated and contributed to the Ebola outbreak response and provided support to the Uganda Ministry of Health.