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Uganda - Suspected case of Ebola

alert

Senior Moderator
http://hisz.rsoe.hu/alertmap/woalert_read.php?glide=EH-20091110-23772-UGA&cat=dis&lang=eng

Panic gripped Mityana Hospital following a report of a case of suspected Ebola fever yesterday. The patient, identified as Jackie Tumuhairwe, was brought to the hospital at midday. The medical workers immediately set up an isolation centre where the suspect was quarantined to receive treatment. Muamin Kalule, the senior nursing officer in charge of the isolation centre, said Tumuhairwe had manifested signs of the deadly haemorrhagic fever, which included vomiting, abdominal pain and bleeding. "These are the signs for Ebola so we have to take extra care," she said. Tumuhairwe, who hails from Mawanda village in Kakindu sub-county, said she had been having a fever for the past four days after eating antelope meat. Kalule, however, disagreed that Tumuhairwe could have developed the symptoms from the meat, saying other family members who had eaten the food were in good health. She said the district surveillance officer, Dennis Mono, had taken samples to Kampala and they were waiting for the results, which are expected today. The director general of health services, Dr. Sam Zaramba and the Mityana health officer, Dr. Fred Lwasampijja, said they were not aware of the suspected outbreak.
 
Re: Suspected case of Ebola

Re: Suspected case of Ebola

http://www.ugpulse.com/articles/dai...+medical+staff+flee+Mityana+hospital&ID=13413

Patients and some medical staff at Mityana district Hospital reportedly disappeared following reports that an Ebola sick person had been brought into the hospital.

Jackie Tumuhairwe was brought to the hospital with signs equivalent to those of Ebola. The brave medical workers however managed to receive the patients and quarantined the room where Tumuhairwe was being treated.

The Senior Nursing Officer of Mityana Hospital, Muamin Kalule has told Ultimate Media today morning that doctors from Kampala have gone to Mityana to study Tumuhairwe?s case.

Kalule says Tumuhairwe is vomiting and bleeding, which signs are linked to the deadly Ebola fever.

The patient says she started vomiting and bleeding after eating an antelope meat. According to the patients? registration book, Tumuhairwe, 26, is a resident of Mawanda Zone, Kakindu sub-county, Mityana district.
 
Re: Suspected case of Ebola

Re: Suspected case of Ebola

The first article said we will get test results today. Antelopes are not known as a carrier of Ebola. The symptoms do seem a little reminiscent of gastrointestinal anthrax. Certainly, the antelope could have been infected with anthrax.

Of note is that back in January, there was a possible outbreak of VHF at Bushenyi, Uganda (with about six fatalities) linked to antelope meat. That outbreak was blamed on anthrax, despite possible H2H transmission, and the fact that no person or animal tested positive for that agent. I don't believe anyone in that outbreak was even tested for Ebola or Marburg. However, Bushenyi is over 200 miles from where the current illness is.
 
Re: Suspected case of Ebola

Re: Suspected case of Ebola

And an EAFR ProMed post.

http://eafr.promedmail.org/

Published Date
2009-11-10 15:40:03
Subject
PRO/EAFR> Ebola hemorrhagic fever - Uganda (03): (Mityana) susp.,
Archive Number
20091110.203583
Full Text
EBOLA HEMORRHAGIC FEVER - UGANDA (03): (Mityana) REQUEST FOR INFORMATION
************************************************************************
Date: Mon 9 Nov 2009
Source: The New Vision (Uganda) [edited]
http://www.newvision.co.ug/D/8/13/700654


Suspected Ebola [hemorrhagic fever] patient in Mityana
------------------------------------------------------
Panic gripped Mityana Hospital following a report of a case of
suspected Ebola [hemorrhagic] fever yesterday [8 Nov 2009]. The
patient was brought to the hospital at midday. The medical workers
immediately set up an isolation centre where the suspect was
quarantined to receive treatment.

Muamin Kalule, the senior nursing officer in charge of the isolation
centre, said the patient had manifested signs of the deadly
haemorrhagic fever, which included vomiting, abdominal pain, and
bleeding. "These are the signs for [ebolavirus infection] so we have
to take extra care," she said.

The patient, who hails from Mawanda village in Kakindu sub-county [in
Mityana district], said she had been having a fever for the past 4
days after eating antelope meat. Kalule, however, disagreed that the
patient could have developed the symptoms from the meat, saying other
family members who had eaten the food were in good health.

Kalule said the district surveillance officer, Dennis Mono, had taken
samples to Kampala and they were waiting for the results, which are
expected today [9 Nov 2009]. The director general of health services,
Dr Sam Zaramba and the Mityana health officer, Dr Fred Lwasampijja,
said they were not aware of the suspected outbreak.


[Byline: Luke Kagiri]


--
Communicated by:
ProMED-EAFR


[This is the 2nd report this year(2009) of a suspect Ebola fever case
in Uganda. The 1st report in August 2009 from Mbale district in
Eastern Uganda turned out to be negative (see ProMED-EAFR posting
20090825.201424). The current report shows that after the past 2
outbreaks of ebolavirus infection in Uganda in 2000 and 2007, health
workers now have a high index of suspicion for viral hemorrhagic
fever. This is good for early detection and timely initiation of
response interventions since viral hemorrhagic fever outbreaks are
usually atypical at the onset. More information from knowledgeable
sources in the country would be greatly appreciated.


Mityana District in the Central Region of Uganda can be seen on the map at
http://www.coetzee-uganda.com/index_files/District_Map_of_Uganda.htm.
For the interactive HealthMap/ProMED-mail map of the country see
http://healthmap.org/r/00_B. - Mod.JFW]


[see also:
Viral hemorrhagic fever - Sudan (04): (West Bahr Al-Ghazal) NOT 20091024.203264
Viral hemorrhagic fever - Sudan (03): (West Bahr Al Ghazal) 20091013.203061
Viral hemorrhagic fever - Sudan (02): (West Bahr Al-Ghazal), RFI
20091011.203026
Viral hemorrhagic fever - Sudan: (West Bahr al-Ghazal), RFI 20091007.202932
Ebola hemorrhagic fever - Uganda (02): (Mbale) NOT 20090825.201424
Ebola hemorrhagic fever - Uganda: (Mbale) RFI 20090825.201420
Marburg virus, Egyptian fruit bat - Uganda 20090802.201034]


[For additional background information on hemorrhagic fever,
available from the general ProMED-mail list, the postings below can
be found at http://www.promedmail.org. - Mod.JFW]


[Undiagnosed fatalities - Congo DR: (BC), hem fever susp, RFI 20090626.2326
Ebola hemorrhagic fever - Congo DR (08): (KS), WHO 20090218.0668
Ebola hemorrhagic fever - Congo DR (07): (KS) 20090202.0462
Ebola hemorrhagic fever - Congo DR (06): (KS) 20090124.0315
Ebola hemorrhagic fever - Congo DR (05): (KS) 20090115.0173
Ebola hemorrhagic fever - Congo DR (04): (KS) 20090114.0159
Ebola hemorrhagic fever - Congo DR (03): (KS) 20090111.0113
Ebola hemorrhagic fever - Congo DR (02): (KS) 20090108.0082
Ebola hemorrhagic fever - Congo DR: (KS), WHO 20090102.0013
2008
----
Ebola hemorrhagic fever - Congo DR (03): (KS) 20081231.4133
Ebola hemorrhagic fever - Congo DR: (KS), WHO 20081227.4086
Undiagnosed illness - Congo DR (02): (KS), Ebola conf. 20081225.4068
Undiagnosed illness - Congo DR: (Kasai) RFI 20081222.4027
Undiagnosed illness - Congo DR: Kasai Occ, Ebola susp, RFI 20081009.3200
Hemorrhagic fever, fatal - Congo DR: (KA), RFI 20080823.2630
Ebola hemorrhagic fever, suspected - Congo DR (02) 20080702.2017
Ebola hemorrhagic fever - Congo DR: susp., corr. 20080604.1790
Ebola hemorrhagic fever - Congo DR: susp., corr. 20080604.1789
Ebola hemorrhagic fever - Congo DR: susp. 20080603.1779
Hemorrhagic fever, fatal - Congo DR: (KA), RFI 20080823.2630]
...................................jfw/mj/be

_______________________________________________
ProMED-EAFR mailing list
ProMED-EAFR@promedmail.org
http://eafr.promedmail.org/
 
Re: Suspected case of Ebola

Re: Suspected case of Ebola

The incubation period for this seems too short to be Ebola. It seems she had fever for four days before being hospitalized, but that the fever started shortly after eating the antelope (and is stomach pain an Ebola symptom?). It seems far more likely that some other food-borne pathogen was in the meat (although why didn't anyone else get ill?). Perhaps she had an additional exposure besides the antelope?

FWIW, the Bushenyi cases in January had an incubation period of 2-3 weeks, so this is unlikely related to that.

I fully expect this to be something other than Ebola.
 
Re: Suspected case of Ebola

Re: Suspected case of Ebola

There is no indication that the husband is ill, so there is no danger that he would spread the disease to others. That seems like just an over-reaction to fear of possible VHF. Apparently, we are still waiting for test results.

http://www.newvision.co.ug/D/8/13/700760

Health team investigatesEbola panic
Tuesday, 10th November, 2009 E-mail article Print article

By Conan Businge and Luke Kagiri

THE Government has sent a team to Mityana to investigate an outbreak of Ebola.

The Commissioner of community health, Dr. Sam Okware, said the health ministry sent a surveillance team to carry out precautionary measures if Ebola was confirmed.

This was after reports this week that Jackie Tumuhairwe, a suspected case, was brought to Mityana Hospital and quarantined.

Muamin Kalule, a senior nursing officer in charge of the isolation centre, said Tumuhairwe had signs of the deadly hemorrhagic fever. The symptoms included vomiting, abdominal pain and bleeding.

Tumuhairwe, from Mawanda village in Kakindu sub-county, said she had been having fever for the past four days after eating antelope meat.

There were fears that Tumuhairwe?s husband, also her care taker, might spread the infection to other patients as he was moving freely in other wards. Authorities promised to handle the matter.
 
Re: Suspected case of Ebola

Re: Suspected case of Ebola

And a Xinhua article (which notably fails to mention that the possible outbreak consists of a single suspected case).

http://english.cri.cn/6966/2009/11/11/1961s528657.htm

Uganda on High Alert Following Suspected Ebola Outbreak
2009-11-11 23:52:04 Xinhua Web Editor: Wu Tong




Uganda is on high alert following suspected outbreak of deadly Ebola hemorrhagic fever in the central part of the country, an official said here on Wednesday.

The state minister for health in charge of general duties, Richard Nduuhura told Xinhua by telephone that they are prepared to combat the outbreak drawing from the past experiences in 2000 and 2007.

"We are very prepared. We have the capacity and manpower to handle and contain any outbreak," said Nduuhura.

"There is no need to worry. We have handled Ebola epidemic in the country before. We managed to contain it in 2000 and 2007 in Gulu and Bundibugyo districts respectively," he said.

The state owned New Vision daily on Wednesday reported that the health ministry sent a surveillance team to Mityana district, 40km west of Kampala, to carry out investigation on a suspected outbreak.

A total of 37 people were killed out of 148 infected in an Ebola outbreak two years ago caused by a new strain of Ebola virus, which seemed more mild than the other known species, in the western district of Bundibugyo.

Ebola virus is highly contagious and causes a range of symptoms including fever, vomiting, diarrhea, generalized pain or malaise and in many cases internal and external bleeding.

Mortality rates of Ebola fever are extremely high, with the human case-fatality rate ranging from 50 percent to 89 percent, depending on viral subtype.
 
Re: Suspected case of Ebola

Re: Suspected case of Ebola

And a ProMed post.

http://www.promedmail.org/pls/otn/f..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,80044

Archive Number 20091110.3895
Published Date 10-NOV-2009
Subject PRO/AH/EDR> Ebola hemorrhagic fever - Uganda (03): (Mityana), susp.


EBOLA HEMORRHAGIC FEVER - UGANDA (03): (MITYANA), SUSPECTED
***********************************************************
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: Mon 9 Nov 2009
Source: AllAfrica.com [edited]
<http://allafrica.com/stories/200911100258.html>


Suspected Ebola Patient in Mityana, Uganda
------------------------------------------
Panic gripped Mityana Hospital following a report of a case of
suspected Ebola fever yesterday, Sun 8 Nov 2009. The patient was
brought to the hospital at midday. The medical workers immediately set
up an isolation centre where the suspect was quarantined to receive
treatment. Muamin Kalule, the senior nursing officer in charge of the
isolation centre, said the patient had manifested signs of the deadly
haemorrhagic fever, which included vomiting, abdominal pain and
bleeding. "These are the signs for Ebola [haemorrhagic fever] so we
have to take extra care," she said.

The patient, who hails from Mawanda village in Kakindu sub-county,
said she had been having a fever for the past 4 days after eating
antelope meat. Kalule, however, disagreed that the patient could have
developed the symptoms from the meat, saying other family members who
had eaten the food were in good health. She said the district
surveillance officer, Dennis Mono, had taken samples to Kampala and
they were waiting for the results [of diagnostic tests], which are
expected today [9 Nov 2009].

The director general of health services, Dr. Sam Zaramba and the
Mityana health officer, Dr. Fred Lwasampijja, said they were not aware
of the suspected outbreak.

[Byline: Luke Kagiri]

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

[Mityana is a town in central Uganda. It is the largest town in
Mityana District and the district headquarters are located there. It
can be located in the map at:
<http://en.wikipedia.org/wiki/Mityana>. Kakindu sub-district, the home
of the patient, which is some distance from Mityana can be located in
the interactive map of Uganda at:
<http://www.maplandia.com/uganda/hoima/bugahya/kakindo/>.

Apart from the signs and symptoms of a haemorrhagic fever, there is no
compelling reason at this point to identify an Ebolavirus as the
causative agent. The results of diagnostic tests in Kampala are
awaited. - Mod.CP]

[see also:
Ebola hemorrhagic fever - Uganda (02): (ME), NOT, RFI 20090831.3061
Ebola hemorrhagic fever - Uganda: (ME), susp. 20090821.2962
2008
----
Ebola hemorrhagic fever - Uganda (06): (Bundibugyo), new species
20081121.3675
Ebola hemorrhagic fever - Uganda (05): (Bundibugyo), susp. 20080304.0883
Ebola hemorrhagic fever - Uganda (04): (Bundibugyo), WHO 20080221.0704
Ebola hemorrhagic fever - Uganda (03): Arua, susp 20080122.0275
Ebola hemorrhagic fever - Uganda (02): (Bundibugyo) 20080107.0092
Ebola hemorrhagic fever - Uganda: (Bundibugyo) 20080104.0050
2007
----
Ebola hemorrhagic fever - Uganda (11): (Bundibugyo) 20071215.4031
Ebola hemorrhagic fever - Uganda: (Bundibugyo), WHO 20071130.3869
2001
----
Ebola hemorrhagic fever - Uganda: postscript 20011019.2576]
.................cp/ejp/jw
*####################################################
 
Re: Uganda - Suspected case of Ebola

I didn't think Ebola was likely, and it has now likely been ruled out. Could be a case of any one of a number of illnesses, including malaria, dengue, etc. Also seems unlikely to be related to the antelope meat at all. Someone should send this to ProMed.

http://www.newvision.co.ug/D/8/13/701079

No Ebola

MITYANA-Preliminary tests show that Jackie Tumuhairwe may not be suffering from the deadly Ebola virus, Dr. Joseph Francis Wamala, an epidemiologist, has said. Wamala is leading the surveillance team that was sent to the district. “It is so far clear that it is not Ebola, but we shall carry out confirmatory tests,” he said.
 
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