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Published Date: 2012-07-31 18:46:27
Subject: PRO/AH/EDR> Ebola hemorrhagic fever - Uganda (05): (KI)
Archive Number: 20120731.1223266

EBOLA HEMORRHAGIC FEVER - UGANDA (05): (KIBAALE)
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[1]
Date: Mon 30 Jul 2012
Source: New Vision [edited]
http://www.newvision.co.ug/news/633603-19-new-ebola-cases-reported-at-kagadi-hospital.html

New Ebola cases reported at Kagadi Hospital
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A total of 19 new Ebola cases [have been reported] at Kagadi Hospital in Kibaale district. Mubende district bordering Kibaale has set up an isolation centre center following reports that Ebola patients from Kibaale were flocking [to] the health unit for treatment. This caused panic as nurses turned away patients for fear that they could be [carrying] the deadly Ebola virus. Mubende Hospital chief Dr. Edward Nkurunziza told New Vision that the isolation center would handle Ebola cases if confirmed.

Meanwhile 7 doctors of Mulago Hospital who treated an Ebola patient from Kibaale district have been placed under quarantine. This was done to prevent the spread of the deadly disease that has claimed 14 lives. Another 13 health workers, who accompanied the patient who died a few days ago, have also been quarantined, President Yoweri Museveni revealed Monday [30 Jul 2012].

In a statement on the outbreak of Ebola, Museveni cautioned Ugandans to avoid activities that could spread the disease. 2 more patients who are suspected to have contracted the deadly disease have been registered in Kibaale, according to the district health officer, Dr. Dan Kyamanywa. By Sunday [29 Jul 2012] evening, there were 5 new cases. "We have taken samples from the patients for testing," Kyamanywa said yesterday.

A total of 14 people have so far died of Ebola in the last 3 weeks. 13 died in Kibaale and [another] of them at Mulago Hospital, where she had been transferred.

[Byline: Ismael Kasooha and Luke Kagiri)

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Communicated by:
ProMED-mail correspondent Kunihiko Iizuka

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[2]
Date: Tue 31 Jul 2012
Source: Time Healthland, Associated Press report [edited]
http://healthland.time.com/2012/07/30/6-more-ugandans-admitted-with-possible-ebola/

More Ugandans Admitted with Possible Ebola
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A total of 6 more patients suspected to have Ebola have been admitted to the hospital days after investigators confirmed an outbreak of the highly infectious disease in a remote corner of western Uganda, a health official said on Monday [30 Jul 2012]. Stephen Byaruhanga, health secretary of the affected Kibaale district, said possible cases of Ebola, at 1st concentrated in a single village, are now being reported in more villages. "It's no longer just one village. There are many villages affected," Byaruhanga said. In a national address on Monday, Uganda's President advised against unnecessary contact among people, saying suspected cases of Ebola should be reported immediately to health officials.

Officials from Uganda's Ministry of Health and the World Health Organization announced on Saturday [28 Jul 2012] that the deadly Ebola virus killed 14 Ugandans this month, ending weeks of speculation about the cause of a strange illness that had some people fleeing their homes in the absence of reliable answers. If the 6 new cases are confirmed as Ebola fever, it would bring to 26 the number of Ugandans infected with Ebola [virus].

This is the 4th occurrence of Ebola in Uganda since 2000, when the disease killed 224 people and left hundreds more traumatized in norther Uganda. At least 42 people were killed in another outbreak in 2007, and there was a lone Ebola case in 2011. Investigators took nearly a month to confirm Ebola's presence in Uganda this year. In Kibaale, a district with 600 000 residents, some villagers started abandoning their homes to escape what they thought was an illness caused by bad luck. One family lost 9 members, and a clinical officer and her 4-month-old baby died from Ebola, Byaruhanga said.

D.K. Lwamafa, of Uganda's Ministry of Health, told reporters on Saturday that one Ebola patient from Kibaale had been referred to the national hospital in the capital but had then died in Kibaale.

The confirmation of Ebola's presence in the area has spread anxiety among sick villagers, who are refusing to go the hospital for fear they don't have Ebola and will contract it there. All suspected Ebola patients have been isolated at one hospital where patients admitted with other illnesses fled after Ebola was announced. Only the hospital's maternity ward still has patients, officials said, highlighting the deadly reputation of Ebola in a country where the authorities do not always respond quickly and effectively to emergencies and disasters. Barnabas Tinkasimire, a lawmaker from the area, said that some nurses refused to look after Ebola patients after one clinical officer died and another was taken ill.

"They are saying, 'We can't remain here if there is no sufficient allowance'," Tinkasimire said of medical officers handling Ebola cases. The lawmaker said the government's response so far has been poor and that it would have been worse without the technical support of organizations such as the World Health Organization and the U.S. Centers for Disease Control and Prevention (CDC). "It took long for the government to respond, and up to now many people don't know how to guard against Ebola. We need sensitization," he said.

Ebola, which manifests itself as a hemorrhagic fever [But not in this outbreak - Mod.CP], is highly infectious and kills quickly. It was 1st reported in 1976 in Congo and is named for the river where it was recognized. A CDC factsheet on Ebola says the disease is "characterized by fever, headache, joint and muscle aches, sore throat, and weakness, followed by diarrhea, vomiting, and stomach pain. A rash, red eyes, hiccups and internal and external bleeding may be seen in some patients."

Scientists don't know the natural reservoir of the virus, but they suspect the 1st victim in an Ebola outbreak gets infected through contact with an infected animal. The virus can be transmitted through direct contact with the blood or secretions of an infected person, or objects that have been contaminated with infected secretions. During communal funerals, for example, when the bereaved come into contact with an Ebola victim, the virus can be contracted, health officials said.

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[3]
Date: Tue 31 Jul 2012
Source: WHO Twitter [edited]
https://twitter.com/WHO/status/230312612469022721

There are now 36 suspected cases of Ebola haemorrhagic fever in Kibaale district, Uganda, of which 4 are laboratory-confirmed and 14 dead.

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ProMED-mail
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[The number of confirmed fatalities remains 14, whereas the number of suspected cases and the extent of the outbreak are uncertain.

Ebola virus belongs to the family _Filoviridae_ which is comprised of 5 distinct species: Zaire, Sudan, Cote d'Ivoire, Bundibugyo and Reston. Zaire, Sudan and Bundibugyo species have been associated with large Ebola haemorrhagic fever (EHF) outbreaks in Africa with high case fatality ratio (25-90 percent) while Cote d'Ivoire and Reston have not. Reston species can infect humans but no serious illness or death in humans have been reported to date.

The natural reservoir of the Ebola virus is unknown despite extensive studies, but it seems to reside in the rain forests on the African continent and in the Western Pacific. Although non-human primates have been a source of infection for humans, they are not thought to be the reservoir. They, like humans, are believed to be infected directly from the natural reservoir or through a chain of transmission from the natural reservoir. On the African continent, Ebola infections of human cases have been linked to direct contact with gorillas, chimpanzees, monkeys, forest antelope and porcupines found dead in the rain forest. So far, the Ebola virus has been detected in the wild in carcasses of chimpanzees (in Cote-d'Ivoire and the Republic of the Congo), gorillas (Gabon and the Republic of the Congo) and duikers (the Republic of the Congo).

Different hypotheses have been developed to explain the origin of Ebola outbreaks. Laboratory observation has shown that bats experimentally infected with Ebola do not die, and this has raised speculation that these mammals may play a role in maintaining the virus in the tropical forest.

Further information can be obtained from the he WHO Fact Sheet at: http://www.who.int/mediacentre/factsheets/fs103/en/index.html.
A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/r/1wa6. - Mod.CP]

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