Published Date: 2012-08-07 15:21:01
Subject: PRO/EDR> Ebola hemorrhagic fever - Uganda (14)
Archive Number: 20120807.1232846
EBOLA HEMORRHAGIC FEVER - UGANDA (14)
A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases
Date: Tue 7 Aug 22012
Source: Times Live, South African Press Association (SAPA)/Deutsche Presse-Agentur (DPA) report [edited]
An outbreak of the deadly ebolavirus in Uganda, which has killed 16 people has been stemmed, according to a World Health Organization (WHO) official
The outbreak started in western region of Kibaale in the East Africa nation in July . Some 300 people who were in contact with those who were infected are likely to still remain under observation.
"The cases are now confined only to Kibaale. The [ebolavirus] outbreak is now under control. But there is need to make follow-ups of the contact cases. Surveillance should be intensified over these cases because we can only be sure that they are safe after 21 days," Solomon Fisseha, WHO deputy head in Uganda, told SAPA DPA press agency. The outbreak had forced hundreds of schools to close and in the worst affected areas even social gatherings were banned.
This is the 4th outbreak of [ebolavirus] in the country since 2000, when it killed 224 people. About 40 people died of the disease in villages along the border with the Democratic Republic of Congo in 2008, while another isolated death occurred last year [2011, in Uganda]. Ebola [hemorrhagic fever], which has no known cure, is highly infectious and symptoms include vomiting, diarrhea, and external and internal bleeding. It was first identified in 1976 in Congo near the River Ebola.
[Byline: Henry Wasswa]
Date Tue 7 Aug 2012
Source: New Vision (Uganda) [edited]
A total of 29 people in Kibaale district, who were initially suspected of having contracted a deadly ebolavirus [infection], have been cleared to return home, the Health Ministry has said. Of the 36 cases that are in isolation, only 3 have been confirmed to have ebolavirus [infection], the Health Ministry spokesperson, Rukia Nakamatte, told New Vision online. She said health experts are still monitoring the condition of those that will be discharged before allowing them to return home. However, 9 were discharged on Monday [6 Aug 2012], New Vision has learnt. "We are finalising plans to allow 29 of the cases to return home because they tested negative for ebolavirus," she said.
Nakamatte explained that while no new cases have been recorded, the ministry surveillance team is still on high alert. Nakamatte also disclosed that health experts were monitoring 398 cases believed to have come into contact with people who died of Ebola [hemorrhagic fever]. Of these, 84 have passed the 21- day period during which signs of infection would have shown, although they are still being monitored.
Dr Joseph Amonye, the national coordinator of the Ebola task force, said the samples taken from these people were negative and there was no reason of confining them at the isolation centre. "We have tested their samples and found out that they do not have Ebola [hemorrhagic fever]," said Amonye.
Meanwhile, Mulago Hospital has discharged a suspected Ebola patient who was admitted at the isolation camp. Speaking in an interview with the press at Mulago, the hospital's executive director, Dr Baterana Byarugaba, said: "This suspected patient had gone to Kibaale. He developed features similar to malaria and people thought that he had Ebola [hemorrhagic fever]. But we have since established that the gentleman does not have [the disease]."
[Byline: Taddeo Bwamba Le, Violet Nabatan Zi, Ismael Kasooha]
ProMED-mail Rapporteur Kunihiko Iizuka
Date: Tue 7 Aug 2012
From: Daniel Bausch <email@example.com> [edited]
[Re: ProMED-mail Ebola hemorrhagic fever - Uganda (12) 20120806.1230691]
A comment on bleeding in hemorrhagic fever
Regarding bleeding in Ebola hemorrhagic fever, during the Ebola outbreak in Gulu, Uganda in 2000-2001, we collected detailed clinical information on over 100 patients with laboratory confirmed Ebola Sudan virus infection. Excluding subconjunctival bleeding/injection, hemorrhage was noted in only approximately 20 percent of the patients and virtually always occurred in the later stage of illness. Hematemesis and bleeding from the gums were the most frequent hemorrhagic manifestations. Many patients die without visible hemorrhage although, when present, hemorrhage does confer a poor prognosis. Studies done in the isolation ward demonstrated that [ebolavirus] was shed in a wide variety of bodily fluids during the acute period of illness but that the risk of transmission from fomites or from convalescent patients was low (Bausch et al, J Infect Dis. 2007 Nov 15; 196 Suppl 2:S142-7).
This information may be helpful to those combating the present outbreak in Kibaale.
Daniel Bausch, MD, MPH&TM
Tulane School of Public Health and Tropical Medicine
[From these and other recent reports it seems probable that this outbreak in the Kibaale District of Uganda has been contained. There have been at least 16 fatalities, but the suspected cases and their contacts are gradually being released provided they show no symptoms during the 21-day surveillance period post exposure.
Dr Daniel Bausch's commentary on hemorrhage is particularly relevant in assessment of the progress of the Kibaale outbreak.
The news story in part  of the post above includes an interesting photograph of containment arrangements at Kigadi Hospital in Kibaale.
A HealthMap/ProMED-mail map can be accessed at http://healthmap.org/r/2Xz8. - Mod.CP]