Ebola outbreak spreading

News24 ^ | 12-2-07

[Mother Abigail]

Ebola outbreak spreading

Kampala - The Ebola outbreak that has killed 18 people in western Uganda appears to be spreading, officials said on Sunday, as authorities examined a sample taken from a dead patient in the south of the country.

Government officials told AFP that the disease, which flared in September, had spread to three new zones in the impoverished Bundibugyo district near the border with the Democratic Republic of Congo.

Virologists were meanwhile examining a sample taken from a suspected victim who died overnight in Mbarara region, 160km southeast of the affected district.

Medics flee

Health officials said several dozen medics and support staff had fled the Bundibugyo when their co-workers became infected with the virus in an outbreak that has already killed 18 people and infected 61.

Virologists were also investigating an isolated patient in the neighbouring Port Portale district as well as the fatality in Mbarara.

"There are fears that the disease has spread," said a top health ministry official, who requested to remain unnamed.

"We are waiting for the results from the samples," he said of the two cases that have spread panic in the east African nation.

The disease, which is fatal in 90% of cases, is spread by contact of body fluids, primarily contamination of blood.

Unknown strain

Meanwhile, epidemiologists and virologists are in Bundibugyo district to try to trace backwards the source of the virus as part of a campaign to avoid future outbreaks.

Authorities say the outbreak was an unknown strain after analysis was done on tissue samples at the laboratories of the Atlanta-based Centre for Disease Control.

Known Ebola sub-types usually attack capillaries and blood vessel linings, draining the body of blood through openings, leaving the patient to die in shock, doctors say.

But the new Uganda subtype, which provokes high fever, kills victims without much loss of blood.

[Mother Abigail]

Related Threads:

http://www.freerepublic.com/focus/f-news/1933052/posts

http://www.freerepublic.com/focus/f-news/1932369/posts

[Mother Abigail]

Related Threads:

http://www.freerepublic.com/focus/f-news/1933052/posts

http://www.freerepublic.com/focus/f-news/1932369/posts

[Mother Abigail]

---

http://www.msnbc.msn.com/id/22028651/

A new strain of Ebola virus has infected 51 people and killed 16 in an area near Uganda’s border with Democratic Republic of Congo, U.S. health experts said on Thursday.

Analysis of samples taken from some of the victims show it is a previously unknown type of Ebola, a team at the U.S. Centers for Disease Control and Prevention said.

“This virus didn’t behave as would be expected of some of the known strains,” Dr. Tom Ksiazek, current chief of the CDC’s special pathogens branch, said in a telephone interview.

“That tipped us off that this is probably a novel or new strain of Ebola.”

Ugandan health officials have said the virus appears to be unusually mild, but Ksiazek said it is not yet clear if this is the case. He said experts need to check to see how many diagnosed patients are still alive.

Ebola is a hemorrhagic fever, meaning it can cause internal and external bleeding. Victims often die of shock but symptoms can be vague, including fever, muscle pain and nausea.

There are four identified strains, Ksiazek said. The two strains that cause the most human disease are the Zaire and Sudan strains, named after the countries in which they first appeared.

A strain called Reston caused an outbreak in a primate facility in the Washington, D.C. suburb of the same name while a single human case in Ivory Coast was caused by the Cote d’Ivoire strain.

The Zaire strain killed 80 percent of victims, while the Sudan strain had just over a 50 percent mortality rate.

The new strain would be the fifth identified. Ksiazek said it had not yet been named.

The CDC said nine researchers were helping in the response to the Uganda outbreak and another team was waiting for an official invitation from Uganda’s government before heading there to help.

[Mother Abigail]

[1]
Date: Sun 2 Dec 2007
Source: News 24.com, Agence France Presse (AFP) report [edited]

The Ebola outbreak that has killed 18 people in western Uganda
appears to be spreading, officials said on Sunday [2 Dec 2007], as
authorities examined a sample taken from a dead patient in the south
of the country. Government officials told AFP that the disease, which
flared in September [2007], had spread to 3 new zones in the
impoverished Bundibugyo district near the border with the Democratic
Republic of Congo.

Virologists were meanwhile examining a sample taken from a suspected
victim who died overnight in the Mbarara region, 160 km southeast of
the affected district. Health officials said several dozen medics and
support staff had fled Bundibugyo when their co-workers became
infected with the virus in an outbreak that has already killed 18
people and infected 61.

Virologists were also investigating an isolated patient in the
neighboring Port Portale district as well as the fatality in Mbarara.
“There are fears that the disease has spread,” said a top health
ministry official who requested to remain unnamed. “We are waiting
for the results from the samples,” he said of the 2 cases that have
spread panic in the east African nation. The disease, which is fatal
in 90 percent of cases, is spread by contact with body fluids,
primarily blood.

Meanwhile, epidemiologists and virologists are in Bundibugyo district
to try to trace backwards the source of the virus as part of a
campaign to avoid future outbreaks. Authorities say the outbreak was
an unknown strain, after analysis was done on tissue samples at the
laboratories of the Atlanta-based Centers for Disease Control and
Prevention. Known Ebola sub-types usually attack capillaries and
blood vessel linings, draining the body of blood through openings,
leaving the patient to die in shock, doctors say. But the new Uganda
subtype, which provokes high fever, kills victims without much loss
of blood.

******
[2]
Date: Sun 2 Dec 2007
Source: Sunday Vision online [edited]

Medical workers in Bundibugyo District have fled their workplaces in
fear of contracting the deadly Ebola virus. Elias Byamungu, the Chief
Administrative Officer, on Friday [30 Nov 2007] said medical workers
had abandoned patients in health units for fear of being infected.
“The health workers are terribly afraid,” he said. Byamungu put the
death toll at 28.

Health authorities, however, last night [1 Dec 2007] put the toll at
18, up from 16 registered by Thursday [29 Nov 2007]. “We have had 2
more deaths in the last 24 hours, and the disease continues to
spread,” Dr. Sam Zaramba, the Director General of Health Services,
told Reuters. He said World Health Organisation (WHO) officials had
teamed up with local experts to draw up a strategy to contain the
outbreak. More than 50 people are also infected.

District health officials said 5 new cases were admitted to
Bundibugyo Hospital yesterday [1 Dec 2007]. “We have set up isolation
wards where all those who have been diagnosed with Ebola have been
quarantined and are being monitored closely,” Zaramba said.

The 1st victim died in August 2007, but the cause of death was
referred to as a “mysterious illness.” Until Wednesday [28 Nov 2007]
when the health ministry and the WHO confirmed it as being Ebola, the
disease, which has ravaged 14 villages in the district, was being
described as “mysterious and strange.” Zaramba said the illness was
confirmed as being Ebola following tests at the Centers for Disease
Control and Prevention in Atlanta, US.

Speaking on the phone, Byamungu said among the infected are 3 medical
workers, including a doctor whom he identified only as Ssesanga, who
he said was critically ill. He said the disease started in Kikyo
Parish, Kasitu Sub-county and later spread to Ngamba Parish,
Bundibugyo Town Council and Bubukwanga Sub-county. The 1st death
occurred after a group of residents of Kikyo feasted on a goat in
August 2007.

“There were accusations and counter-accusations of witchcraft. Some
people were even arrested until we discovered that the problem was
medical,” Byamungu said. He expressed fear that the disease could be
incubating in the neighbouring districts of Kabarole and Kasese,
where infected people could have travelled. Residents of Kabarole are
in a state of panic, with many avoiding handshakes or being in crowed
places. Taxi drivers plying the Fort Portal-Bundibugyo route said
they were taking extra precautions. “We are not overloading our
vehicles so as to reduce body contact among passengers. We also do
not accept to transport visibly ill people,” said one driver.

Ebola is spread through contact with the body fluids of infected
persons. This is the 2nd major Ebola outbreak in Uganda. The last one
occurred in 2000 in Bunyoro and in the north, killing over 140 people.

[Byline: John Thawite]

—

[More information about this new epidemic of Ebola fever is
unfolding. The 1st case dates back to August 2007 and has been
associated circumstantially with feasting on goat meat. Hemorrhage is
not a prominent feature of the disease. The outbreak in the
Bundibugyo District is extending and now involves at least 14
villages. The death toll now stands at 18, and the number of cases is
now 61. An as yet unconfirmed case has appeared at a location 160 km
to the south. The epidemic situation is fluid, and new cases may
begin to appear outside the Bundibugyo District.

[glide625]

More good news............out of Africa. As usual. Let’s just hope it stays there.

[Mother Abigail]

Uganda: Fears of Ebola Spread As More Cases Reported

3 December 2007
Posted to the web 3 December 2007

Kampala

Medical authorities in Uganda have expressed concern over the possible spread of the deadly Ebola disease in the western region after suspected cases were reported in two neighbouring districts.

Sam Zaramba, the director of medical services in the health ministry, told IRIN on 3 December that a patient with symptoms similar to those reported in Bundibugyo district, the epicentre of the outbreak, died on 2 December at Mbarara hospital, farther southwest, causing fears that the disease was spreading out of Bundibugyo.

Another suspected case had also been isolated at Virika hospital in Fort Portal district, next to Bundibugyo, Zaramba said.

“We are waiting for the results of the samples for the two suspected victims,” he told IRIN by telephone.

Another medical official, who requested anonymity, said: “There is cause to worry when we start getting these cases overshooting and appearing in other areas because this complicates contact surveillance. One medical officer who worked on the first cases but moved to Kampala [the capital] to attend to personal issues has also fallen sick and was admitted to Mulago [the main hospital in Kampala]; we are trying to follow his contacts.”

Several dozen medics and support staff have fled western Uganda after their co-workers became infected with the virus in an outbreak that has already killed 16 people and infected at least 58 others.

A government official in Bundibugyo, Samuel Kazinga, said a quarantine had been declared in all homes in the district that had registered a case in order to control contacts and ease monitoring.

“We are mobilising the public to take precautionary measures through public announcements on the radio and talking to people through community [leaders],” Kazinga said.

He said Bundibugyo had appealed for help but efforts to contain the outbreak, which began in September although it was only identified as Ebola last week, have been hampered by lack of medical personnel.

“We have a shortage of health workers and we need more because those who were there on the ground have been infected: two doctors, a medical officer and a nurse. We are trying to get more medical workers to go to the region and help in the fight,” said Zaramba.

Zaramba had initially said two more patients succumbed to the virus on 1 December, bringing the toll to 18. But the health ministry on 3 December revised the number back to 16, saying the two deaths had since been confirmed as due to other causes.

“Cumulatively, we now have 16 deaths and 58 cases,” he said.

Patients were quarantined in Bundibugyo hospital’s isolation ward near the border with the Democratic Republic of Congo (DRC), which has had outbreaks of the virulent disease in the past.

“Those admitted are mainly health workers and those who attended to the patients,” Zaramba said.

Previous Ebola fatalities among medical workers have been blamed on poor sanitation and hygiene in health centres that lack protective suits, masks, latex gloves and other equipment.

Ebola spreads through body fluids, particularly blood, putting health workers without protective gear at risk. Ebola sub-types usually attack capillaries and blood vessel linings, so patients lose blood rapidly, and die of shock, doctors say.

The new Uganda subtype kills patients by provoking high fever, but without much loss of blood. There is no vaccine or cure for Ebola.

“The situation is not yet under control,” Zaramba said. “The main challenge we are facing is detecting cases and following up on those who had contact with the patients.”

A team of epidemiologists and virologists arrived in the region on 1 December to try to retrace the source of the virus as part of a campaign to avoid future epidemics.

Authorities said a team of pathogen experts from the Centers for Disease Control in the US were expected in the country on 4 December to beef up the local response to the disease, including bringing laboratory facilities to detect infections more easily.

[BGHater]

Ebola Virus Infection

The Ebola virus is highly infectious and can spread through the use of unsterilized needles or through contact with an infected individual or the corpse of someone who has died from the disease. About one week after infection, the virus begins attacking blood and liver cells (1). As the disease swiftly progresses, the virus may destroy vital organs such as the liver and kidneys (2), leading to massive internal bleeding (3). Shock and respiratory arrest soon follow, then death.

[353FMG]

“Meanwhile, epidemiologists and virologists are in Bundibugyo district to try to trace backwards the source of the virus as part of a campaign to avoid future outbreaks.”

The future outbreaks that he is talking about might take place right here in the US through contact with new LEGAL immigrants. Oh, I forgot, there is a rigid medical screening of all 3rd world immigrants before departure.

[poindexters brother]

I read “The Hot Zone” a few years ago and it scared the dickens out of me.

So far, the strains of Ebola that are fatal to humans only spread through direct contact with an infected instrument or human. Ebola Reston, the strain that burned through the primate facility in Reston, VA, however is spread by breathing.

Heaven help us if the non-Reston strains of Ebola start spreading via respiration.

TM

[Badeye]

I read it as well, and yep, if you don’t come away very concerned after reading it, your stupid.

That said, I’m not all that concerned over this latest ‘outbreak’ if you can call it that.

[Eccl 10:2]

I just talked to a doctor about these new deadly infections. He basically said that they only attack people whose immune systems have acquired deficiencies. (Let the reader infer the obvious.)

Further, he suggested that people NOT use antibacterial soaps. It kills off all the healthy bacteria as well.

[najida]

Understand that in medical terms,
aquired deficiencies include those with auto-immune disease,
undergoing cancer treatment, post-transplantation, pre-mature infants, the elderly etc.

[Alter Kaker]

Good friend of mine is a humanitarian worker who was right on the DRC/Uganda border last week (he was in both the DRC and Uganda).

Now he's back home in Manhattan!

[texgal]

It’s no more than one airplane trip by the right person away from us. This is the kind of thing we should all be aware of.

[ChiefJayStrongbow]

... I like the screen name and loved the book.

[Oorang]

ebola ping

[kimmie7]

Also those of us who take steroids for asthma.

[Max in Utah]

Further, he suggested that people NOT use antibacterial soaps. It kills off all the healthy bacteria as well.

Tip: fill your liquid hand soap dispensers with dishwashing liquid-- you use less and it's cheaper. I recommend Dove or Ivory.

[glide625]

Believe me, I’m all too aware of it. That’s why me and mine avoid contact with general population in crowded localities at all costs.

It’s only a matter of time before the Globalists manage to bring on a worldwide plague that will kill millions worldwide. And I’ll bet hard earned money it starts in Africa. Nothing good has every come out of Africa.

[Mother Abigail]

TIMELINE:

THURSDAY NOV 29 2007

The mysterious disease that has infected people in Bundibugyo was this morning revealed to be Ebola virus (verified by the CDC-Atlanta laboratories). 79 cases have been identified since August, with a 43% death rate. So far all cases have come from a village area called Kikyo, which is 25 km from our mission, or through direct prolonged contact with patients from that area. Ebola is a panic-inducing word. We are treating this news with sober respect, but thought we’d put out a few facts proactively.

Ebola is a filovirus. There are four subtypes: Ebola-Zaire, Ebola-Sudan, Ebola-Ivory Coast, and Ebola-Reston. Yes, Reston, the latter is from monkeys who were imported through Dulles airport, but did not cause any human infection. Our epidemic does not seem to fit any of these four strains and so may represent a new form of the virus. The good news is that it seems to be slightly less virulent.

This is the 17th documented outbreak of Ebola since 1976. Almost all the cases have come from Africa. The most recent Ugandan outbreak was in the north of the country in 2000; the most recent outbreak at all was in DRC Congo from April to October this year.

The patients we are seeing look ill, but not that different from most patients. The Hollywood version is not what we’re seeing. Most people just have fever, vomiting and diarrhea, some with a rash and some with conjunctivitis (eyes red). A few have bleeding.

More than half of people are recovering, with very basic care. We have met with two nurses who took almost a month to pull through but are OK now. The clinical officer Julius who has managed the majority of the patients is OK.

We consider our non-medical team members to be at low risk. The virus has never been documented to spread through the air to infect humans. The mode of transmission is direct contact, touching body fluids or soiled linens or blood, or by contaminated instruments such as needles. Unless this strain is very different from other Ebola strains, people who are not sick do not spread the disease. We won’t contact it in our homes, or in normal daily life.

The health care workers of Bundibugyo are the ones at risk. We want to support them in every way possible, with gloves, masks, bleach, bandages, IV fluids, etc. Thankfully the World Health Organization, the CDC and MSF (Doctors without Borders), organizations with great experience in this kind of epidemic, are aware and will arrive by air tomorrow to help. We as doctors are taking every possible precaution when we see patients to avoid becoming ill.

Friday, November 30, 2007

The International Emergency Epidemic Response Team (including reps from WHO, Ug MOH, MSF-Swiss, and UNICEF) flew in on a MAF Caravan and spent 7 hours on the ground in Bundibugyo yesterday. The District Director of Health, Dr. Sikyewunda, invited me (Scott) to participate in all of their site visits and meetings. The WHO rep, a sharp, experienced, epidemiologist emphasized in the first meeting of the day with local govt leaders that this seems to be a new (fifth) strain of Ebola, atypical both clinically and genetically from previously identified strains. A more non-specific clinical syndrome (fewer specific hemorrhagic signs) will make the containment of this epidemic more challenging, he said. That first meeting also revealed a lack of consensus on what public health message should be disseminated to the pubic. Will schools, markets, basic health services be shut down or curtailed? Hand-shaking cease? There was no debate about the answers, only a request from the experts to wait for their final assessments.

The visit to the Ebola Isolation Units at Kikyo Health Unit and Bundibugyo Hospital consisted of physical assessment of terrain, potential tent and gate locations, patient traffic patterns, water and latrine availablity, and staffing evaluations. Surprisingly (to me), not one member of the International Team donned protective gear in order to lay eyes on any patient. Their mandate, they said, was logistical assessment not clinical management. At Kikyo Health Unit, the staff and community seem much less aware of the ramifications of the Ebola diagnosis. People milled around the grounds of the Health Unit gawking at the entourage with its six vehicles and foreign visitors.

At Bundibugyo Hospital a significant portion of the hospital staff have gone AWOL or called in sick. A few brave nurses volunteered to staff the Isolation Unit, previously built by MSF for Cholera Isolation. During our discussion of potential layouts of an expanded unit at Bundibugyo Hospital, I received the short message on my cell phone that Dr. Jonah admitted himself to the Mulago Hospital (Kampala) Isolation Unit with fever, headache, and vomiting (and a history of contact with Ebola cases). Up to that moment, we had all expected Jonah to return today to resume his active role in the assessment and management of this crisis. Not possible now.

The last meeting of the day served as a Summary Wrap-up. Each expert presented their assessments. Basically, the plan of attack involves four arenas of activity: Surveillance (case identification and contact tracing), Clinical Case Management ( the resource-intensive task of setting up complete and safe isolation and management of patients with the disease), Logistics (management of all the stuff required to manage this crisis—UNICEF said there is 35 tons of supplies on the way now), and Social Mobilization (the massive task of educating the general population about the disease and measures necessary to control it).

I realized this morning that there are, in reality, two related emergencies. The Ebola Epidemic trumps all as the primary crisis. However, there is a secondary Medical Staffing Emergency in this District. Our only two Ugandan Medical Officers lay ill, presumably from Ebola. The official Ministry of Health initial press release revealed 51 cases and 16 deaths. That’s a 31% case-fatality rate. Nearly three-quarters of those afflicted may survive (according to the official numbers). So, our doctors may survive, but are likely to be out of commission for weeks.

Bottom line....

We desperately need at least one more physician at Bundibugyo Hospital who can do emergency operative obstetrics. The District has failed miserably in recruiting doctors even before Ebola. The likelihood of a Ugandan Medical Officer volunteering to come to Bundibugyo now seems slim and none. I have appealed to MSF to recruit a doctor from their ranks to come and do non-Ebola hospital work (they are sending two already to manage the Ebola cases).

http://www.paradoxuganda.blogspot.com/

[Mother Abigail]

Ebola Bundibugyo Sunday Facts

Admitted at Bundibugyo: 15, including Dr. Sessanga whose sister just came to our house looking for Scott because he’s no longer responsive; the matron (head nurse); the nurse who was working in the isolation unit Fred; a clinical officer named Joshua Kule; and an ophthalmic assistant. Among the other patients are six direct contacts (mother, brother, wife, daughter and two friends) of Muhindo Jeremiah who died just over a week ago.

Admitted at Kikyo: 8 as of yesterday, haven’t heard today.

Died: official number is 18. Likely higher, hard to say.

Calvary: Still en route, but expected any minute. They slept in Fort Portal last night. There is a 17 person team from combined MSF branches (Belgium, France, Spain, etc.) including the doctor who was in charge of the recent outbreak in Congo. They have two doctors, four nurses, and a wide variety of other staff who won’t see patients but do logistics, education, investigation. Even an anthropologist. The CDC lab team arrives in the country Tuesday night. They say they’ll be up and running for labs in Entebbe (Uganda Viral Research Institute) by Thursday, possibly even Wednesday evening.

Ebola Bundibugyo Monday Morning

The good news: Jonah is improving. Dr. Sessanga is still critically ill (down 10kg, 8 days of fever, barely talking) but the MSF doctor said the fact that he can still sit and even walk a little on day 8 is a good sign.

The cavalry is still a bit slow in arriving, only two came yesterday but more expected today. Scott spent the entire day with them again. 16 admissions at BGO hospital, still 8 in Kikyo. We now have the “Ebola Bible” manual for the epidemic and need to work today to shut down non-essential medical services that could spread the disease (like immunizations) and clarify which services are essential (the guidelines take a pretty hard core view of that, such as C section to save the mother only not the baby, due to the volumes of blood involved).

MAF comes at 3 pm to evacuate our non-medical team, and our kids, primarily to prevent the danger of them being infected by us should we fall ill.

http://www.paradoxuganda.blogspot.com/

[Mother Abigail]

You come see me.

http://www.freerepublic.com/focus/chat/865868/posts?page=57

[Judith Anne]

Shades of Marburg Angola!

[Constantine XIII]

Ok, we get it, you really don’t like Africa.

*rolls eyes* :p

[goldstategop]

Nasty bug. But an evolutionary dead end. A virus that kills its host has no change of propagating itself. That's why most viruses are non-lethal.

"Show me just what Mohammed brought that was new, and there you will find things only evil and inhuman, such as his command to spread by the sword the faith he preached." - Manuel II Palelologus

[Mother Abigail]

Yes,

However the evolutionary drift in the direction of less lethality provides more opportunity for host dispersal and is generally a net positive evolutionary gain for the virus.

And remember that pathogenic interactions are an example of co-evolutionary warfare between the host and the pathogen.

Ebola is adapted to infect whatever it normally infects in nature (i.e. bats) and it’s mechanisms of avoiding immunity and virulence have evolved to combat those of its natural host. As it turns out, when that virus gets into us there are three possibilities that may occur: 1) The virus is immediately annihilated by immune defences or simply can’t replicate. 2) The virus destroys the host or 3) the virus evolves in some way so that it can survive in the new host population.

It is possible that we are seeing the later.

MA

[neverdem]

thanks, bfl

[ichabod1]

Well, it’s a mild strain...

[GravityFree]

Somebody Call Art Bell &

Put On Some Blue Oyster Cult

[Domestic Church]

http://www.recombinomics.com/News/12020701/Ebola_Recombination_Uganda.html

“Moreover, Zaire ebolavirus ... and influenza H5 envelope genes ... share a 18 BP region of identity, raising the possibility of recombination between the two negative sense RNA viruses. The identity in H5 traces back to the first H5N1 sequences, from a chicken in Scotland in 1959, although most of the H5 identities are in low path H5, which is transported and transmitted waterfowl, including waterfowl in Africa. “

http://www.paradoxuganda.blogspot.com/

“The official case count has gone up from 51 to 79 since the initial numbers were released four days ago”

http://www.newvision.co.ug/D/8/12/600344

[Rb ver. 2.0]

“Heaven help us if the non-Reston strains of Ebola start spreading via respiration.”

Read Tom Clancy’s Rainbow-Six. That exact scenario.

[txflake]

lofl

[Ptarmigan]

I wouldn’t be surprised if there are multiple strains of Ebola out there, including “milder” strains. I know up to 15 percent of Africans have Ebola antibodies.

[aruanan]

And then there was a continent with about 10,000 people

[AnimalLover]

bttt

[PGalt]

Thanks for posting. Thanks to all contributors to this thread. Life/health BUMP!

[glide625]

You’re correct! And I lived there for 6 years so I know what I’m talking about. And if you don’t like it, that’s just too bad.