Uganda Ebola death toll hits 19

KAMPALA (AFP) — The dreaded Ebola virus has killed 19 people in western Uganda since September, officials said Tuesday, with new outbreaks of linked diseases surfacing in other parts of the country.

Hours after the 19th Ebola patient died in Bundibugyo district, State Health Emmanuel Otaala highlighted fears of extremely contagious cholera, plague, meningitis and hepatitis outbreaks.

"As we are trying to contain Ebola, we came across four other outbreaks," Otaala told reporters.

The health ministry reported cholera in western Hoima and northeastern Nebbi districts; plague in Nebbi; meningitis in Nebbi and Arua district and hepatitis in northern Kitgum district. Ebola killed at least 170 people in Uganda in 2000.

"We are encouraging people to wash their hands, avoid shaking hands, bury the dead with caution and avoid sex because sexual fluids can also spread diseases," he explained.

No figures were given on the new outbreak, except for plague that has infected some 25 people, mainly women.

Health experts fear that Ebola may have spread unnoticed in the mounting medical chaos, its rubberstamp haemmorhaging obscured by companion ailments, only to emerge when cases reported in hospitals.

Epidemiologists are concentrating on western Uganda -- near the frontier with Democratic Republic of Congo -- where a nurse died Tuesday, bringing the Ebola toll to 19 while 64 others infected.

Worried about possible contamination in hospitals, some patients have hidden, complicating the drive to isolate cases, said Samuel Kazinga, district commissioner for Bundibugyo, epicentre of the new outbreak.

"The Congolese have closed their border at Busunga and installed custom officers, who are not allowing movement of people between the two nations," he added.

Blood and tissues samples from two patients who died in neighbouring Port Portale district and southern Mbarara region are at Uganda's Virus Research Institute awaiting screening.

Alarmed that eight medics had been isolated with Ebola symptoms, the health ministry said it was sending more plastic aprons, respirator masks, latex gloves and goggles to the affected district.

Five experts from the Atlanta-based Centers for Disease Control (CDC) that identified the new Ebola virus, are expected in Uganda on Tuesday to carry out tests.

CDC Special Pathogens Branch chief Thomas Ksiazek said it was not yet clear whether the Ebola virus in the current outbreak was more or less deadly than the four previously detected.

Spread primarily by body secrection, mainly blood, Ebola is fatal in up to 90 percent of its cases, mostly killing its victims from both external and internal haemorrhages.

Health authorities say that virus erupted in September but was only identified last week after being obscured by other ailments.

The rare disease killed at least 170 people in northern Uganda in 2000, with experts blaming poor sanitation and hygiene.

The Ebola virus was first detected in the Democratic Republic of Congo and Sudan in 1976. There have also been outbreaks in Ivory Coast and Gabon.

Experts have said the disease is usually containable because it kills victims faster that it can spread to new ones.

http://www.newvision.co.ug/D/8/12/600487

Tuesday, 4th December, 2007

Kabarole

Officials at Buhinga Referral Hospital in Fort Portal have said they will no longer admit Ebola cases for fear of infecting other patients.

Kichwamba Health Centre III, about 10km from Kabarole town on the road to Bundibugyo, will be the reception centre for suspected Ebola cases, he announced. It was at a distance from the town and would reduce the risk of infection, he explained.

Hoima

Hoima district authorities were yesterday thrown into a panic over a suspected Ebola case, prompting them to stop any visitors from Bundibugyo and Kabarole districts.

In a statement, the authorities warned residents against travelling to the two districts until the situation normalised.

It was signed by superintendent Dr. Emmanuel Moro of the Hoima referral hospital, who also heads the newly-formed district surveillance committee.

Kasese

The World Wildlife Fund (WWF) has suspended its operations in Kasese following the Ebola outbreak in the Rwenzori region. According to a statement issued by the WWF office in Kasese, the organisation will only resume work when the epidemic is over.

Kibaale

The Kibaale district local government has banned all inter-district transactions with Bundibugyo, as well as all businesses at the shores of Lake Albert, in an effort to stop the spread of Ebola to Kibaale.

The outbreak in Bundibugyo could easily affect Kibaale due to the daily movements along Lake Albert, he noted. “Given the nature of business taking place on Lake Albert, such as fishing and the movement of passengers from Congo and Bundibugyo, we have no choice but to limit the movement of people on the landing sites on Lake Albert,” Kyamanywa said.

The affected landing sites are Kabukanga, Kitebere, Ndaiga, Kamina, Rwebigongoro, Nyamasoga. Other small fishing villages are also affected.

“If Ebola hits Kibaale, dealing with it will be very difficult given the inadequate staffing we have. Therefore, we must use all means at our disposal to avert the spread of the epidemic to our area,” Kyamanywa said.

Ebola in Bundibugyo: Tues night Report

The District Task Force responding to the Ebola crisis meets every evening for several hours, and today I went with Scott. Mostly because I felt so wiped out by the day in general and wanted to stick with him, as well as experience the politics and planning side of the epidemic. About two dozen people, mostly men, mostly Ugandans except us, MSF, and two Kenyan epidemiologists, gathered in a circle of chairs outside the RDC’s office. Bottom line: there are a slew of competent and motivated people at work. The RDC himself serves as chair, and he’s an impressively large and voluminous presence, practical and authoritative, the kind of person you want in charge.

THE FACTS:
cumulative cases as of 5 pm on Tuesday: 90

cumulative deaths: 19

New admissions: 7; that includes 3 in Kikyo and 4 in Bundibugyo

Current admissions: 23 in Bundi, and I think 14 or 15 in Kikyo

Positive lab samples: 9, but that will change tomorrow, since there are about 15 samples waiting to be sent on the flight, and the CDC has landed and will be operational with their biohazard level 4 virology lab in Entebbe tomorrow.

Identified contacts being followed: 327 (which does not include Scott or me, though the epidemiologist told us to follow ourselves because we should be considered contacts)

Subcounties from which suspected cases have originated: 5 (Kasitu 50, Bubukwanga 18, Bundibugyo Town Council 10, Busaru 4, Harugale 3, others unknown). Note that the case may be counted as arising from a subcounty because the patient’s home is there even if the contact was made elsewhere . . .
snip

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

Commentary

Uganda Ebola Spread Increases
Recombinomics Commentary
December 4, 2007

The conventional wisdom was that Ebola is containable because it kills its victims faster than it can find new ones. However, conditions on the ground are now proving otherwise. While 61 cases have been identified, Zaramba says the health ministry is having difficulty detecting more cases or identifying people with whom patients had contact. And as of the weekend, the disease had spread to three new zones in Bundibugyo district. Local officials speaking on the condition of anonymity say that the death toll is almost twice that reported.

The new species may also have different transmission modes. The symptoms of the cases are closer to those associated with H5N1 than those associated with Ebola. The CDC has partial Ebola sequence data, but the relationship between those sequences and prior Ebola sequences remain unclear.

Release of the partial sequences would be useful. The Ebola / H5 identity is in the envelope gene, and the region has differences in strains of Ebola as well as high and low path H5.

http://www.recombinomics.com/News/12040703/Ebola_Uganda_Spread_Increase.html

Uganda: Kibaale Cuts Off Links With Bundibugyo Over Ebola

The Monitor (Kampala)

5 December 2007

Francis Mugerwa

AUTHORITIES in Kibaale District have barred residents from going to neighbouring Ebola infested Bundibugyo District.

This was disclosed by the Kibaale Resident District Commissioner, Hajji Ali Mutawe, on Tuesday.

“We have stopped residents from traveling to Bundibugyo where they may contract Ebola,” Mr Mutawe said.

He said the directive is a precautionary measure aimed at protecting locals from being infected by the viral disease.

Ebola is a highly contagious disease that has so far cliamed the lives of over 18 people though other independent sources estimate the number to be higher.

Kibaale residents regularly travel to the affected area mainly for business. The two districts border Lake Albert.

The fishermen on the landing sites of Kitebere, Kabukanga, Ndaiga move across the lake and sell their fish in Bundibugyo District.

Ntoroko l anding site which is located in Bundibugyo, is less than 20 kilometres from Kitebere village.

The District Director for Health Services, Dr Dan Kyamanywa, said medics worry that if residents move uncontrolled to and from the affected district, there are chances of contracting the epidemic that could wreck havoc in the district.

“For preventative purposes, we do not want any boat to move from our landing site to Bundibugyo. We have also stopped boats coming from Bundibugyo ,” Dr Kyamanywa said.

Hajji Mutawe said the directive is effective till the situation normalises. “We shall lift the ban if the disease is controlled,” Mr Mutawe said.

http://allafrica.com/stories/200712041140.html

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