Ebola-Fieber in Uganda

[Birgitt]

16 Menschen in Uganda an Ebola gestorben
29.11.2007

Kampala (AP) Einem neuen Ausbruch der Ebola-Seuche im Westen Ugandas sind mindestens 16 Menschen zum Opfer gefallen. Insgesamt seien bislang 51 Fälle der hämorrhagischen Fieberkrankheit registriert worden, teilte ein ranghoher Gesundheitsbeamter am Donnerstag in Kampala mit. Dies hätten Tests in Laboratorien in Südafrika und den USA bestätigt. Man versuche nun, alle etwaigen Kontaktpersonen der Erkrankten ausfindig zu machen ... mehr
___________

Uganda confirms 16 Ebola deaths
29.11.2007

A haemorrhagic fever that has killed 16 people and infected more than 50 others in Uganda has been confirmed as the deadly Ebola virus. The casualties are all in the region of Bundibugyo, on the border with the Democratic Republic of Congo ... mehr bei BBC


Karte: BBC


Gruß
Birgitt

[Birgitt]

Ebola haemorrhagic fever in Uganda
WHO - 30.11.2007

The Ministry of Health (MoH), Uganda, has confirmed an outbreak of Ebola haemorrhagic fever, in Bundibugyo District, western Uganda. As of 28 November, 51 suspected cases, including 16 deaths have been reported. Among the reported cases, 3 health care workers were also infected, including one fatality. Cases are being hospitalized at Kikyo and Bundibugyo.

Laboratory analysis undertaken at the National Reference Laboratories and the Centres for Disease Control and Prevention (CDC), Atlanta, USA has confirmed the presence of a new species of Ebola virus in samples taken from cases associated with the outbreak.

Based on initial field investigations, the MoH/WHO Country office has reported that the outbreak might have been ongoing since Sept 2007. A national task force comprising MoH, WHO and other international partners in the field, is coordinating the response to this outbreak. WHO Country office is assisting the MOH national field team and the District health officials.

[Birgitt]

Uganda - Ebola hämorrhagisches Fieber (EHF)
30.11.2007

Nach einer Pause von sieben Jahren ist die gefährliche Viruskrankheit in Uganda erneut ausgebrochen. Das Infektionsgebiet liegt im Bundibugyo-Distrikt an der ugandischen Westgrenze zur DRC in der Mitte zwischen Albert- und Edwardsee. Nationale und internationale Fachkräfte sind inzwischen vor Ort. Kontakte mit kranken Menschen, durch die es zu einer Ansteckung kommen kann, sind unbedingt zu meiden. Private Reisen in das Infektionsgebiet sollten vorerst unterbleiben. Uganda erlebte zur Jahreswende 2000/01 den bisher größten Ausbruch in der Geschichte des EHF; damals war der Norden des Landes mit dem Schwerpunkt im Gulu-Distrikt betroffen. Eine größere Epidemie gab es zuletzt im Sommer d.J. in der Provinz Kasai Oriental der benachbarten DRC, der inzwischen abgeklungen ist. / Quelle: crm

Gruß
Birgitt

[Birgitt]

EBOLA HEMORRHAGIC FEVER - UGANDA (02): (BUNDIBUGYO)
***************************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

[1]
Date: Fri 30 Nov 2007
Soutce: Atlanta Journal-Constitution, ajc.com [edited]
<http://www.ajc.com/health/content/healt ... 1_web.html>


New Ebola virus discovered by CDC
----------------------------------------------
Inside high-containment laboratories on Clifton Road in Atlanta, GA,
scientists at the Centers for Disease Control and Prevention (CDC)
this week [26-30 Nov 2007] identified what appears to be a new strain
of the deadly Ebola virus. A team of CDC disease detectives on Friday
[30 Nov 2007] was preparing to travel to a remote area in western
Uganda to help contain an outbreak that so far involves 51 people,
including 16 who have died.

"The most important consideration is to have a sense of what's been
going on with the outbreak: How many people are affected, where and
when the outbreak is moving, and trying to stop transmission," said
Dr. Eileen Farnon, the CDC epidemiologist who will be part of a
5-member field team assisting the Uganda Ministry of Health.

Dr. Thomas Ksiazek, chief of CDC's Special Pathogens Branch, said
Friday it's not yet known whether the Ebola virus causing the current
outbreak in Uganda's Bundibugyo District is any more or less deadly
than the 4 previously known strains. "There is very little
information about the eventual outcome in the cases] that have been
confirmed so far," Ksiazek said. Ebola, an often-fatal hemorrhagic
fever, causes internal and external bleeding in its victims. Both
humans and non-human primates can be infected.

Samples arrived at CDC's Biosafety Level 4 labs in Atlanta on Monday
[26 Nov 20007]. By Tuesday [27 Nov 2007], Ksiazek said, it was
apparent this was not a typical Ebola virus. Dr. Stuart Nichol, a CDC
special pathogens team leader, said some molecular tests for Ebola
were coming back negative, when another type of test came back
positive. The CDC lab was then able to extract a small fragment of
the virus' genome. "It looks, based on this, like it's a new species
of Ebola," Nichol said Friday evening. Previously, there were only 4
known types of Ebola. The Sudan and Zaire species were discovered in
1976. A strain called Reston was identified in 1989 among monkeys
imported to a lab in Virginia. And in 1994, the Ivory Coast strain
was identified. Depending on the strain, the death rate varies.
Ebola-Zaire kills about 80 percent of its victims, while the Sudan
strain kills about 50 percent, Ksiazek said. Ebola Reston is not
lethal for humans. - Mod.CP]

[Byline: Alison Young]

******
[2]
Date: Sat 1 Dec 2007
Source: Agence France Presse (AFG) report [edited]
<http://afp.google.com/article/ALeqM5jfn ... Qm8gY0pUxw>


New Ebola strain kills 2 more in western Uganda
--------------------------------------------------------------
Another 2 patients have died from the Ebola virus in western Uganda,
bring the toll to 18, an health official said Saturday [1 Dec 2007],
as the authorities struggled put the disease under control.
"Cumulatively, there are 18 deaths and 61 cases," said Sam Zaramba,
the country's top government physician. A total of 19 patients were
quarantined in Bundibugyo hospital near the border with the
Democratic Republic of Congo, which itself has had harrowing
experience of the virulent disease [but not this strain of Ebola
virus - Mod.CP].

"Those admitted are mainly health workers and those who attended to
the patients," Zaramba told AFP. "The situation is not yet under
control. The main challenge we are facing is detecting cases and
following up who those who made contacts with the patients," Zaramba
explained. The authorities on Friday [30 Nov 2007] said 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.

Initial field probes showed the outbreak [had been] ongoing in
Bundibugyo district since September [2007], the World Health
Organisation said. On Saturday, Rwandan authorities announced they
had tightened border health controls to prevent [the disease] from
travelling across the frontier from western Uganda.

Ebola is a highly contagious disease that can have fatality rates as
high as 90 percent, as there is no vaccine or treatment. The disease
spreads mainly through human fluids, notably blood. An outbreak
killed at least 170 people in northern Uganda's Gulu district in
2000. Another in recent weeks killed at least 26 people in the
Democratic Republic of Congo's West Kasai region. The Ebola virus was
1st identified in 1976 in Sudan and in a nearby region of Democratic
Republic of the Congo (then Zaire). Outbreaks of Ebola have also
occurred in the Ivory Coast and Gabon. Since then, experts have said
the disease is usually containable because it kills its victims
faster that it can spread to new ones.

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

[An unusual feature of this outbreak is that: "Those admitted [to
hospital?] are mainly health workers and those who attended to the
patients," It would be interesting to know the basis for the WHO
statement that the outbreak may have been developing since September,
although the first confirmed cases were not identified until November.

An interactive map of the Bundibugyo region of Western Uganda is available at:
<http://www.maplandia.com/uganda/bundibugyo/>. - Mod.CP]

[Birgitt]

Ärzte fliehen vor Ebola
Bisher 18 Tote im Westen des Landes
02.12.2007

Kampala/Genf – Nach dem neuerlichen Ausbruch des gefährlichen Ebola-Fiebers im Westen Ugandas laufen den Spitälern aus Angst vor Ansteckung die Ärzte und Krankenschwestern davon. In den betroffenen Regionen des zentralafrikanischen Staates herrsche ein Mangel an medizinischem Personal, gab Sam Zaramba, Leiter des ungandischen Gesundheitsdienstes, am Wochenende zu: „Wir haben einen akuten Engpass.“ ... mehr

Gruß
Birgitt

[Birgitt]

EBOLA HEMORRHAGIC FEVER - UGANDA (03): (BUNDIBUGYO)
***************************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

[1]
Date: Sun 2 Dec 2007
Source: News 24.com, Agence France Presse (AFP) report [edited]
<http://www.news24.com/News24/Africa/New ... 44,00.html>


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.

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

******
[2]
Date: Sun 2 Dec 2007
Source: Sunday Vision online [edited]
<http://www.sundayvision.co.ug/detail.ph ... sId=600030>


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]

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

[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.

An interactive map of the Bundibugyo region of Western Uganda can be
accessed at:
<http://www.maplandia.com/uganda/bundibugyo/>.
- Mod.CP]

[Birgitt]

EBOLA HEMORRHAGIC FEVER - UGANDA (04): (BUNDIBUGYO)
***********************************************
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 3 Dec 2007
Source: AllAfrica.com, UN Integrated Regional Information Networks
(IRIN) [edited]
<http://allafrica.com/stories/200712031382.html>


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 2 neighbouring districts. Sam
Zaramba, the director of medical services in the health ministry,
told IRIN on Mon 3 Dec 2007 that a patient with symptoms similar to
those reported in Bundibugyo district, the epicentre of the outbreak,
died on Sun 2 Dec 2007 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 2 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 1st 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 2007, 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: 2
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 2 more patients succumbed to the virus on
Sat 1 Dec 2007, bringing the toll to 18. But the health ministry on
Mon 3 Dec 2007 revised the number back to 16, saying the 2 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 Sat 1 Dec 2007 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 Tue 4 Dec 2007 to beef up the local
response to the disease, including bringing laboratory facilities to
detect infections more easily.

An outbreak killed at least 170 people in Uganda's northern Gulu
district in 2000. Another recent outbreak killed at least 26 people
in DRC's West Kasai region. The Ebola virus was 1st identified in
1976 in Sudan and in a nearby region of DRC, then Zaire. Outbreaks of
Ebola have also occurred in the Ivory Coast and Gabon.

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

[The significant new feature of this most recent report is that the
death toll in the outbreak has been reduced from 18 back to 16 -- the
2 most recent cases having failed to be confirmed. The number of
confirmed cases has been revised down to 58.

Dr C.H. Calisher has raised the interesting question of the taxonomic
status of the virus responsible for this new outbreak. Preliminary
reports have suggested that the outbreak virus is significantly
different from previously isolated Ebola viruses. Should the current
Uganda virus be designated a new strain, a new subtype or a new virus
species? Some guidance from those involved in determination of the
genome sequence of this new Ebola virus would be appreciated. - Mod.CP]

[Birgitt]

EBOLA HEMORRHAGIC FEVER - UGANDA (05): (BUNDIBUGYO)
****************************************************
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: Tue 4 Dec 2007
Source: allAfrica.com, New Vision (Kampala) [edited]
<http://allafrica.com/stories/printable/ ... 40002.html>


Ebola Strikes More Nurses
----------------------------------
A 33-year-old man from Kyenjojo district, who had been admitted at
Virika Hospital in Fort Portal with suspected Ebola, died yesterday
afternoon [3 Dec 2007]. If confirmed, his demise would bring to 17
the number of people who have died since the outbreak of the epidemic
in August [2007]. The team that visited Bundibugyo Hospital yesterday
also learnt that 4 more medical workers were suspected to be
infected. They were among the 9 patients treated at one of the 2
isolation units in the hospital. All of them were health workers,
including the matron and a nursing assistant of the UPDF [Uganda
People's Defence Force].

The unit, formerly an anti-natal ward, seen by a New Vision team, was
poorly equipped and understaffed. There was only one male nurse, who
was wearing gloves and a mask, but no protective over-all. The doors
were not locked and there was no sign that this was an isolation
ward. About 5 attendants walked in and out, some were wearing either
gloves or masks, while others were not protected at all. One
attendant, dressed in white, was touching a patient with her bare
hands, as if she was not aware of the danger. No doctors were seen at
the hospital. The superintendent was still admitted in a private wing
of the hospital. His condition was said to have improved.

Though foreign experts were reported to have come in to help with the
treatment, none were seen by The New Vision team at Bundibugyo
Hospital. Contrary to findings by The New Vision, the Ministry of
Health said only 6 new cases of Ebola had been reported over the last
week, including one health worker. "All the other 6 health care
workers who had been put under quarantine because of Ebola-related
complaints are still under observation," said a statement by Dr. Sam
Zaramba, the Director General of Health Services.

According to Zaramba, experts from the World Health Organisation,
Medecins sans Frontieres and the Centres for Disease Control had
arrived in the country to help with laboratory diagnosis, case
research and management. A permanent laboratory will be set up this
week at the Uganda Virus Research Institute Entebbe to speed up the
diagnosis of Ebola and other viral haemorrhagic fevers, while
equipment for the laboratory is expected to arrive today [4 Dec
2007], the statement added. Currently, samples have to be taken to
South Africa or the Centres for Disease Control in Atlanta, USA.

Meanwhile, the UPDF has deployed a team of medical officers and
health educators to Bundibugyo. They will assist in the management of
Ebola patients and sensitising the public. UPDF 2nd Division
spokesperson, Lt. Tabaro Kiconco, said more personnel from the UPDF
Medical Department would be deployed in Bundibugyo today, while
emergency supplies would be delivered to Kabarole.

No new cases have been reported in Kabarole. So far, 2 patients with
Ebola symptoms have been admitted in Buhinga Hospital in Fort-Portal,
of which one died.

Following the Ebola outbreak, the 5 districts of the Rwenzori region
have postponed their joint education week celebrations, which were
slated to start today in Kasese. Other reports from Bundibugyo say
elders have resorted to consulting their oracles and sacrificing to
their ancestors to appease the gods.

[Byline: Anne Mugisa, Conan Businge, Matthias Mugisha, Bizimungu
Kisakye, John Nzinjah and John Thawite]

--
Communicated by:
Coulibaly Sidi
<sidi_couly@yahoo.ca>

[The number of fatalities in the outbreak has increased by one and
now stands at 17. Otherwise the overall situation remains confused
and the arrival of skilled medical support and diagnostic facilities
is still awaited. - Mod.CP]

[Birgitt]

EBOLA HEMORRHAGIC FEVER - UGANDA ( 06 ): (BUNDIBUGYO)
***********************************************
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: Thu 6 Dec 2007
Source: New Vision online [edited]
<http://www.newvision.co.ug/D/8/12/600646>


A medical doctor and 4 health workers, who treated the 1st Ebola
patients in Bundibugyo, have died of the disease. Dr. Jonah Kule, the
medical superintendent of Kikyo Health Centre, succumbed on Tuesday
night [4 Dec 2007]. He had been quarantined at Mulago Hospital.
Senior clinical officer Joshua Kule, senior nursing officer Rose
Bulimpikya, matron Peluce Tabiita and another nurse not yet
identified died yesterday [5 Dec 2007] in Bundibugyo Hospital,
according to senior clinical officer James Agaba.

In a statement yesterday [Wed 5 Dec 2007], the health ministry said
the number of Ebola cases had shot up to 91, after 7 new cases had
been recorded. The death toll has risen to 24. This includes a
Bundibugyo businessman who died on Tuesday [4 Dec 2007]. Eight of the
Ebola cases are health workers.

Contrary to guidelines by the health ministry to immediately bury the
victims, Kule's remains will be taken to his home in Bundibugyo today
[6 Dec 2007] and buried there. The Director of Mulago Hospital, Dr.
Edward Ddumba, said precautionary measures had been taken and there
was no risk of infection from the body.

Bundibugyo chief administrative officer, Elias Byamungu, said Kule
could have been infected when he went to investigate deaths which
locals had attributed to witchcraft. The Bakonjo had accused the
Bamba of bewitching them. "I warned Dr. Kule, but he insisted,
saying: 'Let come what may. I must go down and investigate what is
killing the people.' He investigated, and he wrote a report. That
report is helping the authorities," said Byamungu.

Kule becomes the 2nd medical doctor to die from Ebola in Uganda
through contact with patients. The 1st, Dr. Matthew Lukwiya, died in
Lacor Hospital in 2000 during the 1st ever outbreak of the disease in
Uganda. In Kasese, a teacher who works in Bundibugyo, has been
admitted at Bwera Hospital in Kasese with suspected Ebola. "We have
not yet confirmed if it is Ebola, but he complains of headache, joint
pain, fever, chest pain and bleeding from the nostrils. We have
isolated him," the hospital's medical superintendent, Dr. Yusuf
Baseke, said. He appealed for protective gear for the hospital staff
to be able to handle Ebola cases.

Meanwhile, health ministry sources said yesterday [5 Dec 2007]
experts from the US-based Centers for Disease Control and Prevention
(CDC) and the Ministry of Health were assembling the Ebola-testing
machine at the Uganda Virus Research Institute in Entebbe. Eight
pathogen experts from the CDC also arrived in the country on Tuesday
[4 Dec 20007]. The equipment was brought this week and is expected to
be operational by the beginning of next week. The machine will make
testing for Ebola and other haemorrhagic viruses faster and
intervention quicker. Currently, samples have to be sent to
laboratories in South Africa and the US, causing delays. The Ebola
outbreak in Bundibugyo was only confirmed on 29 Nov 2007 after
initial tests turned out to be negative, according to the health
minister, Dr. Stephen Mallinga. The Bundibugyo Ebola strain is said
to be different from any other known strain [see comment below]. It
is characterised by high fever, abdominal pain and diarrhoea and not
so much internal and external bleeding.

The authorities at Buhinga Regional Hospital in Kabarole district
said some patients had fled, fearing to contract Ebola. One of the
patients who fled was a woman who had been put in isolation at the
hospital after she vomited blood. She was classified as an alert
case, though the results of her test had not yet come back. Radio
stations in Fort Portal ran announcements for anybody who spots the
woman to alert the authorities.

The Fort Portal Catholic Diocese, where a 13-year-old boy died from
suspected Ebola on Sunday [2 Dec 2007], has warned people to stop
self-medication. The health coordinator, Sr. Euphrasia Masika,
advised people to seek help from the nearest health units as soon as
they suspect they may have contracted the disease. She warned that
concealing the disease minimised their chances of getting cured.

Residents of Mbarara town have stopped their traditional culture of
greeting with a hug and a handshake, fearing to contract Ebola. They
have resorted to waving at each other. This followed the death of a
woman who was vomiting blood at Mbarara University Hospital. The
woman was from areas near the hospital. The Ministry of Health took
samples of her blood for testing and buried her body immediately as a
precautionary measure. The management of all the banks in the town
have instructed their staff to wear protective gloves before handling
money from clients. At Stanbic Bank, manager Enid Natukunda said it
was the bank's obligation to protect its staff. "They are all
supplied with gloves. We cannot take chances," Natukunda said.
Make-shift eating places have been hit hardest by the scare as
patrons abandoned them, fearing contact with other people. Two Ebola
taskforces have been set up at Mbarara Hospital.

[Byline: Anne Mugisa, Bizimungu Kisakye, Kyomuhendo Muhanga, John
Thawite and Matthias Mugisha]

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

[This report records a dramatic upsurge in cases from 58 (3 Dec 2007)
to 91, and the number of fatalities has increased from 17 (5 Dec 2007) to 24.

This report also states that the outbreak virus is distinct from
known strains of Ebola virus. Provisional sequencing of the genome of
this new virus suggests that it is sufficiently different from
previously isolated Ebola viruses to rank as a 5th species alongside
the existing 4 species: _Ivory Coast ebolavirus_, _Reston
ebolavirus_, _Sudan ebolavirus_, and _Zaire ebolavirus_. However,
this will not be clear until the full genome sequence has been determined.

A ProMED-mail correspondent, Debora MacKenzie, has drawn my attention
to a recent paper describing the involvement of recombination in the
emergence of novel Ebola viruses. Wittmann et al. (Proc Natl Acad Sci
U S A. 2007 Oct 23;104(43):17123-7; <http://www.ncbi.nlm.nih.gov/
sites/entre>), which analysed viruses obtained from great apes in the
Democratic Republic of Congo and identified 2 distinct lineages,
suggesting that virus spillover from a reservoir had occurred more
than once, consistent with a multiple emergence hypothesis. However,
the spatial and temporal sequence of the outbreaks conflicted with
this hypothesis. Further analysis demonstrated the existence of
recombinants This 1st demonstration of recombination in the family
_Filoviridae_ adds an additional level of complexity to unraveling
the relationships between viruses within this taxonomic group.

For this reason, a decision on the taxonomic status of the virus
responsible for the current outbreak in Uganda must await further
analysis. - Mod.CP]

[Birgitt]

EBOLA HEMORRHAGIC FEVER - UGANDA: (BUNDIBUGYO)
**********************************************
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: Fri 4 Jan 2008
Source: UN Office for the Coordination of Humanitarian Affairs
(OCHA), ReliefWeb, Government of Uganda report [edited]
<http://reliefweb.int/rw/RWB.NSF/db900SI ... enDocument>


Uganda: Ebola outbreak press statement -- 4 Jan 2008
----------------------------------------------------
The Ministry of Health wishes to update the general public on the
Ebola situation in the country. The cumulative total is 149 patients
with 37 deaths.

In Bundibugyo District, 5 people are currently admitted, one in Kikyo
Health Centre and 4 in Bundibugyo Hospital. Of these, one new
suspected case has been registered and is admitted in Bundibugyo
hospital in the last 24 hours. One patient was discharged from Kikyo
Health Centre. On a good note, 441 out of 771 contacts have completed
21 days of follow up and are considered safe.

The Ministry of Health continues to urge the public to avoid
unnecessary movements and gatherings especially in the districts
around Bundibugyo, that is, Kabarole, Kasese, Hoima, Kibaale,
Kyenjojo, Kamwenge, Ibanda, Bushenyi, and Mbarara.

As we end the festive season, all District Health Officers, in charge
of Health Units and the general public should not relax but continue
being on alert and immediately report any suspected cases. Similarly,
the public is reminded to report to Health Facilities any persons who
present with the following symptoms: very high fever of sudden onset,
diarrhoea, vomiting associated with red eyes, and a measles-like
rash. Ebola is spread by close contact with body fluids of infected
persons or people who have died of Ebola. Anybody handling suspected
cases must use appropriate protective wear and must wash his/her
hands thoroughly with soap and water or JIK [bleach] and water.

The Ministry assures the general public that the epidemic is still
confined in Bundibugyo district and is getting contained. The public
is urged to be compassionate and provide care and support to persons
that have been discharged. I wish to thank all those who have
provided support to the discharged patients. Let us continue. These
people are not infectious and therefore should not be discriminated
against.

The public should continue to be vigilant but without creating
unnecessary fear and panic. The Central Alert Team will continue to
respond to all alert cases brought to our attention. The numbers to
contact remain the same:
Police Mobile 111 or 999
Police control room, Ministry of Health, 0772 587567, 0414 345108.

[Dr Sam Zaramba, Director General of Health Services]

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

[The cumulative number of Ebola hemorrhage fever cases in the
Bundibugyo District of Uganda is now given as 149 and the number of
deaths as 37. These figures are considerably greater than the 113
cases and 27 deaths declared by the Ugandan Health Ministry on 13 Dec
3007. No doubt some of this increase may be due to enhanced
surveillance and retrospective diagnosis, but it is unlikely that the
outbreak has been extinguished. Indeed some patients remain in
hospital and at least one is a new suspected case. - Mod.CP

In view of the fact that Ebola virus is only spread by contact with
the body fluids of an infected monkey or ape, or a human case who is
likely to be too sick to attend any gathering, the requirement to
avoid movements and gatherings seems excessive. - Mod.JW]

An interactive map of the Bundibugyo region of Western Uganda is available at
<http://www.maplandia.com/uganda/bundibugyo/>. - CopyEd.MJ]

[Birgitt]

EBOLA HEMORRHAGIC FEVER - UGANDA (02): (BUNDIBUGYO)
***************************************************
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: Sun 6 Jan 2008
Source: AllAfrica.com The Monitor (Kampala) [edited]
<http://allafrica.com/stories/200801060023.html>


Uganda: Ebola Scare as Dead Monkeys Found in Bundibugyo
-------------------------------------------------------
The discovery of 8 dead monkeys [soecies not named] in the Rwenzori
National Park in Bundibugyo District has again caused more fear and
tension among locals who are just coming to terms with the Ebola
outbreak that ravaged the area and is said to have been brought to the
area by infected monkeys. District leaders and the health workers
suspect that the monkeys may have been suffering from another virus
but are all the same carrying out investigations.

In a meeting of medical experts with the district leaders held on
Thursday [3 Jan 2008] at the district headquarters that was aimed at
assessing and fighting the Ebola epidemic, whose epicenter has been
here, it was noted that the monkeys and chimpanzees have certain
viruses in their blood similar to those detected in human blood
samples. The investigations, however, will take cognisance of the fact
that illegal hunting and killing of monkeys in the Mount Rwenzori
range is going on uninterrupted.

It was resolved that the district authorities of Bundibugyo with
immediate effect [will] alert the Uganda Wildlife Authority to
intervene since a good number of families living in the mountains are
[eating] monkey meat and putting their lives at risk.

Meanwhile, on Fri 4 Jan 2008 the Director General of Health Services,
Dr Sam Zaramba issued a statement saying that the cumulative total of
Ebola patients stands at 149 with 37 deaths. "In Bundibugyo District,
5 people are currently admitted, one in Kikyo Health Centre and 4
in Bundibugyo Hospital. Of these, one new suspected case has been
registered and was admitted to Bundibugyo Hospital in the last 24
hours. One patient was discharged from Kikyo Health Centre," the
statement said. The statement had positive news [also] saying that
441 out of 771 contacts have completed 21 days of follow-up and are
considered safe. Dr Zaramba, however, cautioned against "creating
unnecessary panic."

(Byline: Steven Ainganiza)

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

[Monkeys have been implicated circumstantially in some other outbreaks
of Ebola and Marburg hemorrhagic fevers in Central Africa, either
through hunting and slaying or during preparation and consumption of
monkey meat. Monkeys have transmitted filoviruses to humans (e.g.
Marburg virus in Marburg, Germany, through autopsy procedures) and to
oher monkeys (e.g. Ebola virus in Reston, USA), but transmission to
humans in natural settings has not been confirmed [only from apes to
humans via blood, when infected gorillas or chimpanzees are butchered.
- Mod.JW]. The local authorities in the Bundibugyo District of Uganda
seem more inclined to attribute the deaths of the 8 monkeys in the the
Rwenzori National Park to illegal poaching for meat and not as a
consequence of disease.

It is clear, however, that the Ebola outbreak in the Bundibugyo
district has not yet been extinguished and the death of the monkeys
may foretell a new flare-up. - Mod.CP]

[An interactive map of the Bundibugyo region of Western Uganda is
available at <http://www.maplandia.com/uganda/bundibugyo/>.
- CopyEd.MJ]

[Birgitt]

Uganda: Ebola hämorrhagisches Fieber (EHF)
15.01.2008

Im Rahmen des gemeldeten Ausbruchs im Westen des Landes wurden von August 2007 bis Anfang Januar 2008 insgesamt 149 Erkrankungen mit 37 Todesfällen registriert, darunter auch eine Reihe von Pflegekräften und Ärzten. Das relativ großflächige Infektionsgebiet blieb bisher auf den Bundibugyo-Distrikt an der ugandischen Westgrenze zur DRC in der Mitte zwischen Albert- und Edwardsee beschränkt. Eine Reihe von Verdachtsfällen aus anderen Landesteilen haben sich bisher nicht bestätigt. Inzwischen sind die Fallzahlen rückläufig, der Gipfel des Ausbruchs scheint überwunden, bis Anfang Januar gab es jedoch noch immer einzelne Neuerkrankungen und Verdachtsfälle. Private Reisen in das Infektionsgebiet sollten vorerst weiterhin unterbleiben, Kontakte mit kranken Menschen, durch die es zu einer Ansteckung kommen kann, sind unbedingt zu meiden. Uganda erlebte zur Jahreswende 2000/01 den bisher größten Ausbruch in der Geschichte des EHF; damals war der Norden des Landes mit dem Schwerpunkt im Gulu-Distrikt betroffen. Eine größere Epidemie gab es zuletzt im Sommer d.J. in der Provinz Kasai Oriental der benachbarten DRC, der inzwischen abgeklungen ist. / Quelle: crm

Gruß
Birgitt

[Birgitt]

EBOLA HEMORRHAGIC FEVER - UGANDA (03): ARUA, 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: Tue 22 Jan 2008
Source: allAfrica.com, The Monitor (Kampala) [edited]
<http://allafrica.com/stories/200801220250.html>


Ebola suspect dies in Arua, Uganda
----------------------------------
A 70 year old man, who was taken ill to Arua hospital over the weekend with
severe bleeding through his body orifices and high fever, has died,
sparking fears of a possible Ebola outbreak in the north west region. The
man was reportedly heading to Koboko when he suddenly collapsed aboard a
Gaaga bus and was rushed to the regional referral medical facility.

"The deceased was brought around 6:30 pm on Saturday [19 Jan 2008]. He was
bleeding through the nose and on the tongue. Blood traces were also evident
in his stool," Mr Charles Olaro, the medical superintendent of Arua
Hospital said, yesterday [21 Jan 2008].

Owing to the clinical symptoms the patient presented akin to that of the
highly communicable haemorrhagic fever, Mr Olaro said they decided to admit
him into the isolation ward. "We could not take chances and decided to
seclude the patient in order to protect both the hospital staff and public
-- just in case the patient was suffering from Ebola," he explained.

Ebola, which kills within days, is a highly virulent disease spread through
physical contact with blood and body fluids of an infected person,
including saliva; sweat, vomitus and stool.

It takes between 3 and 21 days for anyone who has contracted the disease to
develop full-blown symptoms of bleeding through body openings, high fever,
diarrhoea, vomiting, and associated red eyes and measles-like skin rash.

Dr Sam Zaramba, the director general of health services, said they were
treating the suspected Ebola infection in Arua as an "alert case".

"The case is being investigated and body tissues of the deceased have been
taken for examination for Ebola at the Uganda Virus Research Institute (at
Entebbe)," Dr Zaramba said yesterday.

[byline: Tabu Butagira]

--
communicated by:
ProMED-mail rapporteur Coulibaly Sidi

[A map showing the administrative districts of Uganda is available at
<http://www.un.org/Depts/Cartographic/ma ... ganda1.pdf>. The Arua
district is located in the north west of Uganda and shares borders with the
Democratic Republic of Congo and Sudan. The Bundibugyo district, the site
of the most recent and as yet not fully contained outbreak of Ebola
hemorrhagic fever in Uganda, lies some 200 km to the south.

The symptoms of the patient are compatible with Ebola hemorrhagic fever.
Laboratory confirmation of the diagnosis is awaited. - Mod.CP]

[Birgitt]

Uganda - Ebola hämorrhagisches Fieber (EHF)
20.02.2008

Der Ausbruch im Bundibugyo-Distrikt an der ugandischen Westgrenze zur DRC in der Mitte zwischen Albert- und Edwardsee, der mit ersten Krankheitsfällen im August 2007 begann und im November/Dezember seinen Höhepunkt erreichte, ist abgeklungen. Nachdem mehr als 6 Wochen nach dem letzten bekannt gewordenen Fall keine weiteren Neuerkrankungen auftraten, wurde das Land am 20. Februar für Ebola-frei erklärt. Es handelt sich um den ersten Ausbruch dieser potentiell tödlichen Viruskrankheit in einer touristisch erschlossenen Region. Erkrankungen bei Ausländern gab es nicht. Allerdings ist das Reiseaufkommen nach Uganda, speziell in die betroffene Region, nach Bekanntwerden der Epidemie deutlich zurückgegangen. Entsprechende Reisewarnungen wurden jetzt zurückgenommen. / Quelle: crm

Gruß
Birgitt

[Alexander]

Uganda erklärt Ebola-Virus für ausgerottet

Der Ebola-Virus stellt in Uganda offenbar keine Gefahr mehr dar. In dem ostafrikanischen Land starben noch im vergangenen Jahr 37 Menschen an dem Virus, wie das Gesundheitsministerium am Mittwoch in Kampala mitteilte. Seit 42 Tagen seien keine neuen Infektionen bekannt geworden. Daher schloss der Gesundheitsminister aus, dass noch Menschen den Virus in sich tragen, ohne schon Anzeichen der Krankheit zu zeigen. mehr...

Grüsse
Alexander