The Monitor (Kampala)

30 November 2007

Uganda: Ebola Strikes Again

Kampala — THE strange viral disease that struck the western district of Bundibugyo in August and has todate killed 16 people has been confirmed by the Health Ministry to be the Ebola haemorrhagic fever, a deadly disease for which there is no cure.

Announcing the existence of the Ebola strain in the country yesterday, Dr Sam Zaramba, the director general of health services said; "The Ministry of Health would like to inform the public that the mysterious disease outbreak in Bundibubyo has now been confirmed to be Ebola." The confirmatory laboratory tests, initially carried out at the National Institute of Virology in South Africa and later at the US-based Centre for Disease Control, comes months after the disease spread to 14 villages in the affected district.

Dr Zaramba yesterday denied reports that the government had known about the deadly epidemic outbreak weeks earlier but concealed it in order not to scare away foreign dignitaries who were scheduled to attend the just concluded Commonwealth Heads of Government Meeting in Kampala.

"It would be unethical for me to keep quiet (about an epidemic outbreak). It is true we knew there was a strange disease in western Uganda but had not got the conclusive confirmation that it was Ebola until today (Thursday) morning," he stressed.

He said the laboratory diagnostic process was so arduous and protracted that out of 20 (blood) samples sent to foreign capitals, "only eight tested positive".

Dr William Sikyewunda, the district director of health services for Bundibugyo said latest reports indicate the disease had killed at least 27 residents and 51 others were infected, mainly in Bubukwanga and Kasitu sub-counties. But other unconfirmed reports put the total death toll to date at 50.

The government yesterday dispatched a team of health officials from the Ministry of Health headquarters in Kampala to strengthen rapid response capability in the trouble spots.

"The initial supplies and drugs for case management have been mobilised and isolation facilities are already operational in Bundibugyo Hospital and Kikyo Health centre (IV)," the ministry said in the press statement.

The chairman of the National Ebola taskforce, Dr Sam Okware, said the Ebola strain identified in the western enclave is "completely different" from the four known sub types of the heamorrhagic fever namely; Ebola Sudan, Ebola Zaire, Ebola Reston (that only affects monkeys) and Ebola Tai (Ivory Coast).

The common symptoms of Ebola, that causes death in 70 to 90 percent of all clinically ill cases; include very high fever, diarrhea, vomiting associated with red eyes and a measles-like rash. Health officials issued a countrywide wide Ebola alert and urged the public to be vigilant and promptly report any suspected cases to the nearest health facility or call the cell phone hotlines 0772507799, 0772409810.

Daily Monitor has established that a core group of specialized staff from World Health Organization, Unicef, MSF - France and Afrinet left for Bundibugyo yesterday to join local medics and bolster case management of patients, contact tracing and public education. "Ebola is spread by close contact with body fluids of an infected person or people who have died of the disease. Anybody handling suspected cases must use appropriate protective wear," the official warning statement said.

Medical experts say the incubation period for the Ebola virus is between two to 21 days, depending on the strain.

By last evening, information emerged that Bundibugyo hospital medical superintendent only identified as Dr Ssesanga and Dr Joshua Akure, another medic and employee of International Air Ambulance were down with illnesses suspected to be Ebola.

Ebola last struck Uganda in the northern district of Gulu in October 2000 and killed 224 people, including Dr Mathew Lukwiya, the then medical superintendent of Lacor hospital, who first identified and later relentlessly spearheaded the fight against the disease. It was believed that Ugandan soldiers who were by then returning from the Democratic Republic of Congo brought the disease into the country.

The WHO says Ebola has in the past four months killed 160 out of 352 infected persons, especially in the southern province of DRC's Kasai Occidental, which is about 2, 000 kilometres away from Uganda.

The virulent disease was first identified in the Western Equatorial province of Sudan and in a nearby region of former Zaire (now Democratic Republic of Congo) in 1976 and about 1500 cases with over 1000 deaths have been documented ever since.

Just like Marburg fever, the Ebola virus' natural reservoir is still a puzzle, experts have said, but it seems to reside in African rain forests and in areas of the Western Pacific, according to the United Nations health agency but is said to be part of a group of negative-stranded RNA viruses, known as Filoviridae and mostly not airborne.

Additional reporting by Jane Nafula

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