Tabu Butagira, Hussein Bogere & Joseph Mugisha
4 December 2007
Kampala/Bundibugyo — UGANDA's main referral hospital, Mulago has received its first Ebola patient since the deadly viral disease broke out in Bundibugyo District in August.
Dr Yonah Kule, an employee of the International Air Ambulance (IAA), who contracted the highly communicable hemorrhagic fever while treating patients at Bundibugyo hospital last week, was admitted at Mulago at the weekend.
"Yes, he (Kule) is in our isolation unit and he is fair now," Dr Edward Ddumba, the director of Mulago hospital told Daily Monitor yesterday; disapproving local press reports - a day earlier - that the infected medic had been secluded in a room at the Ministry of Health headquarters.
Dr Ddumba said precautionary measures had been taken by placing the doctor in an "Isolation Unit" so that he would not get in contact with other people. The virus has so far killed 18 people, with six more new cases recorded and some medical workers placed under quarantine.
In one week, the rate of infection has risen to 58, an increment attributed to free human movement and people's ignorance of the disease since September.
Most staff and patients at Mulago were unaware of an Ebola case in their midst although Dr Ddumba said they had prepared for any eventuality.
"We have sufficient capacity to handle that (Ebola emergencies)," he said by telephone. But in Bundibugyo, the epicenter of the contagion, under-resourced and overstretched health workers at the district hospital and Kikyo health centre IV were grappling with the increasing number of Ebola cases.
Dr Sam Zaramba, the commissioner for health services said that by 1:30pm yesterday, the cumulative number of Ebola infections registered since August had risen to 62 while deaths from the epidemic had remained at 16.
But a source within the ministry said the number of fatalities, including those in communities that are not recorded at health units was 31 and that epidemiologists had so far confirmed 62 out of 80 suspected Ebola cases as positive.
Bundibugyo RDC Samuel Kazinga, who heads the district Ebola Taskforce, said yesterday eight health workers - two doctors and six senior clinical officers - had contracted Ebola, causing acute shortage of medical personnel, especially for other general medical services since medics available are pre-occupied with managing Ebola cases.
However, seven doctors from international bodies like WHO, Unicef, Afrinet and MSF-France were reported to have arrived in Bundibugyo to strengthen the teams there.
Yesterday, the African Field Epidemiology Network Scientists (Afenet) meeting at the second scientific conference in Kampala announced that they were dispatching a team of experts to the Ebola trouble spots but did not specify the number.
"We intend to keep our team there for about two weeks for a start," said Dr David Makanga, the executive director adding, "But this will depend on the situation on the ground. They could even stay longer".
And the UPDF last Thursday sent a medical team to Bundibugyo to bolster the response operations.
The Defence and Army Spokesman, Maj. Felix Kulayigye, said yesterday the team headed by Col. Apollo Musinguzi, the director of Public Health in the army comprises of doctors and nurses.
However, one of the army medics is said to be down with Ebola.
Eighty expatriates, seconded by various global institutions and foundations are expected to arrive in the country this week to trace the details of the unique Ebola strain, Dr Zaramba said yesterday.
No sex
Dr Zaramba cautioned that apart from coming into contact with infected people, infected people should refrain from having sex for their own safety.
"We encourage those (people) who have got symptoms of Ebola, not to engage in sex and if they have to, they must use condoms and we are sending more condoms to Bundibugyo," he said.
Health experts say the incubation period for Ebola virus ranges from two to 21 days, depending on the strain and this could mean that it is only safer for people living in affected regions not to have unprotected sex since infected persons, may in the early days of infection, not show the known Ebola symptoms of measles-like body rash, high fever, red eye, vomiting and bleeding through body orifices.
Goat origin
Dr Zaramba said a group of epidemiologists who have pitched camp in Bundibugyo are investigating clues that the first person to contract Ebola in the district or index case as is called in medical jargons, consumed meat of a dead goat and conclusive findings of this inquiry are not expected to be ready immediately due to strict onerous laboratory test rules.
"It is true the index case ate a dead goat but we do not know what killed the goat," Dr Zaramba said. "The suspicion is that the goat could have been bitten by a Columbus Monkey or other such wild animals".
It emerged yesterday that frightened urban dwellers in Bundibugyo town many of who do not have palm gloves, have stopped receiving bank notes for fear of contracting Ebola.
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