allAfrica.com: Uganda: No Handshakes, Please (Page 1 of 1)

AS UGANDA STRUGGLES TO bring the Ebola haemorrhagic fever under control, the country could face a long and sometimes lonely battle against the deadly virus.

Within days of the confirmation of the presence of the virus in the western Ugandan town of Bundibugyo, neighbours Kenya and Rwanda sent medical teams to their borders with Uganda to screen all travellers, while the Democratic Republic of Congo shut down its borders altogether.

In addition, many diplomatic missions based in Uganda, especially Western ones, have issued travel advisories to their citizens intending to travel to Kampala, advising them to do it only if it is absolutely necessary.

The Uganda government has, however, not restricted travel within the country. The Ebola national task force chairman, Dr Sam Okware, has argued that there is no need to do so, although he asked travellers to adhere to the precautions outlined by the health ministry.

"There is no travel restriction to the affected districts as this disease is transmitted through direct contact with an Ebola patient or contact with body fluids from an infected person," Dr Okware noted in a situation report dated December 6.

President Yoweri Museveni has advised Ugandans to minimise any form of contact, including greeting, until the virus is contained. He said this would minimise the risk of contracting the virus.

"Ebola spreads through contact. For the time being, people should resort to jambo (waving)," President Museveni told Christians who had gathered for prayers at Kololo Airstrip. "If I don't shake your hand, it doesn't mean I don't like you."

The incubation period for Ebola, according to medical studies, ranges from 2 to 21 days.

"The onset of illness is abrupt and is characterised by fever, headache, joint and muscle aches, sore throat, and weakness, followed by diarrhoea, vomiting, and stomach pain. A rash, red eyes, hiccups and internal and external bleeding may be seen in some patients," says a report prepared by the Special Pathogens Branch of the Centres for Disease Control.

MEDICAL EXPERTS SAY Ebola, named after a river in the Democratic Republic of Congo where the first cases of the disease were confirmed, is a severe, often-fatal disease in humans and non-human primates like monkeys, gorillas, and chimpanzees that has appeared sporadically since its initial recognition in 1976.

The disease is caused by infection with the Ebola virus, which is one of the two members of a family of Ribonucleic Acid (RNA) viruses known technically as the Filoviridae.

According to medical experts, there are four identified subtypes of Ebola virus. Three of the four have caused disease in humans; these are Ebola-Zaire, Ebola-Sudan, and Ebola-Ivory Coast. The fourth, Ebola-Reston, has caused disease in non-human primates, but not in humans.

Researchers are yet to identify the exact origin, locations, and natural habitat of the Ebola virus. They, however, believe, based on the available evidence gathered and the nature of similar viruses, that the virus is animal-borne and is normally maintained in an animal host native to the African continent.

Indeed, confirmed cases of Ebola have so far been reported only in the African countries of Uganda, DRC, Gabon, Sudan, the Ivory Coast, and Congo since 1976.

No other country in East Africa, apart from Uganda, has ever been attacked by Ebola - although Kenyans and Tanzanians have been attacked by some mysterious viruses in the recent past like the Marburg virus and Rift Valley fever.

Ebola first struck Uganda on October 8, 2000, when the first case was confirmed in Rwot-Obillo, a village 14 km north of Gulu town, in northern Uganda. Other cases were later reported from the western Ugandan districts of Mbarara and Masindi.

For the duration of the epidemic, which lasted up to January 16, 2001, a total of 425 cases were reported countrywide with 224 deaths. Medical records show that the case fatality rate was 53 per cent, with the attack rate highest in women.

UGANDA WAS FINALLY DEclared Ebola-free on February 27, 2001, 42 days after the last case was reported. The current attack was confirmed on November 29 after test samples submitted to the Centres for Disease Control returned positive results. Since then, the virus has claimed more than 100 Ugandans with others still admitted in hospitals.

Most of the cases have been reported in the western Ugandan districts of Bundibugyo, Kabarole, Mbarara and Kasese, while another two suspected cases were recorded in the capital Kampala in central Uganda and Mbale district in eastern Uganda.

The Mbale case, if confirmed, would punch holes in the Ugandan Health Ministry's assertion that there is no need to impose travel restrictions. This is because the victim, Ms Olive Mukite, until her death the district information officer for Sironko at the foot of Mt Elgon, had just returned from western Uganda when she suddenly fell sick and died shortly after.

MS MUKITE HAD TRAVelled to the western Ugandan district of Kyenjojo, along with a team of 65 district officials, on a study tour before she passed away on returning to Mbale. None of the other officials, had, however, shown signs of having contracted the disease by the time of filing this report.

In western Uganda, Ebola's most high profile victim was Dr Jonah Kule, the first and only doctor to have been produced by the remote district of Bundibugyo. Dr Kule had dedicated most of his life to serving his people near Mt Rwenzori and contracted the disease when he went to attend patients without sufficient protection before the presence of Ebola had been confirmed.

Dr Kule became the second senior Ugandan medical official to succumb to Ebola while attending to its victims. The first was Dr Mathew Lukwiya, who contracted the virus in Gulu district in 2000 when Ebola first struck.

Dr Okware says a number of measures have been put in place to prevent the spread of Ebola in the country under an operational plan that has been drawn up to last 60 days. It is expected to cost an estimated $1.5 million.

Ebola is the second haemorrhagic fever to attack Uganda this year alone. In May, the country confirmed an outbreak of the Marbug virus, which kills within hours, and claimed a number of lives in western Uganda before it was contained. The two diseases do not have a cure.

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