Ebola patient allegedly diagnosed in Kagera

As the government tries to take measures to prevent the deadly disease of Ebola from spreading into the country, one patient has been discovered to have been infected with the viruses at Nyakage hospital in Karagwe district, Kagera region.

According to one doctor from the hospital who declined to be named because he is not the authorised spokesperson, doctors at the hospital discovered a patient whose name was not immediately established with all signs of the disease when he went there for treatment on Friday.

The doctor further noted that the patient had travelled from Uganda and had entered into the country via Mulongo border in the western part of Kagera region.

Efforts to contact the Minister for Health and Social Welfare, Dr. Hussein Mwinyi for more clarification about the matter yesterday bore no fruit as he was not ready to speak about the issue, asking the reporter to call him later.

However, when efforts were made to reach him about an hour later his phone was switched off.

However, speaking in Parliament on Wednesday, Dr Mwinyi said the government had sent medical experts to the Tanzanian border with Uganda in a quest to contain its spread into the country. The disease is known to have killed 14 victims.

Dr Mwinyi told visibly alarmed legislators that the medical experts who have been dispatched to the border were fully equipped with protective gear, medical supplies and other requisite equipment.

They are also able to identify Ebola virus carriers. The minister advised the public, especially those living in the northern regions of Kagera, Mara, Mwanza and Kigoma, some of which share border crossings with Uganda.

The World Health Organisation (WHO) has already alerted Tanzania on the Ebola threat. The ministry issued a statement to the press elaborating that Ebola was a highly contagious disease brought on by the Ebola virus.

As an outbreak of ebola progresses, bodily fluids from diarrhea, vomiting, and bleeding represent a hazard. Due to lack of proper equipment and hygienic practices, large-scale epidemics occur mostly in poor, isolated areas without modern hospitals or well-educated medical staff.

The Ebola virus was first associated with an outbreak of 318 cases of a hemorrhagic disease in Zaire. Of the 318 cases, 280 of them died—and died quickly. That same year, 1976, 284 people in Sudan also became infected with the virus and 156 died.

The viruses that cause Ebola and Marburg are similar, infecting both monkeys and people. The outbreaks of these diseases are often self-contained, however, because they kill their hosts so quickly that they rapidly run out of people to infect.

In Kampala, Uganda the residents have been urged to avoid contact after the deadly Ebola virus hit the city. Kampala residents have been urged to avoid contact after the deadly Ebola virus hit the city but security guard Joseph Karuba's job is to frisk people and he doesn't have gloves.

"The thing has come back -- it came first time and we beat it, then it came again and we beat it and now it is back," he said, waiting for shoppers outside one of the teeming capital's malls.

President Yoweri Museveni on Monday confirmed that Ebola, one of the world's most virulent diseases, had reached Kampala for the first time following an outbreak in the west of the country.

"We shall request gloves, but for now it is a very big problem because we are exposed," Karuba said.

Officials were searching for anyone who might have come into contact with the virus, amid public warnings for people to take precautions and avoid physical contact..

Prisoner with suspected case of Ebola escapes from hospital in Uganda

From David McKenzie, CNN

August 3, 2012 — Updated 1336 GMT (2136 HKT)Kagadi, Uganda (CNN) — One of five prisoners receiving treatment for a suspected case of Ebola virus in Uganda escaped overnight Friday from the hospital at the center of the outbreak, a health official said.

“Should his results come back and he is positive, that causes us a lot of worry. So right now, we have resolved that the remaining prisoners will be cuffed on the beds for fear that they might also escape,” said Dr. Jackson Amune, commissioner at the Ministry of Health.

The inmates from Kibaale prison are among 30 people at Kagadi hospital with suspected cases of the virus. Two additional patients have confirmed cases, according to Doctors Without Borders.

The prisoners have been showing Ebola-like symptoms of vomiting, diarrhea and fever, Dr. Dan Kyamanywa said Thursday.
“We do expect the number of suspected cases to increase,” Kyamanywa said. “It’s important to break transmission and reduce the number of contacts that suspected cases have.”

Many patients fled Kagadi hospital when Ebola was confirmed, he said, and the facility is struggling to respond to all the call-outs to suspected cases.

The outbreak began in the Kibaale district in western Uganda with 53 confirmed cases. At least 16 people have died. An additional 312 people have suspected cases of the virus and have been isolated, pending further testing.

The deaths have stoked heightened fear of the virus, a highly infectious, often fatal agent spread through direct contact with bodily fluids. Symptoms can include fever, vomiting, diarrhea, abdominal pain, headache, a measles-like rash, red eyes and, at times, bleeding from body openings.

“I would like to stress that the disease is under control,” said Joaquim Saweka, the World Health Organization representative to Uganda.

Health officials urged the public to report any suspected cases, to avoid contact with anyone infected and to wear gloves and masks while disinfecting bedding and clothing of infected people. Officials also advised avoiding public gatherings in the affected district.

...Meanwhile, officials in Kenya were taking extra precautions after at least two patients showed symptoms of the virus, according to Jackstone Omoto, a medical official in Siaya, western Kenya. One man tested negative. A second man and two relatives have been isolated at the Moi Teaching & Referral Hospital in Eldoret, pending test results. The man was traveling from South Sudan to Kenya through Uganda.

“We are tracing the bus that he (traveled on), and we have requested the company to contact the ministry so we can know who else was in the bus,” said Beth Mugo, public health minister.

http://edition.cnn.com/2012/08/03/health/uganda-ebola-virus/index.html
________________

BEAUBIEN: Port Shepstone is south of Durban. It’s on the coast, on the Indian Ocean. It’s in Kwazulu Natal, which is the province in South Africa that’s been hardest hit by the HIV epidemic. Nationwide, you got about an 18 percent prevalence rate among adults so that 18 percent of adults everywhere in the country are infected with HIV. But here, it’s even higher.

You go into some clinics, some places where pregnant women are coming in, and they’re testing pregnant women in these clinics. And in some parts of Kwazulu Natal, 50 percent of the women who are pregnant that are entering these clinics are testing HIV-positive. And that’s really just a sign of how hard this province has been hit by the epidemic.

http://www.npr.org/2012/07/20/157129982/south-africa-still-the-hardest-hit-by-hiv-infections

Kampala looks to be about 100+ miles from Tanzania border with one major highway connector. The earlier Kigali Rwanda outbreak is approx 75 miles SW of the border as the crow flies, more by the looping road as indicated on the map. So the hot zone expands a bit.

Air travel is less of a concern as transmission vector than bus travel which is more accessible. Air travel limiting factors are cost and limited flight duration. The virus, IIRC, is transmissible only through direct infected fluid contact, so contagion in a plane would be visibly evident during the flight. Of course absent visible symptoms flying allows the virus carrier to travel farther before bleeding occurs, leap frogging if you will.

The more common and affordable bus travel presents the more opportune transmission for the virus.

couldn't quickly find a topographic map with road and rail overlays which would be interesting and perhaps instructive when compared with same of earlier outbreaks. Commonality of local conditions might help narrow the search.

Currently, there are 32 cases admitted on the isolation ward. However, due to the increasing number of patients, a second isolation ward and a convalescent ward for admitted cases that have tested negative to Ebola have been opened at Kagadi hospital.

The new isolation center constructed by MSF will begin operations on 4 August 2012. Additional staff from other districts with experience of managing previous Ebola outbreaks have been deployed to support and manage the isolation centre. WHO is supporting the Ministry of Health’s response to the outbreak. To date, WHO has deployed epidemiologists and logisticians; and provided essential equipment for personal protection and safe disposal of the deceased.

WHO does not recommend that any travel or trade restrictions be applied to Uganda.

What was your source for that map? Uganda Gov. or WHO? Please accept that I am not hectoring you, just seeking source as it identifies the original publisher’s interests. We all know that African news orgs are easily controlled.

The difficulty with the showing of political administrative district maps is that ZERO pertinent information is conveyed.

How is it that on that map that Matale, to the SE stands aprt as an island apart from the main cluster? Did the virus parachute in? Doubt Uganda Gov will provide answers until they can form their “narrative”.

We encountered this in precious outbreaks as the Gov became more involved information flow was strangled until only self-serving political statements were releleased.

Any news from Medicins sans Frontieres yet?

Yes I did,

On 24 July 2012, the Ministry of Health of Uganda notified WHO of an outbreak of Ebola haemorrhagic fever from Kibaale district, mid-western Uganda [6]. The first case belonged to a family in Nyanswiga village in Nyamarunda sub-county in Kibaale district. As of 31 July 2012, 38 cases, including 16 deaths, have been reported.

Laboratory investigations conducted at the Uganda Virus Research Institute (UVRI), Entebbe, Uganda, confirmed Ebola virus, subtype Sudan.

The main affected area is the Kibaale district, a forested area about 200 kilometres west of the Ugandan capital, Kampala, and near the border with the Democratic Republic of the Congo. In Kampala, the Ugandan Ministry of Health has confirmed one case, a healthcare worker in Kibaale district, who was treated in the hospital and who subsequently died.

According to WHO, the Ugandan Ministry of Health has activated the National Task Force to review progress and provide daily media briefs and the Kibaale district Ebola Task Force to coordinate the field response. The neighbouring districts have been put on high alert and are enhancing surveillance.

A team of experts from the Ministry of Health, WHO, US Centers for Disease Control and Prevention (CDC), Médecins Sans Frontières (MSF) Spain, MSF Holland and the Red Cross are in Kibaale to support the response operations.

Contacts exposed to suspected, probable and confirmed cases are being identified for active follow-up.

Kibaale hospital has established an isolation ward for suspected, probable and confirmed cases. Currently, there are 18 admitted cases on the isolation ward.

RAPID RISK ASSESSMENT Ebola haemorrhagic fever in Uganda 2 August 2012

Holland has mobilised resources for setting up an isolation centre at the hospital. Although the Ministry of Health and Mulago National Referral Hospital have mobilised some staff to manage the isolation centre, more are urgently needed.

Media attention for haemorrhagic fever outbreaks is usually particularly high and increases the risk perception. The media in Uganda are currently reporting additional cases for some other Ugandan districts [8], while the media in Kenya have reported a suspected case having travelled from Sudan through Uganda to seek medical attention in Kenya, presenting with signs of haemorrhagic fever [9]. However, this information should be considered with caution as it has not been confirmed by official sources.

Control activities already in place are active case finding and contact tracing, enhanced surveillance and reinforcing infection control practices, case management and social mobilization.

http://ecdc.europa.eu/en/publications/Publications/TER-020812-RRA-Ebola-Uganda.pdf

Uganda | 03 August 2012

Henry Gray, Médecins Sans Frontières (MSF) water and sanitation coordinator, describes his team’s preparations to care for fearful patients and their families, and to help prevent the disease from spreading.

The team landed in Uganda last weekend and, since then, we’ve been working flat out trying to implement a comprehensive outbreak response in the Kagadi area (in Western Uganda). MSF has a lot of experience with Ebola – we are using the same approach as in previous outbreaks which we’ve found to be effective in stopping the spread of the disease.

We are in the process of installing a treatment centre in Kagadi, which should take seven to and 10 days. Patients will come here to be treated. Isolating them will help reduce the risk of contagion in the community.

Working on an Ebola outbreak isn’t just about reacting to the physical challenges of an outbreak – educating people is also vital. Because they work directly with patients, health workers are continually at risk. Therefore, along with treating patients, one of our main priorities is training Ugandan health staff to reduce the possibility of them catching the disease. We have to put in place extremely rigorous safety procedures to ensure that no health workers are exposed to the virus through contaminated material from patients or medical waste infected with Ebola.

The general public is understandably concerned because this isn’t a disease they regularly encounter. This is the biggest Ebola outbreak in Uganda since 2007, and lots of people don’t really understand what Ebola is. While they know how to recognize malaria or cholera, Ebola is much more frightening for them – partly because the early symptoms can be very similar to well-known diseases.

The symptoms can include fever, vomiting, sore throats and headaches and, in severe cases, internal or external bleeding. Patients with a severe case of the disease will need intensive care. Often they are very dehydrated and need to be given fluids through a drip. Unfortunately there is no specific treatment or vaccine for Ebola – several vaccines are in development, but it’s likely to be several years before one is available.

Ebola spreads quickly and can be deadly, so the social effects can be very severe. The patients we are treating are very frightened, for obvious reasons. Their families are also very scared, so as well as our treatment centre, we are setting up psychosocial support for the patients, their families and also our own staff, who may also be traumatized by what is happening.

Many people have stopped kissing or shaking hands when they greet each other – even though people are only actually infectious when they have Ebola symptoms. There’s a lot of media publicity about how to reduce the risk of catching the disease and to seek medical help immediately if someone becomes ill, and these public messages are vital.

Once we’ve finished constructing the treatment centre and training the staff over the next few days, we will have the capacity to treat and care for between 50 and 60 patients at a time. At the moment we’re hoping for the best but preparing for the worst.

http://www.msf.ca/news-media/news/2012/08/at-the-moment-were-hoping-for-the-best-but-preparing-for-the-worst/

Rwanda: No Panic Over Ebola Scare - Health Ministry

4 AUGUST 2012

The has called upon the general public not to panic over the Ebola outbreak in the neighbouring Uganda saying that all measures to contain it are in place.

The message was given by the permanent secretary in the Ministry of Health Dr. Uzziel Ndagijimana during a press conference at the Ministry head offices.

Ebola hemorrhagic fever is a highly contagious disease transmitted from person to person and characterised by fever, headache, joint and muscle pain, sore throat, weakness, diarrhea, vomiting, abdominal pains and bleeding from all outlets.

Uganda’s Ministry of Health and World health Organisation (WHO) confirmed an outbreak of Ebola hemorrhagic fever in Kibale district in Western Uganda near the border with the Democratic Republic of Congo (DRC) last weekend leading to Rwanda coming up with stringent measures to contain its crossing.

“We have done all we can to make sure that we prevent any spread of Ebola in case it comes to Rwanda,” said Ndagijimana adding that the Ministry is concluding training for district health workers on how to contain the disease with empahsisi on the Ugandan border.

The disease started from Kibale district which is approximately 300 Kilometers from the Rwandan border. It is specifically near the districts of Musanze, Nyagatare, Gicumbi and Burera. Due to high traffic and population movements, there is risk that Ebola can be imported to Rwanda at any time.

The P.S said that the Ugandna authorities are also doing everything possible to contain the spread of the disease caused by a virus called Ebola.

Reports from Uganda indicate that the deaths have so far increased from 12 on Monday to 16, while 12 new cases of the haemorrhagic fever were registered at Kagadi Hospital in Kibaale District. The number of people being ‘actively followed up’ has risen from 176 to 232 in the last 48 hours.

The Ministry of health reminds the public to however, continue be vigilant and to immediately report any case of Ebola they identify to the nearest health center.

http://allafrica.com/stories/201208040766.html

“The facilities are not okay,” says Steven Byaruhanga, the chairperson of the district Ebola taskforce. “The incinerators we don’t have… electricity is on and off, the pump for water is not functioning, the sewer system is also broken down, there’s so many problems.”
Patients at the hospital reportedly rioted on Tuesday, protesting the lack of food and clean water, while vehicles provided by the Ministry of Health sat idle for lack of fuel.

“There are so many cases reported but we could not move because there was no fuel,” Byaruhanga said. “If we could get it, it could make the work so easy.” That is some frightening stuff.

I am curious, "Mother Abigail". Are you affiliated with a global health organization or something? I noticed you rarely post here and when you have done so it seems to be in connection with reports about the spread of highly contagious diseases.

Disclaimer: Opinions posted on Free Republic are those of the individual posters and do not necessarily represent the opinion of Free Republic or its management. All materials posted herein are protected by copyright law and the exemption for fair use of copyrighted works.