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Yellow fever is one of several infectious diseases that can cause a hemorrhagic fever, a fever with organ failure resulting in bleeding complications.

Other viruses that can mimic Ebola disease are lassa fever, and dengue fever.

Ebola scare as patient shows signs

By MAURICE KALUOCH
Posted Sunday, August 5 2012 at 23:30
IN SUMMARY

Hospital held emergency meeting after a woman started oozing blood from her body openings, a symptom of the dreaded ailment
Homabay District Hospital has been placed on a high alert for Ebola after a middle-aged female patient presented symptoms similar to those of the dreaded disease.

The Hospital’s medical superintended, Dr Ojwang Ayoma, was forced to summon the hospital’s top medical team that included doctors, clinical officers and nurses for an emergency meeting to discuss the development in the face of a possible outbreak.

This, was after it was discovered that the patient had blood coming out through all her body openings.

The woman was rushed to the hospital by an elderly relative after allegedly developing high fever, a sore throat and general body weakness.

The patient’s condition was said to have deteriorated late in the night with blood oozing from her body’s openings .

Dr Ayoma said, they were forced to isolate the patient together with her relative who was however unable to give a proper account of the history of the ailing relative.

The elderly woman told the hospital’s authorities that her sister-in-law resides at Sori market of Nyatike area in Migori County.

Dr Ayoma said that it was still premature to conclude that the patient had caught the Ebola virus, but was quick to point out that given the symptoms she had presented, and coupled with the current threats caused by the emergence of the disease in the neighbouring Uganda, they could not take chances.

“We have already set up a tent for both the victim and her relative as their blood samples have been sent to KEMRI for urgent analysis,” said Dr Ayoma.

The incident in Homa Bay has come in the wake of fears among Kenyans residing in the Migingo island of contracting the deadly Ebola virus through the free mingling of Kenyans and Ugandans on Lake Victoria.

The Island currently has close to 2000 fishermen from the two countries.

On Friday, Kenyans living on the disputed Migingo have expressed fears of contracting the haemorrhagic disease.

The fishermen and traders said their Ugandan counterparts were trooping to the island in large numbers to fish but were not being screened due to lack of personnel and equipment on the island.

Some of the fishermen expressed fears that they could easily contract the disease because of their daily interactions with their Ugandan counterparts who arrive every day.

http://www.nation.co.ke/Counties/Ebola+scare+as+patient+shows+signs+/-/1107872/1472018/-/cw32lb/-/index.html

Ebola fear hits Kagera
BY EMMANUEL ONYANGO
5th August 2012

A team of medical experts from Dar es Salaam was yesterday dispatched to Kagera region to further examine the two patients believed to be suffering from the Ebola hemorrhagic fever.

But as the team of medical experts was sent to Kagera region, the Ministry of Health and Social Welfare subsequently confirmed the outbreak of the deadly fever in the western part of the country.

Confirming the reports, the Deputy Minister for Health and Social Welfare, Dr Seif Seleman Rashid, also said that a team of medical experts was still diagnosing a patient in efforts to establish the symptoms.

In the meantime, reports from Nyakahanga designated hospital in Karagwe district, Kagera region indicate that there were two patients including a child, suspected to be suffering from the deadly fever that has rocked neighbouring Uganda.

According to one of the doctors who diagnosed the patient at Karagwe’s Nyakahanga hospital, preliminary findings show that the victim might have contacted the Ebola virus.

However, the doctor who requested anonymity told the Guardian on Sunday that ‘further medical examination’ would be conducted to gather more evidence about the possible outbreak of Ebola, adding that the patient had since been quarantined pending final results.

According to the doctor, the ‘Ebola patient’ was brought to the hospital on Friday morning and, upon diagnosis, it was established that the patient had suffered from Ebola. The patient who is a six-year-old child was brought to the Mulongo hospital by his mother from a village close to the Uganda-Tanzania boarder after the child developed severe symptoms.

“We are doing further medical examination on a patient … we will tell the general public once it is confirmed that we are dealing with Ebola virus infections,” the doctor said, adding that currently the patient alleged to have been infected was admitted in a separate room and now lives in isolation from other patients at the hospital.

He said preliminary check-ups found out that the diagnosis had all signs showed clear symptoms of Ebola – after which he ordered the patient to be admitted for closer monitoring locally, and further medical examination by medical experts from the ministry headquarters.

He added that the patient had since been placed in a special intensive care room which is out of bounds for all other people — apart from his mother who is taking care of the patient. However, he said, this was a medical rule aimed at avoiding quick spread of the deadly disease

Another patient also believed to have crossed the boarder from Uganda was admitted at the hospital as well, but medical investigations of his deteriorating health conditions were still not completed by Saturday evening.

As a precaution, the doctor said his hospital team and the district health workers had since started warning people in surrounding villages to take immediate measures whenever they come across such patients. He has also warned the people living closer to the border with Uganda to be careful not to come into contact with any person whom they see vomiting or bleeding – clear signs of someone suffering from Ebola.

On Wednesday this week, Dr. Mwinyi told visibly alarmed legislators in Dodoma that a team of medical experts had been dispatched to the border with Uganda, fully equipped with protective gear and medical supplies.

The minister advised the general public especially those living in the northern regions of Kagera, Mara, Mwanza and Kigoma — some of which share the border crossings with Uganda — to take precautions because the disease was highly contagious.

Earlier, the World Health Organization (WHO) had alerted Tanzania on the Ebola threat, prompting the ministry to issue a press statement elaborating that Ebola
(Ebola HF) was a severe, often-fatal disease in humans and nonhuman primates (monkeys, gorillas, and chimpanzees) that has appeared sporadically since its initial recognition in 1976.

The disease is caused by infection with Ebola virus, named after a river in the Democratic Republic of the Congo (formerly Zaire), where it was first recognized.

The virus is one of two members of a family of RNA viruses called the Filoviridae; there are five identified subtypes of the Ebola virus — four of which have been known to cause disease in humans: Ebola-Zaire, Ebola-Sudan, Ebola-Ivory Coast and Ebola-Bundibugyo. The fifth, Ebola-Reston, has caused disease in nonhuman primates, but not in humans.

SOURCE: GUARDIAN ON SUNDAY

LOL,

Small potatoes

Very worrisome...

Child, that dark humor will keep you sane in a strange world.

It was in the most stagnant hellholes on earth that my dear friends were always the funniest.

I admire that trait in our species.

EA in panic as Ebola strikes again in Uganda

By JOINT REPORT Special Correspondents

Posted Saturday, August 4 2012 at 19:44

Uganda is studying the puzzling behaviour of the Ebola Sudan virus in the latest outbreak that had killed 16 people mid last week.

“So far what we see is that it is atypical. Its behaviour is very suspicious,” Dr Anthony Mbonye the Commissioner for Health Services at the Ministry of Health told The EastAfrican, explaining that unlike the typical Sudan strain, victims in the latest suffer fevers without the bleeding normally associated with the virus.

“Thank God we took a sample early because we would be thinking they are suffering from fever yet it is Ebola,” said Mbonye.

The Uganda Ministry of Health declared an outbreak of Ebola in Kibaale district, about 160km west of Kampala.

Confirmatory test results were done at the Centres for Disease Control, Uganda Virus Research Institute (UVRI) laboratory in Entebbe.

Authorities were following 176 people that came into contact with the deceased while another 38 suspected cases were under observation.

Although it is confirmed as the Sudan Ebola strain, a viral haemorrhagic fever, it is presenting with less bleeding or haemorrhage, as should be the case with Ebola.

Ebola has no cure and vaccine while this particular strain, Ebola Sudan, kills at least 50 per cent of the people who get infected so more deaths are expected.

“We are not seeing much of the bleeding this time,” said Dr Jackson Amone, the Assistant Commissioner Integrated Services at the Ministry of Health who was travelling to Kagadi Hospital in Kibaale, western Uganda, where the first cases were reported.

Ebola typically presents with fever, fatigue, vomiting, diarrhoea, joint pains and bleeding.

“Most of the patients bleed when they are about to die with the cases we are handling. Sometimes you can confuse it for malaria because there is a high fever, vomiting, diarrhoea,” said Dr Amone.

According to health workers, in the absence of body fluids the latest strain is easier to manage because Ebola virus is transmissible through contact with body fluids-saliva, vomit, sweat, blood or other fluids in the body of an infected person.

Like in all Ebola outbreaks in Uganda, patients may have transmitted it to medical personnel. All medical personnel who were initially in contact with the people who died have been asked to stay at home until after 21 days.

As more investigations are ongoing, samples have been sent to the Centres for Disease Control and Prevention (CDC), Viral Haemorrhagic Fevers (VHF) laboratory in USA. Results are expected after one week.

“CDC is sending samples to Atlanta to do additional sequencing. But the indication now is that it is not a new strain. It is the Sudan strain based on PCR testing, which is specific,” said Erik Friedly, the associate head of communication at CDC-Uganda.

http://www.theeastafrican.co.ke/news/EA+in+panic+as+Ebola+strikes+again+in+Uganda+/-/2558/1471392/-/15qobmx/-/index.html?

http://www.freerepublic.com/focus/f-news/2914476/posts

Earlier thread with info on the Uganda Outbreak

An employee at the Nyakahanga hospital, who declined to be named because he was not the spokesperson, said the admitted Ebola- suspected child was placed under quarantine along with his mother. The employee said the child had clear signs of Ebola, including bleeding profusely through his ears and nose when relatives brought him to the Karagwe District Designated Hospital.

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

RE: MATALE

My guess would be that it was one of the 65 people who attended the funeral of the 3 month old girl. Epicenter event.

We know that at least 15 developed the disease and 11 are dead from that event.

Not for sure - but seems logical.

MA

http://www.newser.com/article/da0d8tc83/group-funeral-of-girl-who-became-ebolas-first-victim-was-catalyst-for-spread-of-the-disease.html

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/

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

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.

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

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
________________

Ebola: The fatal costs of a slow response
Friday, August 3 2012 at 01:00

One month after the death of the first Ebola victim at Kagadi Hospital – an infant whose family would lose nine members in all – the country’s hub for containing the deadly virus is still struggling to cope.

“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.”

No resources

Resources have been coming in piecemeal. According to Byaruhanga, World Vision this week donated 400 litres of fuel to fill in the gap, while Centres for Disease Control and the Red Cross have brought in thousands of protective suits. But as reports of suspected cases continue to increase into the district’s sub counties, a lack of the disposable wear has hindered containment efforts.

“At sub county health centres, we are getting reports that they are shying away from handling patients because they don’t have protective gear,” Byaruhanga said.

As of July 31, the ministry reported two new deaths for a suspected total of 16 people to have died from the fatal Sudan strain, diagnosed by the Uganda Virus Research Institute (UVRI) in Entebbe. The ministry said it is following up 176 people in total, to monitor for telltale symptoms of fever, vomiting, diarrhoea, severe blood loss and intense fatigue.

Meanwhile, traumatised health workers are being fast outpaced by what is being asked of them. Though they have been boosted by 100 Red Cross volunteers, MSF, CDC and WHO technical support, local NGOs and even private support, Byaruhanga says morale is low.

“Some of them are demoralised, others are stigmatised because their colleague has passed away,” he said. “They need at least some motivation, like some money to eat lunch.”

The district Ebola taskforce met on July 30, two days after the outbreak was publicly announced by the ministry, and came up with an emergency response plan, which Byaruhanga says asks for more than Shs800m to tackle the outbreak.

According to health ministry permanent secretary Asuman Lukwago, that budget is being considered by cabinet and the national taskforce chaired by Director of Health Services Jane Acheng, who assesses field needs daily.

“We are mobiliing funds,” Lukwago said. “We have money in our budget for emergencies.”

The ministry’s top bureaucrat says the financial year, which began in July, has opened up a Shs2.5b reserve fund which can be fronted by National Medical Stores to stem the crisis.

One outbreak to the next
The last Ebola scare was quickly contained, and the sole confirmed case of a 12-year-old girl dying in Luwero district, only 75km from the capital, did not spread.

When a Kagadi health worker was transferred and died at Mulago Hospital one week before the outbreak was even announced, officials there had no idea that Ebola was even a worry, Byaruhanga said.

But according to the ministry, the seven remaining health workers being observed there under isolation have not presented with any symptoms, and no new cases reported in the capital.

This delay was due in large part to the family’s spiritual beliefs.

“Losing three people in a day, people would think it is something strange and not normal, so they said this was because of the witch doctors,” Byaruhanga said.

“Actually, it blindfolded other research that would have taken place.”..http://www.monitor.co.ug/artsculture...z/-/index.html

Secretary of State Hillary Rodham Clinton speaks to Reach Out Mbuya, a health clinic that has HIV/AIDS outreach, Friday, Aug. 3, 2012, in Kampala, Uganda. Photo: Jacquelyn Martin, Pool / AP

The national census in 2002 estimated the population of the city at 1,189,142. The Uganda Bureau of Statistics (UBOS) estimated the population of Kampala at 1,420,200 in 2008. In 2011, UBOS estimated the mid-year population of the city at 1,659,600.

Kampala is the largest city and capital of Uganda. The city is divided into five boroughs that oversee local planning: Kampala Central Division, Kawempe Division, Makindye Division, Nakawa Division and Lubaga Division. The city is coterminous with Kampala District.