New deadly strain of Ebola emerges

[Dornroeschen]

New deadly strain of Ebola emerges
Hemorrhagic virus has infected dozens in Uganda
The Associated Press
updated 1:41 p.m. MT, Thurs., Nov. 29, 2007

A new strain of Ebola virus has infected 51 people and killed 16 in an area near Uganda’s border with Democratic Republic of Congo, U.S. health experts said on Thursday.

Analysis of samples taken from some of the victims show it is a previously unknown type of Ebola, a team at the U.S. Centers for Disease Control and Prevention said.

“This virus didn’t behave as would be expected of some of the known strains,” Dr. Tom Ksiazek, current chief of the CDC’s special pathogens branch, said in a telephone interview.

“That tipped us off that this is probably a novel or new strain of Ebola.”

Ugandan health officials have said the virus appears to be unusually mild, but Ksiazek said it is not yet clear if this is the case. He said experts need to check to see how many diagnosed patients are still alive.

Ebola is a hemorrhagic fever, meaning it can cause internal and external bleeding. Victims often die of shock but symptoms can be vague, including fever, muscle pain and nausea.

There are four identified strains, Ksiazek said. The two strains that cause the most human disease are the Zaire and Sudan strains, named after the countries in which they first appeared.

A strain called Reston caused an outbreak in a primate facility in the Washington, D.C. suburb of the same name while a single human case in Ivory Coast was caused by the Cote d’Ivoire strain.

The Zaire strain killed 80 percent of victims, while the Sudan strain had just over a 50 percent mortality rate.

The new strain would be the fifth identified. Ksiazek said it had not yet been named.

The CDC said nine researchers were helping in the response to the Uganda outbreak and another team was waiting for an official invitation from Uganda’s government before heading there to help.
© 2007 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

URL: http://www.msnbc.msn.com/id/22028651/

 

[Exodia]

WHO reports new Ebola virus subtype in Uganda

Nov 30, 2007 (CIDRAP News) – The World Health Organization (WHO) today announced an outbreak of Ebola hemorrhagic fever in Uganda involving a new subtype of the virus that officials suspect was responsible for sickening 51 patients, including 16 who died.

The focus of the outbreak is Bundibugyo district in the western part of the country, the WHO said in a statement today. The reported case-patients include three healthcare workers, one of whom died. Patients are being treated at hospitals in Kikyo and Bundibugyo, the WHO reported.

Analysis of patient samples at the National Reference Laboratories in Uganda and the Centers for Disease Control and Prevention (CDC) in Atlanta have confirmed that a new species of the Ebola virus was involved in the outbreak, the WHO said. Four Ebola subtypes have previously been identified: Zaire, Sudan, Cote d'Ivoire, and Reston.

Investigators from Uganda's health ministry and the WHO said the outbreak might have begun in September, the WHO said. A task force involving the health ministry, the WHO, and international health groups is responding to the outbreak.

WHO spokesman Gregory Hartl said the WHO was particularly concerned about the outbreak because patients are presenting with somewhat unusual symptoms for Ebola, such as vomiting, the Associated Press (AP) reported today.

Pierre Formenty, a WHO hemorrhagic fever expert, told the AP that news of a new Ebola strain "is an important discovery for the scientific community."

"This could be a milder strain of the disease, but we still need additional information to confirm that," Formenty said.

The Ebola virus is highly contagious and known for its high fatality rate, ranging from about 50% to 90%. Initial symptoms include fever, headache, joint and muscle aches, sore throat, and weakness, followed by diarrhea, vomiting, and stomach pain, according to the US Centers for Disease Control and Prevention (CDC). Some patients have internal and external bleeding. There is no vaccine or specific treatment for the disease.

Uganda's last Ebola outbreak occurred in 2000 and involved the Sudan subtype, according to the CDC. In that outbreak, 425 cases and 224 deaths were reported.

The Democratic Republic of the Congo (DRC) had an Ebola outbreak in the DRC's Kasai Occidental (West Kasai) province that began in August and involved at least 17 cases and 6 deaths, according to previous reports. The DRC health ministry said on Nov 20 that it had been contained.

http://www.cidrap.umn.edu/cidrap/content/bt/vhf/news/nov3007ebola.html

 

[Exodia]

Ebola outbreak spreading

02/12/2007 15:58 - (SA)
Kampala - The Ebola outbreak that has killed 18 people in western Uganda appears to be spreading, officials said on Sunday, as authorities examined a sample taken from a dead patient in the south of the country.

Government officials told AFP that the disease, which flared in September, had spread to three new zones in the impoverished Bundibugyo district near the border with the Democratic Republic of Congo.

Virologists were meanwhile examining a sample taken from a suspected victim who died overnight in Mbarara region, 160km southeast of the affected district.

Medics flee

Health officials said several dozen medics and support staff had fled the Bundibugyo when their co-workers became infected with the virus in an outbreak that has already killed 18 people and infected 61.

Virologists were also investigating an isolated patient in the neighbouring Port Portale district as well as the fatality in Mbarara.

"There are fears that the disease has spread," said a top health ministry official, who requested to remain unnamed.

"We are waiting for the results from the samples," he said of the two cases that have spread panic in the east African nation.

The disease, which is fatal in 90% of cases, is spread by contact of body fluids, primarily contamination of blood.

Unknown strain

Meanwhile, epidemiologists and virologists are in Bundibugyo district to try to trace backwards the source of the virus as part of a campaign to avoid future outbreaks.

Authorities say the outbreak was an unknown strain after analysis was done on tissue samples at the laboratories of the Atlanta-based Centre for Disease Control.

Known Ebola sub-types usually attack capillaries and blood vessel linings, draining the body of blood through openings, leaving the patient to die in shock, doctors say.

But the new Uganda subtype, which provokes high fever, kills victims without much loss of blood.

http://www.news24.com/News24/Africa/News/0,,2-11-1447_2231444,00.html

 

[Exodia]

Blog, just posted by docs on the ground at ground zero in Uganda:

Monday, December 03, 2007
Ebola in Bundibugyo: Monday night, still escalating

The official case count has gone up from 51 to 79 since the initial numbers were released four days ago. We now have 21 admitted in Bundibugyo (up from 16 yesterday) while only one more patient came to Kikyo (10 total). Dr. Sessanga continues to struggle on with his case; Dr. Jonah needed IV fluids today but was reported to be stable. It was another dawn to post-dusk day for Scott, which included two three-hour-long meetings as well as final assembly and initial use of a brand new lawnmower we just imported in the nick of time to keep the airstrip open for the sudden increase in flights. Three MSF personnel hitched a ride in on the plane that took our team out; more CDC and WHO folks are expected on Wednesday, so keeping the airstrip open is an important part of the logistics of this operation. Pray for Scott to have wisdom to know his role, to respond with leadership and compassion and wisdom and courage. We are used to being a bit more on the sidelines politically, focusing on patient care. This crisis throws him into the middle of everything, and the lines of authority are not always clear. Added to that is the fact that this is a new strain, so if one person makes a statement about transmission and another challenges it, we really can’t be sure who is right, because this epidemic may not progress in the same way that others have done. The MSF team is impressive and fascinating, they are tracking numbers and plotting maps and have already concluded from interviews that besides patient care in the hospital, the greatest risk factor is the handling of dead bodies at burial.

We do sense the incredible outpouring of concern and prayer from our friends. It is a bit edgy to go hour to hour with the background thought of . . .do I feel a twinge of nausea, could that be a fever coming on . . . But mostly we remain confident that our measures to protect ourselves even before we knew the gravity of the situation were adequate. The kids made it to Kampala safe and sound, and compared to the agony of deciding to send them away, the reality of missing them is not nearly as painful. Scott was remembering the days of war, when the team dwindled down to two or three adults only, it feels like that again now, with all the separation and uncertainty.

http://paradoxuganda.blogspot.com/

 

[BigFootsCousin]

Can you imagine how bad this would be if it was let loose in a large city?

If this wasn't so isolated in its geographical local, I bet that the patient demographics would be much more alarming.

How do you prep against something like this? I don't think that you can. Except maybe practise isolationism in your own home.

BFC

 

[Exodia]

bump for the evening crowd

 

[Swamp Wallaby]

Carp! With something as infectious as Ebola, the emergence of a 'milder' strain is really bad news. In the past, whole villages have died before the inhabitants had a chance to spread the disease. With a milder form, one would think that people will remain infectious for longer, and asymptomatic carriers are more probable, too. Never mind that they're less likely to be abandoned by medical staff, which means more chance of exposure for them. 18 out of 69 is still a 26% mortality rate, and if transmissablilty isn't affected by the mutation... Lets hope the PTB jump on this with both boots and stamp it out before it spreads any further.

Not good. Not good at all.

 

[WriterMom]

Carp! With something as infectious as Ebola, the emergence of a 'milder' strain is really bad news. In the past, whole villages have died before the inhabitants had a chance to spread the disease. With a milder form, one would think that people will remain infectious for longer, and asymptomatic carriers are more probable, too. Never mind that they're less likely to be abandoned by medical staff, which means more chance of exposure for them. 18 out of 69 is still a 26% mortality rate, and if transmissablilty isn't affected by the mutation... Lets hope the PTB jump on this with both boots and stamp it out before it spreads any further.

Not good. Not good at all.

Great comments! Just thinking out loud here.....I wonder if those infected with the milder strain who survive might also be immune to the more deadly strains. If so, they would be a valuable asset to medical teams treating other patients.

Also, I wonder why there is no vaccine yet for Ebola. I'll have to look into that...

Writermom

 

[Exodia]

Update from Paradoxuganda blog:

Tuesday, December 04, 2007
Ebola in Bundibugyo-Tues-Day 6

I hit the wall, perhaps because now my kids are out of the danger zone (I hope), perhaps because we’re finding it hard to sleep, perhaps because we now have lots more information on Jonah who is holding his own but definitely continuing to have symptoms, perhaps because the adrenaline has limits. I’m very weary, and back to borderline weepy.

Jonah: still with fever, not terribly high, still with diarrhea, no bleeding, up and talking and walking and drinking in Mulago Isolation unit. Day 5 of illness.

Sessanga: Refused to unlock door for Scott to enter his house this morning, but answered the phone. Diarrha and vomiting better, but complaining of headache.

BGO Isolation ward: one death this morning 5 am, another contact of Jeremiah Muhindo, who seems to have been very infectious. 2 new admissions, so total caseload 22. Scott says they are finally getting up the mesh fence and controlling the access a bit better.

Kikyo: no news yet today.

The rest of Uganda: Panic mode. Lots of people are coming to have their symptoms evaluated at other hospitals, worried. We have word from the CDC that their lab in Entebbe should be functional on Wednesday, so that will help SO MUCH with the sense of impending spin-out-of-control spread, if the suspect cases from Fort Portal and Mbarara are not confirmed (though I don’t even want to think what it will be like if they are).
The REST of the patients in BGO: Scott got called for another obstetric emergency at 7:30, was up to BGO by 8 but the mother had died, perhaps a ruptured uterus. She had delivered one twin in a distant health center, but by the time they got her to Bundibugyo and called it was too late. He and Scott Will saw all the maternity ward inpatients this morning, trying to discharge those not critical for their own protection. He ultrasounded about 15 women. Staff are present and functioning. There is a police surgeon who came in, and we anticipate any moment the arrival of another doctor sent by Ministry of Health, to be medical superintendent.
The REST of the patients in Nyahuka: Meanwhile I went down to Nyahuka where we still do not have any confirmed cases, nor is there anyone admitted for isolation. The staff is somber but present, willing to work, even a couple of nurses who are not usually there showed up to volunteer during their school break! That surprised me. Since I don’t have any kids I made “hot ice cream”, milk from our cow cooked with eggs and sugar, and took the whole lot down to the ward to feed warm to the inpatients. I was able to discharge 8 kids, one I hesitated on since he had hepatosplenomegaly and diarrhea and a prolonged fever, though he was improving, I considered whether he qualified as an alert case . . . . Then I was called to see a new admission, who is almost certainly going to die. A two-year-old, malnourished-looking, with a week and a half history of fever at home, mucus stools. Not classic Ebola symptoms by any means, but when I saw him gasping and hot and dehydrated . . . I put on gloves at least. Then the knot of panic began to build—is this kid infected? What should I do? Called Scott who called MSF who said that they never saw a child as the first case in any community, so since this kid was from a village with no cases and the only one sick, not considered a suspect. OK. We are giving IV fluids, antimalarials, and antibiotics, but I think they came a day or so too late. When all the inpatients were seen and I had moved around the hospital checking in with all the staff, I came back up to the community center where we had shifted our normal first-Tuesday-of-the-month distribution of food to families with motherless infants (we provide a month of milk when a mother dies, then a ration of beans to increase the caloric intake of a surrogate breast feeder). I should have counted, we must have had 40 families or more. We used the opportunity to do some community education about Ebola, they asked good questions, like WHERE DOES THIS DISEASE COME FROM??? And another lady wanted to know what she should do if her husband gets sick, should she care for him or keep away with the baby??

In a single day we can go back and forth twenty times from “we are OK, we are protected, people are praying for us, we will get through this” to “what if one of us or even worse both gets sick?” Is it wrong to feel anxious when you’re living in the middle of an Ebola epidemic? I don’t think God will judge us. I miss my kids, oddly when I read about myself in my team’s emails I cry.

Posted by DrsMyhre at 4:40 AM

http://www.paradoxuganda.blogspot.com/

 

[Exodia]

Uganda says suspected Ebola cases rise to 75
Tue 4 Dec 2007, 13:18 GMT
By Tim Cocks

KAMPALA (Reuters) - At least 75 Ugandans are now suspected to have contracted a previously unknown strain of the lethal Ebola virus, although the death toll in the east African country remains at 18, an official said on Tuesday.

Uganda confirmed on Sunday it had 58 cases of the virus, which causes symptoms including fever, vomiting, diarrhoea and bleeding. The infected include medical staff looking after Ebola patients, deputy health minister Dr. Emmanuel Otaala said.

"Since the outbreak started back in August, we have registered 75 suspected cases," he told reporters.

Otaala said all patients were in Uganda's western Bundibugyo district, bordering Democratic Republic of Congo, except one nurse being treated in the Ugandan capital Kampala who contracted it in Bundibugyo.

Otaala denied claims in the local press that the government knew of the outbreak but concealed it to avoid putting off the 53 heads of government and thousands of delegates -- including Britain's Queen Elizabeth -- who came to Kampala 11 days ago for the Commonwealth Heads of Government Meeting (CHOGM).

The government announced the Ebola outbreak four days after the summit ended, fuelling speculation of a cover-up.

"We did not keep quiet after learning that we were dealing with Ebola. The medical fraternity would not go to the expense of leaving people to die...because we are hosting CHOGM," Otaala said.
Genetic analysis of samples taken from some victims shows this virus is a previously unrecorded type of Ebola, making it the fifth strain, U.S. and Ugandan health officials say.

The World Health Organisation says it is concerned about the way the virus keeps mutating.

Victims of Ebola -- known to infect humans, chimpanzees and gorillas -- often die of blood loss, but the fever and dehydration can also kill. Otaala said this strain was less lethal than previous ones identified, which normally kill 50 to 90 percent of those infected.

"We have so far registered 18 deaths ... this is a 25 percent (death rate). That means we are dealing with a milder form of Ebola," he said.

Uganda was last hit by an epidemic of Ebola in 2000, when 425 people caught it and just over half died.

This year, an outbreak in Congo -- where some of the first recorded cases in 1976 gave the virus its name after the country's Ebola river -- infected up to 264 people, killing 187.

http://africa.reuters.com/top/news/usnBAN447851.html

 

[Double_A]

One of the reasons Ebola has been so isolated is that it is a HOT disease, so hot it kills all it's victims before they can travel far enough to spread it.

A milder less lethal would have the potential to travel farther and while less deadly, kill more people.

 

[Oreally]

One of the reasons Ebola has been so isolated is that it is a HOT disease, so hot it kills all it's victims before they can travel far enough to spread it.

A milder less lethal would have the potential to travel farther and while less deadly, kill more people.

So far there have been four strains of Ebola. Three of them affect humans - one that only has affected monkey (Reston) . That strain was airborne; the others are only transmitted through fluids.

The great danger here is if this new strain is airborne. If so, heaven help us.

Also, Dr. Niman has brought up the possibility of a recombinant stain of Ebola and H5N1 flu.

 

[Exodia]

Fears of a New Ebola Outbreak
Monday, Dec. 03, 2007 By ALEXIS OKEOWO/KAMPALA

When the Ebola virus resurfaced in the Democratic Republic of Congo earlier this year, health officials hoped to contain the outbreak to the east of the central African country, keeping it to a densely forested area accessible only through dirt roads and tiny villages. That epidemic, which was at its height earlier in the fall, saw 187 people killed and 267 more infected. But the extremely contagious disease, which has a 90% death rate, has now spread to neighboring Uganda, where a new strain of the virus has already killed 19 since September. Now, as the Ebola strain continues to sweep western Uganda, the question is how — and if — the virus can be stopped in time to prevent more mass deaths.

"We are doing everything possible to stop the spread," says Dr. Sam Zaramba, Uganda's top health official. For weeks, Uganda's health ministry released statements about a "mysterious" virus plaguing Bundibugyo, a western region on the border with the Congo. Uganda experienced an outbreak of the Marburg virus — a rare-Ebola like hemorrhagic fever — this summer, raising speculation that the disease had returned. Ebola was last in Uganda in 2000, when 425 people were infected, and over half, including a doctor, died.

But it was only last week that health authorities identified the disease as the Ebola virus after a three-month delay. The lack of rural labs to test phantom viruses resulted in the staggering delay in diagnosis. Ebola symptoms are also vague, and health officials did not suspect the virus was present until it hit its epidemic stride. Meanwhile, local populations have been burying deceased but infected relatives without protection. Usually, infected corpses are covered in plastic before they are buried.

To make matters worse, medical staff members fled treatment centers last week after six health workers were infected with the virus. Ebola is contracted through body fluids, particularly blood, putting at risk health workers who are working in centers without protective gear and proper sanitation. Zaramba says, however, that the workers were likely exposed in the time gap before the virus was correctly classified.

There is no known cure or vaccine for Ebola, which has symptoms of nausea, fever and muscle pain. Humans, chimpanzees and gorillas usually die of shock when the virus attacks capillaries and blood vessel linings, draining the body of blood in a vampire-like manner. The new Ugandan strain kills patients by inducing high fever, without much loss of blood, according to Dr. Sam Okware, head of Uganda's national hemorrhagic fever task force.

The conventional wisdom was that Ebola is containable because it kills its victims faster than it can find new ones. However, conditions on the ground are now proving otherwise. While 61 cases have been identified, Zaramba says the health ministry is having difficulty detecting more cases or identifying people with whom patients had contact. And as of the weekend, the disease had spread to three new zones in Bundibugyo district. Local officials speaking on the condition of anonymity say that the death toll is almost twice that reported.

However, says Zaramba: "We believe this Ebola outbreak is not as serious as the strain we had in 2000." Still, he says, "we cannot predict what will happen." Rwanda, Uganda's southern neighbor, announced Saturday it was tightening health border controls to prevent the disease from spreading south. A team from the U.S. Centers for Disease Control and Prevention will arrive in Uganda this week for further investigation and to advise on further containment of the disease.

http://www.time.com/time/world/article/0,8599,1690210,00.html

 

[Exodia]

Uganda Ebola death toll hits 19
2 hours ago

KAMPALA (AFP) — The dreaded Ebola virus has killed 19 people in western Uganda since September, officials said Tuesday, with new outbreaks of linked diseases surfacing in other parts of the country.

Hours after the 19th Ebola patient died in Bundibugyo district, State Health Emmanuel Otaala highlighted fears of extremely contagious cholera, plague, meningitis and hepatitis outbreaks.

"As we are trying to contain Ebola, we came across four other outbreaks," Otaala told reporters.

The health ministry reported cholera in western Hoima and northeastern Nebbi districts; plague in Nebbi; meningitis in Nebbi and Arua district and hepatitis in northern Kitgum district. Ebola killed at least 170 people in Uganda in 2000.

"We are encouraging people to wash their hands, avoid shaking hands, bury the dead with caution and avoid sex because sexual fluids can also spread diseases," he explained.

No figures were given on the new outbreak, except for plague that has infected some 25 people, mainly women.

Health experts fear that Ebola may have spread unnoticed in the mounting medical chaos, its rubberstamp haemmorhaging obscured by companion ailments, only to emerge when cases reported in hospitals.

Epidemiologists are concentrating on western Uganda -- near the frontier with Democratic Republic of Congo -- where a nurse died Tuesday, bringing the Ebola toll to 19 while 64 others infected.

Worried about possible contamination in hospitals, some patients have hidden, complicating the drive to isolate cases, said Samuel Kazinga, district commissioner for Bundibugyo, epicentre of the new outbreak.

"The Congolese have closed their border at Busunga and installed custom officers, who are not allowing movement of people between the two nations," he added.

Blood and tissues samples from two patients who died in neighbouring Port Portale district and southern Mbarara region are at Uganda's Virus Research Institute awaiting screening.

Alarmed that eight medics had been isolated with Ebola symptoms, the health ministry said it was sending more plastic aprons, respirator masks, latex gloves and goggles to the affected district.

Five experts from the Atlanta-based Centers for Disease Control (CDC) that identified the new Ebola virus, are expected in Uganda on Tuesday to carry out tests.

CDC Special Pathogens Branch chief Thomas Ksiazek said it was not yet clear whether the Ebola virus in the current outbreak was more or less deadly than the four previously detected.

Spread primarily by body secrection, mainly blood, Ebola is fatal in up to 90 percent of its cases, mostly killing its victims from both external and internal haemorrhages.

Health authorities say that virus erupted in September but was only identified last week after being obscured by other ailments.

The rare disease killed at least 170 people in northern Uganda in 2000, with experts blaming poor sanitation and hygiene.

The Ebola virus was first detected in the Democratic Republic of Congo and Sudan in 1976. There have also been outbreaks in Ivory Coast and Gabon.

Experts have said the disease is usually containable because it kills victims faster that it can spread to new ones.

http://afp.google.com/article/ALeqM5i8F4hljiXzj8L-guVQf3olxqqMjg

 

[Exodia]

Part of the paradoxuganda blog:

Ebola in Bundibugyo: Tues night Report

The District Task Force responding to the Ebola crisis meets every evening for several hours, and today I went with Scott. Mostly because I felt so wiped out by the day in general and wanted to stick with him, as well as experience the politics and planning side of the epidemic. About two dozen people, mostly men, mostly Ugandans except us, MSF, and two Kenyan epidemiologists, gathered in a circle of chairs outside the RDC’s office. Bottom line: there are a slew of competent and motivated people at work. The RDC himself serves as chair, and he’s an impressively large and voluminous presence, practical and authoritative, the kind of person you want in charge.

THE FACTS:
cumulative cases as of 5 pm on Tuesday: 90

cumulative deaths: 19

New admissions: 7; that includes 3 in Kikyo and 4 in Bundibugyo

Current admissions: 23 in Bundi, and I think 14 or 15 in Kikyo

Positive lab samples: 9, but that will change tomorrow, since there are about 15 samples waiting to be sent on the flight, and the CDC has landed and will be operational with their biohazard level 4 virology lab in Entebbe tomorrow.

Identified contacts being followed: 327 (which does not include Scott or me, though the epidemiologist told us to follow ourselves because we should be considered contacts)

Subcounties from which suspected cases have originated: 5 (Kasitu 50, Bubukwanga 18, Bundibugyo Town Council 10, Busaru 4, Harugale 3, others unknown). Note that the case may be counted as arising from a subcounty because the patient’s home is there even if the contact was made elsewhere . . .
snip

http://www.paradoxuganda.blogspot.com/

 

[Exodia]

How districts are handling Ebola cases
Tuesday, 4th December, 2007 E-mail article Print article

Kabarole
Officials at Buhinga Referral Hospital in Fort Portal have said they will no longer admit Ebola cases for fear of infecting other patients.

“The hospital is a centre for so many people and it is located in the middle of the town”, said the superintendent, Dr.Abdallah Shabban. “We have so far received only one patient who was bleeding from the nose. The person was treated and taken back home.”

Kichwamba Health Centre III, about 10km from Kabarole town on the road to Bundibugyo, will be the reception centre for suspected Ebola cases, he announced. It was at a distance from the town and would reduce the risk of infection, he explained. Meanwhile, Fort Portal authorities met hotel, restaurant and lodge managers, asking them to take extra precautions. The principal health inspector, Gilbert Mbeire, said people should avoid using towels to dry their hands because they can easily spread the virus. Hotel operators were requested to provide running water and use disinfectants such as jik to wash bed sheets and clothes.

Hoima
Hoima district authorities were yesterday thrown into a panic over a suspected Ebola case, prompting them to stop any visitors from Bundibugyo and Kabarole districts. In a statement, the authorities warned residents against travelling to the two districts until the situation normalised.
It was signed by superintendent Dr. Emmanuel Moro of the Hoima referral hospital, who also heads the newly-formed district surveillance committee.

The committee, charged with detecting any suspected cases, is part of a 15-man Ebola taskforce formed during an impromptu meeting, convened yesterday by the Hoima RDC Martha Asiimwe to respond to any possible outbreak. Asiimwe told a hastily called meeting that fear had spread at Tontema village in Kyangwali sub-county after one of the residents developed signs of the haemorrhage fever. “We have assigned the acting district health officer, Dr. Joseph Ruyonga, and another medical officer to monitor the suspected case and recommend appropriate measures,” she said.

The meeting opposed a suggestion to refer the case to Hoima Hospital, saying it was more effective to treat him in an isolation centre. Kyangwali sub-county, where the case was reported, hosts Kyangwali resettlement camp, which has over 7,000 Sudanese, Congolese and Rwandan refugees.

It is also very close to Kingfisher oil site, one of the biggest oil wells managed by the Heritage Oil and Gas Company.
The Hoima RDC said the ministries of energy and health had contacted both Heritage and Tullow oil companies, which are operating in the area, to prepare for a sensitisation campaign among their workers.

“A team of the Ministry of Health technical staff is going to beef up our district staff so that we carry out an effective campaign among the oil workers as quickly as possible,” Asiimwe said.

Kasese

The World Wildlife Fund (WWF) has suspended its operations in Kasese following the Ebola outbreak in the Rwenzori region. According to a statement issued by the WWF office in Kasese, the organisation will only resume work when the epidemic is over.
Kasese secretary for environment, Sylevano Mulhondi, described the suspension as unfortunate. WWF had been helping the region in conserving the environment.
Their departure means that the recently launched tree planting campaign would hit a snag, he noted.
WWF had been operating in the districts neighbouring Mt. Rwenzori National Park, which include Kasese, Kabarole and Bundibugyo, and across the border in Virunga National Park in the Democratic Republic of Congo.

It is the second organisation to leave the area. Last week, Save the Children Uganda suspended its activities in Bundibugyo and Kasese, including the regional education day celebration.
Save the Children Uganda manager for Kasese district, Kanku Francis, on Sunday said the celebrations were cancelled due to the Ebola outbreak.

Meanwhile, Kasese district has put in place measures to stop the spread of the virus. A 25-member task force has been appointed, chaired by the Kasese Resident District Commissioner, Capt. James Mwesigye. The committee, as a first move, banned the selling and drinking of malwa in Kasese.

According to health expert, sharing the straw could spread the virus. All public places and bars selling malwa have been closed. The committee also stopped the transport of smoked fish, commonly known as Bikayabu, from Ntoroko in Bundibugyo to Kasese and some parts of Congo.
The Kasese district vice-chairperson, Joshua Masereka, said the business could contribute to the escalation of the disease.
The committee also resolved to increase the salaries of medical workers, drivers and the burial team, deployed in the isolation centres, to sh75,000 per day.

Kibaale

The Kibaale district local government has banned all inter-district transactions with Bundibugyo, as well as all businesses at the shores of Lake Albert, in an effort to stop the spread of Ebola to Kibaale.
Addressing journalists at the district headquarters on Monday evening, the director of district health services, Dr. Dan Kyamanywa, announced that no business activities would be allowed at Ndaiga, Kabukanga and Kitebere landing sites in Kibaale district.

The outbreak in Bundibugyo could easily affect Kibaale due to the daily movements along Lake Albert, he noted. “Given the nature of business taking place on Lake Albert, such as fishing and the movement of passengers from Congo and Bundibugyo, we have no choice but to limit the movement of people on the landing sites on Lake Albert,” Kyamanywa said.
The affected landing sites are Kabukanga, Kitebere, Ndaiga, Kamina, Rwebigongoro, Nyamasoga. Other small fishing villages are also affected.

“If Ebola hits Kibaale, dealing with it will be very difficult given the inadequate staffing we have. Therefore, we must use all means at our disposal to avert the spread of the epidemic to our area,” Kyamanywa said.

He directed the beach management units and the Police to park all the boats at the landing sites to avoid unnecessary movements until further notice.
Kibaale district shares part of its border with Bundibugyo district, where the Ebola epidemic has claimed over 18 lives.


http://www.newvision.co.ug/D/8/12/600487

 

[Exodia]

hat-tip MoMosMom at PFI

Uganda: Bundibugyo Nurses Strike

The Monitor (Kampala)

4 December 2007
Posted to the web 4 December 2007

Tabu Butagira, Joseph Mugisha, and Emmanuel Gyezaho
Kampala/Bundibugyo

HEALTH workers handling Ebola patients in Bundibugyo temporarily abandoned duty yesterday morning over delayed payment of their risk allowances and only resumed work after local leaders cleared the overdue bills in the afternoon.

Citing eight of their colleagues who have since contracted the disease while on duty, one health worker said their condition of work was precarious and it was "inhumane" for government officials to hold back "our" little pay.

"For us, no payment of our risk allowance, no work from today onwards," one of the disgruntled nurses said.

Bundibudyo MP Jane Alisemera sounded alarm bells yesterday in Parliament urging the government to "urgently find financial resources" because "volunteers are withdrawing due to none payments."

"They cannot continue working because they are operating under dangerous circumstances."

Bundibugyo RDC, Samuel Kazinga who heads the local Ebola taskforce in the district, downplayed the morning hitch that sparked a wave of panic among district officials, saying the complainants only "demanded" their pay.

"It is one thing to demand and another to strike but we have now paid part of the money they were demanding," said Mr Kazinga, who had earlier attributed the pay to bureaucratic delays in processing payment.

Daily Monitor has learnt that officials of the district Ebola Taskforce were paying doctors a daily risk allowance of Sh30, 000 while nursing officers and other support staff were getting Sh20, 000 and Sh10, 000 respectively.

In Kampala, Unicef Country representative Keith McKenzie told a government-organised news conference that the NGO had sent Sh230 million directly to Bundibugyo District to support the Ebola fight, "including payment for health workers. Latest statistics show that Ebola has killed 19 people out of 74 cumulative infections.

The latest victim has been identified as Mighten Muliwaviyo, the chairman of the business community in Bundibugyo town council who died on Monday night, amid reports of new infections in Kasese, Kabarole and Mbarara District.

By last evening, a man identified as Mr Johnson Baluku, who showed symptoms akin to that of Ebola, was reported to have been admitted at Bwera Hospital in Kasese while three alert cases were registered in Kabarole District.

The minister is expected to table the "emergency funds" budget to his colleagues during the Cabinet sitting today.

The junior minister had indicated that the Sh6b would be used for among other things; meeting recurrent operational costs, buying medical supplies and protective gears as well as paying risk allowance for health workers handling Ebola patients.

Unicef has through the central government separately given protective materials, medical equipments and supplies worth Sh861m to tackle the epidemic.

 

[Exodia]

hat-tip to Commonground at PFI

Two doctors die as Uganda Ebola toll climbs to 21
19 hours ago

KAMPALA (AFP) — The Ebola virus has killed two doctors in western Uganda, bringing the toll to 21 since the strain first appeared in September, an official said on Wednesday.

"The sad news is that our doctor who was admitted in Mulago died last night and a senior clinic officer who had been in critical condition died this morning," said Samuel Kazinga, district commissioner for Bundibugyo, the epicentre of the new outbreak.

Kampala's Mulago hospital is the largest in the country. Some health officials have said that a lack of appropriate equiment in Mulago and other hospitals has allowed the virus to spread.

The health ministry confirmed the latest fatalities caused by the virulent local strain of Ebola, which kills up to 90 percent of its victims, mostly by puncturing blood vessels and spurring non-stop hemorrhage.

Eight pathogen experts from the Atlanta-based Centers for Disease Control (CDC) arrived in the country on Tuesday to help battle the disease that has infected at least 64 people in Uganda.

Efforts to isolate suspected patients in the rural district neighbouring the Democratic Republic of Congo (DRC), have failed as many residents fear hospitals are unsafe, authorities have said.

The rare disease, named after a small DRC river, killed at least 170 people in northern Uganda in 2000, with experts blaming poor sanitation and hygiene.

It was first discovered in the DRC in 1976, but other outbreaks have been recorded in Ivory Coast and Gabon.

http://afp.google.com/article/ALeqM5i8F4hljiXzj8L-guVQf3olxqqMjg

 

[Exodia]

Commentary

Fatal Ebola Infections in Three Health Care Workers in Uganda

Recombinomics Commentary
December 4, 2007
http://www.recombinomics.com/News/12050701/Ebola_HCW_Fatalities.html

"The sad news is that our doctor who was admitted in Mulago died last night and a senior clinic officer who had been in critical condition died this morning," said Samuel Kazinga, district commissioner for Bundibugyo, the epicentre of the new outbreak.

Joshua Kule, the senior clinical officer, and the head nurse of the hospital (Peluce) also died this morning, so with Jonah that brings 3 of 6 health care workers admitted dying within 12 hours of each other.

The above comments describe the deaths of three health care workers in the past 12 hours. One had been admitted to the hospital in Kampala, while two were admitted locally. The high fatality rate for the health care workers as well as clusters of cases, raise additional transmission concerns.

One group was linked to attendance at a funeral, raising concerns of transmission by casual contact. The CDC is setting up a local lab for testing, so the number of confirmed cases should rise shortly, which will help determine the spread of the infections..

The sequence of the virus from patients is said to represent a new species, which is almost certainly a recombinant.

Details on the sequence would be useful.

 

[Dornroeschen]

Panic spreads as Uganda reports 101 Ebola cases
By Tim Cocks
Reuters

KAMPALA

Uganda has 101 suspected cases of Ebola fever and hundreds more people being closely monitored, officials said on Friday, as fear grew in Uganda and neighboring countries that the deadly virus might spread.

Twenty two people have so far died of the fever and Minister of State for primary health-care Dr. Emmanuel Otaala told journalists 11 health workers have fallen sick.

"Cumulatively, we have 101 cases," he said.

Another 338 people are being monitored because they came into contact with those infected by the virulent hemorrhagic fever, which often causes victims to bleed to death through the ears, eyes and other orifices.

All were in western Uganda's Bundibugyo district, except for two in Kampala, including a doctor who died. Otaala said the cabinet had approved a pay increase to compensate health workers taking on the risk of dealing with Ebola.

The outbreak, which started in August, has sparked panic amongst officials, health workers and the public, with the medical union calling on staff to refuse looking after patients unless they are issued proper protective gear.

The affected region borders Democratic Republic of the Congo, whose Ebola river gave the virus its name after some of the first cases were recorded in its valley in 1976.

The independent Daily Monitor said Congo had sealed its border with the district. Congolese officials denied this.

"We have just informed people in the region they need to be vigilant," Congolese Health Ministry official Dr Benoit Kabela told Reuters by telephone from Kinshasa. Kabela said medical staff had been deployed and given protective gear.

Meanwhile, southwestern neighbor Rwanda said it had set up mobile clinics and isolation wards at border posts with Uganda.

"The Ministry of Health has deployed trained medical personnel at the borders," spokeswomen Ines Mpambara said.

Kenya is also screening Ugandans at its western border.

The four-month delay between the start of the outbreak and confirmation last week that it was Ebola has raised suspicions the government covered it up so as not to scare delegates -- Britain's Queen Elizabeth and 53 heads of government -- who met in Kampala two weeks ago for a Commonwealth summit.

The government denies it hid information. "Confirmation of this epidemic took a long time because we had to go to (the U.S. Centres for Disease Control and Prevention in) Atlanta," Otaala said.

The last Ebola outbreak in Uganda was in 2000, when 425 people caught it and more than half died.

Meanwhile, north of the Ebola-hit district, a separate epidemic of bubonic plague has infected 160 people and killed 19 since July, Health Ministry spokesman Paul Kabwa said.

Two outbreaks in separate places struck northwest Uganda's West Nile region. Kabwa told Reuters by telephone a cultural practice of making women sleep on the floor where they are bitten by fleas whilst men take the bed was to blame.

"Women are more affected because they sleep on the floor. The fleas cannot jump onto the bed, so the men survive. We have a program of public education to tackle this," he said.

(Additional reporting by Arthur Asiimwe in Kigali, editing by Mary Gabriel)

Copyright 2007 Reuters News Service. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

Copyright © 2007 ABC News Internet Ventures

http://abcnews.go.com/International/wireStory?id=3968867

 

[Taz]

God help us if something like this hits Mexico or our communities of illegals. We would probably haul them into the US for treatment rather than shut the border down.

 

[Exodia]

Ebola death toll in Uganda rises to 29, 12 new cases recorded

KAMPALA, Dec 10, 2007 (Xinhua via COMTEX) -- Another seven people were killed by the deadly Ebola hemorrhagic fever in Uganda as twelve new cases were reported over the weekend amid an outbreak that has sounded alarm in ten out of 79 districts across the country.

A total of 29 people have so far been killed by Ebola out of 113 infections as of Monday morning, Sam Okware, chairperson of the National Task Force for Ebola, told Xinhua by telephone on Monday.

He said seven new cases were reported in the western district of Bundibugyo which has been hit hard by the epidemic since August.

According to Okware, 32 are still admitted in hospital while six have been discharged. He added that another five are to be discharged.

The deadly virulent disease hit parts of Bundibugyo in August before spreading to neighboring Kabarole and Kasese districts.

This is the second Ebola outbreak in Uganda, which is caused by a new strain of the virus seemingly milder than the other four strains.

The last outbreak in Uganda killed 224 people from October 2000 to March 2001, which started in northern Uganda and later spread to other parts of the country.

The Ugandan government last week declined to declare a state of emergency over the epidemic, arguing that it has put up a mechanism to contain the disease.

Alarmed by the outbreak, the neighboring Kenya, Rwanda and the Democratic Republic of Congo have since last week boosted surveillance along their border with Uganda to block migration of suspected Ebola victims.


http://www.int.iol.co.za/index.php?set_id=1&click_id=68&art_id=nw20071209224958462C571873

 

[Dornroeschen]

Ebola death toll climbs to 29 in Uganda
113 cases suspected; officials urge people to stop shaking hands
Reuters
updated 12:28 p.m. CT, Mon., Dec. 10, 2007

KAMPALA - Uganda has 113 suspected cases of a new strain of Ebola fever that has killed 29 people, officials said on Monday, vowing to take the necessary steps to stop the virus spreading.

Ugandans fear the outbreak could mushroom into a major epidemic affecting the capital Kampala.

"We have an Ebola lab in Entebbe (near Uganda's international airport) where we are testing samples we took from suspected cases," Health Ministry spokesman Paul Kabwa said.

Some banks and supermarkets in the city issued their staff with protective rubber gloves for handling money they feared could be contaminated with the virus, which often causes victims to bleed to death through ears, eyes and other orifices.

All cases so far have been in western Uganda's Bundibugyo district, bordering Democratic Republic of the Congo, except a doctor from the region who went to the capital after treating patients and died soon afterwards in a Kampala hospital.

"I'm very worried," said Valentine Oketcho, 25, who hands out fliers for restaurants in a Kampala shopping mall. "It's terrible, it's killing people in less than a week. This is worse than AIDS. At least you can survive AIDS for some years."

Others said the government should declare a state of emergency, although it has said it is on top of the epidemic.

The outbreak, which started in August, has sparked panic among officials, health workers and the public. A fifth health worker was among the latest dead, officials said.

Kampala was rife with rumors of two Ebola deaths in the city over the weekend, including a man who collapsed in the street, although Kabwa said neither fitted the definition of a suspected Ebola case.

The affected region borders Democratic Republic of the Congo, where the Ebola river gave the virus its name after some of the first cases were recorded in its valley in 1976.

"If it can do all this in Bundibugyo, it could spread further, even Kampala," said Amira Hussein, who runs a gift shop. "So now in addition to malaria, AIDS, plague and all the rest, we have Ebola. Are we unlucky?"

The last Ebola outbreak in Uganda was in 2000, when 425 people caught it and more than half died.

(c) Reuters 2007. All rights reserved. Republication or redistribution of Reuters content, including by caching, framing or similar means, is expressly prohibited without the prior written consent of Reuters. Reuters and the Reuters sphere logo are registered trademarks and trademarks of the Reuters group of companies around the world.

URL: http://www.msnbc.msn.com/id/22185215/

 

[almost ready]

Here's a map link

As you can see, it's scattered over a large area.

Also, the news about that index case and his contacts is grim. Seems there's a recombinant form of the illness at large.

MAP
http://maps.google.com/maps/ms?ie=U...6,31.992188&spn=9.10699,17.29248&t=h&z=6&om=0
Fatal Links to Ebola Uganda Super Spreader Increase

Recombinomics Commentary
December 9, 2007

The Ebola death toll climbed to 25 after three people succumbed to the deadly virus on Friday evening. Two patients died in Bundibugyo Hospital, while a third one exhibiting symptoms of Ebola passed away in Kabarole Hospital in Fort Portal.

Medical workers in Bundibugyo said one of the victims was Enock Bwambale, brother to Jeremiah Muhindo, the very first person to die of the disease in the hospital. The other was an old woman.

The patient who died in Kabarole Hospital was admitted during the night, but died in the morning before he could be transferred to the isolation centre in Kichwamba.

The above comments detail Ebola fatalities on Friday. Once again there is a link to Jeremiah Muhindo, who died in November. Jonah Kule had adjusted Jeremiah Muhindo’s oxygen mask on November 23 and developed symptoms five days later. Jonah Kule and four other health care workers died over a 24 hour period around December 4 and several contacts of Jeremiah Muhindo were hospitalized. One of those contacts also died December 4.

The death of Jeremiah Muhindo’s brother increases the number of fatal cases linked to this index case. Initial sequence data on the Ebola species in Uganda indicated it has 75% homology with earlier strains. The bust of fatal cases liked to the above index case raises questions about additional genetic changes or the presence of co-infections in the infectious case.

More sequence information on Ebola from this cluster would be useful.

http://www.recombinomics.com/News/12090701/Ebola_Super_Fatal_Links.html

 

[Dornroeschen]

Ebola Epicenter

An on-scene report from the Ugandan town hit hardest by the latest outbreak of the deadly virus.
By Andrew Ehrenkranz
Newsweek Web Exclusive
Updated: 6:43 PM ET Dec 11, 2007

There's just one road to Bundibugyo. A nameless dirt track, it winds through dense forest flanked by the verdant Semliki Valley below and crags known as Mountains of the Moon hovering above. Even in the best of times it's a dangerous route. Trucks speed around narrow switchbacks, baboon packs block the way, and Islamic rebels encamped in the surrounding bush have mounted roadside attacks. But these aren't the best of times, and travelers here face a new risk: a mutated strain of the dreaded Ebola virus that has killed at least 28 people and is spreading panic—and allegations of a government cover-up—far beyond this remote region of Uganda.

Bundibugyo is at the epicenter of the outbreak, which began in August. Doctors in the town are monitoring more than 360 sick people believed to be incubating the virus and have recorded 18 local fatalities, including four medical staffers at Bundibugyo Hospital. Townspeople are terrified by the outbreak. Bundibugyo's usually bustling central market is quiet, and residents of nearby villages are anxiously reading newly distributed Ebola information posters. Hawkers sell the antibiotic Cipro at inflated prices on the street, falsely promising that it can prevent infection; local healers and herbalists are offering their own versions of a cure.

Ugandans are no strangers to Ebola; some 225 patients died of the disease in 2000—at a 70 percent mortality rate. But while the new strain seems to be less virulent, it also raises the possibility that the infected are now more likely to survive long enough to spread it elsewhere. Already there have been Ebola cases in eight districts across Uganda, with confirmed cases as far away as Mbale, a village some 600 miles from the outbreak zone. On Uganda's borders, neighboring Kenya, Rwanda, Tanzania, and Sudan are screening all Ugandans for symptoms and travel patterns in an attempt to halt the disease from spreading into their countries.

For Bundibugyo, this is just the latest ill fortune. Isolated and poor even by Ugandan standards, the region is one of the few in this East African country of 30 million that doesn't have electricity. Its overstretched hospital treats 65,000 patients with a budget of less than $250,000 in government funding per year. Those services are now at risk after the Ugandan Medical Workers Union, alarmed by the deaths of the medical personnel, advised its members who are dealing Ebola patients to vacate their hospital jobs until they were provided better protection and sanitary measures. At Bundibugyo Hospital, where two nurseries are now being used as isolation wards, patients aren't isolated from each other, leading the sick to regard being sent to the quarantine ward as a death sentence. Instead, they either refuse treatment or look for help elsewhere. So great is the fear that locals in the nearby Kabarole district attacked and vandalized an isolation ward, forcing its closure.

At Bundibugyo, where red tape—the physical rather than the bureaucratic kind—and staffers in teal and white biohazard suits cordon off the isolation wards, foreign health officials and epidemiologists have begun surveillance of a suspected source of the outbreak: fruit bats living in nearby caves. The scientists believe that the source of this outbreak—a wild monkey eaten by a Ugandan man and his family in the village of Kikyo in late August—was probably bitten or exposed to Ebola by a bat. Ugandan President Yoweri Museveni has since appealed to his people to stop eating monkey meat and has also urged them to stop shaking hands and to practice basic hygiene to help contain the outbreak.

Some Ugandans, however, are questioning whether Museveni's government deliberately covered up news of the outbreak ahead of the recent meeting of the Commonwealth Heads of Government meeting in the capital city, Kampala. The government did not announce the outbreak until just after the conclusion of the high-profile meeting, even though government reports acknowledge that blood samples from infected patients were sent to South Africa for Ebola testing on Sept. 29. These samples were reportedly found negative for Ebola but were subsequently shown to carry a new strain of the virus at the Centers for Disease Control (CDC) in Atlanta on Nov. 24—the second day of the Commonwealth meeting. The initial false negative may have been due to the difficulties of identifying the new strain—even the CDC tests took a day longer than usual—but that hasn't stopped public outrage over whether the government could have acted faster to stop the spread of the virus. "It looks quite strange, from a public health perspective, that blood samples were not taken [to the CDC] earlier," said Dr. George Pariyo, dean of the public health school at Kampala's well-respected Makerere University in a front-page Uganda Monitor feature investigating the suggestions of a government cover-up.

Behind the statistics and the politics there are poignant tales of loss. Among Bundibugyo's dead are three staffers working with Scott Myhre, a Johns Hopkins-trained American missionary doctor who has provided medical services in the Bundibugyo region for more than 14 years. One of the fatalities was Dr. Jonah Kule, a Bundibugyo man put through medical school by Myhre's World Harvest Mission. Kule was especially beloved by his community for turning down lucrative city jobs to help his own people. Myhre tries to console himself over Kule's loss with thoughts of faith and religion. "A seed has to die to produce food," says Myhre, repeating an axiom that comforted him at Kule's burial. If the outbreak isn't contained, it's a line he may find himself using again in the weeks ahead.

URL: http://www.newsweek.com/id/76935

 

[almost ready]

Well, if you want to get out your worry beads

think about this, in neighboring Congo, with its own Ebola outbreak, there is a resurgence of civil war, which has already killed 4 million people. So when you read in the news that the locals are saying it's now the worst it's ever been, take heed.

You might notice that the area of fighting is really, really close to the Uganda Ebola outbreak. So we have the spector rising of possibly thousands of refugees fleeing the how about the new fighting running through Ebola country.

Ebola would seem almost trivial with it's hundred cases compared to the 4 million lost to the war since 1994, but these people are worn out, malnourished, and upset. Not too good for the immune system nor are they plugged into the local village networks and family life which might alert others should someone develop the illness. With the new milder strain of illness, the spread might become much easier. Before, Ebola was so deadly it burnt out very quickly.

Check out this NYTimes article (actually a good article, maybe they've noticed that their readership has crashed)....you can see the map of the fighting area and compare it to the Ebola map from Recombinomics below.
http://www.nytimes.com/2007/12/13/w...em&ex=1197694800&en=46c1b3705873bb0c&ei=5087

http://maps.google.com/maps/ms?ie=U...,32.036133&spn=4.217038,6.745605&t=h&z=7&om=0

 

[almost ready]

More bad news

Major fighting near Goma. tens of thousands of refugees flee there THIS WEEK, Goma is only 50 miles from one of the Uganda Ebola outbreaks. So bad there, the UN aid needs troop convoys and most deliveries of food aid have been "Postponed". Thus people will be leaving, as they were totally dependent on this aid. So right now the areas where there is already a disaster with Ebola, now there are up to half a million refugees running around.

Stephen King couldn't have written a scarier plot, which rivals his THE STAND. Unfortunately, this one isn't fiction.


***
http://allafrica.com/stories/200712130005.html
Congo-Kinshasa: Upsurge in Violent Clashes in Eastern DR Congo Alarms Secretary-General

UN News Service (New York)

12 December 2007
Posted to the web 13 December 2007

New York

Secretary-General Ban Ki-moon said today that he was deeply concerned by the intense fighting engulfing North Kivu province in the far east of the Democratic Republic of the Congo (DRC), especially its impact on local civilians, many of whom have been forced to flee to escape the renewed violence.

In a statement issued by his spokesperson, Mr. Ban said he was "particularly troubled by reports of massive displacement and mistreatment of the population" in North Kivu, where Government forces (FARDC) are clashing with troops loyal to renegade General Laurent Nkunda.

"The United Nations is working closely with the Government of the DRC and with others to help bring peace and security to this troubled region," the statement noted. "The Secretary-General calls on the forces of Laurent Nkunda to lay down their arms."

More than 4,500 blue helmets with the UN peacekeeping mission to the DRC (known by its French acronym MONUC) have been deployed to North Kivu to help ensure the defence of Goma, the provincial capital, and the key town of Saké.

William Lacy Swing, the head of MONUC and the Secretary-General's Special Representative to the DRC, has confirmed that Saké remains under the control of UN peacekeepers and that the blue helmets will do everything under their mandated powers to protect Goma and Saké from falling to the Nkunda forces. Yesterday dissident troops recaptured Mushake, a hillside town about 40 kilometres northwest of Goma.

Since the clashes began in North Kivu earlier this year, MONUC has transported more than 25 tons of provisions for the Congolese armed forces, conducted 33 air reconnaissance missions and evacuated 151 wounded FARDC soldiers.

North Kivu has also been plagued by increased sexual violence against both women and young girls, with some 2,700 cases of rape reported between January and October this year in the province.

The statement from Mr. Ban's spokesperson emphasized that the mission backs the Government's efforts to establish legitimate State authority in the far east of the troubled country and to meet its commitment under the Nairobi communiqué, which the DRC and Rwanda signed last month to try to work together against illegal armed groups operating around the border between the two countries.

"The Secretary-General calls on the Government of the DRC to take all measures necessary to protect civilians."

An inter-agency UN mission headed to the area this week to assess the situation and devise recommendations on how to protect internally displaced persons (IDPs) and the local civilian population.

Yet this week alone, another 60,000 to 70,000 IDPs are reported to be on the move again, this time from camps near Goma. More than 400,000 people have been displaced in North Kivu in the past 12 months.

The UN Office for the Coordination of Humanitarian Affairs (OCHA) reports that currently all humanitarian movements outside Goma are proceeding only under the escort of MONUC blue helmets. Several relief agencies have temporarily withdrawn their staff from areas close to clashes and most aid convoys have been postponed.


The UN Children's Fund (UNICEF) has deposited several thousand basic supply kits to zones that might soon become inaccessible because of the fighting, while the World Food Programme (WFP) is distributing food to thousands of families living at the IDP camp at Kibumba.

The UN's humanitarian action plan for the DRC next year, launched yesterday, calls for $575 million, with almost 30 per cent of the total dedicated just to North Kivu.

The eastern DRC remains the most violent region in the vast country, where MONUC has otherwise overseen the transition from a six-year civil war that cost 4 million lives in fighting and attendant hunger and disease - widely considered the most lethal conflict in the world since World War II - to gradual stabilization, culminating in the first democratic elections in over four decades last year.

 

[Martin]

Inside Ebola's zone of death
Uganda is gripped by fear of an epidemic 'explosion' as the killer virus develops a slower and potentially more lethal version

Anushka Asthana in Kampala
Sunday December 16, 2007

Observer

It is a country where the President has asked people to stop shaking hands, where MPs have called for an end to public gatherings, market vendors wear gloves and Roman Catholic priests no longer give the communion wafers and wine by hand. Uganda is gripped by terror over a new strain of one of the world's most deadly diseases. Ebola haemorrhagic fever, which is spread by touch, kills between 50 and 90 per cent of victims.
Thirty-two people have died and 120 people have the virus - in a nation where malaria kills 300 people a day - but it is the nature of the illness that has caused such panic. After an incubation period of up to 21 days, Ebola patients develop terrible symptoms: high fever, headache and joint pains, then vomiting and diarrhoea, and in some cases bleeding from the mouth, nose, eyes and ears. In most cases, multiple organ failure, haemorrhaging or shock brings death.

This new strain is feared to kill more slowly than previously, leaving more time for the disease to spread. There is no vaccine and no cure. The only hope is to contain the lethal virus, but Ebola moves fast and is hard to track. If just one infected person boards a plane, this could become a global outbreak.

Buses heading west from the capital, Kampala, to the affected region of Bundibugyo normally have standing room only. Now they leave half empty, and anyone crossing into neighbouring Rwanda and Kenya is screened. 'For the time being people should resort to jambo [waving]. If I don't shake your hand, it doesn't mean I don't like you,' President Yoweri Museveni told his people.

'One of the fears with Ebola is that it can move very quickly to different parts of the world,' said Dave Daigle, of America's Centres for Disease Control and Prevention (CDC) in Atlanta, Georgia, where the virus was confirmed as Ebola last month. The date of the announcement, three months after the first deaths had been reported, aroused suspicion, falling just after the Commonwealth heads of government meeting, attended by the Queen, ended in Kampala. Ugandan newspapers accused ministers of suppressing the news to ensure the meeting went ahead, and claimed the delay may have cost lives.

A team of CDC scientists has travelled to the epicentre of the outbreak. The focus, said Daigle, is on containment. He described how experts mapped out the movements of sufferers and tracked those they came into contact with. Hundreds have been confined to their homes over fears that they may have come into contact with infectious people or corpses.

The most senior politician in the affected area, Jackson Bambalira, the Bundibugyo district chairman, fears the worst: 'I am greatly worried that a bigger Ebola bomb could explode, claiming many more lives.'

Among those most at risk are doctors and nurses. The first time Ebola came to Uganda, in 2000, 14 nurses and one doctor died. This time eight medical workers have died and many doctors and nurses are in isolation units after testing positive for the virus. Nurses have threatened to strike, angry about the lack of protective clothing and any risk allowance, and the Uganda Medical Workers' Union has instructed health workers without proper protection to flee the Ebola zone after reports of medics treating patients with bare hands.

It began in late summer in Kikyo, a village hidden away on a mountainside of western Uganda. At the edge of a beautiful game reserve, villagers who spend their lives farming the cocoa crop began to fall ill. There were headaches, fevers, vomiting, diarrhoea and the painful bleeding. Relatives washed the bodies of their loved ones before burying them, unaware of a deadly disease at its most contagious. Although news spread of a strange sickness in the west, the word Ebola was not mentioned.

Local doctor Jonah Kule decided he wanted to help. He drove his motorbike to the district's government offices to see his friend, Elias Byamungu, the region's chief administrative officer. It was a warm day and sunlight was streaming through the windows of Byamungu's office when Kule walked in. 'He told me he was going to find out what the disease was that was infecting his people,' said Byamungu. 'I questioned him; I said it could be deadly.' But Kule insisted he was prepared to die to help Ugandans. 'He was the first person who dared to go and see,' said Byamungu. A few weeks afterwards Kule left Bundibugyo to pick up his children from school in Kampala. While there he fell sick and was admitted to the isolation ward at the city's largest hospital. Eight days later he died. A matron, Rose Bulimpikya, died within 24 hours of Kule.

Dr William Sikyewunda, director of health services in Bundibugyo, said health workers were petrified. 'We are trying to reassure them,' he said. 'It was Rose Bulimpikya's kindness and diligence that put her at risk,' he said.

Bulimpikya was the most senior nurse in the district and next year would have celebrated her 60th birthday. Her devastated family were in disbelief as she was buried. She had fallen ill less than a week earlier.

'She has left a very large family with six children,' said her husband, Hassan Bhatungi Kabho, 60. 'I have lost a beloved wife. We have been working hand in hand to look after the family. I don't know how I will manage. I am very afraid.' Her son Francis said Rose died a heroine. 'She wanted to help people. I feel proud because she died doing her job and she behaved with professionalism.'

Now officials are focusing on who Bulimpikya and the other victims have come into contact with. The early symptoms of Ebola are similar to those of malaria, said Dr Susan Wandera, head of programmes for the African Medical and Research Foundation. 'Ebola is a very big risk for doctors and nurses. Usually sweat is taken as harmless, but it is not in this case.'

Ebola first appeared in two simultaneous outbreaks in Zaire and Sudan in 1976, killing 90 per cent and 50 per cent of sufferers respectively. It was believed to have come from monkeys, perhaps through eating 'bush meat', but scientists remain at a loss. Kule died a day before the anniversary of the death of Dr Matthew Lukwiya, the first doctor to die of Ebola in the last outbreak here, in 2000, which killed 224 people.

Lukwiya has become an international hero, described in the New York Times as a 'fearless commander at the centre of a biological war that threatened everyone in the country'. Called to his hospital in Gulu, northern Uganda, after a mystery virus began to kill student nurses, he suspected Ebola and set up restrictive safety measures that prevented the further spread of the virus.

For his widow, Margaret, this month has been difficult. 'I started recalling how I felt when Matthew was sick and died,' she said. 'I am imagining that poor widow now,' she said of Kule's wife.

Then, as now, the nurses threatened to strike. Lukwiya brought them together and told them: 'Whoever wants to leave can leave. As for me, I will not betray my profession. Even if I am on the ward alone, I will continue.'

More than a month after he returned to the hospital, Margaret gathered her five children around the phone to sing him happy birthday. Six days later she received the call she had dreaded. Margaret rushed to the hospital. She wore protective gear, including six gloves, but was still told not to touch him. In those final days she ignored his own rules, taking his hand and bathing him.

She has not celebrated Christmas since and fought for six years to persuade the government to give families of health workers compensation.

'He went too fast,' she said. 'At first I was bitter. But then I think, suppose it was me that was sick and needed a doctor - if a doctor refused to come to my aid, how would I feel? He died for the right cause.'


http://observer.guardian.co.uk/print/0,,331571392-119093,00.html

 

[Satanta]

Want to resolve it? Arial nuke.

 

[Double_A]

Cultural traditions have doomed these people.

 

[dragonslayer2001]

Aliens

"Its the only way to be sure"



has this thing actually spread out though?