Ebola Virus - Credit CDC
Ebola was first discovered in Zaire and Sudan in 1976 and since then has become almost legendary for its incredibly high fatality rate and gruesome hemorrhagic symptoms.
Luckily, mostly due to the virulence of the disease, outbreaks have remained small and geographically contained.
While the primary zoonotic reservoir for the Ebola virus has yet to be firmly established, bats are considered to be the most likely candidate. Intermediate hosts, which are often consumed as bushmeat, are also suspected as harboring these viruses.
There are currently five known strains of the disease, of which four are highly pathogenic in humans. The odd virus out - Ebola Reston - which can infect and kill non-human primates, has not been shown to produce disease in man.
Which brings us to a press release today that confirms, for the third time time in five months, that Uganda is facing an outbreak from a rare, but deadly, hemorrhagic fever.
The first outbreak, in late July was Ebola
Zaire Sudan (see comments) . That outbreak was declared over in early October (see WHO UPDATE) after 17 deaths (and 11 laboratory confirmed cases).
Within a couple of weeks, another outbreak, this time of Marburg hemorrhagic fever (a close cousin to Ebola) was reported in Kitumba sub-county, Kabale district in South-western Uganda.
The Marburg outbreak is still ongoing with- at last count -18 cases and 9 deaths, including a health worker, reported from 5 districts.
Over the past few days there have been reports of yet another Ebola outbreak, this time in the Luweero district, which is located in the central part of the country.
The twist to this story is that the strain of Ebola in Luweero is Sudan,
not Zaire, (correction, the July outbreak was Sudan – see comments below) as was seen earlier this year.
Readers with good memories will remember this blog about a dispatch in the August 2012 edition of the CDC’s EID Journal regarding a single case of Ebola Sudan detected in a 12-year old girl in 2011 from – you guessed it – the same district (Luweero) as is now reporting fresh cases.
Here are some excerpts from the Minister of Health’s press announcement from earlier today. Follow the link to read it in its entirety.
Ministry Of Health
15th November 2012
EBOLA OUTBREAK IN LUWEERO DISTRICT
KAMPALA - The Ministry of Health would like to inform the general public that another Viral Hemorrhagic fever, Ebola, has broken out in the country. This follows confirmation from the laboratory investigations done at the Uganda Virus Research Institute in Entebbe that two people, all from one family in Kakute sub-county, Sambu parish in Nyimbwa sub-county, Luweero district, had died of Ebola, the Sudan strain.
A total of three people have since the onset of the outbreak died in Luweero district located in the central part of the country. The first case, a boda boda rider, died on October 25th after presenting with signs of high fever and bleeding from some body parts. However, no samples were taken from this case as it was not reported to the health facility.
The second death occurred on November 10th 2012 at Nyimbwa Health Center IV. This was 25-year-old woman who had had nursed the boda boda rider. She too, presented with signs and symptoms of Ebola. The third case, also from the same family occurred on October 12 at Nyimbwa Health Center.
A number of suspects have already been identified and attended to appropriately. Currently, there are five suspects closely being monitored by our surveillance team. One is admitted at Bombo Military Hospital, two at Mulago National Referral Hospital Isolation facility while three are still in the communities. Those admitted have an epidemiological link with the index family and nursed the earlier two who were confirmed to have died of the disease.
The Ministry of Health and its partners have to this effect moved fast and beefed up all the necessary measures to control the spread of this highly contagious disease.
- A team of experts from the Ministry, World Health Organisation, MSF, AFENET are already on ground to support the response plan.
- A national taskforce coordinated by the Ministry of Heath has now refocused its attention to the Luweero epidemic since the Marburg situation in western Uganda is fully under control.
- Plans are underway to create an isolation facility at Nyimbwa Health Center IV or Bombo Military Hospital.
- The Luweero district taskforce has been reactivated and is developing a response plan
- Active and sustained tracing and listing of all possible contacts that were exposed to the suspected and confirmed cases are in high gear. So far, a number of contacts have been recorded and are closely being monitored.
- The isolation facility at Mulago National Referral Hospital has already been reopened and has admitted two suspect cases.
- The necessary drug supplies and logistics for case management have been mobilized. The National Medical Stores have been requested to send the necessary logistics.
- MSF is already on the ground to evaluate and mobilise the necessary requirements for setting up an appropriate isolation centre at Nyimbwa health center IV or Bombo Military Hospital
- The Ministry has already dispatched Personal Protective Equipment (PPEs) and body Bags to Luweero district
- Collection of samples from suspect and probable cases has already commenced. Last evening, two samples from taken from suspect cases admitted at Mulago National Referral Hospital
With the above measures, the Ministry of Health is confident that the outbreak will be effectively controlled and there should be no panic among the population.