Thursday, 2 August 2012


Ebola Hemorrhagic Fever in Uganda On Saturday 28th July 2012 the Ministry of Health has confirmed that there is an outbreak of Ebola Hemorrhagic Fever in Kibaale district, Midwestern Uganda. Laboratory investigations done at the Uganda Virus Research Institute in Entebbe confirmed that the “Strange Disease” reported in Kibaale was indeed Ebola hemorrhagic fever. So far a total of 20 cases with 14 deaths have been recorded. The index case was in Kibaale district. The latest news confirms that 2 cases have been reported in Kampala with one death occurring in hospital. I would like to disseminate this general information on the disease and implications for the general public. Transmission • The Ebola virus is transmitted by direct contact with the blood, secretions, organs or other body fluids of infected persons. • Burial ceremonies where mourners have direct contact with the body of the deceased person can play a significant role in the transmission of Ebola. • The infection of human cases with Ebola virus through the handling of infected animals especially primates has been documented. • Health care workers have frequently been infected while treating Ebola patients, through close contact without correct infection control precautions and adequate barrier nursing procedures. Incubation period: 2 to 21 days. Symptoms Ebola is characterized by: • Initially; sudden onset of fever, intense weakness, muscle pain, headache and sore throat. • This is then by vomiting, diarrhoea, rash, impaired kidney and liver function, and in some cases, both internal and external bleeding. • Laboratory findings show low counts of white blood cells and platelets as well as elevated liver enzymes. Diagnosis Specialized laboratory tests on blood specimens detect specific antigens and/or genes of the virus. Antibodies to the virus can be detected, and the virus can be isolated in cell culture. Tests on samples present an extreme biohazard risk and should only be conducted under maximum biological containment conditions. Testing is available at CDC lab in Entebbe. Treatment and vaccine • No specific treatment or vaccine is yet available for Ebola haemorrhagic fever. Containment • Suspected cases should be isolated from other patients and strict barrier nursing techniques implemented. • Tracing and follow up of people who may have been exposed to Ebola through close contact with patients are essential. • All hospital staff should be briefed on the nature of the disease and its transmission routes. Particular emphasis should be placed on ensuring that invasive procedures such as the placing of intravenous lines and the handling of blood, secretions, catheters and suction devices are carried out under strict barrier nursing conditions. Hospital staff should have individual gowns, gloves, masks and goggles. Non-disposable protective equipment must not be reused unless they have been properly disinfected. • Infection may also spread through contact with the soiled clothing or bed linens from a patient with Ebola. Disinfection is therefore required before handling these items. • Communities affected by Ebola should make efforts to ensure that the population is well informed, both about the nature of the disease itself and about necessary outbreak containment measures, including burial of the deceased. People who have died from Ebola should be promptly and safely buried. Contacts • As the primary mode of person-to-person transmission is contact with contaminated blood, secretions or body fluids, people who have had close physical contact with patients should be kept under strict surveillance. Their body temperature should be checked twice a day, with immediate hospitalization and strict isolation in case of the onset of fever. • Hospital staffs that come into close contact with patients or contaminated materials without barrier nursing attire must be considered as contacts and followed up accordingly. Recommendations Avoid travelling to affected areas. Use private means as far as possible; if not, avoid the crowded ones have on long sleeved clothing. Keep away from crowded areas or public gatherings such as markets, the park, discotheques etc. Avoid touching inanimate surfaces; keep your hands to yourself! Eat out only from trusted places • Carry hand sanitizers, wash/sanitize stuff from supermarkets • Report all suspected cases especially individuals who have travelled to affected areas • Beware that travelling out of Uganda at the moment might cause you embarrassment at some strict airports although no travel ban has been made yet.

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