Everyone's Worst Nightmare 
Ebola Virus Fears Strike Uganda's Capital City
(CBS News)
As fears of the Ebola virus spread through Uganda, health officials are bracing the country's capital city, Kampala, for a possible outbreak.
On Saturday, Ugandan Ministry of Health officials and the World Health Organization (WHO) announced that 14 people had died from the Ebola virus. A spokesperson for the WHO said that thirty-six people are confirmed to have recently had the disease.
While the infected have resided in Kibaale - a district west of the capital - one of the patients traveled from the area to a Kampala hospital, where he later died. The densely-populated city has a population of 1.5 million, according to AFP. No one has contracted the virus yet in Kampala, but because one of the sick was in the city, there are fears they could have spread the virus. While precautions are being taken such as radio announcements and posters alerting people to take care, the fact that there are so many highly-trafficked markets and crowded slums in the area makes it challenging to get the word out.
According to the WHO, the Ebola virus has five different species: Zaire, Sudan, Cote d'Ivoire, Bundibugyo and Reston. Zaire, Sudan and Bundibugyo have been known to cause large Ebola haemorrhagic fever (EHF) outbreaks in Africa, which has a fatality ratio of 25 to 90 percent of the people infected.
The specific strain that is infecting Uganda right now is the Sudan version, which has had five outbreaks in Africa since 1976. It kills about 50 percent of the infected. One of the latest outbreaks was in 2000, in which 224 Ugandan residents died.
Typically, the Ebola virus is transmitted through direct contact with blood, secretions, organs or other body fluids of infected people, the WHO said. Burial ceremonies in which live people have contact with recently-deceased infected remains, or health care workers who aid in the treatment of Ebola victims, are often at risk. Symptoms include intense weakness, muscle pain, headache and sore throat. Vomiting, diarrhea, rash, impaired kidney and liver function, and in some cases, both internal and external bleeding are also observed.
President Yoweri Museveni said on Monday that citizens should take precautions to guard against the disease.
"Ebola spreads by contact," he said in a statement. "When you contact each other physically then Ebola spreads through sweat, through saliva in case you kiss, blood (exchange of blood), vomiting in case you touch the vomit of somebody who is sick or diarrhea, urine, sexual fluids, etc., all those transmit Ebola. Fortunately it seems Ebola does not spread through air (through breathing), rather it spreads through contact."
The seven doctors who treated the patient in Kampala as well as 13 health workers who made the journey with them from Kibaale are currently under quarantine. A typical quarantine involves isolation for 21 days, Centers for Disease Control and Prevention spokesman Tom Skinner said. After two 21-day periods where no one falls ill, the outbreak is considered to be over. The CDC, WHO and Uganda's Ministry of Health are working together to figure out how many people are possibly infected and to control the disease.
As for the disease spreading to other countries, CNN points out that it's highly unlikely to reach the United States. The only known outbreak in the U.S. was when monkeys were imported into Reston, Virginia, which resulted in no human cases; and when two tourists traveling in Uganda were infected and traveled back to the U.S. No one else was infected because of precautions taken.
History Repeats Itself The above story recounts just the latest of Ebola outbreaks. Many have occurred in recent history. On July 27, 1976, the first victim to contract Ebola (Sudan), a cotton factory worker from Nzara, Sudan, began to show symptoms. Soon after, so did his co-worker. Then the co-worker's wife became sick. Ten days later they were dead. The outbreak quickly spread to the Sudanese town of Maridi, where there was a hospital. Since no one in the medical field had ever seen this illness before, it took them awhile to realize that it was passed by close contact. By the time the Sudan outbreak had subsided, 284 people had become ill, 151 of whom had died. This outbreak marks the first appearance of the disease. Later in 1976 the first victim of the Zaire outbreak, a 44-year-old teacher who had just returned from a tour of northern Zaire, fell ill. After suffering from symptoms that seemed like malaria, the victim went to the Yambuku Mission Hospital and received a shot of an anti-malarial drug. Unfortunately, at that time the hospital did not use disposable needles nor did they properly sterilize the ones they used. Thus, the Ebola (Zaire) virus spread through used needles to many of the hospital's patients. Over the course of the next few months the Zaire outbreak involved 318 patients, 280 of whom died. The next serious outbreak occurred in Kikwit, Zaire in 1995. It was traced to an index case-patient who worked in a forest adjoining the city. The epidemic spread through families and hospitals. Three hundred fifteen people were infected; 250 (81%) died. Major outbreaks since then include the Gulu, Masindi and Mbarara districts of Uganda in 2000-2001; the districts of Mbomo and Kéllé in Cuvette Ouest Département, Republic of the Congo in 2002-2003; Kasai Occidental Province of the Republic of the Congo in 2007; and Bundibugyo District in western Uganda in 2007-2008. Each of these outbreaks led to triple-digit deaths.
PathophysiologyMost victims begin to show symptoms between two and 21 days after first contracting Ebola. At first, the victim may only experience influenza-like symptoms: fever, headache, weakness, muscle pain, and sore throat. However, additional symptoms begin to manifest quickly: diarrhea, vomiting, and rash. The victim then starts bleeding, both internally and externally. Despite extensive research, no one is yet sure what vector the Ebola virus takes in nature (fruit bats are suspected), nor why it flares up when it does. What is known is that Ebola infection is passed from host to host by direct contact with infected blood or other bodily fluids.
The Ebola virus, which is also called Ebola hemorrhagic fever (EHF), is a member of the Filoviridae family. There are currently five known strains: Zaire, Sudan, Côte d'Ivoire, Bundibugyo and Reston. So far, the Zaire strain remains the most deadly (80% death rate) and Reston the least (0% death rate). The Ebola-Zaire and Ebola-Sudan strains have caused all the major known outbreaks. There is currently no treatment or vaccine.
Everyone's worst nightmare: airborne Ebola.
Acknowledgments
CBS News Wikipedia Medscape For More Information Click on the Links: CDC: Ebola WHO: Ebola |
