Saturday, December 4, 2010

ACT Alliance alert: outbreak of unidentified disease in Uganda

Date: Fri 3 Dec 2010
Source: UN Office for the Coordination of Humanitarian Affairs (OCHA),
ReliefWeb, ACT Alliance, report [summ., edited]

Brief description of the emergency
An unidentified deadly disease broke out in Abim village located in
the Karamoja region in northeastern Uganda in late October 2010.
Several cases of the disease were reported and several deaths have
resulted. The disease then spread from Karamoja to neighbouring
districts. On Wed 1 Dec 2010, some cases were also reported in Gulu.
The signs and symptoms of the disease indicate that it is most likely
not dysentery, as it is sometimes thought to be in the absence of a
clear diagnosis. Symptoms point to Ebola [haemorrhagic fever] but
authorities have been unable to confirm that disease. The most common
symptoms are headache, fever, and vomiting large quantities of blood.
Tests have been done [presumable in progress] in Entebbe (Uganda) and
in Atlanta (USA).

Unequipped medical staff are fearful of being infected, leaving their
duty stations because they lack personal protective gear. Some refuse
to take care of patients. Kitgum district also lacks transport,
including ambulances to transport patients. Pader district had one
ambulance which no longer functions. People refuse to transport
patients for fear of being infected. In villages, residents do not
know what to do or how to protect themselves. Some have tried to move
out of affected areas, potentially spreading the diseases to new
areas. The spread is fairly slow but follows common "travel routes"
throughout the region.

The number of affected people is unknown. About 60 cases are known,
with at least 20 deaths reported. However, there could be many more
cases and deaths that are unreported, and many more carriers
. The 1st
6 fatalities in Kitgum were one woman, 3 men, and 2 male youths. None
had any serious previous medical history. One had malaria at the time
of death. Death usually occurred within 3 days of the 1st symptom
(Sources: Dr Alex Layoo, medical superintendent Kitgum Government
Hospital, Dr Tenywa (World Health Organisation), Medecins Sans
Frontieres, Uganda Ministry of Health, and Agago District Local

The death rates so far are 25 percent in Agago district (that is, one
in 4 people with symptoms have died), and in Abim, the death rate has
also been about 25 percent. However, in Kitgum district, 8 out of the
10 patients admitted to St Joseph's Hospital have died. Some
connection with animal (domestic and wild) illness and death has been
In Agago especially, links between sick animals and human
cases have been examined. It seems to be established that the disease
can be spread from human-to-human most likely through body fluids.

Two major factors for spreading the disease at the moment include
people trying to move away from affected areas, spreading the disease
further, and scared health staff who, without protective clothing,
refuse to care for patients
. There is need for mobilisation by
agencies, sensitisation of population, patient care, patient
isolation, and proper and safe handling of bodies.

National and international response
An emergency meeting was held in Kitgum on 1 Sep 2010 bringing
together local and international NGOs, governmental institutions, UN
agencies, and ACT Alliance member LWF [Lutheran World Federation]. It
was agreed that all actors participate in the following coordinated
response: [Curious as the 1st cases were reported in October 2010.
[Interested readers should refer to the original document via the URL
at the head of this posting for a list of the participating
organisations. - Mod.CP]

ACT Alliance response
ICCO [Interchurch Organisation for Development Cooperation],
DanChurchAid [Danish humanitarian NGO], Church of Uganda/PDR
[Planning, Development, and Rehabilitation] (the active members of the
Uganda ACT Forum) have approved the Lutheran World Federation proposal
to apply for ACT Rapid Response Funds [RRF]. LWF's primary role at
this stage will be community mobilisation and sensitisation to prevent
further spread of the disease. Provision of protective gear to village
health teams can also be considered so health care workers can move
patients and bodies without being exposed to the disease.

Planned activities
LWF Uganda, with approval from the ACT Uganda Forum, intends to apply
for RRF, with focus on mobilisation/sensitisation of communities and
possibly to provide protective gear for village health teams, in order
to stop the outbreak and save lives. Discussions in working groups and
coordination committees in Kitgum continues. More precise priorities
would be set on 2 Dec 2010. [The funds listed in detail in the
document can be viewed by accessing the original text. - Mod.CP]

For further information please contact: ACT regional programme
officer, Katherine Ireri (phone +41 22 791 6040 begin_of_the_skype_highlighting +41 22 791 6040 end_of_the_skype_highlighting).

Communicated by:
Charles Ortleb

[The ACT Alliance document identifies 60 cases and 20 fatalities and
suggests that the number of victims may be considerably more. Some
involvement of sick animals (domestic and wild) is rumoured, but it is
believed that person-to-person transmission has been responsible for
the rapid spread of the outbreak from village to village. According to
local sources death has occurred within 3 days of appearance of
symptoms. The infectious agent has not yet been identified, but the
disease resembles a severe dysentery rather than a haemorrhagic fever.

The districts in the Northern Region of Uganda affected by the
outbreak can be located in the map at
The HealthMap/ProMED-mail interactive map of Uganda can be accessed at
<>. - Mod.CP]

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