Friday, May 20, 2011

Ebola Haemorrhagic Fever Epidemic DREF operation

20 May 2011

CHF 133,744 has been allocated from the Federation’s Disaster Relief Emergency Fund (DREF) to support the national society in delivering immediate assistance to some 1,731,900 beneficiaries (targeted population for information dissemination campaign). Unearmarked funds to repay DREF are encouraged.
Summary: An Ebola haemorrhagic fever epidemic has been reported in Luwero District of Uganda. One death so far has been reported with two suspected cases in the isolation unit at Bombo military hospital since the outbreak was confirmed on 13 May by the Ugandan Ministry of Health (MoH). The World Health Organization (WHO), MoH, MSF and the Uganda Red Cross Society (URCS) are active in the affected area. The four agencies have conducted preliminary assessments and highlighted the main gaps that need to be addressed for the epidemic to be brought under control.
This operation is expected to be implemented over three months, and will therefore be completed by August 2011; a Final Report will be made available by November 2011 (three months after the end of the Operation).

The situation

The Ugandan Ministry of Health (MoH) and the World Health Organization (WHO) have confirmed an
outbreak of Ebola haemorrhagic fever in the Luwero District located in the central region of Uganda
neighbouring Wasiko, Kayunga, Nakaseke, Nakasongola and Kampala Districts just along the highway to
Northern Uganda and Sounthern Sudan. One death (index case) has been reported and 23 suspected
contacts so far from the military hospital: of these, two suspected cases have so far been reported and have
been admitted to Bombo military hospital in Luwero District, the clinic that attended to the deceased victim
and the village members.
The initial assessment has not yet identified the source of the outbreak, but the national task force has
singled out six districts neighbouring Luwero for active case search, surveillance and social mobilization for
the Ebola outbreak. The Ugandan MoH and WHO have sent blood samples of the other cases admitted to
referral laboratories in Entebbe, and more tests are being conducted to provide detailed information on the
Ebola Sudan, the type confirmed at this time in Uganda, is a highly contagious killer disease in the category
of viral haemorrhagic fevers, with no known cure and with high fatality rate of up to 90% of people exposed
to infection. Its symptoms include high fever, headaches, muscular pain, diarrhoea, reduced urine and
extensive bleeding through body openings such as nose, eyes, ears, gums and sexual organs. It is spread
through direct physical contact with body fluids of an infected person or consumption of animals carrying the
Uganda was last affected by Ebola in 2007 and 2008 in Bundibugyo where over 180 people were infected
resulting in 36 deaths including health workers. In 2000 and 2001, over 800 people were infected in Gulu
and Masindi Districts and more than 150 deaths were reported including health workers.

Coordination and partnerships

The MoH, URCS and other partners have conducted a preliminary needs and capacity assessment in
Luwero. The assessment has identified gaps as outlined below:

A national taskforce has been set up in Kampala coordinated by the MoH and similar task forces
have been formed in Luwero and surrounding districts. Experts from the WHO are already in
Uganda working closely with the Ugandan MoH to contain the epidemic and more are on the
way. WHO is providing technical support to the MoH and is coordinating the international

An isolation unit has been established in Bombo military hospital equipped with protective tools
(50 Personal Protective Equipment (PPE) Kits) provided by the Centre for Disease Control
(CDC) to be used by those handling suspected Ebola cases.

Save the Children has rehabilited the isolation units in Bombo military hospital.
Two meetings so far have been organized and attended by partners to forge a way forward and the following
action points have been agreed on:

Community mobilization and sensitization of the populations on the symptoms and preventive
measures of Ebola in the six districts of Luwero (the epicentre), Kampala, Nakasongola, Wakiso,
Mukono/Kayunga and Nakaseke.

Information, education and communication materials that are context-specific and produced in
local languages.

Active community surveillance case search and referral of contacts in the community.

Being a permanent member of the social mobilization sub-committee of the national and district
level epidemic task forces, URCS has been requested to lead in these related activities in the
Ebola operation.

CDC in collaboration with Central Public Health Laboratory (CPHL) will continue to received
samples from the affected districts in Northern Uganda and will continue supporting the
Government of Uganda in screening samples in response to outbreaks

WHO country office with the MoH are part of the response team supporting the case
management - including drugs and sundry medical supplies for the treatment of Ebola cases,
PPE kits for the health workers and people involved in the response case management,
monitoring the trend of the disease, capacity building with experts in the field.

The MoH deployed technical officers to support case management, surveillance and referral

activities in the affected districts...

Red Cross and Red Crescent action

Actions to date of the Uganda Red Cross Society Ebola Action Team:

Mobilized 50 volunteers in Luwero Branch (the epicentre) and 10 volunteers each from the other
affected branches to be trained in social mobilization and active case research in the

Actively participates in the national and district task force planning meetings for the Ebola
response (as a member of the communications and social mobilization team) in Luwero and

Provided some 30 PPE kits to MoH to assist in the Ebola response and established a URCS

Ebola task force which is meeting every day....

Although the only indexed case so far is that of the 12-year-old girl confirmed in Luwero district, the WHO
threshold requires that only one laboratory confirmed case represents an epidemic and WHO recommends a
mass emergency response campaign for all residents within the affected districts. Uganda has over 95
districts with Kampala having the highest population of over 1.2m people.

Due to the high level of illiteracy in the affected rural and peri-urban populations in Luwero there is generally
a low level of community awareness on the risk factors of Ebola fever transmission, its identification,
prevention and control strategies. This has led to panic in the affected communities. The general conditions
that exacerbate the Ebola fever situation are:

Due to low level of education, majority of the people in the affected communities lack knowledge
and understanding of the disease and what they need to do to avoid contracting it.

The high incidence of poverty forces the residents to spend time in the bush hunting wild
animals for alternative diet as well as income and grazing. This means that the majority of
residents in the affected communities are exposed to fruits and animal diet that could expose
them to the deadly virus.

There is a general lack of resources for response. The NTF developed a plan of action that
requires USD 2.2m to facilitate the planned activities, where over 50 percent of the funds are
required for case management and the protective gears.

Active surveillance and community follow-up cases needs support. This calls for intensive
health promotion campaign to sensitize the affected and/or at risk communities and creates
public awareness about Ebola fever disease, the risk factors for its transmission, its prevention

and control among the people in central Uganda...

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