Panic as Ebola spreads into another district

Friday, May 20th, 2011
By PATRICK JARAMOGI
Panic is the word that can best be used to describe the state at which the residents of Luwero are living in following the reported outbreak of Ebola last week. The strange twist to the epidemic that left a 12 year-old girl dead is its source of origin. Health experts including senior World Health Organisation (WHO) doctors are puzzled with the origin of the deadly disease, which has been identified as Sudan straight (Sudan Ebola). This type of Ebola has a killing rate of up to 60 percent (fatality).
The ministry of Health has, following the outbreak of the disease moved in fast to curb infections and control deaths, though they are still dogged by logistical problems. Luwero District Health Officer Dr Joseph Okware described the situation as “tense” but “calm”. He told a team of officials from the Health ministry, Centre for Disease Control, The African Field Epidemiology Network (AFNET) and WHO that the outbreak had indeed caused panic and anxiety among the locals. “Ebola is not an easy enemy to fight. We need cooperation and dialogue and networking to address it,” said Okware at the Luwero district headquarters on Tuesday.

He confirmed that Kate Nakiguli, the 12 year-old girl indeed died of Ebola. Nakiguli, formerly a primary five pupil at Ngalo nkalu primary school in Zirobwe, Luwero district succumbed to death on the May 6 at the Bombo military hospital where she was admitted. Okware said the 23 people who had had contacts with Nakiguli have been isolated and are being monitored closely.

“Eleven people are from the clinic in Zirobwe where she was admitted first, nine from the girls village in Ngalo nkalu, two from Bombo military barracks, and one person from where the burial took place in Wakiso,” said Okware. He said two other suspected cases, one of a one and half year old baby and that of a mortuary attendant attached to military hospital in Bombo had been reported, though the laboratory results indicated that they had malaria.
The acting director general Health services, Dr. Denis Lwamafa said government was taking the immediate measures to handle the situation. “As government moves in to take control measurers, it is very important that we take precaution and appropriate risk handling of Ebola,” he said. He said surveillance is going to be expanded to exceed Luwero. He urged the district leaders to ensure that burial arrangements are handled well by a team of experts to curb on infections. “We need to be strict while handling Ebola victims. Only body bags must be used. Avoid social gatherings and shaking of hands,” he said.

The National Task Force head, Dr. Anthony Mbonye said the surveillance will be expanded to include surrounding districts of Wakiso, Nakasongola, Nakaseke, Mukono and Kampala. “We can’t only take care of Luwero because we are not certain of the source and the spread that is why we are expanding surveillance to the other five districts neighboring Luwero. Funds are being channeled for surveillance and monitoring,” said Mbonye. He said government was closely working with WHO, AFENET and the MS Spain to ensure that Ebola is contained.
The AFENET senior epidemiologist Dr Monica Musonero Musanza said they would commit funds for training the health workers and communication for the surveillance team on ground. “We have funds to support government with training and communication because these are vital in curbing spread. We are also sending a team of experts on the ground to trace for the exact source of this Ebola,” said Musanza. But government and other development partners seek to control the spread of the killer Ebola in Luwero and its suburbs, reported emerged that another Ebola case had been reported in Bugiri, a town in eastern Uganda.
The Ebola virus is highly contagious and causes a range of symptoms including fever, vomiting, diarrhoea, generalised pain or malaise and in many cases internal and external bleeding. The 30 people who are believed to have had contact with the deceased have not yet developed symptoms according to the ministry of Health officials. “They are currently being monitored and isolated from the public,” said Mbonye. Mbonye said that preliminary investigations have showed that this Ebola virus is similar to the one that broke out in Sudan, thus named Sudan Ebola.

The other subtype is the Congo Ebola which also attacked the western district of Bundibugyo in 2007 claiming 37 lives including a senior doctor Jonah Kule. In 2000 Ebola outbreak in Gulu left at least 170 people dead. These earlier ones had a fatality rate of over 80 percent. Mbonye said that there also ongoing investigations to find out whether the index case got into contact with moneys or bats, the known reservoirs of the Ebola virus.

Following the outbreak, government has reactivated the National Ebola Task Force (NETF) to coordinate the fight against the disease at the national level. District task forces are also in the process of being formed according to Mbonye, who is the chairperson of the NETF. Immigration officials at all the country’s border posts have been put on alert and the neighbouring countries have been notified about the outbreak.

According to Joachim Saweka, World Health Organisation (WHO) representative here, tight border controls are not yet necessary although the immigration officers should be on alert. With some people reluctant to disclose their exact areas of origin for fear of being inconvenienced and perhaps quarantined, it remains a challenge how the immigration staff will handle the situation. According Saweka, a team of experts from WHO are also on the way to Uganda to beef up the team which is already camped in the affected district. A ministry of Health statement issued on Thursday urged the public to stay calm as all possible measures are being undertaken to control the situation. The ministry urged the public to avoid direct contact with body fluids of a person suffering from Ebola by using protective materials like gloves and masks. The public is also urged to bury people who have died of Ebola immediately and avoid feasting and funerals.
Government has also stocked the necessary drug supplies and logistics for case management. Isolation facilities have also been set up in the affected district. “Any claim of somebody bleeding should not just be disregarded but should be rushed to the nearest health centre and then from there we are already working with the health system to try to instruct how to deal with these cases,” said Saweka.