Hints emerge of nastier, mutating West Nile virus

By Brian Vastag, The Washington Post

Posted Nov. 09, 2012, at 11:14 a.m.
Last modified Nov. 09, 2012, at 2:15 p.m.

The West Nile virus epidemic of 2012, the worst in a decade, may be notorious for yet another reason: The virus, in some cases, is attacking the brain more aggressively than in the past, raising the specter that it may have mutated into a nastier form, say two neurologists who have extensive experience dealing with the illness.

One doctor, Art Leis in Jackson, Miss., has seen the virus damaging the speech, language and thinking centers of the brain — something he has never observed before. The other, Elizabeth Angus in Detroit, has noticed brain damage in young, previously healthy patients, not just in older, sicker ones — another change from past years.

But a scientist for the Centers for Disease Control and Prevention said the federal agency has not seen any evidence that the virus is causing a different type of brain damage. He said doctors may be seeing more-serious cases this year because there are more cases overall. But he acknowledged that the CDC does not collect the granular data needed to quickly determine whether the virus is causing more-severe brain damage.

Continued:  http://bangordailynews.com/2012/11/09/health/hints-emerge-of-nastier-mutating-west-nile-virus/?ref=latest

Uganda: One-year-old dies of Marburg in Ibanda

Saturday, November 10  2012

IBANDA

A one-and-half-year old boy has reportedly died of Marburg virus at Ruhoko Hospital in Ibanda District.

The District Health Officer, Dr Julius Bamwine, on Thursday confirmed to Saturday Monitor that the victim, only identified as Alexander, died on Wednesday night. “I can confirm to you that one of the victims from Kikyenkye, who had tested positive to Marburg virus died last night. He is a son to Mr Mande who lost his wife to the same disease recently,” Mr Bamwine said. The baby becomes the second person from Ibanda to die of the virus but the ninth to succumb to the killer virus in the region.

The Health ministry confirmed the Marburg outbreak a month ago in the western district of Kabale. It has since spread to three other districts in Western Uganda. Alexander’s mother, Rosette Katusiime, died of the virus at Mbarara Regional Referral Hospital on October 23. Her husband had also tested positive.

The boy was admitted at Rukoho Hospital with other four suspected cases last week.
The number of suspected cases has since gone up to 12. Dr Bamwine said they are in the process of discharging eight people who have tested negative while four still remain under surveillance as they wait for their results from Uganda Virus Research Institute in Entebbe.

At Mbarara hospital, the three suspected cases admitted last week have tested negative and been discharged but two more cases were on Wednesday admitted with symptoms similar to those of the Marburg virus.

“We have two male suspected Marburg patients; one is from Kisenyi in Kakoba Division, Mbarara Town. He had severe nasal bleeding while the other is from Rwampara County in Mbarara. He was vomiting and passed stool with blood,” said Ms. Eugenia Namulindwa, the in-charge of the isolation unit.

The virus
Seven other people have died of Marburg Virus in Kabale District since October 19 and two are positive and remain admitted at Rushoroza Isolation Centre.

Antibiotic resistance surveillance network extended throughout European Region

On 30 October, WHO/Europe signed an agreement with the National Institute for Public Health and the Environment (RIVM) of the Netherlands, and the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) to expand surveillance of antimicrobial resistance to cover all countries in the WHO European Region.
The establishment of this new Central Asia and European Surveillance of Antimicrobial Resistance (CAESAR) network is a key component of the European action plan on antibiotic resistance, agreed by Member States in September 2011.
“This is very strong tripartite collaboration,” stated Zsuzsanna Jakab, WHO Regional Director for Europe, at the signing. “The agreement brings together the partners’ different surveillance capacities: ESCMID for its expertise in diagnostics, RIVM for its expertise in epidemiology and WHO for its country reach and convening powers.”
“We know we can work together, because we have done so for many years,” added Gunnar Kahlmeter, President of ESCMID.
CAESAR’s surveillance work will complement that of the European Centre for Disease Prevention and Control (ECDC) through the European Antimicrobial Resistance Surveillance Network (EARS-Net). To enable comparison of data for the whole European Region, CAESAR will use the EARS-Net methodology in close collaboration with ECDC.
Concluding the signing ceremony, Andre van de Sande, Director-General of RIVM, commented, “RIVM is proud that the efforts that went into developing what is now EARS-Net are also being used to develop CAESAR.”
The increase and spread of bacteria that are resistant to the antibiotics developed to kill them are a major threat to health in the WHO European Region. Mapping antibiotic use and resistance is vital, providing health professionals, risk managers and decision-makers with the evidence they need to prioritize their resources and efforts to contain antibiotic resistance.

http://www.euro.who.int/en/what-we-do/health-topics/disease-prevention/antimicrobial-resistance/news/news/2012/11/antibiotic-resistance-surveillance-network-extended-throughout-european-region

Early use of antiviral medications may help prevent lung failure in children with the flu Read more here: http://www.sacbee.com/2012/11/05/4962120/early-use-of-antiviral-medications.html#storylink=cpy

By Boston Children's Hospital
Nov. 5, 2012

Excerpt:
Using data from the Pediatric Health Information System (PHIS) ― an administrative database of inpatient admissions from 43 not-for-profit, tertiary care pediatric hospitals in the United States — Randolph, Eriksson, Uyeki and their team compared diagnosis, treatment and discharge data on more than 9,800 children hospitalized with a diagnosis of influenza during the 2009 pandemic against those of nearly 10,200 children hospitalized in total over the three previous flu seasons.
They found that while nearly three times as many children were indeed hospitalized during the pandemic season than would have been expected based on the previous three seasons, the percent of children put on mechanical ventilation during the pandemic was much lower than would have been expected.
Delving deeper, the team also noted that Tamiflu was prescribed much more frequently during the pandemic than other years.


Article:  http://www.sacbee.com/2012/11/05/4962120/early-use-of-antiviral-medications.html

Maine: CDC to use Bangor Civic Center for Epidemic/Pandemic Care

Bangor - If there's ever concern of an epidemic or pandemic of any kind in our state, the Maine Centers for Disease Control will set up shop in Bangor.

The CDC will use the Civic Center to provide vaccines and care for people.

Two years ago, when H1N1 was a concern, the CDC used the Civic Center.

Bangor's finance committee is set to approve the agreement Monday night.

http://www.wabi.tv/news/34948/cdc-to-use-bangor-civic-center-for-epidemic-pandemic-care

NZ flu study finds influenza viruses put more people in hospital than was previously thought

06 November 2012
SHIVERS Study 2012: Overview of preliminary findings

SHIVERS InfographicHigh numbers of people hospitalised with respiratory illness tested positive for infection with influenza viruses.

Children under four hardest hit with highest rate of influenza hospitalisation.

High rates of influenza hospitalisations in people older than 80 years were identified.

Pacific Island and Maori populations had highest rate of hospitalisation from influenza (by ethnic group).

In Auckland, swine flu pandemic A(H1N1) viruses predominated during June and July and then A(H3N2) viruses predominated during August and September.

A(H3N2) viruses were predominant across the rest of New Zealand from June through to September.

If the Northern Hemisphere follows the same pattern found during the 2012 NZ winter with A(H3N2) viruses predominating, then influenza hospitalisation rates, particularly for the very old and very young, may be substantial.

These findings support the boosting of vaccination rates in the community to protect those most vulnerable to the effects of influenza.

The influenza viruses circulating in New Zealand changed throughout the winter period (April to September 2012) and new vaccine strains have been selected to better match currently circulating viruses.

There were substantial numbers of people hospitalised with severe acute respiratory infections caused by other respiratory viruses.

Preliminary findings from the first full year of a multi-million dollar five-year international flu study led by ESR in New Zealand have shown more people are hospitalised with severe acute respiratory infections (SARI) caused by influenza viruses than previously thought.

The Southern Hemisphere Influenza Vaccine Effectiveness Research and Surveillance (SHIVERS) study is investigating five autumn and winter 'flu seasons' amongst the Auckland population. The study is a multi-centre collaboration between ESR, Auckland District Health Board (ADHB), Counties Manukau District Health Board (CMDHB), University of Otago, University of Auckland, the US Centers for Disease Control and Prevention (CDC) and the WHO Influenza Collaborating Centre at St Jude Children's Hospital in Memphis, USA.

The SHIVERS team is building on New Zealand's world leading influenza surveillance systems, which track viruses in real time using data from hospitals and general practitioners (GPs) working in the community.

Over the 2012 New Zealand winter, flu experts led by the SHIVERS Principal Investigator, Dr Sue Huang from ESR, have tracked the ever-changing viruses through patients admitted to ADHB and CMDHB hospitals with influenza-related SARI.

The rate of influenza hospitalisations during the 2012 flu season was the fourth highest recorded over the past twelve  years, with children under four years and the elderly being the hardest hit.

From 30 April 2012 to 2 September 2012 a total of 1,370 SARI cases was recorded, including 38 intensive care unit (ICU) admissions and seven deaths. Infants aged younger than one year had the highest influenza hospitalisation rate of 228.7 per 100,000 age group population. This was followed by people aged 80 and older (128.6 per 100,000), people aged 65-79 years (81.1 per 100,000) and children aged one to four years (54.9 per 100 000).

Dr Sue Huang said although the findings are preliminary, discovering an increased burden from  influenza viruses than previously thought shows the need for countries to work together on the best ways to prevent and manage influenza.

"Influenza causes more illness each year than any other vaccine-preventable illness. This study highlights the importance of tracking the viruses which cause influenza across the population so we can better protect against them through the right vaccines, prevent their  spread and care for those who do get the flu."

One of the areas being looked at by the SHIVERS team is the effectiveness of the flu vaccine. Dr Nikki Turner, Director of the Immunisation Advisory Centre (IMAC), University of Auckland, says this year the study looked at the effectiveness of the vaccine in preventing hospitalisation from flu. "To date, the data is incomplete, so we do not as yet have a very accurate measure for the effectiveness of the vaccine.  However, we will continue to collect data over the next four years.

"In the next year of the SHIVERS study we will also look at patients with influenza presenting to general practice. This means that in future years the study will be able to measure how effective the vaccine is in preventing flu related GP consultations and hospitalisations."

Dr Adrian Trenholme, a paediatrician at Middlemore Hospital says that young children aged  less  than four years are hit hardest by influenza viruses, so getting a flu shot is important to protect them.

"The SHIVERS study has shown a previously under-recognised burden of non-influenza respiratory viruses causing substantial hospitalisations, particularly in young children."

Dr Sally Roberts, Clinical Head of Microbiology at Auckland City Hospital says that SARI surveillance also showed that the most prevalent influenza viruses identified among patients in Auckland this year were different from the rest of the country.

"During June and July, the swine flu pandemic A(H1N1) viruses were predominant in Auckland, but then there was a switch to A(H3N2) predominance in August and September. Whereas, A(H3N2) viruses predominated throughout the winter season for the rest of New Zealand."

The virus strains used for the influenza vaccine have been updated to match what is forecast to be circulating during 2013. This is based on the World Health Organisation's recommendation which has been accepted by Southern Hemisphere Countries, including New Zealand.  The vaccine virus strains are:

    A/California/7/2009 (H1N1)-like virus
    A/Victoria/361/2011 (H3N2)-like virus
    B/Wisconsin/1/2010-like virus.

The New Zealand flu experts involved in the SHIVERS study are briefing their international colleagues from the CDC and St Jude Children's Research Hospital in Memphis, Tennessee, over the next two days in Auckland.

Continued:

http://www.nzdoctor.co.nz/un-doctored/2012/november-2012/06/nz-flu-study-finds-influenza-viruses-put-more-people-in-hospital-than-was-previously-thought.aspx 

Pennsylvania: Washington County students carry devices to help Pitt monitor spread of flu

November 5, 2012

By Jack Kelly / Pittsburgh Post-Gazette

With the help of children who'll be off of school for Tuesday's election, researchers at the University of Pittsburgh hope to find out if school closings can slow the spread of flu and other disease.
Today researchers will distribute remote sensors called motes to about 450 students at Borland Manor Elementary and North Strabane Intermediate schools in the Canon-McMillan School District in Washington County. Students will wear the motes, the size of a beeper and weighing 3 ounces, on lanyards around their necks today, Tuesday and during the school day Wednesday. Researchers will collect the motes before school is dismissed.
Powered by batteries, motes send out a signal that will detect another mote when they get close to each other, and the encounter is electronically recorded. Data collected from motes should give researchers a comprehensive picture of how often children interact.
"This is the first time this is being done anywhere, ever," said Charles Vukotich Jr., senior project manager at Pitt's Graduate School of Public Health.

Read more: http://www.post-gazette.com/stories/news/science/washington-county-students-carry-devices-to-help-pitt-monitor-spread-of-flu-660701/#ixzz2BRJgvfnP

Uganda: Mulago Intensive Care Unit Reopens After Death of Several

Posted by Sandra Birungi on November 5, 2012
By Jane Nambi
The Mulago hospital Intensive Care Unit (ICU) has been reopened after many lost their lives due to its closure over the last few days.
The unit was reopened Friday. It had been previously closed due to the break down of equipment in the unit. As a result, five people were reported dead as a result of the closure of the unit.

It was reported that there was a shortage of bacterial filters – an important component used with ventilators which protect patients from germs and infections coming from the machines through the tubes as well as making the air moist enough for the patient to take in.
The hospital spokesperson, Mr Enock Kusasira explained that Mulago had experienced a temporary shortage of bacterial filters for two machines. “The order for the filters was placed on September 20, 2012 and they were later on delivered on October 12 but were not well packaged,” he said, adding: “Mulago Hospital asked the supplier for another delivery which was delivered on November 1, 2012.”
Whereas the hospital management says they ran out of filters for only two machines, according to Daily Monitor sources, four ventilators did not have filters, and as such no patient could be admitted to the ICU.
Most of the patients, who turned up at the hospital in dire need of life support services, were turned away.

http://www.ugandapicks.com/2012/11/mulago-intensive-care-unit-reopens-after-death-of-several-76742.html

#Marburg Virus: More Death

On November 2, I posted an article speaking of two deaths out of the Ibana Hospital.  That post is located here.
Excerpt:

Two more people suspected to have contracted the Marburg virus have died in Ibanda
District.
If confirmed, this will bring the total number of Marburg deaths to seven.

The deceased whose identities have not yet been revealed include a 14 year old boy
and a 68 year old woman.

Today, there is an article which speaks of 2 more death, for a total of 10, and has different ages, yet within the article it states that the virus has claimed over 5 lives.

2 More Die From Marburg as Death Toll Increases to 10
Posted by Sandra Birungi on November 4, 2012

By Jane Nambi The death toll has increased from eight people to ten after two people died from the disease in Ibanda on Friday. The people who died were from Ibanda and had previously been admitted to Ibanda Hospital after suffering from marburg related symptoms.

The dead have not yet been identified although they were a 14-year-old boy and a 16-year-old girl.

Ministry of Health spokesperson, Rukia Nakamatte has urged all people to be more careful as they do all they can to combat the outbreak which has so far claimed the lives of over five people. The marburg disease broke out less than two months ago in Kabale district after a family of four people died from related symptoms. Over 200 people were put under surveillance over the disease but it seems the situation has not yet been combated.

http://www.ugandapicks.com/2012/11/2-more-die-from-marburg-as-death-toll-increases-to-10-30484.html

India: The avian flu scare and after

Nov 4, 2012
Eleven days after the outbreak of the highly pathogenic avian influenza (AI) - a subtype H5N1 - was reported at the Central Poultry Development Organisation (CPDO) farm at Hesaraghatta near here, the unit has no more birds.

The authorities, under the supervision of appropriate personnel, have culled all the birds in the farm following the Centre’s Action Plan-2012 for control and containment of AI.
Thousands of birds, including chicken, duck and emu, having been culled; and the process of disposing them of and sanitising the 50-odd units that are a part of the farm having begun, the focus now is on how to contain the spread of the virus.

A prohibitory order banning the sale and marketing of poultry and poultry products in a 10-km radius of the CPDO is in place till November 15, as a precaution.

Continued:  http://www.deccanherald.com/content/290001/avian-flu-scare-after.html

Indonesia: Hospital Room Prepare for Bird Flu Patient

04.11.2012

Regional General Hospital (Hospital) M Yunus Bengkulu prepare special care to anticipate patient bird flu (H5N1) due to increased cases of bird flu in the region. "We have prepared a special treatment room in anticipation of the flu patients birds due to increased cases of avian bird flu in this area, "said Director of Hospital M Yunus Bengkulu, Yusdi Zahrias Tazar Sunday.

He explained that the treatment room is provided consisting of two treatment rooms with a capacity of four beds. "In addition, a team of medical personnel were prepared consisting of specialists in internal medicine, pediatricians, general practitioners, and nurses," he said. medics assigned to a combination of several experts for handling bird flu patients requiring rapid and precise measures of various fields of expertise. 

While Head Space Kemuning Care Hospital M Yunus Bengkulu, Sin Vice Director explained, room conditions and medical teams are ready to serve when suddenly there was a bird flu patient."Every bird flu patients has provided a variety of medical equipment such as monitors, regulator drip infusion , and a ventilator to assist breathing, "he said. There are also people who suffer from the symptoms of bird flu include cough, shortness of breath, body temperature reached 40 degrees Celsius, sore throat, and no history of contact with poultry bird flu, for people who have symptoms The symptoms are asked to go to M Yunus hospital to get treatment right away. Head of Department of Agriculture and Livestock of Bengkulu, Gunadi Arif said that during October 2012, 110 birds in this area who died suddenly confirmed positive for the bird flu virus. "Ironically, most people are not willing to surviving poultry culled voluntarily despite flu virus bird that is difficult to control its spread, "he said. Regional spread of avian bird flu in Bengkulu City among others in the Village Circle West, Great Village, Kebung Tebeng, Bentiring, Plow, Nusa Indah, East Beautiful, and Sidomulyo. (ANT)

Health: 4500 injury Alinkafah gland in schools since the emergence of the disease

{The Doctor is talking about Mumps at the beginning of this article }

The Ministry of Health and Population, the total incidence of thyroid an Alinkafah 4 thousand and 500 cases among school students since mid-September so far, including 85 \% in the age group (6-15 years).

And Dr. / Amr Kandil, head of the Preventive Medicine - said in a statement on the sidelines of a press conference held on Saturday at the Ministry of Health - that the disease is not dangerous, and there are no deaths or condition suffered complications as a result of infection. and pointed to low rates of morbidity infectious during the past year, which did not show cases of disease, polio since 2006, and measles cases decreased to 26 cases, as well as German measles cases, which did not exceed the 30 cases, pointing out that AIDS cases ranging between 300-350 case annually and Egypt from less countries in the world in the spread of the disease. and said Kandil 'that the total cases of bird flu this year, did not exceed the 10 cases, of whom died 5 cases, bringing the incidence of the disease to 168 cases since the outbreak started in 2006, He pointed out that death rates did not exceed in Egypt the 36 \% of the injury, and expected decline of the disease next year significantly. its part, said Dr. Abeer Barakat Assistant Minister of Health for Preventive Affairs said the ministry will support during the coming period infection control procedures in hospitals and medical centers, where still disease hepatitis 'C' obstacle to the Gaza Preventive Medicine.

 Continued: http://arabic.arabia.msn.com/egypt/egypt-news/3448744/%D8%A7%D9%84%D8%B5%D8%AD%D8%A9-%D8%A5%D8%B5%D8%A7%D8%A8%D8%A9-%D8%A8%D8%A7%D9%84%D8%BA%D8%AF%D8%A9-%D8%A7%D9%84%D9%86%D9%83%D8%A7%D9%81%D9%8A%D8%A9-%D8%A7%D9%84%D9%85%D8%AF%D8%A7%D8%B1%D8%B3/

Gaza: preparing for winter to meet all influenza viruses

11/4/12

Najla charitypublication day in the vicinity of 04 - 11 - 2012

Dr. Amr Kandil, the Central Administration of Preventive Medicine at the Ministry of Health and Population preparations ministry in general and the Gaza Preventive Medicine in particular to address the diseases of winter to include influenza viruses of all kinds of bird flu and swine and other types of emerging influenza. explained Qandil in a statement the "perimeter "The virus mumps will increase its spread with increasing the number of the injured and to the advent of winter, adding that the mumps virus, like other viruses and does not constitute danger or threat to the health of citizens or patients. noted Qandil to do sector Preventive Medicine ministry to take all preparations and specific measures of will face these seasonal diseases in terms of increasing prevalence the next stage and we on the verge of winter. It is worth mentioning that these preparations awareness among the citizens of all the different media, as well as a few up-to cases as they arise so in addition to providing vaccinations and therapeutic drugs crisis for the injured. stressed Qandil on the need to prevent the crisis to avoid getting any of the various diseases where prevention is the best way healthy and safe Taqi everyone through personal hygiene and cleanliness of the tools specific to each individual and not use common tools among family members as well as non-breathing in the aspects of each other and the need to wash permanent hands soap and water.

Egypt: Alexandria Gov. Organizes Convoy Check for #H5N1 Poultry & Other Pathogens...

November 4, 2012

Directorate of Veterinary Medicine began in Alexandria organized convoys active for veterinary survey of all veterinary departments and rural areas and villages.

These convoys come to make sure it is absent from poultry farms of the avian influenza virus and other pathogens.

The director of the Directorate d. Mohammed Najib, in a press statement Sunday, November 4, "The caravan includes specialized committees to pull samples from poultry farms within the province, and sent for analysis laboratories competent," explaining that convoys are also doing the survey veterinarian villages and homes to make sure free places backyard poultry of different pathogens that infect poultry.

The Saudi Ministry of Health: Healing a Saudi citizen of the SARS virus from the family

[There are no articles to be translated that provide more detail, than the one below].

05/11/2012
RIYADH (AFP): The Ministry of Health Saudi Arabia on Sunday healing Saudi man of mysterious illness of a family SARS virus, which led to the death of Saudi last September. ministry said in a statement it had discovered cases of HIV Corona citizen in a hospital in the city of Riyadh, "where it was suspected his condition and was immediately scans and analyzes necessary for him to laboratories ministry," according to official Saudi Press Agency. said the ministry in a statement that he "was sent a sample to a laboratory specialized outside the Kingdom, note that the patient did not leave the Riyadh area, so the results are uncertain for a positive situation. " The ministry noted that it has taken "measures and precautionary measures to deal with this case in accordance with the norms of scientific and medical guidance WHO, as well as recommended by the National Scientific Committee of Infectious Diseases, whose membership includes specialized consultants representing various sectors of government health." The ministry confirmed that the patient "received appropriate treatment and recovered and that the health status of reassuring not to worry about, where are these cases individually and equal most people infected with the virus to heal .. After providing supportive therapy appropriate, like viruses that cause respiratory infections such as seasonal influenza and others." and confirmed that it "continues in the follow-up to the new situation about this virus in coordination with international organizations and international medical bodies and regional. "

Saudi confirms third case of newly discovered SARS-like virus

ABU DHABI | Sun Nov 4, 2012 11:51am EST

(Reuters) - A Saudi citizen in the capital Riyadh is the world's third confirmed case of a newly discovered SARS-related virus but he has now recovered from his illness, the official Saudi Press Agency reported on Sunday.
 -snip-

Saudi authorities conducted tests on the new case in the Health Ministry and then sent abroad a sample which tested positive, the agency said, citing a statement from the ministry.
"The patient received the appropriate treatment and has recovered," the agency quoted the ministry as stating, adding that the man had not left Riyadh.
-snip-
http://www.reuters.com/article/2012/11/04/us-coronavirus-saudi-idUSBRE8A30EH20121104 

Uganda: The Marburg Virus Puzzle

[Very informative article]
By Sarah Namulondo, 4 November 2012

Dr Thimm, the man at the centre of isolating the disease, explains why it is happening.

 Since the ministry of Health declared an outbreak of the viral hemorrhagic fever, Marburg, in Kitumba sub-county in Kabale district on Oct.19, questions have been asked about the real cause, origin and efforts to find treatment for the disease.

Although the Marburg virus was first identified and traced to Uganda in 1967, the latest attack is the third in five years since 2007. It also follows very closely to a July attack of another viral hemorrhagic fever, Ebola, which killed 17 people in Kibaale district in the same region. It was the third Ebola outbreak in five years.

Continued: http://allafrica.com/stories/201211040378.html

#Marburg Virus: Suspected Marburg patients discharged from Mulago

November 3, 2012

The ministry of health has directed Mulago hospital to discharge the only two Marburg patients who were admitted recently.
The duo to be discharged is Sharon Turyomujuni and her husband.
The ministry says the patients can now be discharged after they tested negative for the virus.
The ministry’s public relations officer Rukia Nakamatte says this implies that the treatment they were subjected to was effective.
She adds that the team of experts in Kabale is ready to reintegrate them back in community.
Nakamatte says the total number of admissions now stands at 12.
6 from Kabale district, 5 in Ibanda, 1 in mbarara and 1 in Kabarole.
The highly contagious disease which broke out in the Kabale district has so far killed 8 people.