US Embassy Uganda: Emergency Msg to US Citizens on Ebola Outbreak, Oops, Scratch Dat — One Confirmed Case of Ebola Virus

On  July 28, the US Embassy in Kampala released the following Emergency Message to U.S. citizens:

Emergency Message for U.S. Citizens | Confirmed Case of Ebola Virus in Uganda

This Emergency Message is to alert U.S. citizens residing and traveling in Uganda of an outbreak of Ebola virus.  On July 27, 2012, local Ugandan press reported 12 deaths due to a “strange illness.”  Laboratory tests conducted by the Uganda Virus Research Institute and the United States Centers for Disease Control and Prevention (CDC) have confirmed, to date, that at least one victim was infected with the Ebola virus (Sudan strain).  The Ugandan Ministry of Health, U.S. CDC, and international partners are investigating the case to determine the extent of the outbreak and if additional cases are present.  At this time, the cases appear to be centered in Nyamarunda Sub County, Kibaale district, although one suspected victim is reported to have traveled to Kampala for treatment at Mulago Hospital where he subsequently died on July 22, 2012.

Ebola is a deadly but preventable disease.  The virus has the potential to spread from person to person, especially among health-care staff and family members who care for patients with Ebola Viral Hemorrhagic Fever. A person suffering from Ebola usually presents with sudden fever, headache, joint and muscle aches, sore throat, and weakness, followed by diarrhea, vomiting, and stomach pain.  A rash, red eyes, hiccups and internal and external bleeding may be seen in some patients. Symptoms become increasingly severe and may include jaundice, severe weight loss, mental confusion, shock, and multi-organ failure. There is no standard treatment for Ebola HF.  Patients receive supportive therapy.

The likelihood of contracting Ebola is considered extremely low unless there has been a direct contact with body fluids like saliva, urine, or blood of an infected person or animal or the body of someone who has died from the disease.  Since the virus spreads through direct contact with blood and other body secretions of an infected person, people living with and caring for Ebola patients are at a higher risk of becoming infected.

The U.S. Mission in Kampala and the CDC office in Uganda recommend that U.S. citizens residing and traveling in Uganda avoid contact with people exhibiting the symptoms described above.  To minimize the risk of contracting Ebola, avoid direct contact with body fluids (blood, saliva, vomit, urine, and stool).  Practice good hygiene, such as washing hands carefully and thoroughly with soap and water, or with alcohol-based hand cleanser if soap and water are unavailable.  Avoid communal washing of hands during funerals or other public gatherings.  Avoid contact with dead animals, especially primates, and refrain from eating “bushmeat.”

Read the whole message here.

English: Biosafety level 4 hazmat suit: resear...

English: Biosafety level 4 hazmat suit: researcher is working with the Ebola virus (Photo credit: Wikipedia)

Here is what the CDC posted about the ebola outbreak on the same date:

2012: Ebola Hemorrhagic Fever Outbreak in Uganda

On July 28th, 2012, the Uganda Ministry of Health reported an outbreak of Ebola Hemorrhagic fever in the Kibaale District of Uganda. A total of 20 probable human cases, including 14 fatalities, have been reported since the beginning of July. Laboratory tests of blood samples, conducted by the Uganda Virus Research Institute (UVRI) and the U. S. Centers for Disease Control and Prevention (CDC), confirmed Ebola virus in five patients, two of whom have died. All reported illnesses and contacts are being investigated.

A team of experts from CDC is traveling Uganda, to work with Ministry of Health and international partners in determining the extent of the outbreak and locating, testing, and treating any additional cases. A laboratory team will also assist in diagnostic testing.

Here is the statement that the Ministry of Health released in Kampala, Uganda:

EBOLA SUSPECTED CASES INCREASE IN KIBAALE DISTRICT
KAMPALA – 07/03/2012 – The Ministry of Health Wishes to inform the public that the number of suspected Ebola cases registered at Kagadi Government Hospital in Kibaale district has since yesterday increased from seven to 18 patients. Currently there are three confirmed cases and 15 suspects admitted at the isolation facility. The patients are receiving the appropriate treatment from the medical team dispatched from the National Task force jointly with local hospital staff. Most of them are responding positively to the treatment administered to them.

The increased number follows the quick response given to suspected alerts from various parts ofthe district. The patients are currently admitted at the hospital isolation facility after they presented with Ebola signs.

There have been no more deaths recorded since the announcement of the outbreak on July 28th, The death toll still remains at 14.

A total of 16 samples have since the outbreak been collected from the suspect cases for investigation at the Uganda Virus Research Institute. The Ministry of Health Surveillance team in Kibaale district is actively and closely following up to 40 people who are suspected to have got into Contact with the dead. These contacts have not shown any signs of the disease but will be monitored for 21 days. After 21 days, they will be declared Ebola-free meaning that they did not contract the disease.

At Mulago National Referral Hospital, a total of eight health workers who attended to the suspect case are closely being monitored. An isolation policy arrangement to last 21 days has been put in place as active monitoring continues.

The Ministry of Health further informs the public that plans are underway to set up Isolation Facility at Mulago National Referral Hospital in readiness for any alerts and suspected cases from Kampala and neighbouring districts.

The public is therefore requested to stay calm as everything is being done to manage the outbreak. The Ministry of Health advises the public to ensure that the recommended safety measures are adhered to and to refer any suspected cases to a nearby health facility for check up. Ebola presents with fever, vomiting, diarrhoea, abdominal pain, headache, measles-like rash, red eyes, and sometimes with bleeding from body openings.

The original statement is online here.

The US Embassy in Kampala cites local press reports which calls the death the result of “strange illness.”  As the Examiner points out, our own CDC has had a long term presence in Uganda and operates a VHF lab in cooperation with the Uganda Virus Research Institute.

So here is what we don’t get —

Why would the embassy emergency message cites press reports about “strange illness” instead of using the information from the CDC?

The embassy emergency message of July 28 cites only one confirmed case infected with the Ebola virus.

The CDC information dated July 28  calls it an outbreak and cites 20 probable human cases, including 14 fatalities, plus, confirmed Ebola virus in five patients, two of whom have died.

The one emergency message with no follow-up message to-date did not mention that the Kibaale district cases have increased from seven to 18 patients. Nor did it mention the three confirmed cases and 15 suspects admitted at the isolation facility. Nor did it mention that the Ministry of Health Surveillance team in Kibaale district is actively and closely following up to 40 people who are suspected to have contact with the dead. Nor did it mention that a total of eight health workers who attended to the suspect case are also closely being monitored under the government’s isolation policy which last for 21 days (the incubation period for Ebola HF ranges from 2 to 21 days).

Although July 28 emergency message is prominently displayed on the embassy’s website, there is no mention of that message on the embassy’s Facebook or Twitter pages. US Embassy Kampala/FB talks about the London Olympics, and the most effective approach Uganda can take to stop terrorists.  Here is what US Embassy Kampala has on Twitter in a 5-day span, not one mention of e-bola:

And so — one more example of just how integrated is the embassy’s social media outreach with its primary consular function.

The Examiner notes the USG presence in the country and the absence of travel restrictions:

Several other U.S. government agencies are active in Uganda and have personnel there. The Peace Corps has about 122 volunteers in the country. U.S. military personnel regularly exercise with their Ugandan counterparts and Special Operations forces have been deployed there since October 2010. The U.S. Agency for International Development participates in 154 projects in that nation.

There is no traveler’s warning from the CDC for Uganda concerning the Ebola outbreak. The U.S. Embassy in Uganda issues a warning message to U.S. citizens in Uganda but has not suggested any travel restrictions.

Just two days before the ebola outbreak, forty-five Peace Corps Volunteers started their service in Uganda.

This is not the first reported instance of ebola outbreak in Uganda in recent history. In 2000/2001, there were 425 reported cases with 53% deaths; in 2007/2008, 131 reported cases with 37% deaths; and a single case in May 2011 which resulted in death.

Domani Spero

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