virus
International effort has been mobilised as the death toll mounts in Uganda
Anna Borzello and Sarah Boseley Ugandan officials this week threatened to use force to prevent anyone leaving three areas of the country stricken by an outbreak of deadly Ebola haemorrhagic fever as an international effort was mobilised to contain the epidemic. As the world death toll mounted to at least 39, including three nurses, worrying signs emerged that the epidemic might be spreading. There is no treatment for Ebola, whose victims rapidly bleed to death. Because it is highly infectious, the only hope of stopping an outbreak is isolating victims and their contacts. Until the weekend, the victims had been restricted to a 32km radius of the northern Ugandan district capital of Gulu, which is 360km north of the capital, Kampala. However, since Saturday new cases have been reported outside the original area of infection.
“Four cases have been reported in neighbouring Kitgum district, while five people have been admitted to hospital from Pece, a suburb of Gulu town which was not affected before,” said Lieutenant Colonel Walter Ochoro, who heads a task force set up to combat the disease. More worrying still, two cases of Ebola have also been reported in Atiak and Amoru, two congested camps north and west of Gulu that are home to tens of thousands of people displaced by the insurgency in the region. Oladapo Walker, Uganda’s World Health Organisation (WHO) representative, said: “This is a problem but we just have to do the best that we can under the circumstances.
“If we are able to quickly isolate the reported cases in the camps we should be able to contain it very quickly. But if we are not able to isolate the reported cases in the camp very quickly, that is a serious business.”
Ochoro said that all schools in the affected areas had been ordered closed and residents were told they could not leave except for medi-cal attention. “We hope we will not have to use force but we are determined to beat this,” he said. International aid workers and scientists are converging on the area to support the Ugandan effort and study the disease. The WHO has sent two Ebola experts to Gulu and two more, one epidemiologist and one specialist in barrier nursing, who were due to fly in this week. A public education programme has been launched, advising local people to stay away from infected people and to suspend cultural practices, such as burial rights, that might inadvertently spread the disease. Until now Gulu’s two hospitals, which are underfunded and overstretched, have been struggling to deal with the epidemic. A shipment of medicines has been provided by the WHO, as well as protective clothing in the form of goggles, face masks and aprons. Ebola is what is known as a filovirus – the only known virus family that scientists are profoundly ignorant about. The first filovirus infection to be identified was of the Marburg strain in 1967, when laboratory workers in Marburg, Germany, were taken ill. The source of infection was identified as green monkeys imported from Africa for use in research. Monkeys appear to have been the source of the virus in each outbreak of Ebola, which first appeared in the Democratic Republic of Congo. It was named after the river Ebola. Since then there have been outbreaks in Sudan, Zaire, C”te d’Ivoire and Gabon. A filovirus named Ebola-Reston was identified in monkeys in Manila awaiting export and among monkeys in quarantine in the United States. A laboratory worker in Britain became ill when he pricked his finger on an infected needle in 1976. So far all the major outbreaks have been relatively easily contained. Never before has there been an epidemic in such a densely populated area as Gulu. Laboratory experiments have shown that the virus can be transmitted through water particles in the air, although it is more likely that people become infected by eating monkeys or touching infected animals or humans.
Nobody has yet established what happens to the virus between epidemics. The last outbreak, in Gabon, was in 1996.