Ebola Outbreak - Bundibugyo, Uganda

The mysterious disease that has infected people in Bundibugyo was this morning revealed to be Ebola virus (verified by the CDC-Atlanta laboratories). 79 cases have been identified since August, with a 43% death rate. So far all cases have come from a village area called Kikyo, which is 25 km from our mission, or through direct prolonged contact with patients from that area. Ebola is a panic-inducing word. We are treating this news with sober respect, but thought we’d put out a few facts proactively.

1. Ebola is a filovirus. There are four subtypes: Ebola-Zaire, Ebola-Sudan, Ebola-Ivory Coast, and Ebola-Reston. Yes, Reston, the latter is from monkeys who were imported through Dulles airport, but did not cause any human infection. Our epidemic does not seem to fit any of these four strains and so may represent a new form of the virus. The good news is that it seems to be slightly less virulent.
2. This is the 17th documented outbreak of Ebola since 1976. Almost all the cases have come from Africa. The most recent Ugandan outbreak was in the north of the country in 2000; the most recent outbreak at all was in DRC Congo from April to October this year.
3. The patients we are seeing look ill, but not that different from most patients. The Hollywood version is not what we’re seeing. Most people just have fever, vomiting and diarrhea, some with a rash and some with conjunctivitis (eyes red). A few have bleeding.
4. More than half of people are recovering, with very basic care. We have met with two nurses who took almost a month to pull through but are OK now. The clinical officer Julius who has managed the majority of the patients is OK.
5. We consider our non-medical team members to be at low risk. The virus has never been documented to spread through the air to infect humans. The mode of transmission is direct contact, touching body fluids or soiled linens or blood, or by contaminated instruments such as needles. Unless this strain is very different from other Ebola strains, people who are not sick do not spread the disease. We won’t contact it in our homes, or in normal daily life.
6. The health care workers of Bundibugyo are the ones at risk. We want to support them in every way possible, with gloves, masks, bleach, bandages, IV fluids, etc. Thankfully the World Health Organization, the CDC and MSF (Doctors without Borders), organizations with great experience in this kind of epidemic, are aware and will arrive by air tomorrow to help. We as doctors are taking every possible precaution when we see patients to avoid becoming ill.
7. Our Overseas Director Paul Leary is ready to field any questions about our team (info@whm.org); more medical information can be seen on the Ebola Information page on CDC web site.
8. I’ll update the blog regularly with more information too.
   

Please pray for our doctors and other health workers. Dr. Jonah is in Kampala now, but he saw quite a few cases before he left, as did Dr. Sessanga. Scott has attended to many of these patients already. Pray for us to wisely support the health system in our district, to graciously care for the ill, to be alert to any danger to our team and children, and to advocate for the best possible response that Bundibugyo can receive from international aid workers.