Saturday, December 22, 2007
Ebola Bundibugyo, Saturday Night Numbers
The Saturday night numbers…
- Cumulative cases: 134
- Cumulative deaths: 34
- Current admissions: Bundibugyo Hospital 3, with one new admission and one discharge. Kikyo 3 with one admission and no discharge. No deaths in either ward.
- Contacts: 584 cumulative, with 125 finished their 21 day follow-up and 379 visited today.
Issues discussed in the Task Force Meeting…
Most significant and distressing. A woman presented to the outpatient department of Bundibugyo Hospital yesterday with symptoms consistent with a miscarriage (vaginal bleeding after a period of amenorrhea). Because of her bleeding she was questioned about the presence of other symptoms related to Ebola (and any history of contacts). She denied such. She was admitted to the Female Ward as a run-of-the-mill spontaneous abortion. A few hours later she developed bloody vomiting with nose bleeding. She was promptly transferred to the Isolation Ward where she is being handled as a suspected Ebola case.
As you might guess, the hospital staff has been thrown into a “fresh panic”, and rightly so. The triage system failed, possibly due to misrepresentation or deceit on the part of the patient in an effort to avoid admission to the Isolation Ward or possibly due to an error in judgment on the part of the triage staff. Hard to say with my limited information. Triage protocols are being reviewed and the staff is being counseled. The situation reemphasizes the reality of the risk of accidental Ebola exposure to general health workers in Bundibugyo. Those NASA-like space suits completely protect health workers from Ebola virus in the Isolation Wards who are knowingly exposing themselves to Ebola, but we can’t live our lives wearing those suits. Sadly, this dark cloud of doubt will probably linger in the minds of Bundibugyo health workers for months (or years) to come. Whenever a patient presents with fever and vomiting, nurses and doctors will wonder if Ebola is possibility. It’s frightening.
On a brighter note, the biggest Bundibugyo market of the year, the Nyahuka Saturday-before-Christmas Market occurred today. A frenetic rush to procure new clothes, shoes, sodas, and other party provisions (goats, chickens, and palm oil…egg nog and ice are not on the list). Excitement (and perhaps are bit of desperation) seemed to be the prevailing emotion of the day…rather than fear…and for that I am very thankful.