Equipo Nizkor - Ebola hits Ugandan capital as president blames victim for 'poisoning' others.

At least four suspected cases of Ebola were being monitored in Uganda's capital Kampala on Wednesday, after the capital's first death on Friday, The Telegraph understands.

The Ministry of Health has confirmed 54 cases in total across the country, and more than 1,000 close contacts are now being monitored across five districts.

The Kampala death was the 19th fatality from country's outbreak - though a further 20 deaths have been classed as "probable" Ebola cases.

Dr Jane Ruth Aceng, the health minister, said that after developing symptoms, the Kampala victim ran away from his home village and visited a traditional healer in a second region before travelling to Kampala.

Health officials now fear that the virus could spread within the capital, which has direct flights to Europe and the United States as well as other destinations.

At a briefing on Wednesday night, which was broadcast on all TV and radio stations in Uganda, president Yoweri Museveni described Kampala as facing a "moderate" risk from the virus.

Speaking about how the Kampala case travelled despite being at risk of carrying the virus, he said: "He was poisoning all of these people he was approaching."

UK sources told The Telegraph a further four suspected cases had been identified in Kampala. However, the president appeared to rule this out during his television appearance.

"I would like to inform that there is no confirmed case of Ebola in Kampala city. The contacts of the person that died at Kiruddu Hospital are all known and under control," he said.

Ebola is a hemorrhagic fever with a high fatality rate, often over 50 per cent. The strain spreading in Uganda is the Ebola-Sudanese variant, which has no known vaccine.

Symptoms take between two and 21 days to develop after contact, and people are not contagious until symptoms appear.

The first symptoms, known as "dry symptoms", are difficult to distinguish from other illnesses and include fever, headache and muscle pains. These later progress to the "wet" stage, which includes vomiting, diarrhoea, hiccuping and bleeding.

The world has battled sporadic Ebola outbreaks since 1976, the most deadly of which killed more than 11,000 people across Sierra Leone, Guinea and Liberia between 2014-16.

Dr Benjamin Black, an Ebola expert who worked during the West Africa outbreak, said the news that a carrier of Ebola made it to Kampala is "very significant".

"[The Kampala case] strikes me as similar to stories we heard in the West Africa outbreak connected with onward transmission," Dr Black said. "The man travelled through at least two other districts before Kampala, and visited a traditional healer once he was unwell. We don't know how many other people the healer then treated."

"This was a major issue in the West Africa outbreak. Traditional healers were linked with hundreds of infections," he said.

Ebola is less contagious than Covid-19, spreading through contact with the blood or body fluids of an infected person or animal. Bats and other wild animals are the suspected reservoirs of the virus.

Dr Black added that it is "entirely possible" that the Kampala case will be contained, as various actors - including the World Health Organization and NGOs like the Red Cross and Médecins Sans Frontières - are involved in the response.

However, international concern is rising. Last week the US announced that all arrivals from Uganda would be directed to five sites for screening. Passengers will have their temperatures and "virus symptoms" checked, and be asked for contact details.

Following the US announcement, the UK Government on Thursday told doctors to be on high alert for symptoms and stock up on personal protective equipment.

The UKHSA said yesterday that the risk to the public in the UK remains low.

"UKHSA constantly monitors emerging infection threats in collaboration with partners across the world," said Dr Meera Chand, UKHSA director of clinical and emerging infection. "We are aware of an outbreak of Ebola cases in Uganda and are monitoring the situation closely. The risk to the public in the UK is very low."

The Telegraph understands that UKHSA is deploying a team to Uganda and will re-run its "risk-assessment" of the threat posed to the UK following the death in Kampala. UK "airport restrictions" are said not to be on the cards but more detailed follow-up of people arriving in the UK from Uganda could be.

The European Centre for Disease Prevention and Control has called for travellers to be screened before exiting Uganda.

"Both experience and evidence show that exit screening can be an effective measure to support the containment of the disease spread," the ECDC said.

Cases were first detected in September in Mubende district of Uganda, 50 miles west of the capital, among people living around a goldmine. A 24-year-old-man was the first known Ebola death, and six members of his family also died. Four health workers have also been among the victims, including a doctor from Tanzania.

Gold traders are highly mobile, particularly along the busy highway that runs between Kampala, and the Democratic Republic of Congo to the west.

The current Ebola outbreak is the seventh in the east African country since the deadliest in 2000, which killed 224 of 425 people infected.

The Ugandan authorities are urging people to avoid large gatherings, crowded places like markets, parties, weddings, and funerals. As worry spreads, some schools are seeing just half their pupils attend classes, according to the British Medical Journal.

An Ebola task force, formed in 2000, has been reactivated, and the unit includes doctors and nurses from various institutions, including the military.

In previous outbreaks, the virus has spread quickly after those infected refused to go to healthcare facilities, instead preferring for their families to care from them at home, said Dr Andre Willemse, the regional medical director of International SOS, who was also involved in efforts to curb previous Ebola outbreaks.

The Ugandan health secretary, Jane Aceng, has said that local people initially thought the new Ebola outbreak was caused by witchcraft, and so didn't seek medical care.

World Health Organization chief Tedros Adhanom Ghebreyesus said on Wednesday that clinical trials would start within weeks on vaccines to combat the strain of Ebola behind the Ugandan outbreak.

12Oct22

Ebola hits Ugandan capital as president blames victim for 'poisoning' others

[Source: By Harriet Barber, Global Health Reporter, The Telegraph, London, 12Oct22]

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