Clinical Updates
13 December 2007
Ebola haemorrhagic fever in Uganda - update
As of 11 December 2007, 116 suspected cases of Ebola haemorrhagic fever have been reported from five sub-counties in Bundibugyo District, Uganda. There have been 30 fatalities reported [1], at least four of which were in healthcare workers [2].
Specimens from suspected cases are being collected and referred for confirmation as part of intensive surveillance activities. The laboratory for diagnosing Ebola in Entebbe, Uganda, is now fully functional [1]. Laboratory testing by US Centers for Disease Control and Prevention, has detected a new strain of virus in samples from nine cases [2, 3].
As of 11 December 2007, 368 contacts have been identified, 298 of whom have been followed up. The follow up of the remaining contacts is underway [4].
Advice for travellers
Ebola haemorrhagic fever is a severe disease caused by a virus of the Filoviridae family. Following an incubation period of around four to ten days (range: two to 21 days) the disease presents with the sudden onset of fever, headache, joint and muscle aches, and weakness. As the infection progresses, nausea, vomiting and diarrhoea, shortness of breath, confusion, and haemorrhage can all occur. This can lead to multi-organ failure, shock, and death in severe cases.
The likelihood of travellers contracting Ebola is low unless there has been direct contact with the blood or body fluids of infected persons, or with objects, such as needles, that have been contaminated with body fluids.
Travellers should avoid all contact with infected patients. Those who are providing medical care or are involved in the evaluation of an outbreak should observe strict barrier protection measures. Travellers who have been potentially exposed to Ebola virus should seek medical attention immediately if they experience any of the above symptoms within the first 21 days of return to the UK.
United Kingdom guidance on the management and control of viral haemorrhagic fevers (VHF) has been written by the Advisory Committee on Dangerous Pathogens: http://www.hpa.org.uk/infections/topics_az/VHF/ACDP_VHF_
Guidance for healthcare workers who will be working with VHF patients in African healthcare settings, has been written by the CDC in conjunction with WHO: http://www.cdc.gov/ncidod/dvrd/spb/mnpages/vhfmanual.htm.
References
1. ReliefWeb. Government of Uganda: Ebola Outbreak Press Statement, 11 December 2007. [Accessed 13 December 2007]. Available at: http://www.reliefweb.int/rw/rwb.nsf/db900sid/LSGZ-79TDRX?OpenDocument
2. World Health Organization. Ebola haemorrhagic fever in Uganda. 7 December 2007. [Accessed 13 December 2007]. Available at http://www.who.int/csr/don/2007_12_07/en/index.html.
3. Centers for Disease Control and Prevention, United States. Outbreak Postings, Special Pathogens Branch. [Accessed 13 December 2007]. Available at: http://www.cdc.gov/ncidod/dvrd/spb/outbreaks/index.htm
4. ReliefWeb. Government of Uganda: Ebola Outbreak in Uganda, National Task Force situation report no. 6, 11 December 2007. [Accessed 13 December 2007]. Available at: http://www.reliefweb.int/rw/rwb.nsf/db900sid/LSGZ-79TDW9?OpenDocument
Links
Health Protection Agency. Viral Haemorrhagic Fever
http://www.hpa.org.uk/infections/topics_az/VHF/default.htm
Centers for Disease Control and Prevention, United States. Ebola hemorrhagic fever. On-line resource accessed 13 December 2007. Available at: http://www.cdc.gov/ncidod/dvrd/spb/mnpages/dispages/
World Health Organization. Ebola Haemorrhagic Fever. On-line resource accessed 13 December 2007. Available at:
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