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1 of 4 Photo: Tim Aro/TT
The outbreak of the contagious and deadly viral disease Ebola is growing in Uganda. The situation is serious because there are currently no approved vaccines and treatments.
– We work to maintain vital functions, says Swedish Anneli Eriksson from Doctors Without Borders.
Hopes that the outbreak of Ebola would be contained were dashed this weekend when eleven cases were found in the capital, Kampala. A little more than a month has passed since the first cases were confirmed on September 20. The contagious and deadly viral disease was then discovered in the Mubende district, roughly eight miles west of the capital, Kampala.
Two days after the outbreak was confirmed, nurse Annelie Eriksson from the Swedish Doctors Without Borders (MSF) went down to help local authorities and health care organizations set up a health care organization and infection tracking to prevent a rampant spread.
Insulation essential
In just a few days, an Ebola center had been established at the hospital in Mubende. It is crucial to quickly get healthcare premises where infected and suspected infected can be cared for in isolation and that staff and relatives use protective equipment and follow hygiene advice.
– Uganda is a relatively well-functioning country and the cooperation works well. They also have experience with previous outbreaks. Unlike eastern Congo where I worked during a major Ebola outbreak, Uganda has no ongoing internal strife. It makes it a lot easier when we work with healthcare, infection tracking and information, says Anneli Eriksson, who is now back in Sweden again.
But there is a big difference compared to previous outbreaks. The so-called Sudan strain that is now spreading is a variant of the virus for which there is still no approved vaccine or effective treatment. It distinguishes it from, among other things, the Zaire strain that occurred earlier.
– We can give painkillers and anti-nausea medicine. We can also provide drips and nutrition so that the patients do not dry out from the diarrhea and vomiting, which are often severe. We track infections but cannot offer vaccines as protection. It is reminiscent of the outbreaks eight years ago before we had vaccines and treatment with monoclonal antibodies, says Anneli Eriksson.
Easy to miss diagnosis
Five weeks after the start of the outbreak, 75 cases have been confirmed, of which 28 have died and 26 have recovered, according to the Ugandan Ministry of Health.
Ebola is transmitted through body fluids such as sweat, saliva and blood. A small amount of virus is enough to become infected, for example picking your nose after being in contact with an infected person, or touching damp sheets where that person has been lying. One problem is that several of the symptoms are common to other infectious diseases such as malaria, which risks delaying the diagnosis.
The sicker a person becomes, the more viruses there are in the body and they remain even after the sick person has died. Therefore, the handling of the dead is important and funerals can become major sources of infection. The fact that relatives are not allowed to get close to their deceased relatives can give rise to suspicion, says Anneli Eriksson, which is problematic because trust in healthcare is crucial to slowing the spread of infection.
Restrictions introduced
TT: Were you worried about getting infected yourself?
– Obvious. You have to be that way and constantly think about how you behave and that you protect yourself properly.
Now she takes her temperature every day and pays extra attention to how she feels, which, according to the Public Health Agency’s recommendations, should be done three weeks after returning from an area with an ongoing Ebola outbreak.
At the start of the outbreak, Ugandan President Yoweri Museveni kept a calm profile, saying no special restrictions were necessary. But then when a death occurred near the capital, Kampala, he swung and ordered a shutdown of the affected regions. For three weeks from last Saturday, people are not allowed to leave the areas or get there. A night-time curfew has been introduced and, for example, markets, bars and churches have been closed.
– If it starts to spread quickly in Kampala, it could have devastating consequences, says Anneli Eriksson.
Facts
No approved vaccine
The beginning of the outbreak
It was after the death of a man with confirmed Ebola in September that the authorities established an outbreak. This was probably not the first case of several unexplained deaths occurring in the same area at the beginning of September.
Against the current virus variant, the Sudan strain, there are no approved vaccines, although development is ongoing. According to the World Health Organization (WHO), clinical trials of vaccines and drugs against the disease can begin within a few weeks.
Source: WHO, Sabin Vaccine Institute
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Contagious via body fluids
Ebola virus is transmitted between people through infected body fluids such as saliva and blood. Sexual transmission also occurs. A particular risk of virus spread is contact with dead bodies during the preparation and execution of burials.
The incubation period is two to 21 days. The symptoms are flu-like with fever, headache, sore throat, stomach and intestinal symptoms and muscle aches. At the end of the course of the disease, bleeding may occur in the skin and internal organs. The mortality rate is estimated to be between 50 and 90 percent.
Ebola virus is an RNA virus. There are six known variants of which four have caused disease in humans.
The likely host animal is the bat. Humans are most often infected indirectly via handling raw meat from other infected animals such as monkeys and deer.
Source: Public Health Agency
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