Uganda
Ebola has spread to Mbarara District

afrol.com, 10 November - The death toll of Ebola in northern Uganda Gulu district is now reaching 100, and more are still getting infected. Further, the epidemic seems to get a firmer hold in Mbarara District in southern Uganda, where 5 cases with 3 deaths have been reported.

The Ugandan Ministry of Health yesterday confirmed the rising numbers of Ebola in Gulu and Mbarara. Only over the last 24 hours there had been 9 new cases in Gulu and 2 deaths. Today, the World Health Organisation further upgraded the numbers, confirming cumulative figures for Gulu district of 301 cases, including 99 deaths. Thus, the trend of new infections and deaths keeps stable, despite the massive efforts to control the outbreak.

Even more worrying are the confirmed reports from Mbarara, where the epidemic seems to gain a foothold, and unconfirmed reports of suspected cases from other parts of the country. The Ugandan Ministry of Health assures that "these are being investigated promptly. So far, Ebola cases have only been confirmed in Gulu and Mbarara districts," the Ministry states.

Samples from the Mbarara cases were confirmed by the laboratory in Gulu, WHO reports. The most recent cases in Mbarara had contact with the initial case, who subsequently died. Ebola was brought to Mbarara by soldier who had been at the army barracks in Gulu and later became ill after moving to the barracks in Mbarara. The soldier died on 27 October, and the cause of death was confirmed to be Ebola one week later. 

Ward, Gulu Hospital — Source: WHO

Highest recovery rate ever
The good news from the Ugandan Ebola outbreak is that fatality rate of this outbreak is lower than anytime before. While other outbreaks of Ebola have had a fatality rate between 60 and 90 percent, so far the fatality rate in Uganda is "only" 36%. The total recovery rate has been a record 64%.

Of the cumulative 295 reported cases on Thursday, 96 had died, 171 had fully recovered and 28 persons were still under medical care. 

The high recovery rate may in part be attributed to the firm and well organised response to the outbreak, but also to the less fatal strain of the virus in Uganda. The Ebola strain in Uganda is a variety of the Sudan strain, with a fatality of between 50-70% in disease outbreaks in southern Sudan in 1976 and 1979. The background for the significant difference in fatality between other outbreaks of the Sudan strain and the Ugandan outbreak is uncertain. Experienced health workers and a better health infrastructure will have plaid an important role.

Women and elder most affected
According to numbers from the Ministry of Health, the disease has been predominant in people over the age of 15 years more than the younger people. This is because of the former being more frequent in the burial ceremonies, and caring for the sick especially during the period before strict isolation and barrier nursing was put in place. 

Statistics so far also show that females are more affected than men. Further analysis of the Ministry's data indicates that the infection is more common among the housewives. This is attributed to the role women have at the household level in providing care for the sick.

Sources: Based on WHO and Ugandan Ministry of Health 

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