Ebola outbreak traced to woman

2000-10-19 10:31

Kabede, Uganda - Esther Awete's body was found one morning six weeks ago in her round, gray mud hut by her mother and three sisters. She had come down with a fever five days earlier and had died in the night.

Keeping with local custom, her body was kept in her hut for two days to allow friends and family to take part in the funeral.

Awete's family and closest friends ritually bathed her body, buried her less than 30 feet from where she died and then washed their hands in a communal basin as a sign of unity.

What they did not know, was that Awete's body had become a time bomb carrying the deadly Ebola virus. That was on 27 September, and now seven other members of her family are dead and the virus has spread in a 25km radius killing 39 people and possibly infecting 55 others.

Ebola is transmitted through bodily fluids and can be passed by a simple handshake with someone who has developed the symptoms, which include a fever, headache and diarrhoea.

Between 10 and 15 days after infection with this rare form of haemorrhagic fever, the victim usually dies from massive blood loss through all the body's orifices.

How Awete - so far the first person known to have contracted the disease in Uganda - came into contact with the Ebola virus is a mystery. In fact, researchers have no idea where Ebola resides in-between outbreaks, which are often years and hundreds of kilometres apart.

Awete had two children, one of which died within days of her funeral from the disease. Until she died, Awete lived with her mother and sisters in a small compound of six thatched huts and a dilapidated house surrounded by banana trees and rows of corn.

Her husband rarely came to see her. She made her living selling home-brewed cassava beer and the corn which she ground by hand inside her 5m wide, windowless hut.

Kabede Opong is only 5km from Gulu town, home to 150 000 people, 360km north of the capital Kampala.

The people do not eat wild animals, a possible source of past outbreaks, and she did nothing unusual before she died, except for a trip to another village to get cassava leaves for brewing.

At first, neighbours thought Awete died of dysentery, cholera or any of a number of illnesses common to the area.

"People had fears after the second victim," said Justin Okot, a police officer who lived in the compound next to Awete. "It was after the eighth victim, that's when we suspected this is a new disease."

Okot and his wife, lifelong friends of Awete, took part in the funeral at the Awete compound. Okot's boss told him not to come to work for at least 12 days, and then get a doctor to certify that he is healthy. While he has no symptoms, his wife has not been so lucky.

"My wife was admitted yesterday to the hospital," Okot said, his voice trembling as he tried to hold back tears.

He feels certain it is Ebola.

More help arrived on Wednesday for Okot and the others who have been infected, or fear being infected. A team from the World Health Organisation brought boxes of protective garments, gloves and a washing machine, as well as the expertise needed to fight Ebola.

"Containment of the outbreak should not be a problem," said Dr Guenael Rodier, a senior WHO official and veteran of a half-dozen Ebola outbreaks in West Africa.

"Simple measures will avoid the spread of the disease from person to person and that is what we are going to work on."

He said investigators from the US-based Centre for Disease Control would soon arrive with equipment to identify who has been infected with Ebola.

In recent days, anyone with the early symptoms of Ebola has been quarantined and counted as potential victims.

Rumours have spread of cases in other districts of Uganda, which could either signify a dramatic spread of the disease or just panic.

"There are many rumours that need to be checked," said Rodier. "[But] it is clear that if you have no contact with Gulu, then you are unlikely to have Ebola."

Professor Francis Omaswa, director general of Uganda's medical services, said unconfirmed reports that two people had died of the disease in neighbouring Kitgum, were false and the virus was being contained in Gulu district.

However, a medical team was dispatched to investigate a suspected outbreak in Lira district, southeast of Gulu, said Paul Kaggwa, spokesperson for the ministry of health.

On Wednesday, Tanzania joined Kenya in introducing medical screening at its border points with Uganda.

- AP