The world's first major outbreak of Ebola hemorrhagic fever since 2009 has killed at least 14 of 20 people infected in a remote area of midwestern Uganda.
International health officials are rushing to respond to the outbreak, which erupted at the beginning of July but was identified as the deadly Ebola virus only on Friday, meaning it potentially spread substantially before being caught.
A team of responders from the Ugandan government, the World Health Organization, and the U.S. Centers for Disease Control and Prevention was dispatched Friday to the affected region—the Kibaale district, a forested area about 125 miles west of the Ugandan capital, Kampala, and near the border with the Democratic Republic of the Congo.
The outbreak started and spread first within one family, said Rukia Nakamate, a spokeswoman for the Ugandan Ministry of Health. Initially, locals believed the illnesses were the result of an attack of evil spirits rather than one of the deadliest viruses known to man, and took the patients to a Christian religious shrine for prayers, where the first two victims died, she said.
"Some of the victims came into contact with many people, including churchgoers," she said.
Once Ebola was suspected, a patient sample was sent to a special laboratory recently established and maintained by the Uganda Virus Research Institute and the U.S. CDC to identify and study Ebola and other deadly viral hemorrhagic fevers in central Africa. The lab received that sample on Thursday, followed by three other samples, and confirmed results Friday, said Stephan Monroe, chief of the Division of High-Consequence Pathogens and Pathology at the CDC in Atlanta.
The dead thus far include nine members of the one family; Clare Muhumuza, a clinical officer who treated one of the initial patients, and Ms. Muhumuza's 4-month-old daughter, according to Uganda's Ministry of Health.
Ms. Muhumuza's sister, who tended to her when she fell ill, also contracted the disease and is in "fairly stable" condition, through still experiencing fever, diarrhea, and vomiting, according to a Ministry of Health statement. A female member of the initial family is in stable condition but also still experiencing symptoms, the ministry said.
Panic has gripped the region where the outbreak has now been confirmed, prompting scores of locals to flee their homes, according to the Ministry of Health.
While the Kibaale district is far from Kampala, Ms. Muhumuza was treated at a hospital in the capital, home to at least four million residents. The possibility that the disease may have reached the capital has sparked some concerns, Ugandan and international officials said. Medical officials didn't handle Ms. Muhumuza's body with protective gear after her death because her ailment hadn't been confirmed, Ms. Nakamate said.
Because the outbreak is in a "fairly remote area, the chance for widespread transmission is not great," Dr. Monroe said. Still, that it might reach Kampala is "always a concern," he added.
Ebola occurs throughout central Africa. There is no vaccine or cure, and its ultimate source isn't known, though the hypothesis is that its reservoir—where it is maintained naturally—is in bats, said Dr. Monroe.
The disease was first reported in 1976 and named for the river in the DRC where it was first recognized. Ebola is rare but extremely deadly; the most lethal strain has killed as many as 89% of those it infected, though death rates vary widely among outbreaks.
The current outbreak was identified as caused by a strain believed to be somewhat less virulent, known as Ebola Sudan. Still, in the largest recorded Ebola outbreak, which occurred in Uganda in 2000 and 2001, that strain killed 224, or 53%, of 425 people infected.
The previous most recent outbreak of Ebola occurred in the DRC in late 2008 and early 2009, infecting 32 people, with 15 deaths. Ebola caused the death of a 12-year-old girl last year in Uganda, but the disease didn't spread.
The cause of the current outbreak isn't yet known, though Ebola is normally contracted through contact with the blood or other bodily fluids of infected monkeys—who may have become infected by bats, researchers hypothesize.
Once the virus infects a human, it spreads to others through contact with the blood, urine, or other bodily fluids of the infected person, putting family members, hospital staff, and others who tend to the ill at risk. Infected people remain contagious even after they are dead—a challenge because traditional funeral rites in Uganda call for touching a loved one's body.
The lab in Uganda that confirmed the virus is the only one in the region to be able to test for Ebola; previously samples had to be shipped elsewhere, taking valuable time. The nearest labs able to test for Ebola aside from the new one in Uganda are in South Africa and Gabon, and getting samples to them would take a minimum of two days and involve special expertise in packing and shipping, Dr. Monroe said.
An isolation ward has been set up at Kagadi hospital in Kibaale, and relatives aren't allowed to attend to patients suspected of infection with Ebola, said Denis Lwamafa, director of health services for the Ugandan Ministry of Health.
The government is awaiting at least 2,000 sets of protective clothing and body bags from the World Health Organization to contain the spread of the disease, he said.
The CDC is preparing to send additional experts, including a team of epidemiologists and a laboratory expert, pending a formal request from Uganda's Ministry of Health, Dr. Monroe said. They will help identify cases, trace possible contacts, help strengthen infection-control practices in hospitals, and educate people about how to bury their loved ones without infecting themselves.