Update on suspected Ebola patient under quarantine in Mumias, Kakamega

Preliminary tests on a suspected Kenyan Ebola patient, who had travelled to Uganda, show that he might not be having the highly contagious disease.

The 32-year-old male patient was admitted to a Mumias hospital with Ebola symptoms.

Records indicate that the man had travelled to eastern Uganda on September 15 to visit a relative.

So far, Uganda has confirmed at least 36 cases of Ebola, with 19 people confirmed to have died of the disease.

The Kenyan patient's medical history says: "While in Uganda, he got a trauma and was cut in the right upper limb. As a result, he sought medical attention at a health facility in Uganda. The cut was treated. He, thereafter, moved to Kenya for further medical attention. On Thursday, September 28, he started experiencing blood in urine and proceeded to the St. Mary's Hospital in Mumias for further management."

Main Ebola symptoms, according to medical journals, include fever, aches and pains such as severe headache and muscle and joint pain; weakness and fatigue, sore throat, loss of appetite, gastrointestinal symptoms including abdominal pain, diarrhoea, and vomiting and unexplained haemorrhaging bleeding or bruising.

Mumias Sub-County Health Officer Charles Namasake told The Standard that the patient's "only Ebola symptom" was bleeding from a body opening, and that the haemorrhaging "could be as a result of other causes".

"Preliminary examination shows that he could be Ebola-free. He had blood traces in his urine. We've forwarded the urine sample to the Kenya Medical Research Institute (KEMRI) in Kisumu for further analysis," said Namasake.

The Mumias lead public health officer said that the patient did not exhibit all the other symptoms of Ebola including fever, aches and pains and diarrhoea among others.

"There's a high likelihood that the patient is not suffering from Ebola," said Namasake.

The Public Health Officer said the patient will remain in quarantine awaiting conclusive test results from KEMRI.

Ebola cases in Uganda

On September 20, health authorities in Uganda declared an outbreak of Ebola disease caused by Sudan virus (SUDV), after a case was confirmed in a village of Madudu Sub-County in Mubende District, central Uganda.

The case was that of a 24-year-old male patient who developed a wide range of symptoms on September 11.

He had high-grade fever, tonic convulsions, blood-stained vomit and diarrhoea, loss of appetite, pain while swallowing, chest pain, dry cough and bleeding in the eyes.

He visited two health facilities between September 11 and September 13.

His condition did not improve. He was, consequently, referred to the Regional Referral Hospital (RRH) on September 15, where he was isolated as a suspected case of viral haemorrhagic fever.

A blood sample was collected on September 17 and sent to the Uganda Virus Research Institute (UVRI) in Kampala where RT- PCR tests conducted were positive for Sudan Virus Ebola on September 19. On the same day, the patient died.

Results of preliminary investigations identified a number of community deaths from an unknown illness in Madudu and Kiruma sub-counties of Mubende District reported in the first two weeks of September. These deaths are now considered to be probable cases of Ebola caused by Ebola virus.

So far, Uganda has confirmed at least 36 cases of Ebola disease, with 19 confirmed to have died of the contagion.

Ebola disease is now sub-categorised depending on the causative virus.

Outbreaks of Ebola disease caused by Sudan virus are named Sudan Virus Disease (SVD) outbreaks.

Prior to May 2019 all viruses causing Ebola disease were grouped together.

The incubation period of Ebola virus ranges from two to 21 days. People infected with Sudan virus cannot spread the disease until they develop symptoms, and they remain infectious as long as their blood contains the virus.

The diagnosis of SVD can be difficult, as early nonspecific manifestation of the disease may mimic other infectious diseases such as malaria, typhoid fever and meningitis.

Confirmation is made using numerous diagnostic methods including RT-PCR. Supportive care - rehydration with oral or intravenous fluids - and treatment of specific symptoms improve survival.

There are no licensed vaccines or therapeutics for the prevention and treatment of Sudan virus disease.

Uganda has reported four SVD outbreaks, in 2000, 2011 and 2012 (two outbreaks).

Uganda also reported a Bundibugyo virus disease outbreak in 2007 and an Ebola virus disease outbreak in 2019.