# 5185
More than two months after it began, we now appear to have an official cause of the mystery disease outbreak in northern Uganda; Yellow Fever.
My first blog on this outbreak came in mid-November (see Uganda: Unidentified Hemorrhagic Outbreak), and at that time a hemorrhagic fever like Ebola, Marburg, or Lujo virus was considered the likely cause.
Two weeks later, I reported that Health Ministry officials had stated that laboratory tests had come back negative for the usual suspects from that part of the world; Ebola, Marburg, Congo Crimean fever, Rift Valley fever and Typhoid.
On December 7th, it was widely reported that Plague (pneumonic and bubonic) had been identified as the cause of the outbreak, which I covered in Uganda Outbreak Identified As Plague: Officials.
Within a few days, the plague diagnoses began to look less and less likely, and in recent days Yellow Fever – a disease not seen in Uganda in nearly 40 years – has come to the forefront.
For a detailed history of this outbreak’s progression, FluTrackers has an extensive thread on this story, with more than 150 entries as of this morning.
Treyfish has been a particularly close follower of this story, and has posted many of these reports, although he is by no means alone in this effort.
Yesterday afternoon Treyfish posted a U.S. Embassy Warden Message that identifies the outbreak as Yellow Fever.
Warden Message
U.S. Embassy Kampala, Uganda
Warden Message - December 28, 2010Outbreak of Unidentified Illness Now Confirmed as Yellow Fever in Northern Uganda
After discussions with the Ugandan Ministry of Health and WHO, the U.S. Centers for Disease Control and Prevention (CDC) now confirms that the unknown severe illness reported in Mission Kampala’s November 30 Warden Message is an outbreak of Yellow Fever.
Although as many as seven districts are now reporting occurrences - including two possible cases from southern Sudan- almost all of the reported severe cases (characterized by fever, vomiting and bleeding) continue to be concentrated in three districts of Northern Uganda, namely Abim (specifically Morulem sub-county), Agago (Omiya P’Chua, Adilang and Paimoi sub-counties) and Kitgum (Orum, Namokora and Kitgum Town Council).
In light of these findings, the U.S. Mission in Kampala recommends that U.S. citizens residing and traveling in Uganda avoid travel to Northern Uganda unless they have been vaccinated against Yellow Fever within the past 10 years. If vaccinated recently, do not travel to Northern Uganda for at least 10 days after receiving the vaccination. (Yellow Fever vaccinations do not take effect for 10 days.) Only U.S. government officials with Yellow Fever vaccinations are permitted to travel to the affected areas.
Via newshound Alert we get this update from Uganda’s leading independent daily, The Daily Monitor.
National
Yellow fever deaths reach 48
By Flavia Nalubega
Posted Wednesday, December 29 2010 at 00:00
Kampala
The number of people killed by yellow fever in northern Uganda has reached 48 and 187 are hospitalised, an official has confirmed. Dr Isa Makumbi, a commissioner in the health ministry, made the revelations last night.
Earlier, Junior health minister James Kakooza had told Daily Monitor on phone that the viral disease has been confirmed in Abim, Agago, Lamwo, Kitgum, Pader, Gulu, Arua, Kaabong and Lira districts.
“The infection was in place as early as two months ago. Since then, we have been doing investigations to ascertain the disease. It is only two weeks ago that we confirmed the viral infection as yellow fever,” Mr Kakooza said. He said the disease has taken a new string of infection where patients suffer severe vomiting of blood, diarrhoea and swollen eyes.
Yellow fever is a mosquito borne viral illness, that according to the World Health Organization, infects roughly 200,000 people each year and claims 30,000 lives.
Once the scourge of Africa, the Americas and Europe, Yellow fever is now endemic only to the tropical areas of South America and Africa.
(Source link)
In the 18th and 19th century, Yellow fever caused major epidemics in Europe and in the United States, up the Atlantic seaboard and as far north as New England (Boston was hard hit in 1780, and Philadelphia saw several thousand deaths in 1793).
Yellow Fever has been cited as one of the primary reasons why the French abandoned their attempt to build a Panama canal in the late 1800’s, as the combined burden of Yellow Fever and Malaria reportedly claimed the lives of more than 20,000 construction workers.
For more on the history of `Yellow Jack’, I would point you to Ian York’s excellent Mystery Rays blog, where he gives us some terrific background in:
Yellow fever, stasis, and diversification
The deadliest, most awe-inspiring of the plagues
The good old days
You can find more information on yellow fever at these websites:
http://www.cdc.gov/ncidod/dvbid/yellowfever/
http://wwwnc.cdc.gov/travel/yellowbook/2010/chapter-2/yellow-fever.aspx