Ebola Outbreak Traced to Ugandan Woman

K A B E D E  O P O N G, Uganda, Oct. 19, 2000 -- Esther Awete was found dead sixweeks ago in her round, gray mud hut by her mother and sisters fivedays after she fell ill with a fever.

In keeping with custom, her body was kept in her hut for twodays to allow friends and family to take part in the funeral.Awete’s family and closest friends ritually bathed her body, buriedher less than 30 feet from where she died and then washed theirhands in a communal basin as a sign of unity.

What they did not know was that Awete’s body had become a timebomb carrying the deadly Ebola virus. That was on Sept. 7. Now, hermother, three sisters and three other relatives are dead and thevirus has spread across a 15-mile radius, killing 39 people andinfecting as many as 63 others.

Painful Disease

Ebola is transmitted through contact with bodily fluids, such asmucus, saliva and blood, and can be passed through a simplehandshake. Four days after exposure, flu-like symptoms set in,followed by bloody diarrhea and vomiting. Ten to 15 days later, thevictims “bleed out” through the nose, mouth, eyes and other orifices. Blood andother bodily fluids also begin seeping through the skin, producingpainful blisters.

How Awete — so far the first person known to have contractedEbola in Uganda — became infected is a mystery. In fact,researchers have no idea where the virus lives in betweenoutbreaks, which are often years and hundreds of miles apart. Whilethey know it resides in a host animal or insect that it does notkill, they have not identified the host.

One of Awete’s two children, a 9-month-old boy, died of Ebolawithin days of her funeral, although her 8-year-old son — who didnot take part in the funeral — has so far survived.

She Sold Beer and Corn

Awete, 36, lived with her mother and sisters in a small compoundof six thatched huts and a dilapidated house surrounded by bananatrees and rows of corn. She made her living selling home-brewedcassava beer and corn she ground by hand inside her 15-foot wide,windowless hut.

Kabede Opong is three miles from Gulu, a town of 150,000 about225 miles north of the capital Kampala. People here do not eat wildanimals, suspected as the source of some past Ebola outbreaks, andshe did nothing unusual before she died, except for a trip toanother village to get cassava leaves for brewing.

At first, neighbors thought Awete died of dysentery, cholera orany 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 wasafter the eighth victim, that’s when we suspected this is a newdisease.”

Okot and his wife, lifelong friends of Awete, took part in herfuneral. Okot’s boss has told him not to come to work for at least12 days, and then get a doctor to certify that he is healthy. Whilehe 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 feelscertain it is Ebola.

Help From WHO

More help arrived Wednesday when a team from the World HealthOrganization brought in boxes of protective garments, gloves and awashing machine, as well as the expertise needed to fight Ebola.

“Containment of the outbreak should not be a problem,” saidDr. Guenael Rodier, a senior WHO official and veteran of ahalf-dozen Ebola outbreaks in West Africa. “Simple measures willavoid the spread of the disease from person to person and that iswhat we are going to work on.”

He said investigators from the U.S.-based Centers for DiseaseControl were bringing sophisticated equipment not available inUganda that is required to confirm infection with Ebola.

In recent days, anyone with early symptoms of the disease hasbeen quarantined and counted as a potential victim. Rumors aboundof cases in other districts of Uganda, which could either signify adramatic spread of the disease or just panic.

“There are many rumors that need to be checked,” said Rodier.“But it is clear that if you have no contact with Gulu, then youare unlikely to have Ebola.”

Professor Francis Omaswa, director general of Uganda’s medicalservices, said reports that two people died of Ebola in neighboringKitgum were false and that the virus was being contained in Guludistrict.

However, a medical team was sent to investigate a suspectedoutbreak in Lira district, southeast of Gulu, said Paul Kaggwa, aHealth Ministry spokesman.

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