Fear Grows Along With Ebola Deaths

Another 10 cases of the deadly Ebola virus were diagnosed in Uganda on Tuesday, bringing to 81 the number of recently reported infections, as schools were closed and a ban issued on traditional funerals in areas afflicted by the disease.

At least 37 people are confirmed dead from the virus in Uganda’s northern Gulu district. In all, three northern districts have been placed under quarantine, and local authorities have vowed to use force to prevent people from leaving the region.

The ban on traditional funerals was introduced because local authorities suspect that the ritual cleansing of the dead has contributed to the spread of the disease.

Meanwhile, fears mounted Tuesday here in neighboring Kenya over the possible spread of the virus from Uganda, where the outbreak was detected two weeks ago. But Kenyan medical officials appealed for calm and moved to reassure residents that the government had taken adequate precautions to stem the disease.

“There is a potential danger, but the most important thing is a high degree of alertness,” said Dr. Dominic Mutie, a disease control officer at the Kenya office of the World Health Organization, or WHO. “We have a program of preparedness. Surveillance at the border towns has been reinforced, including at our airports.”

So far, no cases of Ebola have been reported in Kenya.

The virus, for which there is no vaccine or cure, causes high fever, muscular pains, vomiting, diarrhea and bleeding through the ears, nose and other bodily orifices.

The exact origin of Ebola--named after a river in Congo where it was first detected in 1976--and how and why it flares up are not known. It is spread through direct contact with a victim’s bodily fluids, such as perspiration, saliva or urine. Outbreaks can be difficult to spot because similar symptoms are experienced by people with a wide variety of illnesses, including malaria and acquired immune deficiency syndrome, both rampant in East Africa.

In Kenya, a special surveillance team has begun to question travelers arriving from Uganda, and medical experts were dispatched to key border crossings.

Close watch is being kept on herdsmen who drive their livestock between the two countries. Visitors from neighboring Sudan and Tanzania are required to provide detailed itineraries “so if a person gets sick somewhere in a village here, he can be contained there,” Mutie explained.

“The measures we have taken are not meant to cause panic among Kenyans but assure them of our preparedness,” Kenyan Public Health Minister Sam Ongeri said.

But critics charged the government’s creation of an Ebola surveillance squad is not enough, since the medical personnel are in a position only to isolate suspected victims and observe their symptoms. The team lacks the sophisticated equipment necessary to test for the disease. In addition, detractors cautioned that visitors can easily lie about their intended whereabouts in Kenya.

Because the disease typically has an incubation period of five to 12 days, it is possible that people who arrived in Kenya from Uganda before last week’s announcement of the outbreak might have already contracted the disease.

“Manning the borders is not an end in itself,” said an editorial Tuesday in the Standard, a popular daily newspaper. “With the kind of interaction within East Africa, nobody within the region is safe, not least Kenya.”

A Western disease specialist based in Kampala, the Ugandan capital, said Kenyans’ fears of the virus spreading to their country were justified because Ebola is “a highly infectious, highly fatal disease.” The specialist requested anonymity.

But Dr. Oladapo Walker, a WHO representative in Uganda, said it was unlikely that there had been a lot of human traffic from the infected rural district of Gulu to Nairobi, the Kenyan capital.

“The chances of [Ebola] spreading like wildfire across the border are low,” Walker said. “If the outbreak had been in Kampala, then I could understand [Kenyans’] fears, because travel from Kampala to other East African capitals is like the flow of a river.”

Mutie, the Nairobi-based WHO official, said the disease’s infection rate could be minimized through a high degree of cleanliness and with extra care taken by medical personnel who come in contact with suspected Ebola victims.

“The way the disease is transmitted, it is much easier to get flu than to get Ebola,” Mutie said. “If people maintain personal and domestic hygiene, they will be safe.”

Villagers throughout the region were being encouraged to wash their hands before sharing food, a common practice among rural folk here.

Walker said the outbreak of Ebola in Uganda had been traced to a child, who ultimately spread it to his entire family. It is unknown how the child contracted the virus.

Investigators from the Atlanta-based Centers for Disease Control and Prevention were heading to Gulu, where they will set up a temporary laboratory and collaborate with WHO specialists already there.

The latest African outbreak of Ebola has focused attention on the most enduring mystery associated with the lethal virus: Where does it live when it is not actively killing people?

Most experts believe Ebola is a virus that exists in a natural host that it does not kill, almost certainly in an animal whose habitat is somewhere deep in nature--the rain forest, perhaps, or a cave, a riverbed or grasslands. As is the case with many emerging diseases, humans become infected when they increasingly encroach upon these areas.

A virus is nothing more than a bit of genetic material surrounded by a coat of proteins, whose sole purpose is to survive. To do so, it needs to make copies of itself, a process known as replication. But it cannot do this alone--it needs the machinery found in living cells. Human cells are often destroyed when a virus tries to use them--this is what causes people to become sick or die.

Ebola kills most people who contract the virus. According to WHO statistics, 793 of 1,100 known cases ended in death. The last major Ebola outbreak hit the Congolese town of Kikwit in 1995, killing 245 people.

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Times staff writer Marlene Cimons in Washington contributed to this report.