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How Not to Catch Ebola: A Wise Traveler’s Guide

26 Oct

 

who.org/ebola West Africa 2014

who.org/ebola
West Africa 2014

The sign above warns people in West Africa: Attention Ebola!,  Don’t  Touch Anyone,  Don’t Manipulate Objects, The Animals You’ll Find Dead in the Forest

Last week a dear friend and neighbor called to ask about her chances of contracting the Ebola virus if she was traveling back from West Africa on an airplane. She had no intention of taking a flight to anywhere in Africa but it bothered her that she had no idea what to do if she ever encountered this situation while traveling abroad. She had heard me talk about living with the threat of Ebola while traveling through East and Central Africa and felt that the media in the United States had not told  the American public the entire truth. After I answered her questions and told her what steps she could take to keep herself safe she felt somewhat better and  more in control of her life. Then she begged me to write this post in order to educate anyone else who felt as she did. So this one is for you Diane, I truly hope the information I’ve included in this post helps save lives one day. I have meticulously researched and referenced all of the factual information presented in the post and matched it to that cited by the World Health Organization as well as the Center for Disease Control. I have also included direct  links to each of these web pages so my followers can check out this information for themselves.

http://www.cdc.gov/vhf/ebola/

So what have I learned about Ebola during my summers in East and Central Africa and what do I do to keep myself safe? First, out of all the diseases one can catch in East Africa, like AIDS, Malaria, Yellow Fever, Blackwater Fever, Tuberculosis and hundreds of parasitic illnesses – it’s Ebola that terrifies my African friends and colleagues the most. “ Three Days,” ( the time they believe it takes the virus to kill them) they whisper after I ask about Ebola then either make the sign of the cross over themselves repeatedly or shake their heads back and forth in absolute dread. When travelers meet on back roads throughout the bush, its news about Ebola they ask for first and the name, itself has the power to turn a cheerful, laughing Ugandan into a silent, nervous wreck. But knowledge is power and so there are certain things you can do to protect yourself against bringing this virus into your body and infecting you with the disease.

Ebola has been classified as a virus and as such there are a few things you need to remember about this virus in particular when traveling that can keep you safe. A person can only spread Ebola if they are in the active symptoms stage. That means they are either running a high fever, vomiting, experiencing diarrhea, severe headaches, muscle pain, weakness, abdominal pain, or unexplained bleeding around or from any opening in their body. And they don’t have to have all of these symptoms – one is enough. But these symptoms also describe other illnesses such as influenza so a blood sample must be taken and examined by a laboratory to confirm whether it’s actually Ebola or not. This makes the disease very difficult to detect and confirm especially in rural districts where lab reports are not readily available and by the time competent medical staffers have been called in an entire village could be infected. Doctors have determined that there is a definite incubation period between 2 to 21 days (time between becoming infected and the actual onset of the physical symptoms) but it is not the same length of time in all patients so this has caused a lot of confusion in the past. How would I even suspect I had the disease if I didn’t show any symptoms until 21 days later? By then most people who had come in contact with Ebola would feel they were free from the disease. Plane travel from Africa to the United States usually takes two separate flights and between twelve to sixteen hours depending on the European airport selected for the second flight. Hypothetically I could travel through the first flight symptom-free but develop stage one symptoms like a high fever during the second flight. That means I could become contagious while in-flight and have no idea what’s happening to me. And now you’re sitting next to me. So what can you do to protect yourself?

A person demonstrating active stage one symptoms of Ebola can transmit the virus through all of his/her bodily fluids like sweat, mucus, tears, saliva, urine, feces, and blood. You infect yourself when you come in contact with my Ebola-rich body fluids and bring them into you own body through any open cut/wound or bring your contaminated fingers to your eyes, nose, or mouth. So I advise when on an airplane where there is reason to suspect Ebola that you wear a surgical mask and either sunglasses that thoroughly surround/cover your eyes or clear glasses that do the same thing. You may not look like the sexiest person in Coach or Business Class but you’ll go a long way in protecting yourself from this debilitating disease. Before you hit the airport remember to examine your body closely especially any exposed areas like hands and feet making sure that all cuts, no matter how tiny- even hangnails have been thoroughly covered up by Band-Aids or adhesive strips. Make sure to bring extra ones with you and if you have a deep wound on your hand I would wear a pair of gloves while traveling. Make sure to pack these things in a carry-on bag when leaving the US for any country in Africa- you’ll never know when you’ll need them. Remember, “ an ounce of prevention is worth a pound of cure.”

I heard a newsman on television say that you can’t catch the Ebola virus from a sneeze. Wrong, wrong, inexcusably wrong!!! Technically you can’t catch the virus from airborne particles released through your nose during a sneeze but when people sneeze they usually release some saliva from their mouths as well. Think about your last hearty sneeze- I know I do and I bet you do too. That means that saliva from an infected person’s mouth could be sprayed out onto your hands, shoulder, head, lap, or even food depending on how close he/she was when the sneeze occurred. If a person with active symptoms sneezes on you, spits on you, vomits on you, bleeds on you, or you come in contact with his/her urine or feces you’d better have any wounds covered up and your eyes, nose, and mouth covered too or you’re at risk for infecting yourself with the virus.

Now this virus can live for hours outside its host’s body so carry disposable wipes soaked in bleach with you and use them to wipe down the tray in front of you, both metal side arms; then give the cloth seat a quick swipe too before sitting down. Wipe down any earphones and touch screens before using them as well. I always take a large African scarf with me and wrap myself up in it during the flight. No airplane pillows or blankets for me. Using the bathroom can be especially dangerous if you have bleeding hemorrhoids or any other open wounds in that area of your body. Make sure to take your bleach wipes with you and make a thorough swipe of the toilet seat before sitting down. Wash your hands well with plenty of soap and make sure to wipe your hands with fresh wipes before and after using the toilette and sink. When eating your meal watch what the people on either side of you are doing. If for some reason they sneeze on your food leave it alone!!! It’s better to go hungry than sicken yourself with Ebola. And watch where you put your hands. Do not put them anywhere near your eyes, nose, or mouth without wiping them off with bleach wipes first. Once you arrive home take all clothes off immediately and throw them in the washing machine. If you have worn a suit or “dry clean only” garments place them on a hanger and put them outside in the sunlight for a day or two. Other things that can kill the virus once it’s outside of its host- hand soap, detergent, hand sanitizers, heat, and alcohol- the kind you drink as well as rubbing alcohol and hydrogen- peroxide. Remember people who tend to sick Ebola patients can be infected by handling bedding, clothes, cups, dishes, or utensils so they must take the proper precautions as they minister to them. Following these steps may make you feel embarrassed at first- even look like you suffer from Obsessive Compulsive Disorder but who cares? Would you rather be pretty or dead? Adults traveling with children will have a more difficult time enforcing many of these protocols but remember they work and have been designed to save you and your family members from a terribly painful illness you might not survive.

Stage two of the disease according to one friend, “is a journey into hell and back”. The infected person suffers from extreme bouts of vomiting and diarrhea, agonizing rashes, and gradually his/her liver as well as the kidneys slowly shut down. There’s lots of bleeding from every orifice in the body and much more pain. The very old and the very young succumb first as well as anyone in poor health at the onset of the disease. Many East Africans will tell you that anyone who catches Ebola dies but WHO maintains that the average fatality rate is more like 50 %. It all depends on the general health of the person at the onset of the disease. And according to the CDC, those people who do manage to survive develop personal antibodies that remain in their blood stream and protect them from further infection from Ebola for up to 10 years; although scientists are not sure if these survivors are immune to the four other species of Ebola or mutations of each strain as well. There is no cure or vaccine for Ebola at the moment although blood transfusions and a serum called Z-Mapp was used on the doctors who became infected with Ebola in West Africa but  is still in the experimental stage.

And now the most crucial fact in preventing epidemics like the one that occurred in West Africa. People can fully recover from the Ebola virus and still remain infectious (that means they can still infect others) as long as their blood and/or other body fluids including semen and breast milk contain the Ebola virus. Men who have recovered from the disease and demonstrate no symptoms whatsoever can still transmit the virus to others in their semen for up to 7 weeks after recovery. Doctors who have been treating male patients in West Africa who survived Ebola are advising them to abstain from all forms of sex for 30 days and to wear condoms after that. According to Mother Jones, in one 2000 study a woman who recovered from Ebola still had the virus in her breast milk weeks after she made a full recovery and her infant eventually died from the disease. It is not clear if she transmitted the virus to her infant and more research needs to be conducted before scientists can establish a direct cause –effect relationship between breast milk and the transmission of the virus.

http://www.motherjones.com/politics/2014/10/how-long-ebola-sperm

As of October 24, 2014 five countries located in West Africa have had outbreaks of Ebola Hemorrhagic Virus in the past several months: Guinea, Liberia, Nigeria, Sierra Leone, and Senegal. Of these, Nigeria and Senegal have been classified by the World Health Organization (WHO, 2014) as “Ebola –Free” with no new reported cases of this disease for six weeks in a row. This was the largest and most complex outbreak of Ebola ever recorded with more deaths than all other outbreaks combined. To show you how contagious this virus can be according to the CDC the first case in West Africa was confirmed in March of 2014. It started in Guinea then was spread by land to Sierra Leone, after that one traveler was responsible for spreading the virus by airplane to Liberia, then one traveler spread it to Nigeria by land, and one traveler spread it to Senegal by land. It seems that the world’s attention was focused exclusively on West Africa when in fact there had also been an outbreak of Ebola in Central Africa, in Lokolia, south of Equateur Province in the northwestern region of the Democratic Republic of the Congo (DRC) as of September, 2014 with a confirmed tally of 68 cases of Ebola and 41 deaths. But Ebola outbreaks have occurred in the past in the DRC, Uganda, South Sudan, and Gabon.

http://www.who.int/csr/disease/ebola/en/

According to historical data on Ebola supplied by the Center for Disease Control (CDC, 2014) the Democratic Republic of the Congo has experienced 7 outbreaks of Ebola in the last 38 years- more than any other country in the world and the Congo Basin has been identified by scientists as the source of several major pandemics. As far back as 1976 the first recorded cases of Ebola came out of the Congo Basin in the DRC, the second largest tropical rain forest in the world. What’s more, it is now believed that Human Immunodeficiency Virus (HIV) emerged from the same rain forest sometime in the late 1920’s after that virus crossed from chimpanzee into human blood streams.

This has also made the doctors serving the populace of the DRC some of the most knowledgeable “ Ebola Doctors” in the world. And one of the very best is the virologist and professor Dr. Jean- Jacques Muyembe Tamfum, who heads the Institut National de Recherche Biomedicale, at The University of Kinshasa in the DRC’s capital city of Kinshasa. It was Dr. Tamfum who identified the Ebola virus 38 years ago. According to Dr. Tamfum, “Ebola is the most dangerous virus in the world at this time classified as a ‘level four’ virus and there are more just like it out there.”

Five species of the virus have been identified so far: Zaire, Bundibugyo, Sudan, Reston, and Tai Forest. And each of these has the ability to mutate. The most recent outbreak of Ebola in West Africa has been attributed to a mutation of the Zaire species which according to the CDC is the most deadly strain.

According to Jonna Mazet, global director of the US Agency for International Development (USAID) “Predict Program,” a five year project charged with identifying viruses before they become a threat and building a global database to store this information, “most of the global epidemics in the world originated in these same forest ecosystems. The three areas in the world currently classified as “Virus Hot Spots,” the Amazon Basin in South America, the Congo Basin in Central Africa, and Southeast Asia- all three have the heat, the water, and the tree cover to act as pathogen incubators. According to the latest version of the Thorndike- Barnhart Dictionary- a pathogen is “any infectious agent that can produce illness in its host and can appear in the form of viruses, bacteria, fungi, and other micro-organisms.” The medical community at large knows by now that viruses mutate easily enough inside their host, some can live outside of their host for hours on end, and all are not easily treated. Mazet goes on to say,” In the last five years we have detected over 800 viruses globally and 540 of these viruses have never been seen before. Many could be just as deadly as Ebola.” This means that a good 68% of these new viruses have the potential to be as destructive to humans and animals as Ebola and AIDS have been. Scientists have also determined that 60% of the emerging diseases that infect humans worldwide are “crossovers” that originally came from animals, especially wild ones.

http://www.usaid.gov/ept2

An estimated 270 species of animals and 40 million people call the Congo Basin home. In a country identified by the United Nations Human Development Index as 186 out of a total of 187 countries (only Niger was given a lower score) it has the poorest quality of life in the entire world. Locals around the Basin eke out a living from the forest each day or literally die of starvation. As I discussed before in my blog on Ebola after the Ugandan outbreak of 2012 while traveling through the infected area of Uganda near the DRC/ Uganda border, primates such as monkeys and apes can catch Ebola just like humans who are also primates. Because Gorillas share 95% of their genetic code with humans it is extremely easy for the virus to cross over between the two causing prolonged outbreaks of the disease. Contrary to Americans’ preferences for red meat, the Congolese will hunt and eat wildlife in any form they find it. Animals such as bats, monkeys, chimpanzees, forest antelope, and porcupines are caught and sold in outdoor markets as fresh or cooked meat and eaten by a community that truly enjoys this cuisine. Unfortunately, these are the same animals that have been identified as the culprits responsible for spreading the Ebola virus in the Congo Basin especially into hunters who handle the infected blood, bodily fluids, and feces of the wounded or dead animals before they’re cooked. The CDC currently believes that it is a species of fruit bat living in the Congo Basin that’s primarily responsible for holding the Ebola virus in its blood stream between outbreaks.

Jonna Mazet warns that the Congo Basin is home to millions of viruses and many of them could be far more virulent than Ebola or HIV. As the rain forest in the Congo Basin is being destroyed to accommodate a growing population of Congolese citizens they in turn are coming in contact with new and deadlier microorganisms like never before and who knows what the repercussions will be for the global community at large? And for those who doubt me! In 2009 a new virus was discovered in Mangala, a small village deep within the Congo Basin’s rain forest. Three people had been stricken with a mysterious fever that suddenly spiked and began to vomit up blood. Two of the patients died within three days of demonstrating active symptoms and the third survived the disease going on to develop preventive antibodies in his blood stream. It was first thought that they had contracted the Zaire species of Ebola virus but then it was confirmed through laboratory tests that the villagers had become infected by a totally new virus. It was eventually named the Bas- Congo Virus and there have been no reported cases of the Bas- Congo Virus since. Virologists finally determined that it had been spread by insects.

Voyons ce que demain nous, mes amis!

Kat Nickerson      Kingston, RI   USA

 

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Ebola in Congo Now!: Man & Gorilla in Great Danger

29 Aug

World Widlife Federation, 2012

No sooner did the outbreak of Ebola in western Uganda subside than Ebola Hemorrhagic Virus struck again in Isiro, the capital city of Haut- Uele District located in the north-eastern region of the DR Congo. It is about 50 km from Isiro to the Ugandan border and travel does occur between residents of this city and Kabaale District where the Uganda outbreak took place in July of 2012. The doctors responsible for treating the Congolese patients stricken with Ebola maintain that there is no connection between the Congolese and Ugandan outbreaks. Ten people brought to the town have died and six more may have been infected with the Ebola virus in the first weeks of August, 2012. The strain of Ebola that hit Isiro has been identified as Ebola – Bundibugyo, a less deadly strain of the virus than the strain that hit Kigadi, Uganda where 16 people died of the more deadly strain Ebola – Sudan.  Although the Bundibugyo strain is still considered dangerous and deadly, the mortality rate is somewhat lower, 25% to 35% compared to the 70% mortality rate credited to the Sudan type.

On August 3, 2012, one of five Ugandan prisoners from Kibaale Prison suffering from Ebola- like symptoms was brought to Kigadi Hospital for treatment but escaped the very night he arrived. Rumors ran rampant around Kabaale district that he would eventually spread the disease throughout the rest of Uganda and in the DR Congo- but that was not the case.

Ebola is spread by contact with bodily fluids from humans and primates. There is no vaccine to prevent the disease at this time although researchers are working on the creation of a vaccination serum for use with both human and primates. Ebola has a strange history. According to The Center for Disease Control: Yearly Statistics for the Ebola Virus (CDC, 2012), the first cases were reported in the year 1976 in the country of Sudan and during the same year in the DR Congo (Zaire). In 1977 it was reported in the DR Congo and in the Sudan again in 1979. Fifteen years go by with no reported outbreaks of Ebola and in 1994 one case was reported in the Tai National Park, Ivory Coast. Ebola is very prevalent after this but infects small numbers of people in the 1990’s and only in the countries of Gabon and the DR Congo. Ebola outbreaks continue and are reported in 1994, 1995, 1996, 1997 in Gabon and 1995, 1996, 1997 in the DR Congo. Then in 2000 Ebola is reported for the first time in Uganda and 425 people are infected; this is the largest number ever recorded in any country. It should be noted that there is a civil war raging through northern Uganda at the time and this is where the outbreaks occured.  The years between 2001 and 2007 show that outbreaks occurred in three countries: Gabon, Sudan, and the DR Congo. It takes seven years for Uganda to see its next outbreak from 2007-2008. This time a new strain appears in Uganda, Ebola- Bundibugyo but it does not infect as many people as the Sudan strain did in the year 2000. By 2008-2009 small outbreaks continue to occur in the DR Congo and in 2011 only one person reportedly dies in Uganda. Now in 2012 Ebola returns to western Uganda and to north-eastern DR Congo with small numbers of infected patients and lower mortality rates in humans.

Although not reported as thoroughly or as often, there is an animal population that is being adversely affected by the Ebola virus as well. It is the primate group- especially the Great Apes. These primates are highly susceptible to human ailments like measles, scabies, and intestinal parasites. Since they interact with humans, they have become infected with a range of illnesses and diseases- with Ebola being the most deadly. In the year 2004, several hundred gorillas died due to an outbreak of Ebola in Odzala National Park in DR Congo.

The great apes such as the mountain gorilla share approximately 97-98% of human DNA, because of this they can catch diseases from humans. The gorilla is the largest primate in existence today. It is an omnivore, which means that it eats both plants and other animals. But what it really means is that the Gorilla primarily eats vegetation but will eat insects such as termites and ants if it gets the chance.

In December of 2006, National Geographic reported that Ebola was moving across central and western Africa and was wiping out 90% of the lowland gorillas in its path. It also stated  that most of the remaining gorillas lived within 125 miles of the 2006 outbreak. Ebola seemed to be moving at 31miles per year across these regions. According to Peter Walsh, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany, “Twenty-five percent of all gorillas in the world have died from Ebola in the past twelve years.”

What hasn’t been determined though is what’s occurring between humans and primates as each group becomes infected with Ebola. Are we catching the disease from the primates or are they catching the disease from us? Or is something far more dangerous at work? We know that humans have become infected with Ebola from eating the meat of primates and birds infected with the virus. We suspect that it is the fruit bat that carries the Ebola virus between outbreaks but is immune to the virus itself. We know that gorillas and other primates such as chimpanzees and bonobos have become infected with the same strains of Ebola as humans.

According to Dr. Khan of the Center for Disease Control, “The infections in Uganda caught from animals represent 75 % of all the emerging infectious diseases, and so if you’re really going to tackle these diseases, you can’t just focus on people. You need to focus on the animals, you need to focus on the environment, and on the interface where those come together to decrease infectious diseases worldwide.”

And animals such as the gorilla are in turn catching diseases from humans. In 2002, Dr. Kalema-Zikusoka, a veterinarian who founded the nonprofit organization Conservation Through Public Health, to tackle diseases that could be transmitted between humans, livestock, and wildlife in areas surrounding Uganda’s national parks. She saw gorillas dying from simple human skin infections such as scabies. “Gorillas were losing hair and developing white, scaly skin. The baby gorilla had lost almost all its hair and was very thin. And the mother had also lost almost all of her hair where she was carrying the baby,” Kalema-Zikusoka recalls. “The baby was also making crying sounds, which is extremely abnormal for gorillas. I actually went and visited a human doctor friend of mine, because they could have picked it up from people. And she said it was scabies.

Dr. William Karesh heads the Global Health Program at the Wildlife Conservation Society. “When we say that there’s human health, or there’s livestock health, or there’s wildlife health, we just made that up. There’s only one health,” he says. “If animals are the source of a disease, we want to break the chain from people getting it. If people are the source of disease, we need to break the chain going in the animal direction.”

The mountain gorilla is the largest of all the gorillas and is the most endangered. The world’s remaining mountain gorillas currently reside in three different countries in Central Africa but actually inhabit the same, small region in a trio of national parks located within the Democratic Republic of Congo, Rwanda, and Uganda. They all share the same geographic area. The Gorillas’ territory is the same, open stretch of land that extends beyond each country’s borders and the gorillas are free to travel back and forth between the three parks: Virunga National Park in north-eastern DR Congo, Uganda’s Bwindi Impenetrable Forest, in south western Uganda, and Volcanoes National Park in northern Rwanda. 

The mountain gorilla is one of the most endangered species.  According to the latest World Wildlife Federation data (WWF, 2012) only fifty thousand gorillas currently live in central Africa- about 2,500 eastern low land gorillas and six hundred mountain gorillas. Most primate biologists feel that the mountain gorilla is on the verge of extinction and will not survive the latest outbreaks of the Ebola virus. Remember that as humans in the region suffer from outbreaks of the Ebola virus so do the great apes in the area.

The Western lowland gorillas have the largest population of the four types of gorillas living in central Africa- but even they have are considered “Critically Endangered” in the wild. One of the most significant factors for this decline has been directly connected to “death from disease”. The WWF estimates that the total lowland population in the wild has been cut in half over the last 25 years. These gorillas face severe danger even in national parks and almost half of their protected habitats now contain one or more strains of the Ebola virus.

The Ebola virus is the most deadly disease ever to have threatened African primates in Central Africa. During the last twenty years the Ebola- Zaire strain of the virus has killed about one third of the world’s gorilla population in Gabon and the DR Congo. And about 30% of the world’s chimpanzees have been killed by another strain, Ebola- Cote d’Ivoire. Ebola –Zaire is the most deadly form of the virus and causes death in humans in 80 to 90% of cases.

It has been proven that apes and humans are able to pass the same strains of the Ebola virus along to one another – making specific outbreaks all that more difficult to end. More and more humans are encroaching on the primate’s territories as refugees in search of arable land settle there so are in closer contact with wild animals. Primates are even capable of passing the Ebola virus on to one other: to other members of their own families, to different social groups, and even between species.

A successful Ebola vaccine trial was conducted on chimps in 2011 and led to the development of a potential vaccine for wild gorillas. The project was housed at the New Iberia Research Center, at the University of Louisiana, Lafayette. The vaccination serum was manufactured by Integrated Biotherapeutics. So far the vaccine has been extensively tested to determine its safety and has shown no signs of exceptionally high protective immune responses among its test participants. The next step will be to create a way to give it to the Central African primates especially the low and highland gorillas in a manner that will not threaten them. The dense undergrowth in the lush tropical forests where they live and their reclusive nature may make immunizing them especially difficult; so methods will have to be created, such as the distribution of oral vaccines that do not scare them or disrupt their daily routines. Many scientists are not convinced that this can be done in time. But the clock is ticking and for many, like Peter Walsh, “ if we don’t move right away- we may have already run out of time.”

The Wildlife Conservation Society (WCS, 2012) is on the move and is busy fulfilling the following goals:

Determine effective ways to deliver an oral vaccine to the great apes

Insure the flow of the latest Ebola information to remote areas in central Africa

Guide existing community programs on how to prevent “animal to human” and “human to animal” transmissions of Ebola

Create healthcare programs for the apes, tourists, and villagers of rural communities in the area where all three groups can be effectively serviced

Train medical personnel field staff, and national agents working in the great apes’ habitats to safely work with the animals and to collect all biological samples and other wildlife health data

Hopefully we are not too late!

Kat Nickerson           Kingston, RI        USA

Vaccinations in East Africa: Effective or Evil?

14 Aug

 

Amuru District, Northern Uganda- On August 8, 2012, 50 pupils at Kaladima Primary School, Lamogi collapsed on the second day of an immunization program to prevent River Blindness. According to the District Health Officer, Dr. Patrick Okello Olvedo the teachers had administered the drug, Praziquanthel to the children before they had eaten. Apparently this drug can cause dizziness and fainting when taken on an empty stomach. On the first day the children received two other drugs and on the second two more. It was on the second day that they took the drug Praziquanthel which has been identified as the cause of the problem. This school vaccination program is part of a mass immunization program launched by President Museveni of Uganda to combat the disease River Blindness, a parasitic infection carried by the Black Fly which he believes is somehow causing the mysterious Nodding Disease in children. Nodding Disease has already infected around 7,000 children and a few adults in Northern Uganda. The Acholi Elders of Amuru district are concerned about this vaccination initiative and have accused the government of carelessly embarking on its course of action without a proper investigation into the vaccines that are being used in the program or a knowledgeable plan.

This alarming headline from the Acholi Times made me sit up and take notice last week. Was another vaccination scandal about to take place in northern Uganda just like it has occurred around the world many times before? And is Museveni trying to connect Nodding Disease to River Blindness because it is a simple solution to a much more complicated problem?

In 2001, John Le Carre, a British novelist published a novel, The Constant Gardener about a English diplomat whose wife is murdered because she discovers that a pharmaceutical company has tested a new tuberculosis drug on AIDS patients without informing them. It is eventually found that this new drug has had deadly side effects but the company decides to cover up what it has done and chooses not to help the people whose lives it has knowingly destroyed. Le Carre chose to locate his novel in the country of Kenya, East Africa but the real story was based on an American pharmaceutical company that conducted its own unethical trial in Kano State, Nigeria. According to Le Carre the actual incident was far crueler than his story.

In 1996 in Kano State, Nigeria the American pharmaceutical company Pfizer conducted a test of its new drug, Trovan during a meningitis outbreak that was already killing children in the area. Trovan is a broad spectrum antibiotic that had yet to be tested on real people. In the trial one hundred children were administered the new drug Trovan, and one hundred more were given the drug Chloramphenicol, which had been approved by the World Health Organization (WHO). Out of the entire group of 200 children, eleven deaths were attributed to taking the drug Trovan and low dosages of Chloramphenicol but the survivors suffered irreparable side effects and permanent injuries such as paralysis, deafness, blindness, brain damage, liver damage, and joint disease from ingesting Trovan in the dosages prescribed by the company. In 1997 The U.S. Food and Drug Administration (FDA, 2000) approved Trovan for use with adults but by 1999 after becoming aware of a range of harmful side effects decided to severely restrict its use with all patients. Europe banned any and all use of the drug Trovan within its borders.

By 2000 a Nigerian report was published that exposed Pfizer’s poorly conducted trial and the host of side effects suffered by the young patients who had survived the Meningitis outbreak and the drug Trovan. There were demonstrations and demands for justice for the victims all over Nigeria. In 2001 thirty families sued Pfizer in a group action suit. And in 2007 both the Government of Nigeria and Kano State Municipal Government filed separate law suits and sued for damages. In February 2009, The Pfizer Pharmaceutical Company settled with all parties for a reported 45 million dollars US.

In 2003 the World Health Organization attempted to conduct a polio vaccination program in Nigeria. People there had not forgotten about the last disastrous drug trial conducted by an American Drug company in Kano State and were suspicious of any medicines from the United States of America. Tempers flared and ugly demonstrations broke out on the streets. The Nigerian government halted the WHO Polio Vaccination Program after Nigerians refused to come into the clinics for these polio vaccinations or bring their children, boycotting the WHO’s initiative. The Nigerian government only resumed the program when a polio vaccine was brought in from Indonesia which is a Muslim country and many of the affected families in Nigeria and in Kano State were Muslims. The people found this vaccine acceptable after their Muslim leaders approved it and the WHO Polio Vaccination Program in Nigeria resumed.

In 2010, The Finnish National Institute for Health (THL) proposed suspending vaccinations for H1N1 swine flu, due to suspected links to increased narcolepsy in children and adolescents. This was in response to six cases of narcolepsy, a chronic disorder that causes excessive daytime sleepiness and extreme fatigue. All of these patients were reported to have been given the H1N1vaccine containing the adjuvant, Pandemrix. According to Webster’ Dictionary – an “adjuvant” is an agent that may stimulate the immune system and increase the response to a vaccine, without provoking the antibodies itself. Six cases of narcolepsy occurred immediately after these patients had been vaccinated, and nine additional cases were been reported but not yet confirmed.

In August 19th, 2010, the Medical Products Agency of Sweden initiated its own investigation for the same reason. Sweden bought 18 million doses of H1N1 vaccine, sufficient for everyone in the country to receive two injections. In Europe, about 30 million people have been vaccinated, and worldwide at least 90 million. During the winter of 2009, 29 million children in the United States were given a seasonal influenza shot that incorporated the swine flu vaccine but they did not receive the vaccine containing the adjuvant, Pandemrix- only European countries received that.

By February, 2011, a Finnish study found that the H1N1 flu vaccine may have contributed to a spike in narcolepsy cases in that country among 4-to-19-year-olds.  Sixty children and adolescents had developed narcolepsy, and 52 of them had received the flu vaccine Pandemrix.

According to Finnish officials “people who received the injection had a nine-fold increased risk of narcolepsy over those in the same age group who had not been vaccinated.” It’s not known just how many children and adolescents were vaccinated with Pandemrix. So far 12 of the 47 countries that used the vaccine containing Pandemrix, including Sweden, Iceland, Finland, Great Britain, and Ireland have reported increases in the number of individuals diagnosed with narcolepsy.

And then there is the belief that childhood vaccines could lead to Autism Spectrum Disorders (ASD) in children. Current Figures from the CDC state that 1 in 88 children have been diagnosed with ASD. This estimate is considerably higher than previous estimates from the early 1990s. I have met parents at ASD workshops who have sworn to me that their child was never the same after receiving his/her vaccines as a toddler. One vaccine ingredient that has been suspected by many is Thimerosal, which once was used as a preservative in childhood vaccines. In 2001 Thimerosal was removed or reduced to trace amounts in all childhood vaccines except for one type of influenza vaccine, and Thimerosal-free alternatives are available for influenza vaccine. Evidence from several studies claim that there is no connection between the presence of Thimerosal in a vaccine and the presence of autism. If so, then what about the Somali children now living in Minnesota?

In August 2008, the online newspaper MinnPost first reported that “12 % of kindergarten and pre-school children with autism in Minneapolis speak Somali at home, and more than 17 percent of the kids in the early childhood autism program have parents born in Somali.” The Minneapolis Star tribune published that among Somali students in the district, “3.6 % had autism – a rate of 360-per-10,000, (or 1 in 28). This is twice as high as the district’s average and more than five times the national average. “Virtually all of these children were the children of Somali refugees and born in the United States. They appear to be the most severely affected children with autism in the district: Last year, one-in-four children in the preschool class for the most severe cases was Somali.”

And what will come as no surprise -none of the refugees surveyed had ever seen or heard of a single child who displayed any of the common symptoms of autism when living in Somalia. These parents are desperate to know what is hurting their children and there is a nagging belief prevalent throughout the Somali community that it is the vaccines their children were required to receive from the community health clinics that have changed them in this way.

And just to remind you all- “A vaccine is a biological preparation usually a serum that improves immunity to a particular disease. It is often made from the weakened or killed forms of the microbe itself, its toxins, or one of its surface proteins.” This tells me that every time I am given a vaccination I receive a weak form of the actual disease itself. I remember preparing for my first visit to East Africa in 2005. Like all obedient Americans I went to the local travel clinic and submitted to all of the shots they prescribed. I had shots for Hepatitis B, Polio, Yellow Fever, Tetanus and others I can’t remember over a three month period. About four weeks later I noticed a bright red rash that started on my side and followed across my back in lines and it hurt. I didn’t know what it was and showed it to a friend who ran the Copy Center at my university. She immediately knew what it was and sent me over to Health Services, who sent me right away to my own doctor- who confirmed that I had Shingles. He fixed me up and I was over it by the time I left for Kenya in May.

Well I took the liberty of including what the CDC says about Shingles. “Shingles is caused by the varicella zoster virus, the same virus that causes chickenpox. After a person recovers from chickenpox, the virus stays in the body in a dormant (inactive) state. For reasons that are not fully known, the virus can reactivate years later, causing Shingles. They went on to say that it usually happens in people over 60 years of age which was not me and then “People who have medical conditions that keep their immune systems from working properly, such as certain cancers, including leukemia and lymphoma, and human immunodeficiency virus (HIV), and people who receive immunosuppressive drugs, such as steroids and drugs given after organ transplantation are also at greater risk of getting shingles.”

And I knew that those many different shots all pumping weak dosages of very bad diseases into my bloodstream seriously compromised my immune system- enough so, that they caused my Shingles. Prior to this I had been in exceptionally good health and my immune system had been just fine. If the shots I received did this to me, and there is no doubt in my mind that they did,  then I believe that there is a viable chance that something inside of vaccinations can be dangerous even deadly to some people.  We all know of someone who has deadly allergies to things that the rest of eat without thought or suffer through just fine such as nuts, sea food, and bee stings. Some of us are highly allergic to medications such as codeine but didn’t know until we had health problems that required us to take these drugs. So it’s possible that there is a percentage of the world’s population that could be adversely affected by vaccines.  And I believe that there are a lot more than just a few.

I found this quote when researching about the H1N1 vaccine and narcolepsy. “According to a World Health Organization panel, genetic factors may have played a role in Finland’s Pandemrix-narcolepsy cases. WHO tested 22 narcolepsy patients and found that all had a gene commonly associated with narcolepsy. About 30% of people in Finland have that particular gene, compared with 15% in the rest of Europe,” according to Patrick Zuber, WHO’s top vaccine safety official. So could other children around the world have a gene that makes them dangerously susceptible to whatever is inside certain vaccines?

A connection between River Blindness as the cause of Nodding Disease is still inconclusive.   While in Uganda this summer I extensively researched the possibility that children in the north had been part of a vaccination trial but found no recorded evidence that some children contracted Nodding Disease after receiving vaccinations. I asked the Acholi villagers I visited and no one had heard of or taken their children to clinics to be vaccinated- they would have told me if they had. Although the Center for Disease Control suspects that there is a strong link between the parasite that causes River Blindness and the onset of Nodding Disease they’re still not sure what. There are many other children in Northern Uganda who have been diagnosed with River Blindness but have not contracted Nodding Disease. So how one becomes or leads to the other is not known at this time.  Removing the threat of River Blindness from the districts is a good thing but using vaccinations without serious consideration as to the range of possible consequences may not be the best idea. I pray that the government of Uganda takes this vaccination process more slowly and plans each move more thoughtfully than last week’s incident at the school implies; because the lives of the rest of the children in northern Uganda, not infected with Nodding Disease, may very well depend on it.

Kat Nickerson      Kingston, RI    USA

Ebola Appears in Western Uganda: Disastrous Repercussions for East Africa

6 Aug

Does this picture look like we shouldn’t worry WHO?

Yes the Ebola virus has appeared again in Uganda and has been credited with killing 16 Ugandans out of an infected group of 36 since the end of July 2012. There is no vaccine or cure for the Ebola Hemorrhagic Virus  and the recommended course of medical treatment is a combination of intravenous or oral re-hydration solutions, blood infusions, and when all else fails, life-support machines. It is a documented fact that humans have become infected with the Ebola virus after handling dead primates such as gorillas, chimpanzees and duikers.

Ebola is not new to Uganda, or The Democratic Republic of the Congo, or South Sudan. According to The World Health Organization (WHO, 2012) there have been 1,850 reported cases of Ebola since it was first detected in the in Sudan, near the border of the Democratic Republic of the Congo (DRC), between June and November of 1976. A second outbreak occurred there 3 years later in 1979. Meanwhile in 1976, an outbreak due to the Zaire subtype occurred in the DRC, near the borders with Sudan and the Central African Republic and only one person was reported to have been infected with thissame subtype in June of 1977. The virus was named for the Ebola River, which flowed past Yambuku where the first outbreak occurred in 1976. And then there was a fifteen year grace period where no cases of Ebola were reported in Sub-Saharan Africa at all. But by1994 the Ivory Coast subtype had been identified and Ebola –Zaire was back again in the DRC in 1995, 1996 and 1997.

Ebola has caused more than 1,200 deaths worldwide and that is a 65% death rate. In the year 2000 a significant Ebola epidemic that caused 224 deaths was recorded from three districts in Uganda with largest infected population coming from Gulu District, located in northern Uganda. This outbreak began in October, 2000 and did not end until January, 2011- not all that long ago.

This newest outbreak was first reported as a “mysterious disease” that had killed 17 people in two months. The first outbreak was posted on July 27th, 2012 and was reported inaccurately by the international press. The virus broke out in the town of Kigadi first which is located within the district, not the town of Kibaale; although Kibaale like many Ugandan districts is also a town in that district. This disease which was thought to be a form of the flu infected several members of the same family first. They were reported to be suffering from fever, diarrhea, and vomiting which can be also be symptoms of the flu or a twenty-four hour virus. But slowly these patients’ symptoms worsened unlike a typical case of the flu. The doctors began to suspect Ebola Hemorrhagic Fever and took the necessary precautions. The first person to die of Ebola was a 3-month-old girl and 15 mourners who attended her funeral eventually contracted the disease.

Ebola is an extremely contagious virus and can be spread through direct contact with any infected bodily fluids such as saliva, blood, stool, vomit, urine and sweat. It can also be spread by touching needles or medical tools previously used by the infected person, touching the body of a person who has died from Ebola, and even through touching the bedding and the clothes worn by an infected person.  The incubation period lasts between 2 to 21 days, and the range of the outbreak lasts around 42 days after the last person has contracted the virus.

Ebola begins like the flu with some – not all of these symptoms. The infected person may experience a sore throat and overall weakness soon followed by a headache, joint pain, muscle aches, like the beginnings of a winter cold or flu. Then the individual is usually hit with violent diarrhea, vomiting, and stomach pain. A rash on the body may develop or the individual may experience red, swollen eyes, or the hiccups. But at the same time the virus goes on to severely impair the individual’s immune system somewhat like AIDS and without supporting treatments and considering the age and overall health of the individual, he/she can waste away in no time at all. The one thing most East Africans remember from the first recorded outbreaks of Ebola is that people experienced internal and external bleeding. They eventually “bleed out of every physical orifice in their body.” Although this does not happen to all humans infected with the Ebola virus it is the one symptom that no one in East Africa can forget. People who meet one another on the roadways traveling across East Africa will ask whether or not anyone knows where the latest outbreak of Ebola is taking place. I can honestly say as one of those travelers that Ebola terrifies me much more than the presence of Al Shabaab, Malaria, River Blindness, or AIDS. Although not officially determined yet by specific scientific research the medical community has enough information to believe that the first patient to become infected with Ebola did so through contact with an infected animal such as a bat or a primate. The reason for Ebola outbreaks have been well established and it was because the first infected people had handled even eaten animals such as bats, dead gorillas, chimpanzees or duikers.

There are five types of Ebola virus-. four of them have been known to infect human beings and other primates”: Ebola-Zaire, Ebola-Sudan, Ebola-Ivory Coast and Ebola-Bundibugyo. The strain involved in the current outbreak in Uganda right now is the Ebola-Sudan type, which has been the cause of five separate outbreaks in Sub-Saharan Africa since 1976 and has a 50 % death rate in infected individuals (WHO, 2011).

The fifth Ebola strain has only infected the nonhuman primates such as monkeys and chimpanzees so far. And that leads us to the next deadly outbreak of the Ebola virus. A new scientific study has confirmed that certain strains of the Ebola virus have caused the death of gorillas and chimpanzees all over Sub-Saharan Africa. In the Democratic Republic of Congo( DRC), scientists had been tracking gorillas families for several years now. And then about four years ago they started to find gorilla carcasses. Over the next four months they determined that 130 of the 143 gorillas that lived within the Lossi Sanctuary had died from the same subtypes of the Ebola virus as human beings.

Dr.Tom Geisbert is currently involved in developing an Ebola vaccine at the U.S. Army Medical Research Institute located on the grounds of Fort Detrick, Maryland. Currently he has designed an Ebola vaccine that has worked successfully on monkeys, but even he has admitted that it will be years before he will be able to mass produce an Ebola vaccine that will protect human beings.

President Museveni began with a National Address to the People of Uganda this July and was broadcasted by the local media. He has continued to use the media to urge his citizens to stay away from crowds, which is pretty hard to do in the local outdoor markets frequented daily by most Ugandans. And he has urged everyone to wear masks and to stay away from people who either have contracted the virus or who have died from the Ebola virus. Other medical warnings include abstaining from killing or butchering wild game because it has been proven that humans can contact Ebola through handling infected animals. “Avoid shaking of hands, do not take on burying somebody who has died from symptoms which look like Ebola, instead call the health workers to be the ones to do it and avoid promiscuity because these sicknesses can also go through sex,” he said in his address.

Another great tragedy is the effect that this outbreak has already had on the Ugandan Tourist industry. This year Kenya, the “King of the Safari”  had its best year ever. All of the safari camps and hotels were booked months in advance of the “ Great Migration”- in July when the wildebeests, giraffes, zebras, and their predators begin to cross the Mara River from the Serengeti of Tanzania to the Maasi Mara of Kenya. Even Mombasa, the “Riviera of East Africa” was full to bursting with tourists and  when the American Embassy told them to leave the city in late June because it suspected that there would be a terrorist attack, all of the American tourists in the resort hotels stayed put.

Because the Kenyan safaris were all booked up, the remaining tourists flocked to Uganda and their safari companies.  Guides like my Patrick were doing a booming business throughout the months of May, June, and the beginning of July. But six of the eleven National Parks in Uganda are located in south western Uganda, not far from Kibaale District and all are known for the exceptional range of primate species living within their forests. And one more, the Kibale National Park is actually located within Kibaale district. After the news broke about the Ebola virus tourists from around the world cancelled their safari reservations in Uganda which seriously hurt the national economy and scores of dedicated safari lodges, businesses, guides, and drivers suffered as a result.

There is an eminent danger beyond the current problems in Uganda, First the East African apes, chimps, and monkeys are dying from the same strains of Ebola as human beings. There may come a time in the foreseeable future when the National Forests could lose their primate populations and what will happen then?   Inside Odzala National Park, Ebola broke out at in December 2003. The epidemic lasted for almost a year, and killed about 95% of the some 377 identified gorillas that formerly frequented the area (Caillaud et al., 2006). Devos & al., reported that both gorillas and chimpanzees’ nests decreased by 80-85%. Dr. Lahm has reported a decrease of 90% of the gorilla population and 98% in the chimpanzee there compared to her previous observations in the same area before the 1994 and 1996 Ebola epidemics ( Lahm, 2000).

My friends living in Kampala are terrified that there will be an outbreak of Ebola in the capital city. The people in the countries of Kenya, Rwanda, South Sudan, and the Democratic Republic of the Congo are plenty nervous too and rightly so. The World Health Organizations has stated that “the Ebola outbreaks normally happen within small, localized areas and that the risk of spreading from country to country is minimal.” They have recommended that no travel warnings or trade restrictions on Uganda are necessary.

And the World Health Organization is “lying through its teeth”. The Ebola virus is highly contagious and could already have been spread by people crossing the borders between countries – it can very easily be carried along by human beings. The incubation period lasts between 2 to 21 days -more than enough time for a person or a group to take a bus from Kigadi to Kampala or to the city of Goma in the Democratic Republic of the Congo (DRC) infecting hundreds of people along the way.

Wake up World Health Organization and Center for Disease Control! Tell the people the truth. There has been a steady increase in the deaths of human beings due to the Ebola virus and a lot more of these “small locations” have been showing up on the map throughout Sub-Saharan Africa lately. And there is a devastating Ebola epidemic going on among the non-human primate groups in East Africa which could “wipe them out” of all of the National Parks in East Africa and increase the number of infections in human beings. Scientists in the Minkebe Forest have already attributed the outbreaks of Ebola in humans to the drastic decline in the great ape populations (Huijbregts & al., 2003). And all of this has been directly linked to these “small outbreaks” of Ebola that you have failed to mention in the rest of the countries bordering Uganda for many years now, especially the DRC and South Sudan. According to your own records, this is the fourth outbreak of Ebola in Uganda since 2000 (WHO, 2012). And you wonder why we’ve stopped believing in you?

Kat Nickerson               Kingston, RI               USA