Ebola Hemorrhagic Fever Transmission and Risk Factors of Contacts, Uganda1
Paolo Francesconi*, Zabulon Yoti†, Silvia Declich* , Paul Awil Onek‡, Massimo Fabiani*, Joseph Olango‡, Roberta Andraghetti*, Pierre E. Rollin§, Cyprian Opira†, Donato Greco*, and Stefania Salmaso*
Author affiliations: *Istituto Superiore di Sanità, Rome, Italy; †St. Mary’s Hospital Lacor, Gulu, Uganda; ‡Ministry of Health, Kampala, Uganda; §Centers for Diseases Control and Prevention, Atlanta, Georgia, USA
Figure. Chains of transmission relative to 27 Ebola cases, Gulu District, Uganda (September–October 2000). The numbers above the blocks indicate the total number of healthy contacts identified for that patient. The slashes indicate patients who died. The isolation ward was opened on October 8. *A laboratory facility for serologic diagnosis of Ebola was set up at Lacor Hospital by the Centers for Disease Control and Prevention on October 21. Description of individual cases follows: 1. AF, young woman, admitted at Gulu Hospital Sept. 19, died the same day. She was buried the following day, next to her parents’ house, without known identified case-patients among those who attended the burial ceremony; 2. OS, son of AF (4 months old); breastfed even during the last days of his mother’s life; admitted to Lacor Hospital; died Sept. 30. 3. OA, father-in-law of AF; nursed his daughter-in-law during the last days of the disease, both at home and in the hospital; reported contact with blood and vomit; died Oct. 7. 4. AR, grandmother of OS; nursed the child after the mother’s death; reported contact with feces and urine; survived. 5. ON, cousin of OA, whom ON touched before and after OA’s death; no reported contacts with body fluid; died Oct. 16. 6. OR, brother of OA; nursed him during last days; reported contacts with feces; died Oct. 17. 7. OJ, brother of ON; used the blanket left by his brother; survived. 8. AE, young woman who sold beer to soldiers; died Sept. 17. 9. OS, son of AE; breastfed; died Sept. 21. 10. AD, mother of AE; nursed her; reported contact with vomit and feces; prepared the dead body; died Oct. 1. 11. AJ, sister of AE; nursed her; reported contact with feces and vomit; prepared the dead body; died Oct. 4. 12. AV, aunt of OS; nursed the child after the mother’s death; reported contact with vomit and feces; died Oct. 11. 13. AN, cousin of OS; they slept together; reported contact with vomit and feces; survived. 14. AV, daughter of AD; nursed her; reported contact with vomit and feces; died Oct. 7. 15. AV, niece of AD; reported direct contact with her during illness; died Oct. 23. 16. AS, daughter of AJ; nursed her, both at home and in the hospital; no reported contact with body fluids; died Oct. 24. 17. AS, co-wife of A J; nursed her; reported contact with blood; died Oct. 24. 18. AE, sister-in-law of AJ; assisted her during delivery on Sept. 28; died Oct. 17. 19. LV, aunt of AJ; assisted her during delivery on Sept. 28; died Oct. 22. 20. OW, son of AJ; born on Sept. 28; died Oct. 9. 21. OJ, husband of LV; nursed her; died Nov. 1. 22. AC, cousin of AV; nursed her; reported contact with feces; survived. 23. AG, young woman; lived next to the barracks; died Oct. 8. 24. AL, sister of AG; nursed her; reported contact with vomit; died Oct. 18. 25. JB, sister of AG; nursed her; reported contact with vomit; died Oct. 26. OR, son of AL; breastfed; died Oct. 21. 27. AF, grandmother of OR; nursed the child after the mother’s death; reported contact with feces and vomit; survived.
1This paper is dedicated to Dr. Matthew Lukwiya, Medical Superintendent of St. Mary’s Hospital Lacor, and the other health staff who contracted and died of Ebola while taking care of hospital patients.
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