Ebola in Uganda

Yesterday, Xeni told you that the deadly virus Ebola has reemerged in Uganda. The disease has actually been infecting and killing people in the western part of the country for three weeks. We're hearing about it now, in big font, because some sources have reported that the disease has reached Kampala, the country's capital. (Other sources say only that one person infected with Ebola traveled to Kampala, and that there have been no reports of anyone catching the disease in that city.)

The Kampala link is somewhat concerning. Previous Ebola outbreaks have centered on rural areas, villages, and mid-sized towns. With the exception of a handful of highly monitored cases that centered around research labs in the U.S. and Europe, and the case of a medical worker who accidentally brought the virus to Johannesburg, South Africa in 1996, Ebola has not previously found its way into any major global hubs of human life. Kampala may not be on your radar with New York, Tokyo, or London, but air travel and money give it strong ties to the rest of the world and population density gives it a much larger number of potential victims within striking distance.

But here is a key thing about Ebola—it's scary as hell, but it burns itself out pretty fast and it's not that easy to spread. On average, Ebola kills a majority of the people it infects, and it kills them quickly. The time between infection and onset of symptoms ranges from two to 21 days. That means the virus only has so long to find new hosts. Meanwhile, Ebola isn't airborne. To catch it, you have to have contact with infected blood or bodily fluids. Historically, it's been a disease of people and their medical workers, or people and their immediate families. In rural communities, Ebola can burn through the small, isolated population and find itself with nowhere to go in the span of a couple months.

That isolation has been aided by the traditional practices of village leaders. I'm currently reading No Time to Lose ">No Time To Lose, the memoir of Peter Piot, a microbiologist who was part of the team that first identified and named Ebola back in 1976. In the book, he recalls how he and a World Health Organization team arrived in what is now the Democratic Republic of the Congo to find that local people had already blocked off roads in infected regions—part of traditional semi-quarantine measures that probably originated as a way to deal with smallpox.

If it is loose in a capital city, then Ebola has a bigger link right now to the rest of the world than it really has had in the past. That doesn't mean, though, that it's likely to make the jump to the global stage ... or even out of Uganda. Remember, this isn't something that can spread to other people on a plane just by breathing. It takes a more intimate sort of contact. And Ebola sickens people fast enough and hard enough that the virus might be its own worst enemy when it comes to widespread infection. None of this means Ebola won't ever pop up in the wilds of the United States. Just that the global spread of this virus is not inevitable in the same way as something like the flu. The same traits that make Ebola terrifying have also, so far, limited its scope to regional outbreaks.

14 People have died so far in Uganda, and at least 36 cases have been identified.

Learn more about the different strains of Ebola and related diseases.


  1. Maybe I’ve seen too many bad movies – but one angle that troubles me is that the closer Ebola gets to a major city, the easier it becomes for bad actors to get a sample of infectious material for unfortunate ends. It’s hard to get out to the back-country in Uganda or the DRC or whatever, but how hard would it be to get to a hospital in Kampala and buy some soiled bedclothes? Find someone willing to infect himself, put him on a plane, and you’ve got a problem. 

    1. I mean this as an absolutely straight question — I honestly have no clue — but is acquiring the pathogen itself necessarily the “hard part” of bioterrorism, the main limiting factor? Or is it building the facilities that can keep such a thing safely contained and weaponizable, and keeping those facilities secret?

      I’m genuinely curious — I’d welcome any facts or idle speculation, because I don’t even know where I’d start researching this topic. :)

      1. Okay, apparently, yes, it’s pretty damn pretty difficult. And I hate to be bearer of bad news but a scenario just like the one you’ve described has apparently happened. :) (Unsuccessfully, thank god!)

        “The military have not been slow to recognise to potential of the Ebola virus as a weapon of war. Terrorists too, have looked to the Ebola virus as a means to spread death. Members of Japan’s Aum Shinrikyo Cult were known to be considering the use of the virus when in 1992, their leader Shoko Asahara took about forty of his members to Zaire under the pretence of offering medical aid to Ebola victims in a (failed) attempt to acquire an Ebola virus sample.” — http://gaizy.hubpages.com/hub/Mystery-Files-The-Ebola-Virus-Agent-of-Death (fairly skeezy site, admittedly, but that’s the best quote I could find)

      2. I strongly recommend reading “Biohazard” by Ken Alibek. It’s the fascinating and profoundly disturbing autobiography of the chap who used to run the scientific/medical side of the Soviet biological weapons programme before the collapse of the USSR. It goes into incredible detail about such things. One of the only books I’ve literally read cover to cover in two days, recently. They mention attempts to weaponise the viral haemmhoragic fevers (ebola, Marburg, lassa, etc) and there’s a particularly detailed account of what happens to one technician who accidentally injects himself in the hand with a shot of Marburg, while struggling with an agitated guinea pig. Seriously darkside. Read it.

        1. This looks like something going from the “Global Frequency” pages.

          PS: In one of his stories, a Global Frequency agent diarms a bomb basically made of a mutated Ebola that goes capable of spreading via air

    2. Well, we would mostly have one dead person. Ebola (in its natural form) isn’t airborne (meaning, spread by droplets when you sneeze). I have a hard time figuring out how naturally occuring ebola could even be made weaponized, other than to kill some specific person in a really nasty way.

      Edit: While Googling on the subject I found that in one case some monkeys were infected apparently by viruses caught in aerosol droplets from when the cage of an infected monkey was cleaned with a water spray. That actually could be one way to spread it in a low-tech way… Disturbing.

      If somebody managed to mutate it with some other virus to make it airborne, then that would be a Really Bad Thing. Hopefully nobody is that stupid.

      1. If somebody managed to mutate it with some other virus to make it airborn, then that would be a Really Bad Thing.

        Are you nuts?  That would make it really easy to cure.

  2. “None of this means Ebola won’t ever pop up in the wilds of the United States.”

    That being the true measure of disaster, naturally …

  3. Over the past few years, we’ve seen quite a few posts here tending to give the impression that a certain percentage (though by no means all) of TSA screeners in our  airports are poorly vetted, poorly trained, arbitrary and dictatorial and petty in their treatment of passengers, and not especially good at their jobs.  This post right here seems like a good illustration of why we urgently need that not to be the case.

  4. Ebola in its current form is too lethal to spread.  If (heaven forbid) it evolves a slightly less lethal form that waits a few days before killing the patient, then we could have a serious problem.

    Early forms of many diseases were very lethal, but evolved into less lethal but more dangerous versions – syphilis, polio and others are good examples.

    Ebola getting spread in an urban environment would be a very dangerous situation if it happens to mutate in a particular way at a particular time.  Let’s hope it doesn’t.

  5. “The time between infection and onset of symptoms ranges from two to 21 days. That means the virus only has so long to find new hosts. Meanwhile, Ebola isn’t airborne. ”

    Except… wasn’t the Reston ebola virus (which only affects non-humans, mainly macaques) determined to be airborne contagious?  With a mean incubation period between 12 to 13 days, all you need is for a mutation of the Zaire/Sudan ebola to make it airborne contagious or of the Reston ebola to make it infect humans, and then, Rampart, we have an emergency.  In 12 to 13 days, one infected person could travel around the globe, infecting thousands of people.  I always think of that when a co-worker comes back to work the day after arriving home from traveling abroad and seems to have acquired a cold during his trip…

    1. Yes… and it does infect humans, but only causes very mild symptoms if even that. Although does anybody know if it was ever proven that it is airborne? I remember reading about it a looooong time ago, and in that article it sounded like it was just assumed that that was the cause of the infection of some of the monkeys, and I couldn’t find anything really about that when Googling… just mentions of it being or possibly being airborne.

      Perhaps a more disturbing thing is that it also has been found in (domestic) pigs. My first thought was of course that domesticated pigs and fowl tend to be nature’s own biohazard lab for the influenza virus… but of course also a risk to spread the disease when the pig is eaten, as the Zaire ebola seems to be spread that way, too. A good article on the subject: http://scienceblogs.com/aetiology/2011/05/18/ebola-in-pigs-1/

  6. It’s a bit concerning, because according to CNN, this version of Ebola does not present with all of the typical symptoms:

    “This month’s outbreak in western Uganda initially went undetected because patients did not show typical symptoms, Health Minister Dr. Christine Ondoa told CNN on Sunday. Patients had fevers and were vomiting, but did not show other typical symptoms, such as hemorrhaging.”

    Some of the first people to get it were medical workers who thought they were dealing with cholera. I’m hoping they can track & monitor all the contactees of the patients who’ve had it, but…

  7.  We covered Bioterrorism in my microbiology degree and to summarise…

    Different viruses and bacteria are weaponised for different purposes. Ebola can be designed for use as a horror weapon, it won’t kill many people but the manner in which they die and the very high chance of dying if infected will cause horror and panic out of proportion to the actual damage. It’s difficult to increase infectivity as it spreads through blood, therefore the more infective it is (the more bodily fluids it causes to leave the body), the faster it kills and so the less time there is to infect.

    More worrying from a mass destruction point of view are anthrax and smallpox.
    smallpox can be distributed covertly and can infect like wildfire in urban areas, a co-ordinated outbreak at different cities could easily overwhelm healthcare efforts to stop it.

    Anthrax can be used essentially as a bomb, British tests in the second world war showed that it can be spread across a wide area in a single blast and leaves the area uninhabitable for a very long time (The British government tried waiting for decades, burning off the vegetation and finally pumping lime and seawater throughout the topsoil to try and eliminate antrhax spores from the test site)

    An anthrax bomb is much easier to mass produce than other WMD’s and can quite happily spread spores over an area wider than say, the bomb that destroyed hiroshima. Anthrax can easily be treated with antibiotics but infect a few million people at once and many of them are bound to die.

    So yes in theory Ebola can be weaponised but as far as bioterrorism is concerned its really not the one to worry about :-)

  8. Being Scary Disease Girl, I ought to be interested in pumping up this jam, and I hate to spoil the fun, but: Lassa, a related viral hemorrhagic fever, has actually come via plane to Chicago, Philadelphia and the NY/NJ suburbs without spreading, including admission to a hospital. One of those victims changed planes in London. More details in this (old) post: http://www.wired.com/wiredscience/2010/10/lassa-fever-coming-to-an-airport-near-you/

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