Ebola claims 37 lives in Uganda; even the nurses are afraid

GULU, Uganda - Dressed in surgical gowns, flimsy masks and knee-high rubber boots, the nurses at Locar Hospital know that with each day that passes they have a greater chance of becoming infected with the deadly Ebola virus.

One doctor and two nurses are among the 37 who have died so far from the terrifying hemorraghic fever that can be passed through a simple handshake - including two more victims who died Tuesday. And with 10 more suspected cases identified each day, their work load will only increase.

''Most of us are so afraid,'' said nurse Peter Otim, peering anxiously from behind a thin mask that hid all but his eyes. ''It is so challenging because we are so few and there is so much work to be done.''

Reaching down, he took the pulse of a dying patient with the false bravado of a child touching a hot iron on a dare. His fingers touching her throat, he was all too aware that the incurable virus was now on his fingertips - and could only hope the precautions he had taken would be enough.

Other health workers have fanned out across the countryside, where officials suspect Ebola has already infected more than 81 people.

''We are adding about 10 cases every 24 hours. It is still spreading until we can get people into the field and identify all of those infected,'' said Dr. Nestor Ndayimirije, a World Health Organization epidemiologist helping Ugandan authorities trace the source of the Ebola outbreak, the nation's first.

There is no blood test for Ebola and a case can only be confirmed through sophisticated blood analysis requiring special equipment not available in Uganda. Health workers have begun quarantining anyone complaining of flu-like symptoms, diarrhea or vomiting, the earliest signs of exposure.

A ward at Locar Hospital, one of two well-guarded wards accepting Ebola patients, is divided between those showing signs of the disease and those who clearly have it and are dying. Some 90 percent of confirmed Ebola victims die.

Ebola is spread through contact with bodily fluids, including saliva, blood and mucus, though it is not spread through the air. It is feared for its devastating speed and painful death. Four days after exposure, flu-like symptoms set in, followed by bloody diarrhea and vomiting. Ten to 15 days later, the victims ''bleed out'' through the nose, mouth and eyes. Blood and other bodily fluids also begin seeping through the skin, producing painful blisters.

''We are just trying to provide ... care, give them basic medicines to keep them comfortable,'' Otim said.

Gulu, 225 miles north of Kampala, is home to about 150,000 people, but is surrounded by small villages with a largely illiterate population. A large army base nearby defends against attacks by the rebel Lord's Resistance Army and there is a nighttime curfew. Ebola has never been detected in Uganda before, so few people recognize the disease or know how it is spread.

Okat Lokach, acting director of health services for Gulu district, said the outbreak has so far been traced to a housewife who died around Sept. 7. She was buried according to local tradition, which involves the ritual cleansing of the dead by family and friends. The next two victims were her daughter and mother.

Other mourners returned to their villages, fell ill and infected their friends and family. It wasn't until Oct. 7 that the first case was seen in a hospital. But Lokach said the search for who infected the housewife was still on, and the disease may have surfaced even earlier.

Experts from the U.S. Centers for Disease Control were expected to leave for Uganda on Tuesday to investigate the outbreak and trace its origins.

Lt. Col. Walter Ochola, the chairman of Gulu district ordered all schools closed Tuesday and said funerals had been banned because the ritual contributed to the spread of the disease. He said the district needs disinfectant, disposable gloves and garments to help stem the spread of the disease, as well as body bags so victims can be buried safely.

There were reports that two people had died of the disease in neighboring Kitgum district, but those cases have not been confirmed.

Ochola rejected speculation that the disease was brought to Uganda by soldiers who had served in neighboring Congo, where it has been detected before. He said no soldiers had contracted Ebola and denied earlier reports that a Congolese woman married to a soldier had been diagnosed with the disease.