Ebola outbreak traced to Ugandan woman

KABEDE OPONG, Uganda - Esther Awete was found dead six weeks ago in her round, gray mud hut by her mother and sisters five days after she fell ill with a fever.

In keeping with custom, her body was kept in her hut for two days to allow friends and family to take part in the funeral. Awete's family and closest friends ritually bathed her body, buried her less than 30 feet from where she died and then washed their hands in a communal basin as a sign of unity.

What they did not know was that Awete's body had become a time bomb carrying the deadly Ebola virus. That was on Sept. 7. Now, her mother, three sisters and three other relatives are dead and the virus has spread across a 15-mile radius, killing 39 people and infecting as many as 63 others.

Ebola is transmitted through contact with bodily fluids, such as mucus, saliva and blood, and can be passed through a simple handshake. 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.

How Awete - so far the first person known to have contracted Ebola in Uganda - became infected is a mystery. In fact, researchers have no idea where the virus lives in between outbreaks, which are often years and hundreds of miles apart. While they know it resides in a host animal or insect that it does not kill, they have not identified the host.

One of Awete's two children, a 9-month-old boy, died of Ebola within days of her funeral, although her 8-year-old son - who did not take part in the funeral - has so far survived.

Awete, 36, lived with her mother and sisters in a small compound of six thatched huts and a dilapidated house surrounded by banana trees and rows of corn. She made her living selling home-brewed cassava beer and corn she ground by hand inside her 15-foot wide, windowless hut.

Kabede Opong is three miles from Gulu, a town of 150,000 about 225 miles north of the capital Kampala. People here do not eat wild animals, suspected as the source of some past Ebola outbreaks, and she did nothing unusual before she died, except for a trip to another village to get cassava leaves for brewing.

At first, neighbors thought Awete died of dysentery, cholera or any of a number of illnesses common to the area.

''People had fears after the second victim,'' said Justin Okot, a police officer who lived in the compound next to Awete. ''It was after the eighth victim, that's when we suspected this is a new disease.''

Okot and his wife, lifelong friends of Awete, took part in her funeral. Okot's boss has told him not to come to work for at least 12 days, and then get a doctor to certify that he is healthy. While he has no symptoms, his wife has not been so lucky.

''My wife was admitted yesterday to the hospital,'' Okot said, his voice trembling as he tried to hold back tears. He feels certain it is Ebola.

More help arrived Wednesday when a team from the World Health Organization brought in boxes of protective garments, gloves and a washing machine, as well as the expertise needed to fight Ebola.

''Containment of the outbreak should not be a problem,'' said Dr. Guenael Rodier, a senior WHO official and veteran of a half-dozen Ebola outbreaks in West Africa. ''Simple measures will avoid the spread of the disease from person to person and that is what we are going to work on.''

He said investigators from the U.S.-based Centers for Disease Control were bringing sophisticated equipment not available in Uganda that is required to confirm infection with Ebola.

In recent days, anyone with early symptoms of the disease has been quarantined and counted as a potential victim. Rumors abound of cases in other districts of Uganda, which could either signify a dramatic spread of the disease or just panic.

''There are many rumors that need to be checked,'' said Rodier. ''But it is clear that if you have no contact with Gulu, then you are unlikely to have Ebola.''

Professor Francis Omaswa, director general of Uganda's medical services, said reports that two people died of Ebola in neighboring Kitgum were false and that the virus was being contained in Gulu district.

However, a medical team was sent to investigate a suspected outbreak in Lira district, southeast of Gulu, said Paul Kaggwa, a Health Ministry spokesman.

On Wednesday, Tanzania joined Kenya in introducing medical screening at its border points with Uganda.