Ebola Super Spreaders in Uganda?
Recombinomics Commentary
December 7, 2007
Admitted at Bundibugyo: 15, including Dr. Sessanga whose sister just came to our house looking for Scott because he’s no longer responsive; the matron (head nurse); the nurse who was working in the isolation unit Fred; a clinical officer named Joshua Kule; and an ophthalmic assistant. Among the other patients are six direct contacts (mother, brother, wife, daughter and two friends) of Muhindo Jeremiah who died just over a week ago.
one death this morning 5 am, another contact of Jeremiah Muhindo, who seems to have been very infectious.
Friday November 23 is the day Jonah believed himself to have been infected. That was the day he and Scott examined Jeremiah Muhindo. In between two of the times they saw the patient together, Jonah went in alone and arranged a face mask of oxygen onto the dying man, hoping to provide some relief or comfort. He was not wearing gloves because he could not find any at the hospital at that moment, and he felt that his friend needed the oxygen. That was his greatest exposure.
The above comments are from a blog of two physicians in Uganda here, here, and here. The repeated mention of the same patient, Jeremiah Muhundo, in association with multiple suspect / confirmed cases, raises the possibility of a super-spreader. Several of the above cases, including four health care workers, died within 24 hours of each other, raising concerns that they were infected by a common source.
The repeated mention of the same patient raises concerns that he was a super spreader, leading to infection of multiple contacts. More information on the direct contacts would be useful.
Super spreaders were implicated in the transmission of SARS coronavirus, and the above linkages raise questions about the new strain of Ebola, which is likely to be a recombinant. In the SARS outbreak, sequences of isolates from the same super spreader suggested co-infections and recombination contributed to the multiple linked infections. Although the case fatality rate of this new Ebola strain may be lower than that of prior strains, confirmed or alert cases throughout Uganda (see satellite map), suggest that transmission may be more efficient than seen for prior strains, resulting in a large geographical reach.
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