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Newsweek magazine has weighed in on the escalating/deteriorating situation in Uganda.  And if you read the article carefully, and match Newsweek's suspected case total with the official records, you get a wildly divergent -- and extremely unsettling -- new number of potentially infected persons.  Not to mention the possibility of a deliberate cover-up of the virus by government officials.

The article itself is a good digest of what has already happened. And as we know and is proven by the presence of a reporter in the village -- Newsweek's Andrew Ehrenkranz (photo) -- there is no substitute for Journalist Boots on the Ground.  As admirable a job as as the Myhres' have done to update their blog, they are not journalists, aimed at extracting the truth. 

The paragraph in question is this one:

Some Ugandans, however, are questioning whether Museveni's government deliberately covered up news of the outbreak ahead of the recent meeting of the Commonwealth Heads of Government meeting in the capital city, Kampala. The government did not announce the outbreak until just after the conclusion of the high-profile meeting, even though government reports acknowledge that blood samples from infected patients were sent to South Africa for Ebola testing on Sept. 29. These samples were reportedly found negative for Ebola but were subsequently shown to carry a new strain of the virus at the Centers for Disease Control (CDC) in Atlanta on Nov. 24—the second day of the Commonwealth meeting. The initial false negative may have been due to the difficulties of identifying the new strain—even the CDC tests took a day longer than usual—but that hasn't stopped public outrage over whether the government could have acted faster to stop the spread of the virus. "It looks quite strange, from a public health perspective, that blood samples were not taken [to the CDC] earlier," said Dr. George Pariyo, dean of the public health school at Kampala's well-respected Makerere University in a front-page Uganda Monitor feature investigating the suggestions of a government cover-up.

Other news regarding the actual number of infected, plus the prospect of large numbers of "super-spreaders" of the disease, are also mentioned by Newsweek:

Bundibugyo is at the epicenter of the outbreak, which began in August. Doctors in the town are monitoring more than 360 sick people believed to be incubating the virus and have recorded 18 local fatalities, including four medical staffers at Bundibugyo Hospital. Townspeople are terrified by the outbreak. Bundibugyo's usually bustling central market is quiet, and residents of nearby villages are anxiously reading newly distributed Ebola information posters. Hawkers sell the antibiotic Cipro at inflated prices on the street, falsely promising that it can prevent infection; local healers and herbalists are offering their own versions of a cure. (bold mine)

The piece continues:

But while the new strain seems to be less virulent, it also raises the possibility that the infected are now more likely to survive long enough to spread it elsewhere. Already there have been Ebola cases in eight districts across Uganda, with confirmed cases as far away as Mbale, a village some 600 miles from the outbreak zone. On Uganda's borders, neighboring Kenya, Rwanda, Tanzania, and Sudan are screening all Ugandans for symptoms and travel patterns in an attempt to halt the disease from spreading into their countries.

Let's hope the global media keeps its focus on this growing problem in Eastern Africa.  The entire story can be found at:

http://www.newsweek.com/id/76935

You gotta love the story coming out of Suffolk, England.  As we all know, Suffolk was the epicenter of Britain's worst bird flu outbreak of the last few years.  High-path H5N1 was found in free-range poultry, and this threatened to put a huge dent in Britain's holiday fowl season.

Anyway, the tab was just presented to the government.  And what a tab it is!  Some 160 persons stayed at luxury hotels, running up a hotel and meal/entertainment tab of £121,000!  That is about a quarter of a million dollars, or about $1,600 a person for a month.

This, understandably, has MPs (Members of Parliament) and local officials fuming.  Local economies were already reeling from the state of Britain's economy (not good) and then, to have a massive bird flu die-off and cull on top of that -- well, the ripple effect can be well-imagined.  So did Her Majesty's government choose to slip some of that quid back into the pockets of local Bed and Breakfast owners and restaurateurs (pictured), to help them recover economically?  No, of course not!  they stayed at the luxury hotels and the locals failed to benefit economically.

Notice to FEMA workers, emergency managers and well-meaning bureaucrats everywhere:  Government produces no revenue.  It TAKES revenue from others.  It produces no widgets. The least government can do (and except for pandemic preparedness and homeland security, as a general rule the less government can do the better), please inject those taxpayer dollars back into the local economies. 

Here is the story, from the Suffolk Evening Star,  http://www.eveningstar.co.uk/content/eveningstar/news/story.aspx?brand=ESTOnline&category=News&tBrand=estonline&tCategory=News&itemid=IPED12%20Dec%202007%2014%3A41%3A14%3A653

TAXPAYERS have forked out £121,000 in less than a month on accommodation for officials dealing with the second bird flu outbreak in Suffolk.

There were 160 people put up in accommodation for a combined total of 1,295 nights by The Department for Environment, Food and Rural Affairs (DEFRA) between November 12 and December 2.

This works out at an average of £94 per night or £758 for each individual.

The figures emerged after MP for Bury and Stowmarket, David Ruffley, questioned Jonathan Shaw MP, parliamentary under-secretary at the Home Office.

Mr Ruffley said: “I am quite simply staggered by the size of the hotel bill DEFRA seem to have racked up while staying in Suffolk.

“On average they have spent £94 per night putting up their officials. This is incredibly frivolous when one considers that bed & breakfasts in the area charge in the region of £30 to £35 per night.

“This wasteful attitude will make farmers in the region sick - they are struggling to make ends meet, following bluetongue and avian influenza outbreaks, while the government is sending their officials to some of the finest hotels our area offers.

“By my calculations, if these officials had been found bed & breakfast accommodation the bill would have been in the region of £40,000. Not only would this have saved nearly £80,000 but it would have supported the very communities that have been shattered by these outbreaks.

“The government should be ashamed of this colossal waste of tax payers' money and Suffolk's farmers, who are receiving very little in the way of support or compensation, have every right to be livid.”

In answering Mr Ruffley's question, Mr Shaw said: “In an emergency, a large number of staff need to be found hotel rooms near to the local disease control centre at very short notice.

“DEFRA employs the services of an external provider to ensure that the most appropriate accommodation is secured and provides the best value for money.”

Do you think too much money was spent on accommodation? Write to Your Letters, Evening Star, 30 Lower Brook Street, Ipswich, IP4 1AN or e-mail eveningstarletters@eveningstar.co.uk

An article in today's Washington Post reveals the growing concern with Adenovirus 14.  Intrepid readers of this blog will note the multiple dispatches I have written concerning this emergent substrain -- an apparent mutation of Adenovirus 14, one of the 50+ known substrains of adenovirus.

Written by Post writer Rob Stein, the article has been picked up by the wires and news Websites.  titled "Virus starts like a cold — but can be a killer, New form of adenovirus is spreading, but level of threat is unknown," the article does a good job of condensing the adenovirus story into lay-readable form.

What is distressing in this article is the depth and breadth of the emerging epidemic of adenovirus -- and the growing concern that it attacks the young with special verve.  A snippet:

"Infectious agents have the capacity to mutate and change form, and from time to time, either genuinely new agents appear or old agents appear in new guises," said William Schaffner, an infectious-disease expert at Vanderbilt University. "This appears to be another one of those emerging infections that has taken on genetic material or mutated so that it is now more virulent than it used to be."

The virus, which spreads like those that cause flu or colds, raises many questions: Why has it suddenly become more common? Why is it apparently more dangerous? How often does it make people seriously ill? Who is most vulnerable? Is the threat growing or fading?

‘Questions we’re trying to answer’
"We don't know why it's associated with these severe cases," said Dean D. Erdman, who is studying the virus at CDC headquarters in Atlanta. "We don't know whether it's going to become a bigger problem in the future or whether we'll see more outbreaks of severe disease. These are all questions we're trying to answer."

....But then (Infectious-disease expert David N.) Gilbert (of the Providence Portland Medical Center in Oregon, last April) started seeing patients like Joseph Spencer, 18, a high school varsity swimmer who was suddenly racked by fever, chills and vomiting.

"At first I thought it was just the flu," Spencer said. "But then it was the worst feeling I ever had. I felt so miserable. I really felt like I was dying."

Spencer's mother took him to the emergency room, where he was placed in intensive care, sedated and put on a respirator. "Even then, we told the family we didn't think he was going to survive," Gilbert said.

The teen spent 18 days in the hospital and was able to return home. But after weeks of bed rest and physical therapy, he remains short of breath and weak, and he is having memory problems.

"I don't know if I'll ever be fully recovered," Spencer said. "I never imagined anything like this would ever happen to me."

Spencer was not even the sickest. Of the 30 patients Oregon officials identified as having the virus, seven died. "That's an incredibly high mortality rate," Gilbert said.

One of the many problems with modern medicine is that we are not testing enough for these emerging pathogens. If someone enters an emergency room or doctor's office with flu-like symptoms, and influenza tests are negative, the patient is usually dismissed with a "it's just a cold" sentence and told to get bedrest.  However -- and you'd think we would have learned more in the post-SARS era -- we are not looking for what it is, we are looking for what it isn't.  And if it isn't influenza, we are sent home.  This practice is repeated time and time and time again, all over the world.  We don't look for the culprit -- we are simply too busy, or the doctor is of the opinion that finding a cause is not relevant to the treatment.  Who knows how many general practitioners are even aware of adenovirus 14?

If you search my blogsite for "adenovirus," you will uncover my first entry.  It had to do with my wife's recent illness.  She tested negative for strep, staph and influenza, but whatever virus she acquired knocked her down for days.  I have seen my wife with a cold.  She copes and manages her illness remarkably well.  This year's virus knocked her off her feet for a week.  It was NOT a cold.  What it was, we will never know.  But I strongly suspect adenovirus.

As for me, I am worthless when I get a cold.  Some would say I am worthless all the time, but that is beside the point.  The point is we do not know what we do not know.  But we do know that adenovirus is spreading and infecting people in multiple states, including confirmed cases in Texas, Georgia, South Carolina, Oregon, New York, Washington state, California and Illinois.   Deaths have occurred in several of these states.

If we were talking mumps here, we would be inundated with media.  Indeed, yesterday's New York Times covered a mumps outbreak in a Portland, Maine college, and that college has ordered mandatory vaccinations of all students for mumps.  Despite warnings that student dorm and meal smartcards will be deactivated for anyone not vaccinated by Wednesday, many students are ignoring the order and attending classes without vaccine protection. 

But we are talking something else with adenovirus 14 -- we are talking about a wolf in sheep's clothing.  We are talking about a virus that has apparently and suddenly been able to mutate and acquire the genetic traits of more sinister diseases and, as a result, can prey upon the young with deadly force. 

State departments of health need to immediately ramp up the testing capability to detect and confirm the spread of adenovirus 14.  This can, quite literally, mean the difference between life and death for scores of the afflicted.  This is not something to be dismissed as routine.  Young people do not die of the common cold.  Pneumonia does not ordinarily grip the lungs of otherwise extremely healthy young people.  And if physicians know going in that a person is suffering from adenovirus 14, they are far more likely to order life-saving measures early in treatment, rather than later.

Likewise, parents need to know that if a child is suffering from an apparent cold that only grows worse, and their child is having extreme difficulty breathing, by all means get that child to a hospital and have that child tested for flu and adenovirus.  Demand those tests. 

That would be some consolation to Michelle and Don Villers, parents of deceased daughter U.S. Air Force airman Paige Villers (photo) of Coventry Township, Ohio, Paige Villers died Aug. 7, 2007. She died at Lackland Air Force Base near San Antonio, Texas, of Adenovirus 14. (Photo credit Lew Stamp/Akron Beacon Journal) 

The article can be viewed at: http://www.msnbc.msn.com/id/22192270/

There is concern that another human-to-human infection of H5N1 has occured in China.  The son, aged 24, died last week.  His father is now in hospital with confirmed H5N1.  Earlier, the Chinese government reported that there was no known contact between the index case (son) and either poultry or wild birds.  It is unknown if the dead young man frequented poultry "wet markets" where he would purchase poultry and then have it prepared for cooking.

The son developed symptoms in late November; the father, in early December.  This fits the profile for human-to-human transmission timeframes, with an incubation period of several days before onset of symptoms.

Watch this blog, plus Crawford Kilian's H5N1, Mike Coston's Avian Flu Diary, FluWiki and FluTrackers, and the other sites in the links frame on the left side of the page, as events progress.  Not good news.

Some general housekeeping issues:

First, that mystery illness in Angola that I referred to last week has been identified by the WHO as bromide poisoning.  The WHO statement can be found at: http://www.who.int/csr/don/2007_11_30/en/index.html . A snippet:

Toxicology laboratories in Munich (Germany) and Birmingham (UK) have detected very high levels of bromide in blood samples of patients. In addition, laboratories in Geneva (Switzerland) and Munich have detected very high levels of sodium bromide (>80%) in table salt samples collected in the households of patients.

These findings provide a clear indication that this outbreak is very likely due to bromide poisoning which occurred through use of table salt highly contaminated with sodium bromide. It is still unknown how the salt samples were contaminated. Additional food samples are currently being analysed to identify any potential secondary source of exposure.

Also, swiftlets have apparently been ruled out in the death of Muhammad Nabih of Indonesia (http://www.scottmcpherson.net/journal/2007/11/14/did-edible-nest-cause-the-death-of-muhammad-nabih.html ).  Ducks are now the suspect.  In response, the swiftlets have retained attorneys and are suing for defamation of character.