Ebola Sudan Outbreaks

• 1976. Nzara and Maridi, Sudan.
  
  The first case of Ebola-Sudan (EBO-S) was first detected in Nzara, Sudan and then spread to Maridi, Tembura, and Juba. On June 27, 1976, a Nzara Cotton Manufacturing Factory cloth room worker, YuG, became ill with a hemorrhagic febrile disease, Ebola hemorrhagic fever (EHF), and died in the Nzara hospital on July 6, 1976. The second primary case of EHF was a man, Bz, who also worked in the cloth room and died in the hospital on July 14. Bz's wife, who nursed him during his illness, suffered a fatal case of Ebola hemorrhagic fever. The epidemiologically most important primary case, PG, who worked alongside YuG and Bz, became ill on July 18 and died on July 27 after several short stays in the Nzara hospital. 69% of all the EHF cases in Nzara and the introduction to Maridi and Tembura were traced to PG. The World Health Organization (WHO) investigators reported observing direct person-to-person transmission of EBO-S through six generations of EHF cases traced back to PG.
  
  
  References:
  • WHO Study Team. "Ebola haemorrhagic fever in Sudan, 1976." Bulletin of the World Health Organization, 56 (2): 247-270 (1978).

• 1979. Nzara, Sudan.
  
  On 2 August 1979, a 45 year-old man was admitted to the Nzara hospital with a fever that had lasted for three days and recent onset of diarrhea and vomiting. While at the Nzara hospital, he developed gastrointestinal hemorrhaging and died on August 5. The Nzara hospital was poorly stocked, and the hospital staff had not taken precautionary isolation measures or practiced barrier nursing techniques. The hospital did not learn until several weeks after the patient's death that three of his relatives who had cared for him during his illness had developed hemorrhagic fever and subsequently died in the family compound. Later in August, several people in a second family developed hemorrhagic fever and were hospitalized, and an outbreak was identified. The district was quarantined and was under regional surveillance in early September. After two Nzara hospital nurses had died of HF, WHO sponsored a team on September 22nd to contain the outbreak. During this outbreak, there were 34 people infected with a 65% case fatality rate. Every case had direct links to the index case who was employed at the Nzara Cotton Manufacturing Factory.
  
  
  References:
  • Baron, R.C. et al. "Ebola virus disease in southern Sudan: hospital dissemination and intrafamilial spread." Bulletin of the World Health Organization, 61 (6): 997-1003 (1983).