In September 2022 the WHO announced that health authorities in Uganda had declared an outbreak of Ebola. This follows a case of the Sudan ebolavirus in the Mubende district. Ebola is described by the WHO as a “severe, often fatal illness” in humans and other primates. Of the 6 different species, 3 (Bundibugyo, Sudan, and Zaire) have caused large outbreaks in the past.
The Uganda Virus Research Institute (UVRI) released a statement on 20th September 2022. This referred to a case that had been “identified and isolated” in Mubende Regional Referral Hospital. The patient was a 24-year-old male from Ngabano Village, Madudu Sub-County. He was referred by St John’s Medical Clinic after presenting with “high grade fever, convulsions, blood-stained vomitus, diarrhoea, loss of appetite, and pain on swallowing”. Further to this, the report details “chest pain, dry cough, and bleeding in eyes”.
The illness progressed on the 17th of September to “yellowing of eyes”, dark urine, and abdominal pain. Suspecting Viral Haemorrhagic Fever (VHF) the clinical team took a sample. This was received on the 18th and confirmed Ebola infection was established on the 19th. Unfortunately, on the morning of the 19th, the patient died. The statement explains that the body is being kept in isolation awaiting “safe and dignified burial”.
This is the second Ebola outbreak of the Sudan strain in Uganda. Previously, it has also experienced an outbreak of the Zaire ebolavirus. UVRI suggests that the incubation period for Sudan ebolavirus is 2-21 days.
A Direct Rapid Response team investigated “unconfirmed deaths in different communities” following reports of “strange illness and sudden deaths” in the Kiruma and Madudu Sub-Counties. Between the 1st and the 15th of September 6 deaths have been reported in these Sub-Counties. The WHO suggests that there are a further 8 suspected cases receiving care.
Ministry of Health advice
The Ministry of Health has initiated “preliminary containment measures” and encouraged the community to “remain calm but vigilant”. It urged health workers to have the “highest index of suspicion” and observe “heightened safety precautions”.
Dr Matshidiso Moeti, WHO Regional Director for Africa, emphasised her intention to collaborate with the health authorities to “investigate the source” and promote “effective control measures”.
“Uganda is no stranger to effective Ebola control. Thanks to its expertise, action has been taken to quickly detect the virus and we can bank on this knowledge to halt the spread of infections.”
The WHO has “dispatched supplies to support the care of patients” and is “sending a tent” for isolation of patients.
Vaccination not approved
Although “ring vaccination of high-risk” people with the Ervebo (rVSV-ZEBOV) vaccine has helped to control the spread of Ebola in recent outbreaks in the Democratic Republic of the Congo and other locations, the vaccine has “only been approved to protect against the Zaire virus”. A vaccine candidate by Johnson and Johnson “may be effective” but has not yet been specifically tested against this Sudan strain.
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