Ebola

In a significant milestone in Uganda's fight against the Ebola Sudan virus, all eight patients who had been hospitalized for treatment have been discharged after testing negative twice for the virus in tests conducted 72 hours apart. The World Health Organization (WHO) regional office for Africa has confirmed this development, describing it as an important step in controlling the outbreak.

The patients had been receiving treatment in the capital city, Kampala, and in Mbale. Despite their discharge, health officials continue to monitor 216 to 265 individuals who remain in quarantine due to potential exposure. Uganda’s Health Minister, Jane Ruth Aceng Ocero, confirmed the recovery of the eight patients and urged communities to welcome them without stigma.  If no new cases are confirmed in the next 42 days, the outbreak can be declared over.
 

A lower fatality rate compared to previous outbreaks

The outbreak, which began in late January, marked Uganda’s first Ebola Sudan outbreak since 2022 and the world's ninth recorded instance of the virus. Historically, Uganda has experienced eight Ebola outbreaks since the first recorded case in 2000.

The outbreak has resulted in a total of nine cases and one death, which involved the index patient, a 32-year-old male nurse who worked at a referral hospital in Kampala. The case-fatality rate (CFR) stands at 11.1%, significantly lower than previous outbreaks, where the CFR ranged between 41% and 100%.

The Sudan strain of the Ebola virus is a highly infectious hemorrhagic fever transmitted through direct contact with infected bodily fluids and tissues. Unlike the more common Zaire strain, there is currently no approved vaccine for the Sudan strain. However, Uganda responded swiftly to the outbreak by launching a trial of a candidate Ebola Sudan vaccine earlier this month.

Swift response from health authorities and partners

Uganda’s response to the outbreak has been supported by various health organizations, including the WHO, which deployed 47 experts and delivered seven tons of emergency medical supplies to aid the country’s efforts. WHO Representative in Uganda, Dr. Kasonde Mwinga, emphasized that while the discharge of the patients is a positive development, efforts to completely halt the outbreak are ongoing.

The WHO reiterated that the Sudan strain of Ebola is severe, typically killing at least 40% of those infected, making the lower fatality rate in this outbreak a notable success.

Sources:

WHO: Uganda discharges all eight Ebola disease patients 

CIDRAP: Remaining patients discharged in Uganda's Ebola Sudan outbreak

BBC: Uganda discharges Ebola patients

New Vision: Uganda discharges all eight Ebola patients, health minister says

Daily Monitor: Joy as 8 Ebola patients are discharged

About Ebola

Ebola: Transmission, Symptoms, Diagnosis, Treatment, Prevention and control

Uganda’s Ministry of Health, in collaboration with the World Health Organization (WHO) and key partners, has launched the world’s first vaccine trial for the Sudan strain of the Ebola virus. This landmark trial, initiated just four days after the outbreak was confirmed on January 30, marks an unprecedented pace for a randomized vaccine study in an emergency setting.

Leading the trial are principal investigators from Makerere University and the Uganda Virus Research Institute (UVRI), supported by WHO and other partners. The trial aims to assess the clinical efficacy of a vaccine against Ebola Sudan, demonstrating the impact of advanced research preparedness while ensuring strict adherence to national and international regulatory and ethical standards.

The candidate vaccine was donated by IAVI, with financial backing from WHO, the Coalition for Epidemic Preparedness Innovations (CEPI), Canada’s International Development Research Centre (IDRC), and the European Commission's Health Emergency Preparedness and Response Authority (HERA). The Africa Centres for Disease Control and Prevention (Africa CDC) also provided critical support.

Read more:

WHO:  Groundbreaking Ebola vaccination trial launches today in Uganda 

IAVI: First participants vaccinated with IAVI’s Ebola Sudan vaccine candidate in Uganda amid Ebola outbreak

Ebola: Transmission, Symptoms, Diagnosis, Treatment, Prevention and control

On 8 May, 2018, the Ministry of Health of the Democratic Republic Congo (DRC) declared an outbreak of the Ebola Virus Disease (EVD) in the Bikoro Health Zone, Equateur Province in the Western part of the country.

By 15 May, 2018 a total of 44 EVD cases (3 confirmed) had been reported with 19 deaths, including three health care workers. As of 16 May, 393 contacts had been identified and are being followed. A new confirmed case in the 1.2 million people town of Mbandaka, some 150 km away from Bikoro, increases the risk of spreading the disease.

The World Health Organization (WHO), Medecins Sans Frontieres (MSF), the International Committee of the Red Cross and other international organization are on site and supporting the DRC in the fight against the outbreak, the ninth that has occurred in the country.

Ebola is a zoonotic virus disease that is transmitted from animals to humans. Experts believe that bats are the reservoir for the pathogen. While they do not get sick, the Ebola virus causes a severe, often fatal illness in humans. It spreads in the human population through human-to-human transmission, via direct contact with the blood, secretions, organs or other bodily fluids of infected people and through contaminated surfaces and materials, such as bedding or clothing. There is no therapy yet for EVD and about 50% of people infected with the virus may die. Health workers have an increased risk due to the nature of their work that exposes them to infected people.

Five out of six EAC Partner States share borders with the DRC, and all of them maintain close trade relations with high border traffic. There are also direct flights between the DRC and individual East African Partner States. These factors have caused the EAC to be on high alert. Partner States have put safety measures in place that range from screening people arriving from DRC at the border posts for signs of the disease to alerting health personnel; enhancing diagnostic capacities at major research centres; and informing citizens of the risk and of preventive measures. To date, no cases of Ebola have been detected in the EAC region.

The EAC region has experienced a number of Ebola outbreaks in the past, and some 500 East African experts assisted in the fight against Ebola in West Africa in 2014-2016, when the disease killed more than 11,000 out of almost 30,000 infected people. These experts represent a unique pool of professionals from different disciplines, all with hands-on experience in responding to EVD outbreaks. They can be mobilised at short notice to join the common effort of preventing the disease to spread into the EAC. 

Still, the EAC Secretariat encourages the public to be vigilant and alert. People should seek medical attention when the following symptoms are observed: a sudden onset of fever, fatigue, muscle pain, headache and sore throat. This is often followed by vomiting, diarrhoea, and a skin rash. It can be accompanied by internal and external bleeding (e.g. oozing from the gums, blood in the stools). The public is also urged to continue cooperating with the health workers of their nearest health facilities by availing themselves of information about EVD. 

The EAC Secretariat commends the Partner States for their vigilance and quick and prudent response across disciplines as reflected in the One Health approach. The Secretariat will continue to monitor the situation together with the EAC Partner States to detect any occurrence of EVD in the region at the earliest possible time.

East African Community Headquarters, Arusha, 22 July 2019:  The confirmation of a fatal Ebola case in the Ituri province of the Democratic Republic of Congo (DRC) further increases the risk for the East African Community (EAC) region of the outbreak crossing the borders. The Ituri province is only 70 km from the South Sudanese border and even closer to the Ugandan border. The first three cases of Ebola in the EAC region were diagnosed in Uganda in June 2019 and triggered strong response measures by the Ugandan government. Trade is vibrant between DRC and the EAC region and can exacerbate the spread of the Ebola Virus Disease (EVD) due to the high mobility of people and goods. In the light of the Public Health Emergency of International Concern declared by the World Health Organization,) Dr Michael Katende, acting Head of Health at the EAC Secretariat urges the Partner States to strongly engage the communities in the border regions and traders and trade associations in risk and crisis communication measures. “This is particularly important, as most of the border line is porous and difficult to control” says Katende, “informal and formal traders need to know the risk and be able to take informed decisions to minimise it and to actively take precautions.”

EAC Partner States have put in place precautionary measures to stop the spread of EVD into the EAC region. This includes vaccinating frontline health workers, screening all travellers at points of entry including airports and training the first responders in case of an outbreak. However, these measures might not be sufficient. Dr Michael Katende, acting Head of Health at the EAC Secretariat was especially concerned about EVD spreading into South Sudan with its still rather weak health system.

The EAC Secretariat calls upon the Partner States to increase risk and crisis communication by involving community, religious and other leaders and the media in public awareness raising. At the same time, the Secretariat calls upon traders and trade associations and those travelling across the border with DRC to take extra precaution, as the EVD threat is real:

• All people crossing the border should cooperate with immigration, health and security officials who are conducting screening at the points of entry and should strictly follow their advice.
• Frontline health workers and members of the affected communities should accept to be vaccinated against EVD for their own protection and to help prevent the further spread of EVD.
• People in the affected regions should avoid unnecessary ‘body to body’ contact as this is the main way of disease transmission.
• The public should be vigilant and immediately inform the nearest health workers when spot a person with signs of EVD which are: fever, severe headache, body weakness, fatigue, diarrhea, vomiting, and unexplained haemorrhage (bleeding or bruising) from various body outlets like the nose, ears and mouth. This is particularly important along the “green border” where no screening measures are in place.

Ebola outbreak in the Democratic Republic of the Congo declared a Public Health Emergency of International Concern

https://www.who.int/news-room/detail/17-07-2019-ebola-outbreak-in-the-democratic-republic-of-the-congo-declared-a-public-health-emergency-of-international-concern