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On January 11, 2023, Uganda officially declared the end of the Ebola outbreak caused by the Sudan ebolavirus, following 42 consecutive days without any new cases since the last patient was discharged from care.

In total, there were 142 confirmed cases of Sudan virus disease (SVD), resulting in 55 deaths (a case fatality rate of 39%), while 87 individuals recovered. Additionally, 22 deaths were reported among probable cases, individuals who passed away before samples could be collected, bringing the overall case fatality rate to 47%. Among the affected were 19 healthcare workers, seven of whom tragically died.

The World Health Organization (WHO) reported that over 4,000 contacts were monitored for 21 days during the outbreak.

The virus spread across nine districts in Uganda, including Bunyangabu, Jinja, Kagadi, Kampala, Kassanda, Kyegegwa, Masaka, Mubende, and Wakiso.

Background

On 20 September 2022, the Ministry of Health in Uganda, together with WHO AFRO, confirmed an outbreak of SVD in Mubende District, Uganda, after one fatal case was confirmed. 

The index case was a 24-year-old man, a resident of Ngabano village of the Madudu sub-county in Mubende District. The patient experienced high fever, diarrhoea, abdominal pain, and began vomiting blood on 11 September 2022. Samples were collected on 17 September 2022 and SVD was laboratory-confirmed on 19 September. The patient died on the same day, five days after hospitalisation. 

This was the fifth SVD outbreak that occurred in Uganda.

What is Ebola?

Ebola virus disease (EVD) is a rare, severe, and often fatal illness in humans. The disease was first identified in 1976 during two simultaneous outbreaks in South Sudan and the Democratic Republic of the Congo, near the Ebola River, from which it takes its name. Ebola is caused by a virus from the Filoviridae family, which includes three genera: Cuevavirus, Marburgvirus, and Ebolavirus. There are six species of Ebolavirus: Zaire, Bundibugyo, Sudan, Taï Forest, Reston, and Bombali.

Transmission

Ebola is thought to be spread to humans from infected animals, particularly fruit bats, which are considered the natural hosts. The virus can also be transmitted through contact with blood, organs, or other bodily fluids from animals like chimpanzees, gorillas, monkeys, or forest antelopes. Human-to-human transmission occurs through direct contact with body fluids of infected individuals or contaminated objects, like clothing or bedding.

Health-care workers and individuals involved in burial ceremonies are at increased risk of infection. Ebola can also be sexually transmitted after recovery, and pregnant women may still carry the virus in breast milk or pregnancy-related fluids after recovery.

Symptoms

Ebola symptoms typically appear 2 to 21 days after exposure and begin with fever, fatigue, headache, and muscle pain. This progresses to vomiting, diarrhea, rashes, and both internal and external bleeding. People can only transmit the virus once symptoms develop, and those who recover may experience long-term symptoms such as joint pain, memory loss, and vision problems.

Diagnosis

Distinguishing Ebola from other diseases like malaria or typhoid fever can be difficult. Diagnosis is confirmed through methods such as:

Antibody-capture ELISA

Antigen-capture detection tests

RT-PCR assay

Electron microscopy

Virus isolation by cell culture

Treatment

Immediate medical care is essential for improving survival rates. Treatment includes fluids, pain management, and medications for secondary infections. An effective vaccine exists for the Zaire species of Ebola, and antibodies administered intravenously increase the chance of survival. Research continues on vaccines and treatments for other species of Ebola.

Prevention and Control

Preventive measures include regular handwashing, avoiding contact with body fluids of infected individuals, safe burial practices, and vaccination for those at risk of the Zaire Ebola species. Outbreak containment relies on a combination of case management, contact tracing, safe burials, and community engagement. Health-care workers must follow strict infection control measures to prevent transmission.

WHO Recommendations

WHO emphasizes the importance of raising awareness and following guidelines to reduce the risk of transmission. Laboratory samples should only be handled by trained professionals in properly equipped facilities. Health-care workers should use personal protective equipment and follow standard precautions at all times.

More details on this link .

The IGAD Climate Prediction and Applications Centre (ICPAC) has released its October to December 2024 seasonal forecast, revealing contrasting weather patterns across East Africa. Drier-than-normal conditions are expected in the eastern parts of the region, particularly in southern Ethiopia, Somalia, eastern Kenya, and central and southern Tanzania. These areas face increased risks of drought, which could exacerbate food insecurity and affect livelihoods. On the other hand, western parts, including northern Uganda, western Kenya, northern Tanzania, southern Burundi, and parts of Rwanda, are predicted to receive above-normal rainfall, likely boosting agricultural productivity and water availability.

This forecast highlights the urgent need for coordinated action to mitigate the impacts of these climate extremes. Warmer-than-average temperatures are also expected across the region, with the highest probabilities in eastern Tanzania, Kenya, and Ethiopia. In contrast, cooler conditions are anticipated in northern Tanzania and parts of Uganda, Kenya, and South Sudan. Experts, including IGAD's Executive Secretary Dr. Workneh Gebeyehu, stress the importance of early warning systems and preparedness efforts to address the region's food security challenges and build resilience against the growing threat of climate change.

Read more on this link . 

Burundi’s Ministry of Health declared a cholera outbreak on Wednesday, 6th September 2023, with 15 cases reported in the western part of the country, an area prone to water shortages.

Polycarpe Ndayizeye, spokesperson for the Ministry of Public Health and AIDS Control, confirmed that cholera patients had been admitted to hospitals and treatment centers in the municipality of Bujumbura. He called on authorities, residents of affected areas such as Bujumbura, Gatumba, and Rugombo, and all stakeholders to collaborate in combating the outbreak. Residents, especially those in impacted districts, were urged to strictly adhere to hygiene practices to help contain the disease.

Earlier this year, cholera claimed two lives in Bujumbura’s health district, notably at Kajaga beach on Lake Tanganyika. Water shortages, particularly during the dry season from May to September, exacerbate the risk of cholera outbreaks in Burundi’s western region.

Causative agent

Cholera is caused by the bacterium Vibrio cholerae. It produces a toxin that targets the intestines, leading to severe watery diarrhea and dehydration. According to the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC), not all strains of V. cholerae cause illness; only specific toxin-producing strains are responsible for cholera outbreaks.

How cholera spreads

Cholera spreads through the consumption of contaminated food or water, particularly in areas with inadequate sanitation or limited access to clean water. The bacterium thrives in environments where drinking water, food, or sanitation is compromised, often after natural disasters or in densely populated areas.

Symptoms

Symptoms of cholera typically manifest within 2-5 days after exposure and include:

Profuse watery diarrhea (often described as “rice-water stools”)

Vomiting

Rapid dehydration

Muscle cramps

Severe thirst

If untreated, cholera can lead to shock and even death within hours due to the rapid loss of fluids.

Preventive measures

Preventing cholera requires addressing the core issues of water and sanitation. The WHO, Africa CDC, and US CDC recommend the following preventive actions:

Ensuring access to safe drinking water by boiling, treating with chlorine, or using bottled water

Proper disposal of human waste

Regular handwashing with soap, especially before eating and after using the bathroom

Safe food handling, including thoroughly cooking food and washing fruits and vegetables

Vaccination in high-risk areas, although vaccines alone are not a substitute for proper hygiene and sanitation practices

What to do if you get cholera

Immediate rehydration is crucial in treating cholera. The WHO recommends:

Drinking Oral Rehydration Salts (ORS) solution to replace lost fluids and electrolytes

Seeking medical care immediately if severe symptoms like frequent vomiting or extreme diarrhea occur

In severe cases, intravenous (IV) fluids may be necessary if oral hydration is insufficient

Treatment

Cholera treatment primarily focuses on rehydration. Antibiotics can also be prescribed in more severe cases to shorten the duration of the illness and reduce the volume of diarrhea. Zinc supplements are also recommended for children to aid recovery. Access to adequate treatment dramatically reduces cholera’s mortality rate to less than 1%, according to the WHO.

Regional impact

Burundi is not alone in facing cholera outbreaks. A recent update from the WHO African Region, as of August, 2023 reported cholera cases across 15 countries. Among the latest outbreaks, six countries—Burundi, Cameroon, Kenya, Mozambique, Uganda, and Zimbabwe—account for over 200 new cases. While the overall trend in the region is declining, WHO and other public health authorities urge countries to bolster surveillance, readiness, and community-based prevention measures, especially around border crossings to limit cross-border infections.

Read more here: Cholera in the WHO African Region

https://iris.who.int/bitstream/handle/10665/373305/AFRO-Cholerabulletin30.pdf

The United States has committed $4.1 million (15 billion UGX) and 5,500 mpox tests to support Uganda's response to the Mpox outbreak. The funding will be channeled through various partners, including the World Health Organization (WHO), UNICEF, and the University Research Collaborative (URC). Additionally, $1.7 million will support the United Nations High Commissioner for Refugees (UNHCR) in managing mpox screenings at Uganda’s border crossings, refugee settlements, and host communities. This effort is part of the broader U.S.-Uganda partnership to strengthen health systems and prevent the spread of the virus.

U.S. Ambassador William Popp emphasized the importance of a healthy Uganda, noting that the U.S. partnership aims to build Uganda’s long-term capacity to respond to health crises. The U.S. has a longstanding role in Uganda’s healthcare, having helped establish over 70 accredited laboratories since 2015. In refugee areas, the U.S. funds screening efforts and builds treatment centers, and U.S. agencies continue to assist Uganda's Emergency Operations Centers. For more details, read the full press release .

The UK has announced a significant package of support to help tackle the outbreaks of Mpox and Marburg virus in central Africa. This includes up to £9 million in funding to bolster efforts in the Democratic Republic of Congo (DRC), Uganda, and other affected countries. UK experts from the UK Public Health Rapid Support Team have been deployed to provide technical expertise to the Africa Centres for Disease Control and Prevention, assisting in strengthening surveillance systems, healthcare services, and community awareness. Additionally, the UK is collaborating with Rwanda to support its response to the Marburg virus outbreak, mobilizing £1.9 million in aid to provide expertise and enhance outbreak management.

This assistance comes at a critical time, as Africa faces significant public health challenges from both diseases. The UK's partnership with organizations like UNICEF, the World Health Organization (WHO), and Africa CDC aims to not only respond to these immediate threats but also build long-term resilience in healthcare systems across the region. The funds will contribute to saving lives, protecting vulnerable communities, and strengthening health systems to safeguard the continent against future outbreaks.

Read more on this link . 

The number of recoveries from the Marburg virus in Rwanda has reached 30, while the total number of vaccinated individuals stands at 876 as of Thursday, October 17, according to the Ministry of Health.

An update from the ministry also confirmed 62 cases of the virus, including 15 deaths and 4 patients currently in isolation receiving treatment (down from 17 earlier in the week).

A total of 4,486 tests have been conducted so far.

Since the outbreak was first declared on September 27, all new confirmed cases have been linked to the hospital cluster in Kigali, and affected individuals remain in isolation and treatment.

Read Ministry of Health's update here .

Kenya has ramped up its efforts to combat the spread of Mpox and neglected tropical diseases (NTDs) with the receipt of vital testing kits and medicines from global health partners, including the World Health Organization (WHO) and USAID. This support arrives as the country records its first Mpox death, with confirmed cases rising to 13. Health officials emphasized the significance of these resources in strengthening the nation’s capacity for disease surveillance and response, particularly in regions with high disease burdens. The Ministry of Health also announced upcoming mass drug administration campaigns aimed at controlling NTDs like lymphatic filariasis and schistosomiasis. Read more here and and here . 

 

Professor Tumaini Nagu, Tanzania's Chief Medical Officer, has highlighted several key actions the government is taking in response to the Marburg virus outbreak. She emphasized that Tanzania is ramping up preparedness, especially in high-risk regions like Kagera, Rukwa, Mwanza, and Katavi. The measures include distributing over 1,000 protective gear kits to healthcare workers and conducting training to ensure staff follow strict infection prevention protocols.

Prof. Nagu reiterated the importance of protecting healthcare personnel and urged the public to report symptoms like fever, vomiting, and bleeding to avoid the spread of the virus. She also stressed the need to avoid contact with infected individuals and dead animals. Border controls have been enhanced, and public awareness campaigns are underway to educate people on prevention measures, similar to those used during the COVID-19 pandemic​ (The Citizen newspaper).

Read more on this link.

3rd October 2024. Rwanda’s ongoing battle with its first Marburg virus outbreak intensified as the Ministry of Health confirmed seven new cases and an additional death yesterday. In a briefing today, Health Minister Sabin Nsanzimana provided updates, including plans to begin a vaccine trial soon.

Meanwhile, two travelers returning to Germany from Rwanda tested negative for the virus after being isolated in Hamburg due to potential exposure in a Rwandan hospital where Marburg patients were being treated.

The latest figures bring Rwanda’s Marburg virus outbreak to 36 cases, 11 of them fatal, marking it as one of the largest recorded globally. In a media briefing organized by the Africa Centres for Disease Control and Prevention (Africa CDC), Nsanzimana revealed that healthcare workers make up 80% of the infected, with 29 cases reported among them. Currently, 25 individuals are receiving care in isolation, and health officials are monitoring 323 identified contacts.

The outbreak was first detected when healthcare workers began falling ill, and early patients did not respond to treatment for conditions like malaria, which shares initial symptoms with Marburg. The virus spreads through contact with infected body fluids, and many cases have been linked to an ICU cluster where the suspected index patient was treated.

Nsanzimana also announced that Rwanda is expecting 5,000 doses of remdesivir to enhance treatment efforts. The ministry plans to initiate a vaccine trial soon, with details on the vaccine and its rollout to be announced in the coming days. As of now, no specific treatments or vaccines for the Marburg virus are officially approved.

Genetic sequencing and further epidemiologic investigations are ongoing, and though Nsanzimana described the outbreak as "controlled," it is not yet fully contained.

Read more: Gilead Donates Remdesivir for Emergency Use in Response to Marburg Virus Disease in Rwanda here  and 

Marburg Virus updates on this link and the Situation in Rwanda, Epidemiology, Public health response, WHO risk assessment, WHO advice at this link.

East African Community Headquarters, Arusha, Tanzania, 4th October, 2024:  The East African Community (EAC) Secretariat has called for a swift and coordinated regional response to contain the ongoing Marburg Virus Disease (MVD) outbreak declared in Rwanda. The outbreak poses a serious threat to regional health security and requires urgent action from all EAC Partner States to prevent its spread across borders.

On the 27th September 2024 Rwanda’s Ministry of Health declared the Marburg Virus Disease (MVD) outbreak and as of 30th September, 2024 there were 29 confirmed cases and 10 deaths with more than 297 contacts under close monitoring and healthcare workers have been disproportionately affected. The World Health Organization (WHO) has raised concerns about the potential regional spread of the disease due to confirmed cases in districts near the borders of the Democratic Republic of the Congo (DRC), Uganda, and Tanzania.

“There is an urgent need for a coordinated regional response to contain the spread of this highly infectious virus through swift identification, isolation, and treatment of cases and enhanced screening at borders and health facilities,” said Hon. Andrea Aguer Ariik Malueth, EAC Deputy Secretary General, in charge of Infrastructure, Productive, Social & Political sectors

He called for Partner States to strengthen their public awareness and infection control protocols including handwashing, avoiding physical contact with symptomatic individuals and surveillance at borders and health facilities.  Read more on this link