2022 Uganda Ebola outbreak

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2022 Uganda Ebola outbreak
2022 Ebola outbreak in Uganda.png
Spread of Ebola in Uganda.
DiseaseEbola
Virus strainSudan ebolavirus
LocationWestern Region and Central Region, Uganda
Date20 September 2022–present
Confirmed cases140 (13 November)[1]
Deaths
55 (13 November)

The 2022 Uganda Ebola outbreak is an ongoing outbreak of the Sudan ebolavirus, which causes Ebola, in the Western Region and Central Region of Uganda. Over 130 people have been infected as of 28 October, 2022.[2] It is Uganda's fifth outbreak with Sudan ebolavirus.[3] The infections were declared an outbreak on 20 September 2022 by the Ugandan Ministry of Health.[4] As of 25 October 2022, there were confirmed cases in the Mubende, Kyegegwa, Kassanda, Kagadi, Bunyanga, Kampala and Wakiso districts.[5][6][7][8][9] As of 24 October 2022, there were a total of 90 confirmed or probable cases and 44 deaths.[10] On 12 October, the first recorded death in the capital of Kampala occurred;[11] 12 days later on 24 October, there had been a total of 14 infections in the capital in the last two days.[12]

Background[edit]

Uganda has previously had four outbreaks of Sudan ebolavirus; one outbreak in 2000 and 2011 and two outbreaks in 2012, as well as an outbreak of Bundibugyo virus disease in 2007 and an Ebola virus disease outbreak in 2019.[8]

Date Virus Human
cases
Human
deaths
CFR Description
Oct 2000–Jan 2001 SUDV 425 224 53% Occurred in the Gulu, Masindi, and Mbarara districts of Uganda. The three greatest risks associated with Sudan virus infection were attending funerals of case-patients, having contact with case-patients in one's family, and providing medical care to case-patients without using adequate personal protective measures.[13] Victims included Matthew Lukwiya.
Dec 2007–Jan 2008 BDBV 149 37 25% Occurred in the Bundibugyo District in western Uganda. This was the first identification of the Bundibugyo virus (BDBV).[14][15]
2011 SUDV 1 1 n/a
2012 SUDV 7 4 n/a
Jun–Aug 2012 SUDV 24 17 71% Occurred in the Kibaale District.[16]

Epidemiology[edit]

The first cases were detected in the Mubende District among people living around a gold mine. Gold traders who move along the highway between Kampala and the Democratic Republic of the Congo may have spread it.[17] As of October 20, the eight most recent Ebola cases had no known contacts with known patients, suggesting incomplete contact tracing and unknown chains of transmission.[18]

As of November 5, 2022, a total of 132 confirmed cases had been identified; 39% of confirmed cases died, a total of 61 patients with confirmed Ebola have recovered from illness and been discharged. Cases have been found in seven districts including Mubende, Kassanda District, Kyegegwa District, Bunyangabu District, Kagadi District, Wakiso District, and the capital of Kampala.[19] As of November 8, 23 Ebola cases had been confirmed among pupils, hence education minister Janet Kataha Museveni announced schools across Uganda would close November 25, two weeks before the scheduled end of term.[20]

Timeline[edit]

On 11 September 2022, the index case of the outbreak, a 24-year-old man in a village of the Mubende District developed symptoms of Ebola and died on 19 September 2022.[8]

On 20 September 2022, the Ugandan health authorities declared an outbreak of Sudan ebolavirus in the Mubende District.[8][21]

By the 25th September cases had been confirmed in Kyegegwa District and Kassanda District. [22] On the 29th September Kagadi District confirmed its first case. [6]

On 30 September 2022, there were 38 confirmed cases and eight total deaths in confirmed cases.[23]

On 1 October 2022, physician Mohammed Ali, one of six infected health workers who treated the index case, died as the first health worker.[18][24]

On 2 October 2022, there were 41 confirmed cases and nine total deaths in confirmed cases. Furthermore, the Bunyanga District had its first confirmed case.[25]

On 5 October 2022, there were 43 confirmed cases and 29 reported deaths.[26]

On 10 October 2022, there were 63 confirmed or suspected cases and 29 reported deaths.[17]

On 12 October 2022, the first confirmed case and death in the capital of Kampala occurred, although he was believed to have fled from an already infected district.[11] [27]

On 20 October 2022, there were 60 confirmed cases and 44 reported deaths.[18] On the 22 October Wakiso District had confirmed its first case. [28]

On 24 October 2022, there were 90 confirmed cases and 28 confirmed deaths, with 14 confirmed cases reported in Kampala in the previous 48 hours. [29]

On 26 October 2022, the Ugandan Ministry of Health confirmed that there were 6 cases in school-aged children who attended classes at 3 different schools in the Rubaga Division of Kampala. One of the children died from the disease and 170 contacts were identified from these cases.[30][31]

On 2 November Masaka District confirmed its first case and death after a 23 year old woman came to Masaka from Kampala to be looked after by her parents and was admitted to a hospital on the 31 October and later died after being transferred back to Kampala. [32]

On 13 November Jinja District confirmed its first case and death after a 45 year old man died and was linked to a probable case case connected to the Rubaga Division of Kampala. [33]

On November 17, Colchester Hospital had its first suspected case of Ebola.[34]

Districts Cases Deaths Last update
Mubende District 64 + 19 probable 29 + 19 probable 13 November 2022 [5] [1]
Kyegegwa District 4 1 13 November 2022 [5] [1]
Kassanda District 48 + 2 probable 20 + 2 probable 13 November 2022 [5] [1]
Kagadi District 1 1 13 November 2022 [5] [1]
Bunyangabu District 1 13 November 2022 [5] [1]
Kampala District 17 2 13 November 2022 [5] [1]
Wakiso District 3 13 November 2022 [5] [1]
Masaka District 1 1 13 November 2022 [5] [1]
Jinja District 1 + 1 probable 1 + 1 probable 13 November 2022 [5] [1]
Total (140 confirmed + 22 probable) 162 Total (55 confirmed + 22 probable) 77 Total 13 November 2022 [5] [1]

Response[edit]

According to Jane Aceng, Uganda's health minister, local people initially believed the new Ebola outbreak was caused by witchcraft.[17] Aside from this misinformation, there are also no effective vaccines against the Sudan ebolavirus,[8] and merely early supportive care is the best management option of an infected person, but experts are hopeful that much has been learned about infections with Ebola viruses, including diagnosis, contact tracing and how to improve survival.[35] The World Health Organization (WHO) has been supporting the Ugandan Ministry of Health with surveillance, communication and coordination efforts.[8] Similarly, Médecins Sans Frontières has been supporting the Ministry of Health with deploying initial emergency response.[36]

The International Federation of Red Cross and Red Crescent Societies (IFRC) has appealed for emergency aid to Uganda.[3] The European Union has responded to the request with €200,000 in initial emergency funding.[37]

On 6 October 2022, the United States announced that they would begin screening air passengers from Uganda for cases of Ebola.[38]

According to Ana Maria Henao-Restrepo and her team in WHO’s Health Emergencies Program, an adenovirus based vaccine developed by the Sabin Vaccine Institute in a partnership with the Vaccine Research Center at the US National Institute of Allergy and Infectious Diseases will be offered to contacts of known cases as part of a clinical trial.[39]

On 15 October 2022, the first lockdown came into effect. The lockdown, affecting the Mubende and Kassandra districts, prevents anyone, except cargo trucks, from leaving or entering the districts for three weeks. Furthermore, bars, nightclubs, places of worship and entertainment venues are closed and a curfew is in place.[40]

On 17 October 2022, president Museveni put Kampala under high response alert after two cases from Mubende reached the capital. One of the patients died. Museveni also warned that there had been contacts and risks of infections in the city.[41]

The United States has sent the antiviral drug remdesivir and the experimental combination of antibodies MBP134 to Uganda to help protect healthcare workers from the outbreak with CDC-responsible Joel Montgomery saying that if healthcare workers are at risk, then it will negatively impact the response to the outbreak.[42] Supply shortages , for example inadequate PPE, and limited food for those in quarantine have meant that patients and contacts have escaped isolation; interns have only been paid every three months, meaning they were unable to cope with the rising cost of living, all of which are important issues in the response to stem the epidemic.[43]

Transmission and virology[edit]

Ebola is mainly spread through contact with bodily fluids. The average case fatality rate of Ebola (all 4 viruses) is 50%.[44] In this outbreak of Sudan Ebolavirus, the case fatality rate has been 39%.[19]

Misinformation[edit]

Some politicians and other public figures opposed to the 36-year rule of President Yoweri Museveni have declared that the Ebola outbreak is fake or exaggerated, and that Ugandans are being used as vaccine "lab rats" to enrich the ruling party. Individuals such as former presidential candidate Joseph Kabuleta further claimed that Ebola vaccines may have deadly side effects, similar to his earlier claims about COVID‑19 vaccines.[45]

A contributing factor in misinformation campaigns has been what researchers observed to be uneven application of public health measures to stifle dissent during the COVID-19 pandemic.[46] Ugandan Health Minister Margaret Muhanga cited opposition politicization of the Ebola outbreak as a key concern, however an independent fact-checking organization in Uganda has found that a lack of community education regarding disease spread is more widespread than targeted misinformation.[45]

Citizens have also expressed fears of heavy-handed lockdowns at a time when the economy was still struggling with the fallout from nationwide COVID-19 lockdowns and ongoing global inflationary pressures.[47] Museveni had locked down Mubende and Kassanda districts as of November 2022, but promised no national lockdowns akin to those deployed for COVID-19. Markets, bars, and churches were to be closed for the duration of the localized lockdowns, together with travel bans and dawn-to-dusk curfews.[48]

References[edit]

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External links[edit]