Intended for healthcare professionals


Ebola: Uganda battles fresh epidemic as infections threaten to spread

BMJ 2022; 379 doi: (Published 07 October 2022) Cite this as: BMJ 2022;379:o2420
  1. Henry Wasswa
  1. Kampala

Ugandan health authorities are setting up emergency response teams, isolation centres, and treatment tents in 20 places around the central Mubende district after the first death from a new outbreak of Ebola virus disease was announced on 19 September.

The outbreak has so far claimed the lives of 10 people, including a doctor and three other health workers, out of the total number of 43 confirmed cases. The health ministry tweeted on 6 October that four patients had been discharged from Mubende Hospital, with 39 continuing to receive treatment.

The ministry and the World Health Organization have identified the strain as the rare Ebola-Sudan, which has no known vaccine.

Over 800 close contacts of people who are infected with Ebola virus have been identified, the ministry said, and a further 19 probable Ebola deaths have been recorded since 19 September.

Ugandan government officials are working with, among others, WHO, the US Centers for Disease Control, Médecins Sans Frontières, Unicef, USAID, and the Red Cross to contain the epidemic. As well as testing and isolation hubs, they have set up mobile Ebola testing facilities in Mubende’s referral hospital to test samples that had originally been taken to a national virus institute south east of Kampala.

Emmanuel Ainebyoona, a ministry spokesman, told The BMJ, “We deployed a mobile laboratory to support Ebola virus testing for the region. We get alerts from deep in the villages. and we test the samples there and then. It’s to ease the testing load and reduce the turnaround time of results.”

The current Ebola outbreak is the seventh in the east African country since the deadliest one in 2000, which killed 224 of 425 infected people.

The outbreak in Uganda occurs as neighbouring Democratic Republic of Congo announced an end to its own outbreak, in which just one person became infected. The strain in that case was the Zaire ebolavirus, one of the six species of the Ebola genus.

Uganda’s president, Yoweri Museveni, has downplayed the current problem despite the fact that in just under three weeks the virus has spread to five other districts in Uganda to the north and west of Mubende. “Ebola is not as dangerous as covid-19. It’s easy to fight this enemy—there is no need for anxiety,” he said.

However, authorities in Mubende district are urging people to avoid large gatherings, crowded places like markets, discos, weddings, and funerals. As worry spreads, some schools are seeing just half their pupils attend classes.

The health ministry has set up a toll free hotline for people to report any suspected Ebola cases. It has also publicised the symptoms of Ebola in newspapers and social media as red eyes, severe headache, coughing blood, sore throat, and vomiting. Posters in public areas also warn that the Ebola virus can be transmitted through syringes, clothing, blood, saliva, sweat, and urine of an infected person.

An Ebola task force, formed in 2000, has been reactivated, and the unit includes doctors and nurses from various institutions, including the military.

The Uganda Red Cross has been picking up people with suspected Ebola carrying out burials of those thought to have had Ebola.

Joseph Kasumba, a doctor with the Red Cross, told The BMJ, “We are engaged in case management and community based surveillance. Once we handle the dead bodies, [and] the suspect or infected people, we secure the places involved and disinfect the environment around.”

International responses

The UK Health Security Agency has urged health providers to ensure that relevant clinical services—particularly primary care, urgent care, and emergency departments—to ensure they have adequate stocks of appropriate personal protective equipment and that relevant staff are trained in its use for the assessment and treatment of patients presenting with possible Ebola virus disease.

The agency emphasised that there has never been a case of Ebola virus disease contracted in the UK. Two cases contracted overseas were transported to the UK in 2014, and both people recovered after treatment.

In the US federal authorities said that they would screen passengers who have travelled in Uganda in the previous three weeks for Ebola at five designated airports. They will undergo temperature checks and verification of their contact data for follow-up. The screening is based on the fact that it can take 21 days for symptoms of Ebola virus disease to appear, which is when they become contagious.