There are growing fears that the latest outbreak of Ebola in Uganda could spread to neighbouring countries such as the Democratic Republic of the Congo (DRC).
Unlike the and the , this epidemic has been caused by the Sudan variant of the virus, which currently has no effective treatment or vaccine.
As of 2 October, Uganda鈥檚 Ministry of Health said 43 people were known to have been infected with the virus. Nine deaths from Ebola have been confirmed in laboratory tests, and 20 further deaths are thought to have been from Ebola.
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Most cases are in people aged between 20 and 29, according to the Ministry of Health. There have been 10 cases so far in children aged 9 or younger.
On 1 October, the Ministry of Health announced that a doctor had been killed by the disease 鈥� the聽country鈥檚 second healthcare worker to die in this outbreak. Jane聽Aceng, Uganda鈥檚 minister for health, also confirmed last week that 65 healthcare workers had been exposed to the disease and were in quarantine.
Ebola mainly spreads via contact with an infected person鈥檚 bodily fluids, such as blood, faeces or vomit. Symptoms include fever, muscle pain and vomiting. Fatality rates of the Sudan variant have varied from 41 per cent to 100 per cent in previous outbreaks, according to the .
The virus is generally only spread by people when they are symptomatic, says at King鈥檚 College London. This makes it easier to find infected people and their contacts and isolate them.
But one issue that health officials in Uganda face is that many of the Ebola cases they have discovered in this outbreak appear to centre around in central Uganda.
鈥淕old mining is an industry which has a lot of transient workers and so people will just come in for a bit and then leave again and cross borders,鈥� says MacDermott. 鈥淚t makes it much harder to trace people and work out what鈥檚 going on.
鈥淵ou also tend to find more prostitution in such areas and so obviously that increases the risk of spread,鈥� she says. 鈥淚 think there鈥檚 a good risk that it could spread across the border to the Democratic Republic of [the] Congo, given that [the gold mine is] on a main road into the DRC.鈥�
Zeles Nabusaye, who heads a local health surveillance team in Uganda, says her team is preparing isolation centres in districts with suspected cases. Contact tracers have already tracked 400 potential contacts of people infected with the Sudan variant, she says. 鈥淭his one has spread from one district to other districts 鈥� it will not be an outbreak that is easily controlled,鈥� she says.
The provision of personal protective equipment (PPE) for healthcare workers is also an issue. Some staff at Mubende鈥檚 regional hospital in Uganda have to protest the lack of PPE they have been provided with to treat Ebola patients.
Both Kenya and have tightened their borders with Uganda and are using non-contact thermometers to check the temperatures of people crossing the border.
This is the first outbreak of the Sudan variant of Ebola in Uganda since 2012, according to the WHO. Other major outbreaks of the disease in recent years have been caused by the Zaire variant, which can be tackled with approved vaccines.
In 2020, health workers in the DRC fought an outbreak of the Zaire variant using a ring vaccination strategy, in which people with the virus, their contacts and healthcare and frontline workers were quickly vaccinated. More than were vaccinated through this approach.
There is no approved vaccine against the Sudan variant but the WHO hopes to conduct of an experimental vaccine in Uganda this year. 鈥淲e will be able to move fast and start the evaluation of the vaccines as soon as possible,鈥� said Anna Maria Henao-Restrepo, the co-chair of the WHO鈥檚 research and development blueprint, at a .
In a on 28 September, Uganda鈥檚 president Yoweri Museveni called for calm. 鈥淭he government has got capacity to control this outbreak as we have done before,鈥� he said. 鈥淭herefore there is no need for anxiety, panic, restriction of movement or closure of public places.鈥�
Nabusaye is similarly confident in her country鈥檚 ability to contain the disease. 鈥淥ur surveillance system is strong and all our health facilities are on the lookout,鈥� she says.
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