DRC Ebola outbreak spreads to neighboring Uganda, activating rapid preparedness response

Several Ebola cases were treated here at Kagadi Hospital in Kibaale District, Uganda, in August 4, 2012. Three new cases have been identified in people who entered Uganda from the DRC border. Photo by CDC via Flickr: CC BY 2.0.

On June 12, Ugandan officials from the Ministry of Health released a press statement confirming two Ebola cases. A 5-year-old boy and his grandmother, 50, tested positive for Ebola on June 10 and died two days later, on June 12. A younger brother, 3, is being kept in isolation, along with a 23-year-old man unrelated to the family, at a hospital in Bwera, on the DRC-Uganda border district of Kasese, western Uganda.

The family of three were traveling to Uganda from the neighboring Democratic Republic of Congo:

NTV Uganda later confirmed the grandmother's death:

Ebola is a rare, often fatal virus that spreads through close human contact with fluids like blood, feces, vomit. According to the Center for Disease Control, the disease gets its name from the first case discovered in 1976 near the Ebola River in what is now the Democratic Republic of Congo, with outbreaks in several African countries as well as England, Italy, Russia and the Philippines. Symptoms include high fever, severe headache, muscle pain and unexplained hemorrhaging.

Neighboring DRC has been battling an Ebola outbreak in North Kivu Province since August 2018, that has been difficult contain due to armed conflict, disinformation and mistrust. The latest figures from DRC's Ministry of Health show that nearly 1,400 people have died in DRC of the Ebola Virus Disease (EVD) since August 2018, but the World Health Organization (WHO) has hesitated to declare it a “Public Health Emergency of International Concern,” or “PHEIC” — until now.

With close proximity to Uganda, these cases have confirmed fears over the likelihood of Ebola cases appearing at some point, due to frequent, informal and porous cross-border migration. In August 2018, when the Ebola virus broke out in North Kivu, Uganda kickstarted Ebola preparedness and surveillance activities in 22 districts bordering DRC to prevent the disease from crossing into Uganda.

The Ministry of Health set up Ebola Treatment Units (ETUs) at Bundibugyo General Hospital, Bwera Hospital in Kasese, where the boy and his grandmother were treated and died, and Rwebisengo Health Center in Ntoroko district.

This is not the first time Uganda has confronted Ebola, but these are the first reported cases in Uganda carried into the country via DRC's current Ebola crisis.

Now that Ebola has spread to Uganda and potentially other countries like neighboring Rwanda and South Sudan, WHO is calling an emergency meeting on June 14 in Geneva to discuss the potential designation of the crisis as a PHEIC:

Tedros Adhanom Ghebreyesus, director-general of WHO, commended the Ugandan health ministry for recognizing the need for nationwide action to prevent the spread of Ebola. He says that Ugandan officials vaccinated nearly 4,700 health workers in 165 health centers, including the hospital where the infected boy and grandmother were treated before they died:

According to a WHO report from 2018, Uganda's Ministry of Health began to strengthen its Ebola response system. Activities include “strengthening surveillance, capacity-building in contact tracing, laboratory diagnostics, infection prevention, and control, [and] clinical management of patients including psychosocial care, safe and dignified burials, enhanced risk communication and community engagement.”

According to the report, Mpondwe border point registers over 20,000 people during the market days. Border officials screen for body temperature for those crossing into Uganda from DRC is screened for body temperature, and those with high fevers are further screened for Ebola-like symptoms:

Uganda has called on communities to halt border markets in the wake of its confirmed Ebola cases.

Since last year, health educators have gone door-to-door to make visits and educate people and Ebola messages also run on TV and radio.

Local phone numbers listed as Ebola hotline in Kagadi Hospital, Kibaale District, 2012, when an Ebola outbreak occurred. Photo by CDC via Flickr: CC BY 2.0.

Ugandan netizens have expressed fear about the new cases but also praise for the Ugandan government's quick response and proven commitment to detection and prevention:

This is not the first time Uganda has faced Ebola and managed to contain it, though the strain is different this time:

In 2012 alone, Uganda dealt with two Ebola outbreaks that left 21 people dead. Uganda's record in responding to epidemic viral diseases is starkly different from many countries in the region because of its heavy investment in the Uganda Virus Research Institute (UVRI) and its standing as a “world leader in virus surveillance.”

Uganda now faces a unique threat because the outbreak has spread from neighboring DRC, with its long borderline and an unrelenting Ebola outbreak.

Uganda has banned public gatherings in Kasese district. WHO reassured, however, that movement across the DRC-Uganda borders has not been restricted at this time.

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