On 20 September 2022, the health authorities in the Republic of Uganda declared an outbreak of Ebola disease caused by Sudan ebolavirus, after a case was confirmed in a village in Madudu sub-County in Mubende District, central Uganda on 19 September, according to a press release issued by the World Health Organization on 28 October. As of 26 October, a total of 115 confirmed and 21 probable cases, including 32 confirmed and 21 probable deaths (a fatality rate among confirmed cases of 27.8%) have been reported. Overall, 15 cases with four deaths have been reported among healthcare workers. A further 1844 contacts were under surveillance in nine districts of the country on 26 October. A cumulative total of 3166 contacts have been listed since the start of this outbreak, of which 1194 (37.7%) have completed the follow-up period of 21 days. A total of 94 'safe and dignified burials' have been undertaken since the beginning of the outbreak, of which 92 were community burials.
The most affected district is Mubende, which has reported 63 cases (54.7% of the total number reported) of all confirmed cases, and in particular Madudu sub-County with 21 confirmed cases reported (18.2% of all confirmed cases). Since the previous week (20 October 2022), two additional districts reported new cases, bringing the total number of affected districts to seven.
Ebola Virus Disease is caused by RNA Viruses of the genus Ebolavirus. It has a reputation for being the world's deadliest viral disease, at least in part due to the 1995 film Outbreak, though this is probably slightly inaccurate as about 50% of victims survive, making it less deadly than diseases such as Rabies. The most common strain of Ebolavirus, Zaire ebolavirus, is extremely contagious, with know known cure, and has a tendency to rapidly overwhelm local health systems as health workers themselves are infected. Sudan ebolavirus has a lower transmission rate than Zaire ebolavirus, and Uganda has experience in responding to outbreaks of Zaire ebolavirus and Sudan ebolavirus and necessary action has been initiated quickly. The current outbreak is the first outbreak of Sudan ebolavirus in Uganda since 2012. In the absence of licensed vaccines and therapeutics for prevention and treatment of Sudan virus disease, the risk of potential serious public health impact is high.
Ebola begins with a fever similar to that caused by Influenza or Malaria, which tends to come on rapidly two-to-three weeks after infection (during at least part of which time the patient is already infectious). This tends to be followed by extreme respiratory tract infection, headaches, confusion, rashes and tissue necrosis and heavy bleeding. Death is generally caused by multiple organ failure.
The only known treatment for Ebola is intensive rehydration, which can improve the survival prospects of patients greatly, accompanied by anticoagulants and procoagulants to mange the diseases attacks on the circulatory system, analgesia to cope with the pain of the disease and antibiotics and antimycotics to prevent secondary infection. Due to the highly contagious nature of the disease it is recommended that healthcare workers wear full-body protection to maintain a barrier between them and their patients; a daunting prospect in the tropical regions of Africa where the disease is endemic.
Ebolavirus is thought to have a non-human animal vector, since its rapid onset and high mortality rate appears to preclude a permanent residence within Human hosts. Surveys of wild animals have found Ebola infections in Rodents and Great Apes, however these were affected by the disease in a similar way to Humans, and are therefore unlikely permanent hosts. The most likely vectors are thought to be Fruit Bats or small Primates, which are endemic to the areas where the disease occurs and which are widely eaten; cooking meat probably kills the virus, but there is a distinct danger of infection while preparing carcasses.
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