We are prepared for Ebola – Government

The Ministry of Health has dispatched a team of epidemiologists to Mubende to trace and isolate individuals who got in contact with confirmed or suspected Ebola Virus Disease (EVD) victims.

This publication was the first to break news of the outbreak of EVD in Uganda on Tuesday before Health ministry Permanent Secretary, Dr Diana Atwine, later made the official announcement at an emergency press conference in Kampala. 

She identified the type, confirmed during tests by Uganda Virus Research Institute (UVRI), as “Sudan strain”, which is different from the Ebola Zaire strain battering eastern Democratic Republic of Congo, which shares end-to-end eastern border with Uganda.

READ: Govt starts Ebola vaccination for UPDF soldiers in DR Congo

Dr Atwine told yesterday’s media briefing attended by representatives from the World Health Organisation (WHO) and the United States Centers for Disease Control (CDC) that the government was prepared to handle the Ebola outbreak  and any epidemic.  

“We have already dispatched a team that has gone to work alongside the district rapid response teams, especially in the community tracking all the contacts of those who died and isolate [the contacts],” she said.   

She added: “We got the results on Monday and we are still investigating the source. But we have sent epidemiologists on the ground and they are working backwards to trace the contacts.”

HERE: 21 districts at risk of Ebola as DRC declares resurgence

The Health ministry’s briefing notes show that residents and health workers initially treated patients who presented with Ebola-like symptoms as suffering from a “strange” disease.

Earlier victims, among them six – three adults and three children - who have died in Kiruma and Madudu Madudu sub-counties since start of the month, were cared for and buried without observing protocol applicable for Ebola victims.

The epidemiologists on the ground in Mubende are, among others, conducting verbal autopsies to assess whether the dead, other than the 24-year-old, whose case was on Monday confirmed to be Ebola, succumbed to the disease.

With Ebola taking anywhere between two days and three weeks to manifest, surveillance teams were racing against time amid concerns that the number of possible contacts and areas of reach of the disease could be more and wider than initially thought.

ALSO: Kisoro asks for Ebola screening equipment

The man confirmed to have died of Ebola passed on at Mubende Regional Referral Hospital on September 19, four days after he was referred from St John’s Medical Clinic in the East Division of Mubende Municipality, where he had spent three days.

“He presented with high grade fever, convulsions, blood stained vomitus and diarrhoea, loss of appetite and pain on swallowing, chest pain, dry cough and bleeding in the eyes,” Dr Atwine said.

While at the isolation unit at Mubende Regional Referral Hospital, he developed yellowing of the eyes, tea-coloured urine and complained of abdominal pain.

This prompted the clinical team to extract samples from him for testing at UVRI, which tested positive for Ebola Sudan variant.

Health ministry honchos are expected to issue guidelines for the public and health workers in managing the disease and preventing transmission.

At yesterday’s press conference, Ms Amy Boore, the programme director in the Division of Global Health Protection at the CDC, revealed plans to support UVRI and Uganda in containing Ebola.

“The USA government in general is aware and they will offer the necessary support during this period,” she said.

Uganda has had at least three previous episodes of Ebola Virus Disease, registering both the Zaire and Sudan strains, the most deadly being in 2000 that killed hundreds in Gulu, including its lead treatment Doctor Mathew Lukwiya. 

Lt Col Henry Kyobe, the incidence commander in the Ministry of Health, said yesterday that they have instituted preliminary measures to control transmission of the viral disease, both within and outside Mubende.

“We have sent our rapid response team to go ahead and do what we call oral/verbal postmortem to guide deeper and see whether the people who passed on could have had symptoms similar to Ebola symptom,” he said.

Lt Col Kyobe added: “Those found with Ebola symptoms will be probable cases, but the team will go ahead to trace the contact of those cases who will be with such symptoms similar to Ebola, they will assess the contacts for any symptoms and those that will have symptoms will be referred to healthy facilities, isolated and given treatment and samples taken.” 

The contacts that will not present any symptoms will be followed up progressively for the next 21 days for any development of symptoms.

Like Dr Atwine, Lt Col Kyobe said the source of the current strain is not yet known.

“For now, we don’t know the source of infection, what we know is that the strain which is circulating is Ebola Sudan. We can’t speculate that it came from [DR] Congo because currently, what is circulating in Congo is Ebola Zaire …,” he explained.

Ministry of Health guidelines

●    Health professionals should supervise and make sure they handle dead bodies according to standard operating procedures.

●    Public facilities to provide hand-washing facilities.

●    Private clinics to observe the stand operating procedures and report any suspected Ebola case to the nearest district heath authorities for further investigations and management.

●    Caretakers to wear gloves to limit infection.

The ministry encourages the public to call toll-free line 0800100066 to report any suspected cases.

The government urged people to avoid physical contacts with anyone with Ebola-like symptoms, continue with washing hands and avoid contact with body fluids that include urine, blood, sweat saliva, vomits and stool of infected persons.   

The ministry urges all health workers to have the highest index of suspicions and maintain heightened safety precautions.

Govt rules out travel restrictions

Dr Atwine, has said the government is not imposing travel restrictions, despite the confirmation on Monday that Ebola Virus Disease (EVD) had killed one person in Mubende District.

“Uganda is safe and all national and international travellers are free to travel to and within the country. All places of economic and social interaction such as national parks, tourist sites are open and accessible to the public,” she said.

She, however, called upon the population across the country, and Mubende sub-region in particular, to remain calm but vigilant and promptly report any suspected case to the nearest health facility for assessment.

Dr Bayo Fatunmbi, the World Health Organisation Cluster lead for Communicable and Non-Communicable Diseases, said the vaccine that is being used to vaccinate people in the Democratic Republic of Congo against the Zaire strain cannot be used to vaccinate against the Ebola Sudan strain. He said testing is underway to assess the efficacy of a vaccine developed by the American drug maker, Johnson&Johnson, in fighting Ebola Sudan strain.

“Prevention is better than cure. Let us embrace infection control and prevention measures. Somebody might not be showing signs and symptoms, yet carrying the strain. The incubation [period] for Ebola Sudan period is two to 21 days,” he said.

What is Ebola?

Ebola Virus Disease, formerly categorised as haemorrhagic fever, is an acute infection that can turn fatal if left untreated, according to the United Nations health watchdog.

The World Health Organisation (WHO) says Ebola is transmitted through close contact with blood, secretions, organs or other bodily fluids  of infected animals such as  fruit bats, chimpanzees , gorillas, monkeys, forest antelope or porcupines found ill , dead or in rainforest.

Human-to-human transmission is possible through direct contact with body fluids, mucous or blood of an infected person.

One can also get infected if they come into contact with objects that have been contaminated with blood and fluids like blood, faeces, and vomit of an infected person.

The symptoms include sudden onset fever, fatigue, chest pain,   diarrhea, vomiting, unexplained bleeding, yellowing of the eyes.

Bleeding manifestation is usually a late presentation after the above symptoms.

This is the second Ebola Sudan strain in Uganda. The first case was reported in Luweero in 2012. Uganda’s worst Ebola outbreak was in 2000, and it killed hundreds in Acholi, including Dr Mathew Lukwiya, the lead doctor treating the patients.

Source: World Health Organisation and Ministry of Health