Deadly Ebola Outbreak Spreads to Uganda’s Capital

The first Ebola patient in Kampala died at the National Referral Hospital last week, but the death was only confirmed Tuesday, triggering fears that the disease has been silently circulating in the traffic-choked city of more than three million. Kampala is a major transit point for regional trade routes to the landlocked economies of Rwanda, Burundi and eastern Democratic Republic of Congo.

Neighboring countries—their healthcare systems battered by the Covid-19 pandemic and economic downturns—have bolstered border controls to stop the virus spreading. Last week, federal officials ordered U.S.-bound passengers who have been in Uganda in the past 21 days to arrive at select airports for enhanced Ebola screening.

On Wednesday, health ministers from at least 11 neighboring countries converged in the Ugandan capital for an emergency meeting with the World Health Organization and Africa Centres for Disease Control and Prevention to devise means on how to respond to the outbreak.

“Our primary focus now is to rapidly control and contain this outbreak to protect neighboring districts, as well as neighboring countries,” WHO Director-General

Tedros Adhanom Ghebreyesus

told the meeting. “Although the outbreak is troubling, it is not unexpected.”

The death toll of the outbreak stands at a likely 38 from 73 confirmed and probable cases, the highest in Uganda since the 2000 epidemic that killed 224 people. Although the Sudan strain is considered less lethal than some of the other earlier strains, there is no effective vaccine: Case-fatality rates range from 41% to 100%, according to the WHO.

The outbreak started in the forested farming district of Mubende, but has spread to six more districts. Deaths from an Ebola-like disease were first reported in early August, but were only confirmed as the deadly Ebola in late September, raising fears that there might be more unknown cases.

Most outbreaks in recent years, including the 2014-16 epidemic that killed more than 11,000 people across West Africa, were caused by the Zaire strain of Ebola, which can effectively be contained by antiviral treatments and vaccines.

Complicating Uganda’s response efforts is the state of the country’s health facilities, which are in disarray after more than two years of battling the Covid-19 pandemic. Medical supplies are inadequate. Trainee doctors at the main Ebola treatment center have gone on strike for want of protective wear. Several frightened patients have fled Ebola treatment centers, while some patients prefer to seek treatment from traditional herbalists, further spreading the disease.

The patient who died in Kampala was known to health authorities as a contact of the Ebola virus, health officials said. But the patient managed to leave his village to visit a traditional healer near Kampala. His condition deteriorated, forcing him to seek treatment at a national referral hospital. Since his death, health authorities have traced and quarantined 42 people who came into contact with him, including health officials at the hospital and the traditional healer.

A team of health specialists led by WHO Executive Director Michael J. Ryan arrived in Uganda this week to assist with the response efforts. Ugandan authorities have appealed for $18 million from donors to respond to the outbreak, but so far WHO has released $2 million from its contingency fund. Other agencies including Doctors Without Borders and International Rescue Committee have also sent medical supplies and specialists.

To counter the outbreak, Uganda is fast-tracking regulatory approvals to commence clinical trials on two vaccines being developed for the Sudan strain, the Health Ministry said. A spokeswoman for the WHO said that the most advanced vaccine candidates likely to be deployed in Uganda include one being developed by the Washington-based Sabin Vaccine Institute and another from the University of Oxford’s Jenner Institute.

Write to Nicholas Bariyo at [email protected]