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TIMELINE
August 2022: The IFRC alerts the URCS to take stock of their preparedness efforts after an EVD outbreak in eastern DRC.
20 September 2022: The government declares an EVD outbreak in Mubende district.
22 September 2022: DREF allocation CHF 499,259 for the initial response of the URCS in Mubende and neighbouring highrisk districts.
25 September 2022: IFRC Juba cluster delegation operations, finance and logistics staff deployed alongside a CP3 health delegate and epidemic preparedness delegate from the Africa regional office.
28 September 2022: The IFRC issues a Federation-wide Emergency Appeal for CHF 10M for 2.7 million people for one year.
DESCRIPTION OF THE EVENT
In a statement issued on 20 September 2022, the Ministry of Health of Uganda announced a positive case of the Ebola virus disease (EVD) which indicates an outbreak of the Sudan strain in the district of Mubende (130 km west of the capital, Kampala).
Sudan (SUDV) virus disease is a severe and often fatal illness affecting humans. First reported in southern Sudan in June 1976, it has since then, emerged periodically. Up to now, seven outbreaks caused by SUDV have been reported, four in Uganda and three in Sudan. The four in Uganda were reported in 2000, 2011 and 2012 (two outbreaks).
Uganda also reported a Bundibugyo virus disease outbreak in 2007 and an Ebola virus disease outbreak in 2019.
There are no licensed vaccines or therapeutics for the prevention and treatment of SUDV. The estimated case fatality ratios of SUDV have varied from 41% to 100% in past outbreaks.
Severity of humanitarian conditions
1. Impact on accessibility, availability, quality, use and awareness of goods and services.
Since the outbreak declaration and as of 14 October, the number of confirmed cases has increased to 58, with 40 deaths (confirmed and probable). The virus has now spread to an additional five districts. Although the outbreak was declared 20 September, probable EVD deaths had already occurred in previous weeks; the current hypothesis is that the outbreak may have started in late August or early September, meaning that multiple chains of transmission were likely already in existence at the time of the first case confirmation. The highest risk is still concentrated in Mubende districts as shown by the number of high-risk contacts. However, movement of high-risk contacts from the epicentre to the neighbouring districts has led to the emergence of clusters in Kyegegwa, Kagadi, Bunyangabu and Kassanda. In addition, a confirmed case has died in Kampala, the capital. The surveillance pillar is reviewing its risk mapping and ramping up surveillance activities in all districts with contacts.
The incubation period ranges from 2-21 days. People infected with Sudan virus cannot spread the disease until they develop symptoms, and they remain infectious as long as their blood contains the virus.
2. Impact on physical and mental well-being
The Ebola virus, part of the class of filoviridae, has multiple strains, of which, the Zaire and Sudan strains are the most common. SUDV is a severe and often fatal illness. Up to now, seven outbreaks caused by SUDV have been reported, four in Uganda (the last one in 2012) and three in Sudan. The estimated case fatality ratios of SUDV have varied from 41% to 100% in past outbreaks. While a vaccine and specific treatment exist for the Zaire strain, neither exists for the Sudan strain. However, treatment of specific symptoms and supportive care improve the chances of survival.
Ugandan authorities and partners are facing challenges in understanding the depth of the outbreak and containing the spread of the virus.
Misinformation, issues of mistrust, and conspiracy theories have spread quickly across the region. This is compounded with low-risk perception, fear of treatment centres, and dissatisfaction with the response. This results in ongoing practices that heighten the risk of transmission, people not engaging in response actions, not seeking early treatment, escaping health facilities, evading contact tracing, and instances of resistance against response teams and health workers.
The other challenges are related to inadequate staffing, lack of appropriate infection prevention and control (IPC) at health facilities, and inadequate isolation units and overall capacity to conduct safe and dignified burials (SDBs).
3. Risks & vulnerabilities
Given the mobility of communities across the highrisk districts for cultural, and trade reasons there are significant risks of an expansion of the affected area outside the Mubende district and beyond the neighbouring districts including Kampala. There are also risks of the disease spreading to adjacent countries – the DRC, Kenya, South Sudan, Burundi, Tanzania, and Rwanda.
