Deadly Ebola outbreak spreads in Uganda’s capital

The first Ebola patient in Kampala died at the National Referral Hospital last week, but the death was only confirmed on Tuesday, sparking fears that the disease is silently circulating in the suffocating city of more than three million. Kampala is an important transit point for regional trade routes to the inland economies of Rwanda, Burundi and the eastern Democratic Republic of Congo.

Neighboring countries – their health care systems battered by the Covid-19 pandemic and economic downturn – have stepped up border controls to stop the spread of the virus. Last week, federal officials ordered U.S.-bound passengers who had been in Uganda in the past 21 days to arrive at select airports for enhanced screening for Ebola.

On Wednesday, health ministers from at least 11 neighboring countries gathered in the Ugandan capital for an emergency meeting with the World Health Organization and Africa’s Centers for Disease Control and Prevention to find ways to deal with the outbreak.

“Our primary focus now is to quickly control and contain this outbreak to protect neighboring regions, as well as neighboring countries,” WHO Director-General Tedros Adhanom Ghebreyesus told the meeting. “While the outbreak is concerning, it is not unexpected.”

The death toll from the current outbreak stands at 38 out of 73 confirmed and probable cases, the highest in Uganda since the 2000 outbreak that killed 224 people. Although the Sudan strain is considered less deadly than some of the other previous strains, there is no effective vaccine: Mortality rates range from 41% to 100%, according to the WHO.

The outbreak started in the Mubende Forest Rural District but has spread to six more districts. Deaths from an Ebola-like illness were first reported in early August but were not confirmed as the deadly Ebola until late September, raising fears that there may be more unknown cases.

Most outbreaks in recent years, including the 2014-16 outbreak that killed more than 11,000 people across West Africa, were caused by the Zaire strain of Ebola, which can be effectively contained with 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 insufficient. Trainees at the main Ebola treatment center have gone on strike over a lack of protective clothing. Many frightened patients have left 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 an Ebola contact, health officials said. But the patient managed to leave his village to visit a traditional healer near Kampala. His condition worsened, forcing him to seek treatment at a national referral hospital. Since his death, health authorities have identified and quarantined 42 people who came into contact with him, including health workers at the hospital and the traditional healer.

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

To tackle the outbreak, Uganda is fast-tracking regulatory approvals to begin clinical trials on two vaccines being developed for the Sudanese strain, the health ministry said. A WHO spokeswoman said the most advanced vaccine candidates likely to be developed in Uganda include one being developed by the Washington-based Sabin Vaccine Institute and another by Oxford University’s Jenner Institute.

Write to Nicholas Bariyo at [email protected]