UGANDA – The Sudan ebolavirus (SUDV) seems to be rising at an alarming rate in Uganda. Since the outbreak declaration on 20 September, a total of 141 confirmed cases and 55 confirmed deaths (CFR 39%) have been reported by the Uganda Ministry of Health as of 21 November.
In addition, 22 probable cases (all are deaths) have been reported since the beginning of the outbreak. Overall, 19 cases with seven deaths occurred among healthcare workers (HCWs).
According to WHO, the weekly number of confirmed cases reported has decreased for the third consecutive week after the peak observed in the week 17-23 October.
During the week commencing 7 November, five confirmed and one probable case was reported, including one confirmed case and one probable death from a newly affected district (Jinja), in the Eastern Region of Uganda, which is 80 km distant from Kampala.
The most recent confirmed case was reported by the Uganda MoH on 14 November, from Kampala district.
A higher proportion of cases are male (57.5%), and the most affected age group is represented by those aged 20-29 years, followed by those aged 30-39 years.
Around 25% of cases are reported among children under 10 years old, indicating potential household transmission.
Since the last DON published on 10 November, one newly affected district has been reported (Jinja), leading to a total of nine districts that have reported confirmed SVD cases.
The most affected district remains Mubende with 64 (45%) confirmed cases and 29 (53%) confirmed deaths, followed by Kassanda with 48 (34%) confirmed cases and 20 (36%) confirmed deaths. Two districts, Bunyangabu and Kagadi, have not reported cases for more than 42 days.
Although there is significant improvement in surveillance activities in most affected districts, contact tracing gaps have been reported in newly affected districts.
The suboptimal performance could be attributed to different factors, such as the non-reporting of probable cases, high population mobility including the movement of non-listed and/or missing contacts, and initial gaps in human and material resources.
Surveillance strengthening plans have been put in place in newly affected districts.
Since the beginning of the outbreak, 4652 contacts have been registered, of which 3599 (78%) have completed the 21-day follow-up period.
As of 21 November, a total of 700 contacts in five districts (Jinja, Kampala, Kassanda, Masaka, and Mubende) were under active surveillance.
In the week commencing 14 November, the average follow-up rate was 65%, representing a decrease of 26% in the follow-up rate as compared to 91% the previous week. Follow-up rates have been particularly low in Jinja and Masaka, at an average of 42% and 53%.
The daily number of alerts received has not been regularly reported to WHO since 7 November, however, the number of alerts verified has been reported.
During the week commencing 14 November, at least 953 alerts were verified (daily average 159), of which 335 (35%) met the definition of a suspected case.
Advice from WHO
According to WHO, successful SUDV disease outbreak control relies on applying a package of interventions, including case management, community engagement, surveillance and contact tracing, strengthening laboratory capacity, safe and dignified burials.
It recommends that health-care workers should always take standard precautions when caring for patients, regardless of their presumed diagnosis. Implementation of IPC measures in health care (e.g., hand hygiene, training of health workers, adequate personal protective equipment (PPE) supplies, waste management, environmental cleaning, and disinfection etc.) with ongoing monitoring and supervision for implementation is required to reduce risks of health care facilities amplifying the outbreak.
Ensuring the provision of safe and dignified burials, supporting IPC in community settings (including adequate WASH facilities, hand hygiene capacity and safe waste management) and community engagement and social mobilization are essential to prevent and mitigate ongoing transmission.
Upon case identification, early initiation of supportive treatment has been shown to significantly improve survival.
Establishing active surveillance at points of entry is an essential component of the outbreak response to mitigate the risk of international spread due to the high cross-border mobility between Uganda and neighbouring countries.
WHO advises against any restrictions on travel and/or trade to Uganda based on available information for the current outbreak.
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