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  • Writer's pictureStudents for Global Health UCL

Ebola Strikes Back: key takeaways from the 2022 Ugandan outbreak

Bleeding in his eyes, a 24-year-old patient was admitted to Mubende Regional Referral

Hospital on 15 September 2022. He had presented with convulsions, high fever, and blood-

stained vomit and diarrhoea. He died four days later. Lab tests confirmed he had Ebola.

As of 6 December, Uganda has had 142 confirmed cases of Sudan ebolavirus disease

(SUDV) and 55 deaths. With no approved vaccine available, the government has prioritised

contact tracing, setting up treatment and isolation centres, closing schools, and putting

affected areas under lockdown.

Ebola is a severe disease with an average fatality rate of 50%. Symptoms include sudden

fever, muscle pain and sore throat, followed by diarrhoea, vomiting, and sometimes

haemorrhaging. Transmitted to humans by wild animals like fruit bats, Ebola spreads

between people via direct contact with contaminated bodily fluids. The incubation period is

between 2 and 21 days, though an infected person cannot spread the virus until symptoms

start to present. Rehydration with oral and intravenous fluids along with treatment of specific

symptoms can improve survival, while a range of drug therapies and blood products are

undergoing evaluation.

11,000 people were killed by the more common Zaire strain of ebolavirus in West Africa from 2013 to 2016. Over 28,000 people were infected enabling researchers to develop two

vaccines, Ervebo and the two-dose Zabdeno-and-Mvabea, both approved in 2020 to protect against the Zaire strain. Neither has been tested against the Sudan virus, though a ring vaccination trial will evaluate the efficacy of three candidates from Merck, Sabin, and Oxford.

In addition to the illness, authorities and medics must combat rapidly-spreading

misinformation. An independent fact-checking organisation found that most misinformation

highlighted a lack of understanding of the disease and its prevention. Some of the claims, for instance that case numbers are being falsified or the outbreak is covering up illegal organ harvesting, have been mixed with anti-government sentiment and criticism of President Yoweri Museveni, who has held uninterrupted power in Uganda since 1986.

Without a vaccine to use immediately, emphasis has been on prevention, with measures

including maintaining good hygiene, using chlorinated water to clean surfaces, and isolating cases and contacts. At funerals, bodies must only be buried by those in full PPE – clear body bags have been deployed so families can view their loved ones safely. While Ebola survivors can help care for the infected (since they cannot be re-infected), medical personnel must be supplied with full PPE at all times when treating patients.

Promisingly, on 14 December, after no new cases were reported in over two weeks, the

WHO Director-General, Tedros Adhanom Ghebreyesus asserted that “If no new cases are

detected, the outbreak will be declared over [on] the 10 January.” Until then, Uganda must

remain vigilant. Referring to the wider global context, in a more optimistic light, Tedros

continued: “So we end a difficult year with some encouraging news: COVID-19, mpox and

Ebola are all declining.”

Encouraging, yes, but also very important – as these outbreaks decline, lessons must be

taken away from the responses to them, if only to help prevent the next one.

Written by: Omar Khan


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