WEEKLY BULLETIN ON OUTBREAKS
AND OTHER EMERGENCIES
Week 43: 17 - 23 October 2022
Data as reported by: 17:00; 23 October 2022
...
Ebola Virus Disease caused by Sudan virus in Uganda
90 cases
28 Deaths
31.0% CFR
EVENT DESCRIPTION
The Ebola disease caused by Sudan ebolavirus (named Sudan
virus disease, SVD) outbreak has been ongoing in Uganda since 19
September 2022, following confirmation in a 24-year old patient
in Madudu Sub-County of Mubende District. As of 23 October
2022, a total 90 laboratory-confirmed and 20 probable cases
have been reported. Forty-eight fatalities have been registered
including 28 confirmed cases, for an overall case fatality ratio of
46.0%, and 31.0% among confirmed cases. A total of 32 patients
have been discharged, giving a recovery rate of 36.0%. A total of
13 healthcare workers have been affected, of whom four (31.0%)
have died.
Two new Districts have reported cases of SVD, including
Kampala and Wakiso. Cumulatively, seven Districts have so
far been affected: Mubende, which remains the epicentre (60
confirmed and 19 probable), Kassanda (10 confirmed and one
probable), Kampala (14 confirmed), Kyegegwa (three confirmed),
Bunyangabu (one confirmed), Kagadi (one confirmed), and
Wakiso (one confirmed). Of note, no new cases of SVD have been
reported in Bunyangabu, Kagadi and Kyegegwa districts since the
symptom onset of the last confirmed cases, respectively for 24,
26 and 32 days.
A total of 2 430 contacts have been listed around confirmed and
probable cases of SVD since the beginning of the outbreak, in
13 districts including Bunyangabu, Luweero, Fort Portal City,
Kagadi, Kakumiro, Kampala, Kassanda, Kyegegwa, Mitooma,
Mityana, Mubende, Nakasongola, and Ntungamo. All listed
contacts in Bunyangabu, Fort Portal City, Kagadi, and Kyegegwa
have completed 21 days of follow-up. Currently, 1 237 contacts
are actively followed-up in nine Districts, of which 1 161 (94%)
have been seen over the past 24hrs. In addition, several alerts are
being received and validated across the country.
PUBLIC HEALTH ACTIONS
Coordination
Epidemiological investigations, contact tracing, and active
case finding are ongoing in all affected Districts. As of 23
October 2022, 1 237 contacts were still under follow-up,
with 1 161 (94.0%) followed-up over the past 24hrs. A
total of 118 alerts were received nationwide, all of whom
were verified; 58 (49.0%) of them were validated as new
suspected cases and 37 (64.0%) were evacuated to Ebola
Treatment Units (ETUs).
Eighty surveillance officers in Makindye and Rubaga divisions
of Kampala Capital City Authority (KCCA) were trained on
active case finding, case investigation and contact tracing.
Go-Data accounts were created, and data were harmonized.
Orientation of ten contact tracers at community level was
done in Mityana District
A mobile laboratory remains operational at the Mubende ETU
with adequate test kits facilitating timely sample collection,
testing and release of results within six hours.
Cumulatively, 1 009 samples have been collected and tested
since the beginning of the outbreak, yielding 90 confirmed
cases.
Ninety laboratory personnel in KCCA were trained on sample
collection, transportation, biosafety and biosecurity across
the divisions.
Case management and psychosocial support
Three ETUs, one each in Mubende, Entebbe and Madudu are
fully operational. Cumulatively, 32 (36.0%) recoveries have
so far been recorded.
A symposium has been organised on SVD management,
attended by healthcare workers across the country as well as
international consultants, and during which field experiences
were shared.
A tent has been set-up in Bunyangabu District to act as a
holding place for suspected cases of SVD.
The Emergency Medical Services call centres are now fully
operational in Kassanda, KCCA and Mubende. A total of 45
evacuations have been done in Kassanda, 29 in Mubende,
three in Kampala, one in Kagadi, one in Kakumiro, and one
in Ntungamo.
Psychosocial support continues to be offered to suspected
and confirmed cases in ETUs, as well as to their family
members. Pre-test (and post-test) counselling are also being
offered to all patients at ETUs, and to contacts. In addition, the
resettling of the discharged persons and negative suspected
cases into their community continues.
Infection, prevention and control (IPC)
Daily monitoring of IPC measures in ETUs is still ongoing.
A mentorship session was organised in KCCA, conveying 30
IPC mentors on proper personal protective equipment (PPE)
donning and doffing, risk assessment, preparing chlorine
solutions, setting-up screening and isolation area and no
touch care for suspected cases.
In Mubende, an IPC Compliance Team was formulated
at ETU, comprising all pillar leads; an IPC orientation was
resolved to be conducted for this team, and the ETU work
plan was developed.
In Kassanda, 18 IPC focal persons from 18 healthcare facilities
have been oriented. An action plan was drawn which shall be
implemented in the respective 18 healthcare facilities.
An orientation was conducted for 21 Mubende ETU hygienists
on the cleaning and decontamination procedure, PPE use
and preparation of chlorine solution.
A total of 51 IPC mentors from Nakawa and Rubaga Divisions
have been trained on basic IPC and use of the IPC score card.
They are expected to cascade the training to IPC focal persons
in the different healthcare facilities of these Divisions.
Four safe and dignified burials have been conducted in
Mubende were conducted in the past 24hours. In addition,
the burial team in Kassanda has been trained.
Risk communication and community engagement
RCCE interventions are ongoing in all affected Districts and
beyond.
There are ongoing media activities in Mubende and Kassanda
including radio talk shows. A total of 15 radio spots continue
to run daily, and community audio tower messages continue
to run in 10 hotspot areas.
RCCE Team in Kassanda worked with the contact tracing
pillar members to address stigmatization in Kalamba village
following confirmation of SVD cases in that village. Together
with the Local Council (LCI) chairman, the team sensitized
the residents on the signs, symptoms, and prevention
of SVD, care for patients, and on the importance of early
reporting.
RCCE Team in Mubende conducted a planning meeting with
the Village Task Force of Kisekende cell - South Division,
attended by the LCI chairman, two village health teams, the
Community Development Officer, and the health assistant.
Logistics
The distribution of supplies in healthcare facilities within all
affected districts is ongoing, including PPE, spray pumps,
wooden pallets, tarpaulin, essential medicines, discharge
packages, fuel, vehicles, stationery, digital thermometers,
infra-red thermometers from MoH and partners.
Laptop and desktop computers have been offered to support
the response.
An additional 14 mini-buses have been made available to
support movement and transportation of response teams on
ground.
SITUATION INTERPRETATION
The evolution of the ongoing SVD outbreak in Uganda has
been marked by an expansion of the disease to two newly
affected Districts including Kampala.
Kampala is the capital
city of Uganda with an estimated population of 4 million
inhabitants, with a density reaching 21 032 hab./km2. Therefore,
if uncontrolled, the situation would become highly disastrous.
Response interventions need to be rapidly put in place to control
the disease. Fortunately, all cases identified there have been
contacts of known SVD cases and had already been quarantined
since their identification as contacts.
Kampala is very close to
an international airport and is not far from the shores of Lake
Victoria, which forms part of the frontier with Kenya and Tanzania.
Therefore, the risk of international spread of the disease is to be
considered. Accordingly, preparedness and readiness activities
should be reinforced and/or scaled-up in neighbouring countries
and beyond.
...
https://apps.who.int/iris/bitstream/handle/10665/363780/OEW43-1723102022.pdf
