What next for Uganda?
Ugandan authorities have now drawn up a list of 98 contacts, or contacts of contacts, potentially exposed to the Ebola virus, of whom 10 are considered “high risk”, said Mike Ryan, executive director of WHO’s emergencies programme.
Vaccination of those contacts and health workers with a Merck experimental vaccine is to start on Saturday, he said.
Ryan told Reuters on Friday that there had been no sign of local transmission of Ebola virus in Uganda.
“No evidence yet…But we’re not out of the woods yet,” he said, noting that the incubation period is up to 21 days.
June 14: WHO’s position on Ebola
The World Health Organization on Friday decided not to declare an international emergency over Congo’s Ebola outbreak despite its spread to Uganda this week, concluding such a declaration could cause too much economic harm.
In a statement, the panel of 13 independent medical experts on the WHO’s Emergency Committee urged neighbouring “at risk” countries to improve their preparedness for detecting and managing imported cases, “as Uganda has done”.
“This is not a global emergency, it is an emergency in the Democratic Republic of Congo, a severe emergency and it may affect neighbouring counties,” Dr. Preben Aavitsland, the panel’s acting chair told a news conference at the U.N. agency’s headquarters in Geneva.
“It was the view of the Committee that there is really nothing to gain by declaring a PHEIC(Public Health Emergency of International Concern), but there is potentially a lot to lose.”
Such a declaration would risk creating restrictions on travel or trade “that could severely harm the economy in the Democratic Republic of Congo,” Aavitsland said.
WHO director-general Tedros Adhanom Ghebreyesus, speaking by telephone from Kampala, said: “The spread of Ebola to Uganda is a new development but the fundamental dynamics of the outbreak haven’t changed.”
Some medical groups had urged the committee to declare an emergency which would have led to boosting public health measures, funding and resources.
Lawrence Gostin, a global health law professor at Georgetown University Law School, voiced disappointment that the panel had failed to declare an emergency for the third time.
“The @WHO was criticized for delay in declaring a PHEIC in W Africa. Will it’s failure in DRCaffect legitimacy?” Gostin tweeted. He said he admired the panel members but disagreed with their conclusion.
Only four emergencies have been declared in the past decade, including the worst ever Ebola outbreak, which hit West Africa in 2014-2016. The others were an influenza pandemic in 2009, polio in 2014 and the Zika virus in 2016.
June 13: Uganda repatriates Ebola suspects to Congo
Authorities in Uganda on Thursday banned public gatherings in the Western district of Kasese, where two people have died of Ebola.
Relatives of the two people who died of Ebola were also repatriated from Uganda to Democratic Republic of Congo, where they will receive experimental and therapeutic treatment.
“Hand washing facilities have been put in place, with washing materials like JIK (bleach) and soap. There’s no shaking of hands, people just wave at each other,’‘ local journalist Ronald Kule told reporters.
While the repatriation means there’s no confirmed case of Ebola in Uganda as of Thursday, three other suspected Ebola cases not related to the family remain in isolation, the health ministry said.
“Uganda remains in Ebola response mode to follow up the 27 contacts (of the family),” read part of a statement from the Uganda’s health ministry.
Meanwhile, Red Cross teams have embarked on an Ebola awareness drive in the Uganda-DRC border area following confirmed cases of the disease.
Managing a porous border
Uganda’s Health Minister Jane Ruth Aceng said challenges remained at “unofficial entry points” between Congo and Uganda, which share a porous 875-kilometre (545-mile) border.
These unauthorised border crossings, known as “panyas” in the local Lukonzo language, are often merely planks laid down across a point in the river, or through forests and mountains where there is no surveillance.
The family that was repatriated on Thursday had crossed from Congo to Uganda earlier this week and sought treatment when a 5-year-old boy became unwell. He died of Ebola on Tuesday. His 50-year-old grandmother, who was accompanying them, died of the disease on Wednesday, the ministry said.
June 11: WHO emergency meeting scheduled for June 14
The World Health Organization announced an emergency committee would meet Friday to determine whether to upgrade its assessment of the situation to “a public health emergency of international concern”.
WHO, in October and again in April, held off declaring the DRC epidemic an emergency of international concern, because the outbreak was contained to one part of DRC.
For the committee to make the emergency call, it must determine that the epidemic “carries implications for public health beyond the affected State’s national border and may require immediate international action”.
If such a declaration is made Friday it will represent a major shift in mobilisation against the disease.
The current Ebola epidemic began in August last year in eastern Congo and has already infected at least 2,062 people, killing 1,390 of them.
“This epidemic is in a truly frightening phase and shows no sign of stopping anytime soon,” said Jeremy Farrar, an infectious disease specialist and director of the Wellcome Trust global health charity which is involved in fighting Ebola.
“We can expect and should plan for more cases in DRC and neighbouring countries,” he said, adding: “There are now more deaths than any other Ebola outbreak in history, bar the West Africa Epidemic of 2013-16, and there can be no doubt that the situation could escalate towards those terrible levels.”
The Red Cross said it was scaling up efforts to contain the spread of the virus since it was detected in Uganda.
“This is a worrying development, but we have been preparing for this day for months now,” Robert Kwesiga, Uganda Red Cross Secretary General, said in a statement Wednesday.
Experts noted that Uganda, which has been on high alert for possible spread of Ebola and has already vaccinated many frontline healthworkers, is relatively well prepared and should be able to limit the virus’ spread.
“The current cases in Uganda will be quickly contained but the failure to stop the current Ebola epidemic in DRC is simply tragic,” said Ian Jones, a professor virology at Britain’s Reading University.
Brief: Uganda’s Ebola preparedness
Since the epidemic began in August in eastern Congo, the Congo health ministry said on Monday that it had recorded 2,062 cases, including 1,390 deaths.
Neighbouring Uganda has suffered regular outbreaks of Ebola and Marburg over the years, both high-fatality viral haemorrhagic fevers. Health facilities to treat the diseases are relatively robust.
A donor-supported laboratory in Entebbe, a lakeside town south of the capital Kampala, means Uganda typically confirms outbreaks much faster than many of its neighbours.
Preparing for possible cases of Ebola, Uganda has vaccinated nearly 4,700 health workers, disease monitoring has been intensified, special treatment units set up and health workers have been trained to recognize symptoms of the disease, WHO said.
Uganda’s worst Ebola outbreak was in 2000 when 425 people were infected. More than half of them died.
June 11: Ebola deaths recorded
At least two people have so far died of Ebola in Uganda, following Tuesday’s confirmation that the deadly virus had crossed into the country.
The five-year-old Congolese child who was the first recorded case in Uganda and its grandmother have both succumbed to the virus, at Bwere General Hospital, where an isolation facility has been established.
Authorities are now worried about the spread of the epidemic, after more cases were confirmed on Wednesday.
“Two more samples … have tested positive,” the World Health Organization agency said on Twitter, citing the health minister and bringing the total tally of confirmed cases to three.
Local news channel, Daily Monitor, said Ebola cases in the country have risen to 10, citing the country’s health minister Dr. Ruth Aceng who said there are seven more suspects, including two men, two women and a six-months-old baby, who came from the Democratic Republic of Congo.
June 10: Ebola confirmed in Uganda
A case of Ebola has been confirmed in Uganda, ten months after the deadly virus was confirmed in the Democratic Republic of Congo. The 5-year-old Congolese child, who entered Uganda on June 9 through Bwera Border post, is receiving care, the World Health Organization (WHO) said on Tuesday.
“This is the first confirmed case in Uganda during the Ebola outbreak on-going in neighbouring Democratic Republic of the Congo,” the WHO said in a statement.
The child’s family sought medical care at Kagando hospital and the child was transferred to Bwera Ebola Treatment Unit for management, the WHO said.
“The confirmation was made today by the Uganda Virus Institute (UVRI) …contacts are being monitored,” WHO said.
How the Ebola victim came to Uganda
The boy was accompanied by his Ugandan father and Congolese mother, who had returned to Congo to nurse her father before he died of Ebola, Uganda’s Health Minister Jane Ruth Aceng told a news conference.
The family returned to Uganda with four other family members of Congolese origin, Aceng said. All the other Congolese family members are in isolation at Bwera Hospital. Two of them have already developed symptoms similar to those of Ebola and samples have been removed from them, Aceng said.
Results of tests are expected Wednesday. Eight more contacts are being followed up, Aceng said.
Aceng said the family entered Uganda on June 10, not 9. The reason for the discrepancy was not immediately clear and neither the WHO nor the government was reachable for clarification.