Four health workers have already died in the Ebola outbreak in Uganda and, while rapid tests are still not available, authorities have managed to cut the testing turnaround time from 24 to six hours, according to the World Health Organization (WHO) Africa region and Africa Centres for Disease Control.

Meanwhile, the US is routing all citizens who have been in Uganda in the 21 days before their arrival to five US airports – New York, Newark, Atlanta, Chicago or Washington – for “enhanced screening”, the US Embassy in Uganda announced on Thursday.

At separate briefings on Thursday, the WHO AFRO and Africa CDC attributed the shortened testing time to the establishment of a new test facility at the epicenter of the outbreak that is capable of conducting real-time polymerase chain reaction (RT-PCR), as well as the availability of more testing reagents.

However, the genomic sequencing data available at present has not yet enabled health authorities to identify origin of the disease or Patient Zero.

The outbreak was declared on 20 September, but public health experts suspect that it started in early September, several weeks before the first confirmed case was seen at a government health facility. 

As of 5 October, the WHO reported 63 probable cases and 29 deaths. Ten health workers are confirmed infected, for of whom have died.

Dr Yonas Tegegn Woldemariam, WHO Representative in Uganda,  reported that about 77% of the listed contacts have been reached.

“I believe we are proceeding fast in responding to this disease outbreak. We started with three districts but it has now gotten to two additional districts but we relate these new district cases to the original districts where either a health worker or a positive case have had contact with original cases,” said Woldemariam.

Initially, samples were being sent to the Uganda Virus Research Institute (UVRI) which is 160km from the epicenter of the outbreak, but the new on-site laboratory facility.

“I am positive that we could control this in reasonably good time,” he said. 

Uncertainties remain

At the WHO AFRO press briefing on Thursday, Professor Pontiano Kaleebu, director of the Medical Research Council at UVRI, said that the current strain “is the nearest to the Ebola virus we had here in Luweero (an agro-pastoralist district in central Uganda) in May 2011. It is very close to that strain but there are few mutations in the virus.”. 

While the virus was first identified in Sudan, it has since spread and Uganda has had at least two previous outbreaks. 

Kaleebu admitted that the sequencing data was not sufficient to convincingly identify the index case or the origin of infection.

“Doing that will require an extensive multidisciplinary approach that involves everyone including ecologists. This is already underway and we will be looking at the whole picture to identify connections. But we need to also be aware that if the index patient has died and was not tested, we may not be able to specifically pinpoint that case,” Kaleebu told Health Policy Watch.

Meanwhile, a range of organisations is assisting Uganda to respond to the outbreak, including Medicins sand Frontieres, which has set up an isolation facility in the Mubende district.

Highly impressed with the new Ebola Isolation facility put up by @MSF at Madudu HC III in response to #EbolaOutbreakUG in Mubende District. Thank you MSF, @UNICEFUganda, @WHOUganda, @USAIDUganda, @CDCgov and all other partners for a great job done. MSF, you rock! pic.twitter.com/h8BznDboNC

— Dr. Jane Ruth Aceng Ocero (@JaneRuth_Aceng) October 6, 2022

Image Credits: Naomi Nolte IFRC emergency communication coordinator.