Six schoolchildren in the Ugandan capital of Kampala are the latest to be infected with Ebola, according to the country’s health minister on Wednesday – and with 15 cases in the densely populated city, some want the government to impose a lockdown.

So far, there have been 109 confirmed cases, including 30 deaths, of the Sudan strain of Ebola for which there is no vaccine – although two vaccines exist for the Zaire strain.

Ebola is highly infectious and has a mortality rate of up to 90%. The 2014-16 Ebola outbreak in West Africa, the largest on record, killed more than 11,000 people. In 2000, Uganda suffered an outbreak of Ebola that killed over 200 people.

After a slow start, contact tracing kicks into gear

With support from the World Health Organization (WHO) and partners, the Ugandan Ministry of Health has trained and deployed around 300 contact tracers, who play a critical role as the country looks to minimize the spread of the virus.

“When the community cooperates in the response and contacts are identified, it becomes easier to contain the disease,” said Dr Bernard Logouomo, the Ministry of Health Surveillance Lead in Mubende district, the outbreak’s epicenter.

In the first days of the outbreak, only 25% of contacts were properly traced, the WHO said. But by mid-October, nearly 94% of people who had come in contact with the virus were being properly monitored.

Despite dangers of urban Ebola, president resisting Kampala lockdown

Ugandan President Yoweri Museveni has so far resisted calls to lock down the capital, although he announced a three-week lockdown in Mubende and Kassandra districts, where the outbreak started, on 15 October. 

However, the Kampala schoolchildren’s infections have been traced to a man who travelled to the city from Mubende.

On Tuesday, the head of the Uganda Medical Association, Dr Samuel Oledo, urged health authorities to impose a lockdown in Kampala. “The earlier we lockdown Kampala, the better,” he told reporters. “People are not even reporting cases right now.”

Uganda’s Ministry of Health acknowledged in a press statement on Thursday that urban Ebola can create “a situation of rapid spread,” but that lockdowns would remain limited to the epicentres of Mubende and Kassanda. 

“The situation in Kampala is still under control,” said Health Minister Jane Ruth Aceng. “There is no reason to restrict people’s movement.”

Trials are working

Without any known treatments available, trials are ongoing amid the outbreak. Uganda’s Ministry of Health said that a number of treatment options are being explored, including monoclonal antibodies, and repurposed drugs like Remdeservir donated by the US government. But doses are scarce.

“Thirteen patients have received these trial drugs with relatively good outcomes,” said health authorities. In total, 34 people have recovered from the virus. Four patients admitted in critical condition died despite treatment, highlighting the importance of early reporting and detection of symptoms.

“The spread of the outbreak relies on reducing the time between the first symptoms of the disease and its management,” said Denis Mbae, outreach project coordinator of Médecins Sans Frontières activities in Uganda. “The earlier patients are treated, the greater their chances of survival and the less risk there is of the disease spreading within the community.”

 

 

 

 

 

 

 

 

 

Image Credits: WHO, Angella Birungi.