Ugandan health officials have announced an Ebola outbreak following the confirmation of the relatively rare Sudan strain in the country’s Mubende district, while the government of Ghana has declared the end of the country’s first ever Marburg outbreak. 

According to the health authorities in Uganda, the Uganda Virus Research Institute confirmed Ebola in a 24-year-old male who has since died. The country’s National Rapid Response investigated six suspicious deaths in the district this month, while eight suspected patients are receiving care in a health facility.

“This is the first time in more than a decade that Uganda is recording the Ebola Sudan strain. We are working closely with the national health authorities to investigate the source of this outbreak while supporting the efforts to quickly roll out effective control measures,” said Dr Matshidiso Moeti, World Health Organization (WHO) Regional Director for Africa. 

“Uganda is no stranger to effective Ebola control. Thanks to its expertise, action has been taken to quickly to detect the virus and we can bank on this knowledge to halt the spread of infections.”

Vaccine may not against Sudan strain

Recent Ebola outbreaks in a number of African countries, including in the Democratic Republic of the Congo (DRC), have benefited from ring vaccination of high-risk people in contact with Ebola patients with the Ervebo (rVSV-ZEBOV) vaccine. However, the vaccine has only been approved to protect against the Zaire strain of Ebola and not the Sudan strain driving the outbreak in Uganda. 

WHO noted that another vaccine produced by Johnson and Johnson may be effective but has yet to be specifically tested against the Sudan strain.

This is not the first Ebola outbreak caused by the Sudan strain. Seven previous outbreaks of the strain have been reported, four of which occurred in Uganda and three in Sudan. 

Uganda’s last outbreak of Ebola Sudan occurred in 2012. Seven years later, the country experienced an outbreak of Ebola Zaire (in 2019) when the virus was imported from neighbouring DRC which was battling a large epidemic in its northeastern region.

Even though the case fatality rates of the Sudan strain have varied from 41% to 100% in past outbreaks, health authorities believe that an early initiation of supportive treatment which has been shown to significantly reduce deaths from Ebola will better position the country to combat the disease.

Ghana overcomes Marburg

Meanwhile, Ghana’s Ministry of Health has declared the country’s first-ever Marburg outbreak over after no new cases were reported in the past 42 days or two incubation periods – the time between infection and the onset of symptoms. 

During the outbreak that was declared on 7 July, three confirmed cases, including two deaths, were recorded. The outbreak declaration followed laboratory confirmation of the virus that affected the country’s Ashanti, Savannah and Western regions. Some 198 contacts were identified, monitored and completed their recommended initial 21-day observation period which was then extended for another 21 days.

Genomic sequence analyses of the Marburg virus at Senegal’s Institut Pasteur and Ghana’s Noguchi Memorial Institute for Medical Research connected the outbreak to a case reported in Guinea in 2021. However, there are suggestions that the origin of the outbreak may be a shared animal reservoir or population movements between the two countries.

Elsewhere on the continent, previous outbreaks and sporadic cases have been reported in Angola, DRC, Kenya, South Africa and Uganda.

Even though the outbreak is over, WHO has warned that a resurgence of Marburg can still occur, and it is working with Ghana’s health authorities to maintain surveillance and improve detection and response to a potential flare-up of the virus. 

The virus is transmitted to people from fruit bats and spreads among humans through direct contact with the bodily fluids of infected people, surfaces and materials. Illness begins abruptly, with high fever, severe headache and malaise. Patients often develop severe haemorrhagic signs within seven days.

Image Credits: Photo: Anna Dubuis / DFID.