Ebola: Nigeria on alert as virus rocks Uganda

Nigeria is currently on alert following the outbreak of Ebola in Uganda. Daily Trust Saturday reports.

The health authorities in Uganda had declared an outbreak of the disease on 20 September after a case of the Sudan ebolavirus was confirmed in Mubende district in the central part of the country. 

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The Uganda Virus Research Institute confirmed the case after testing a sample taken from a 24-year-old male.

This followed an investigation by the National Rapid Response team of six suspicious deaths that had occurred in the district in September.

Ebola is a severe, often fatal illness affecting humans and other primates. 

The World Health Organization (WHO) said it has six different species, three of which (Bundibugyo, Sudan and Zaire) have previously caused large outbreaks. Case fatality rates of the Sudan virus have varied from 41 percent to 100 percent in past outbreaks. Early initiation of supportive treatment has been shown to significantly reduce deaths from Ebola.

As of 29th September 2022, the Ugandan Ministry of Health has reported 54 cases (35 confirmed and 19 probable) and 25 deaths (7 confirmed and 18 probable).

Uganda last reported an outbreak of Sudan ebolavirus in 2012. In 2019, the country experienced an outbreak of Zaire ebolavirus. The virus was imported from neighbouring Democratic Republic of the Congo which was battling a large epidemic in its north-eastern region.

The strain responsible for the current outbreak was first reported in southern Sudan in June 1976. Since then, seven outbreaks caused by this strain have been reported (four in Uganda and three in Sudan).

Like other types of Ebola virus, people infected cannot spread the disease until the development of symptoms.

The symptoms include fever, fatigue, muscle pain, headache, and sore throat later followed by vomiting, diarrhoea, rash, symptoms of impaired kidney and liver function. They may appear anywhere from 2 to 21 days after exposure to the virus, but the average is 8 to 10 days.

According to the Nigeria Centre for Disease Control and Prevention (NCDC), the likelihood of importation to Nigeria is high due to the increased air travel between Nigeria and Uganda, especially through Kenya’s Nairobi airport, a regional transport hub, and other neighbouring countries that share a direct border with Uganda.

Dr Ifedayo Adetifa, Director General, NCDC, said based on available data, the overall risk of importation of the Ebola virus and the impact on the health of Nigerians has been assessed as high for the following reasons:

“The Sudan Ebola Virus does not currently have an effective drug for treatment or licensed vaccine for prevention.

“The extent of the outbreak in Uganda has not yet been ascertained as investigations have shown that some persons may have died with similar symptoms which were not reported to health authorities. In addition, their burials were not conducted safely to prevent transmission.

“The case fatality rate of the Sudan virus varied from 41 percent to 100 percent in past outbreaks.”

He said the likelihood of spread in Nigeria following importation is high due to the gatherings and travel associated with politics, the coming yuletide as well as other religious gatherings and festivals during the last few months of the year.

On Nigeria’s preparedness to respond in case of an outbreak, he said “Despite this risk assessment, Nigeria has the capacity – technical, human (health workforce) and diagnostic – to respond effectively in the event of an outbreak.”

Dr Adetifa said this is exemplified by our successful response to the Ebola outbreak in 2014, as well as improvements in our capacity for health emergency response during the COVID-19 pandemic.

“We have the diagnostic capacity to test for the EVD presently at the National Reference Laboratory in Abuja and the Lagos University Teaching Hospital’s Centre for Human and Zoonotic Virology’s Laboratory. However, diagnostic capacity will be scaled up to other laboratories in cities with important Points of Entry (POE) and others as may be required.

“An effective response system is in place with the availability of control capacities (trained rapid response teams, and an effective infection prevention and control programme) to limit the risk of spread in the event of a single imported case,” he said.

While saying that currently, no case of EVD has been reported in Nigeria, he said nonetheless, the Nigerian government through NCDC’s multisectoral National Emerging Viral Haemorrhagic Diseases Technical Working Group (NEVHD TWG) has put several measures in place to prevent and prepare for immediate control of any outbreak of the disease in-country.

He said, “These include: The NCDC Incident Coordination Centre (ICC) is now in alert mode, and development of an incident action plan for the first few cases of EVD has commenced.”

Dr Matshidiso Moeti, WHO Regional Director for Africa, said this is the first time in more than a decade that Uganda is recording an outbreak of Sudan ebolavirus. 

She said, “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.

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

WHO is helping Ugandan health authorities with the investigation and is deploying staff to the affected area. The organization said it has dispatched supplies to support the care of patients and is sending a tent that will be used to isolate patients. 

Experts say recovery from EVD depends on good supportive clinical care, management of co-morbidities, and the patient’s immune response. People who recover from Ebola virus infection develop antibodies that last for at least 10 years.