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Ebola Cases Confirmed in Uganda

JUN 11, 2019 | MICHAELA FLEMING
Updated: 6/12/2019 at 8:30 AM EDT

The World Health Organization (WHO) in Uganda has announced on Twitter that a confirmed case of Ebola has been detected in Uganda. This case is the first confirmed case of Ebola that Uganda has detected during the ongoing outbreak in the neighboring Democratic Republic of the Congo (DRC).

According to the Twitter thread, the confirmed case is in a 5-year-old Congolese boy who traveled from the DRC into Uganda on June 9, 2019. The family entered the country through the Bwera Border post which is located along the Western border of Uganda which is shared with the DRC.

The child initially sought care at a hospital in Kagando hospital where health workers identified Ebola as a potential diagnosis. At that point the child was transferred to an Ebola Treatment Unit in Bwera.

In the treatment unit at Bwera the child was diagnosed with Ebola Virus Disease after confirmation was made by the Uganda Virus Institute. According to WHO Uganda and the Ugandan Ministry of Health, the child is under care and receiving supportive treatment at the facility.

In response to the confirmed case a rapid response team has been dispatched to Kasese to being contact tracing and “management of cases that are likely to occur.” The team will also being vaccination individuals who have been in contact with the ill child, including frontline health workers.

In a follow-up tweet posted on June 12, 2019, WHO Uganda confirmed that the 5-year-old boy died of his illness. 

In an accompanying press release, the Ugandan Ministry of Health reported that 2 additional cases of Ebola have been confirmed in Uganda. The 2 new cases have been confirmed in the grandmother and 3-year-old brother of the deceased patient. According to the statement all patients are being treated at the Bwera Hospital Ebola Treatment Unit and presented with symptoms of vomiting blood, bloody diarrhea, muscle pain, headache, fatigue, and abdominal pain. 

Response workers are currently following-up with 8 contacts of the patients and the Ministry of Health and WHO announced that ring vaccination of contacts and non-vaccinated frontline health workers will begin on Friday, June 14, 2019.

In April, Uganda health workers conducted a simulation to assess preparedness, in the event of Ebola spreading to the country.

The simulation exercise was conducted in the Wakiso and Kasese districts and set out to evaluate Ebola outbreak readiness on local, district, and national levels. According to a summary of the simulation, the National Task Force demonstrated that they were aware of the proper protocols and could easily mobilize different elements of outbreak response in a short amount of time.

For the simulation, health workers established primary and secondary screening checkpoints at points of entry in the provinces, established an Ebola treatment unit in Bwera, and formed village health teams that were tasked with identifying suspected cases and disseminating educational information. Health workers were also tasked with conducting safe transportations of Ebola “patients” via ambulance.

During the simulation, health officials observed productive communication between the Public Health Emergency Operating Center and designated emergency sites. Check-points at points of entries were observed to be well-conducted, with health officials noting that adequate materials including thermometers, protective equipment, hand washing facilities, and chlorine were available, reinforcing that the nation has been diligent in preparing in case of an outbreak.

It was observed that the treatment unit was prepared and well-maintained with proper materials and staff were well-trained in Ebola management. The village health teams were also observed as being prepared and competent in identifying suspected cases while disseminating information. Health officials with WHO Uganda reported that the simulation “found heightened community risk perception pointing to the good work done on community engagement and risk communication.

The simulation also exposed challenges that could inhibit critical elements of the response. Although the emergency operations center had good communication with emergency sites, there were roadblocks to communication with health workers at the health centers, points of entry and, in particular, the Ebola treatment units at 2 hospitals and the international airport. If this situation occurred during a real outbreak, it would lead to delayed identification of patients along with slow transfers and management of suspected cases.

Additional challenges included gaps in contact tracing and security at the treatment units, inconsistent travel screenings, inadequacies in use of personal protective equipment, and other elements included in infection prevention protocols. The exercise also identified a need for more defined roles for health workers, including the laboratory teams who test samples of blood for the virus.

“We have to build a sustainable system not only for EVD but also for other health problems. The more we do this the better we shall get at it. WHO is there to support the process,” Yonas Tegegn Woldemariam, MD, the WHO Representative in Uganda, said in the report. 
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