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WHO EMRO Weekly Epidemiological Monitor: Volume 16; Issue no 03; 15 January 2023

Declaration of ending Sudan Ebola virus disease outbreak in Uganda

On 11 January 2023, the Ministry of Health (MoH) of the Republic of Uganda declared the end of the Sudan Ebola Virus Disease (SUVD) outbreak that affected nine districts. In accordance with WHO recommendations, the declaration was made 42 days (twice the maximum incubation period for Sudan Virus infections) after the last confirmed case was accorded a safe and dignified burial on 29 November 2022.

Editorial note

Ebola viruses and Marburg are zoonotic pathogens, members of the Filoviridae family, which cause severe, often fatal illness in humans. Ebola virus disease (EVD) first appeared in 1976 in two simultaneous outbreaks. Since then, regular disease outbreaks have been reported in Africa, each affecting a limited number of people. However, the 2014–2016 outbreak in West Africa was the largest and most complex Ebola outbreak ever, with over 11 000 deaths. The outbreak demonstrated that filoviruses represent a very serious public health threat. Sudan virus was first reported in southern Sudan (former Sudan) in June 1976, since then, the virus has emerged periodically, and up to now, seven outbreaks caused by SUDV have been reported, four in Uganda and three in Sudan. Case fatality rates of the Sudan virus have varied from 41% to 100% in past outbreaks.

On 20 September 2022, Uganda declared an outbreak of Ebola disease caused by SUVD, after a case in Mubende district was confirmed by the Uganda Virus Research Institute. In total, 164 cases (142 confirmed, 22 probable) with 77 deaths (55 among confirmed cases and 22 among probable cases) and 87 recovered patients, were reported. A higher proportion of cases occurred among males (59%), while the most affected age group was represented by those aged 20-29 years (31%), followed by those aged 30-39 years (30%). A quarter of cases were reported among children under 10 years old. Overall, 19 confirmed cases with seven deaths occurred among healthcare workers.

Mubende was the epicentre of the outbreak, accounting for 45% of confirmed cases (64 confirmed and 19 probable), followed by Kassanda with 35% of confirmed cases (49 confirmed and 2 probable), Kampala with 13% of confirmed cases (17 confirmed and 1 probable), Wakiso with 3% of confirmed cases (4 confirmed cases), Kyegegwa with 2% of confirmed cases (3 confirmed cases), Jinja with 1% of confirmed cases (2 confirmed cases), and Bunyangabo, Kagadi and Masaka, which reported one confirmed case each (Table). From 20 September to 10 January 2023, a total of 4793 contacts were listed and 11 025 alerts were reported, of which 8088 (73%) were investigated and 7382 (67%) were validated as suspected cases of Ebola disease caused by SUVD. During this period, 1087 safe and dignified burials (SDB) were undertaken (all suspected deaths had to be tested and accorded a SDB), and 6681 samples were tested for Sudan ebolavirus. A total of 314 603 travelers were screened at international points of entry and four suspected cases of SUDV were detected, who all tested negative.

Source: World Health Organization

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