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Saturday, June 10, 2023

The U.S. Response to Ebola Outbreaks in Uganda

While there have been no confirmed cases of Ebola related to this outbreak reported in the U.S., public health agencies are prepared to defend against this threat here at home.

The Uganda Ministry of Health (MOH) announced the first positive case of Ebola virus disease (EVD) in Uganda in 2022 caused by Sudan virus (species Sudan ebolavirus) on September 20. At this time, there are no confirmed cases of Ebola virus disease related to this outbreak reported in the United States or other countries outside Uganda, and the current geographic scope of this outbreak in Uganda is small. As part of the U.S.’s efforts to address this outbreak with the international community, the U.S. Centers for Disease Control and Prevention (CDC) and the U.S. Agency for International Aid and Development (USAID) are working closely with public health departments, public health laboratories, and healthcare workers throughout the U.S., Uganda, and neighboring countries to raise awareness and address this outbreak.

The CDC remains committed to being a strong public health partner by supporting Uganda, neighboring countries, and countries around the world experiencing infectious disease outbreaks. Federal agencies and embassies are working closely with local, national, and international partners to ensure the response efforts to the Uganda outbreak are well integrated and aligned to tackle the outbreak in Uganda, as well as keep the United States protected. These efforts include:

  • Entry screening for U.S.-bound travelers from Uganda: Currently, about 140 people per day enter the U.S. from Uganda. The U.S. has not restricted travel from Uganda at this time. The U.S.is implementing health screenings upon entrance at five domestic airports – Chicago O’Hare, Hartsfield-Jackson Atlanta, John F. Kennedy (NY), Newark Liberty and Washington Dulles – for travelers who have visited Uganda within the last 21 days. CDC is also offering follow-up consultations with travelers being performed by local health departments. Entry screenings for Ebola when entering the U.S. and exit screenings from the infected country are standard public health practices together with patient isolation and contact tracing.
  • Building local response capacity: Since 2003, the U.S. has supported the Ugandan MOH in establishing a robust laboratory network through concentrated efforts with the Ugandan Viral Research Institute (UVRI) to provide safe and effective diagnostic and surveillance services.  The U.S. has also supported strengthening the country’s capacity to prevent avoidable epidemics, detect threats early, and respond rapidly and effectively to disease outbreaks and other critical infectious disease threats. The Ugandan MOH, through UVRI, operates a world class viral hemorrhagic fever laboratory. The CDC provides additional support to lab services through reagents and human resources and shares augmented biosafety and security standards as needed.  The Ugandan government established a mobile laboratory at the Mubende Regional Referral Hospital (MRRH), closer to the Médecins Sans Frontières (MSF) Ebola Treatment Unit (ETU). UVRI and CDC have equipment and resources in country and are prepared to establish a second field laboratory if required. USAID has invested in community engagement and risk communication capacity alongside the MOH for outbreak response in Uganda over the past eight years.  This investment enabled the rapid deployment of trained Uganda Red Cross volunteers to partner with affected communities to improve uptake of community-based surveillance, contact tracing, alert investigation, and safe burials. PEPFAR investments in clinical staff, community health workers, supply chain, laboratory support, and community outreach are being leveraged to support Uganda’s outbreak response efforts.
  • Increasing virus surveillance and case management systems: The U.S. continues to work with partners to strengthen Uganda’s capacity to prevent, detect, and respond to public health threats, like Ebola. Since September 20, the MOH, with CDC support, has intensified surveillance efforts to detect Ebola in the five districts with Ebola cases and worked with the Ugandan MOH to enhance the country’s preparedness capacity, including sharing guidance on establishing a rapid response unit and training local teams to perform contact tracing and follow-up. Together, the Uganda MOH, CDC, MSF, and WHO also created a unique ID tracing system to track cases and contacts. As of October 12, CDC has deployed 27 staff in Uganda, including seven field epidemiologists, four laboratory technicians, three ecologists, three infection prevention and control scientists, one management and operations specialist, and one health communication specialist to help optimize surveillance and response capacity for Ebola in country. USAID is supporting risk communication, community engagement, and community-based surveillance efforts in districts at risk for spread.
  • Accelerating availability of Ebola vaccines: The U.S. is coordinating closely with the World Health Organization (WHO) and the Government of Uganda on the possible deployment of an investigational vaccine developed by scientists at the National Institute of Allergy and Infectious Diseases, part of the U.S. National Institutes of Health, and licensed to the Sabin Vaccine Institute. The vaccine may be deployed as part of a clinical trial in Uganda with the support of the U.S. Department of Health and Human Services (HHS) and the U.S. Department of Defense (DoD).  The U.S. has a small number of doses of the Sabin vaccine available for deployment and is working to expediate the fill and finish of an additional 7,000–9,000 doses. The first shipment of the monoclonal antibody MBP-134 arrived in Uganda in early October.
  • Mobilizing resources to optimize the response: USAID announced it will provide up to $8.9 million to surge support to Uganda. This funding will go toward efforts to help identify cases and conduct contact tracing, provide community education on symptoms and prevention strategies, strengthen infection prevention and control in health facilities, support safe and dignified burials, provide rapid and safe transport of suspect Ebola samples for diagnostic testing, support case management, and distribute personal protective equipment in Uganda. This builds on more than $3 million allocated in September to the WHO, UNICEF, and other partners in support of immediate response efforts. The MOH is also partnering with USAID to develop a nation-wide risk communication plan and has already developed standardized and updated messaging and rumor-tracking systems. Additionally, USAID partners are working with district governments in approximately half of the country to reactivate District Task Forces and ensure that those platforms include functional rapid response teams to identify and contain possible cases emerging in those districts.
  • Ensuring health providers are prepared in the U.S.: While there have been no confirmed cases of Ebola related to this outbreak reported in the U.S., public health agencies are prepared to defend against this threat here at home. On October 6, thousands of healthcare providers and professionals received a Health Alert Network (HAN) advisory from the CDC to summarize CDC’s recommendations for case identification and testing and clinical laboratory biosafety considerations. On Wednesday, CDC conducted a Clinician Outreach Communication Activity (COCA) call that provided an update about the Ebola outbreak to more than 4,600 participants. Additionally, CDC Director Rochelle Walensky penned a joint letter on October 6 with Association of American Medical Colleges (AAMC) President and CEO David Skorton to alert the AAMC’s membership about the outbreak.

Read more at CDC

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