Health workers among Ugandan Ebola outbreak deaths | Global health

It looks like a normal day in Mubende, central Uganda. Shops remain open, children are in school and public gatherings are allowed, provided people remain socially distanced.

Ambulances passing by every few hours and health workers washing thoroughly before returning home are the only indications that things are not business as usual in the densely populated mining district struggling to contain an Ebola outbreak.

Twenty-nine people, including four health workers, have died since the outbreak was declared in the area on September 20, the World Health Organization (WHO) confirmed on Wednesday.

Among them was Mohammed Ali, a 37-year-old Tanzanian doctor who worked at Mubende Hospital and had operated on a patient who later tested positive for the virus. Six more health workers have been infected, bringing the total number of reported cases to 63 in five sub-counties.

“We are scared but there is nothing we can do,” said Kesande Pamela, who runs a shop in the town center of Mubende. “I have to keep my shop open and make money. We have information and we are trying to keep it safe. We hope for the best.”

Yesterday, Yoweri Museveni, the country’s president, told Ugandans that the epidemic was under control. “The government has the capacity to control this outbreak as we have done before. Therefore, there is no need for anxiety, panic, movement restrictions or unnecessary closure of public places,” he said in a televised address.

However, Dr Christopher Mambula, a program manager for Doctors Without Borders (MSF) in Uganda, said the situation was “very serious”. Cases are increasing daily and it is not yet clear how widely the virus has spread, he said, adding that the lack of a vaccine to treat the strain of Ebola responsible for the outbreak – the Sudan virus – is a cause for concern.

Vaccines used to successfully contain recent Ebola outbreaks in the Democratic Republic of Congo (DRC) are not effective against Sudan virus. The WHO said several vaccines are in various stages of development, two of which may begin clinical trials in Uganda in the coming weeks.

“In terms of contacts and spread, if you spread in five [regions]or in more than one place, the question becomes what is the chain of transmission between these different cases, did one person infect other people, or was there something like a super-spreading event, like a funeral, where not just one person got infected, but several,” said he.

“Until we are instructed otherwise, I would say this is very serious,” Mambula said. “The reality is that especially when you look at the incubation period, which is usually up to three weeks, it’s possible to go a week without seeing a case and then suddenly have 50 cases in one day.

“It’s still very early and it seems to be increasing, not decreasing.” As of today, there is nothing to say that it is under control.”

Health workers also said they were concerned the disease could spread to refugee camps. Mubende, about a three-hour drive from the capital Kampala, lies along a highway to the DRC. There are several refugee settlements along this route, housing at least 200,000 of Uganda’s 1.5 million refugees.

The WHO has provided $2 million from its emergency fund and is sending “additional specialists, supplies and resources” to help Uganda’s Ministry of Health contain the virus, which is spread through contact with blood and body fluids. MSF has set up a treatment unit at Mubende Hospital and plans to open another in nearby Madudu district, the epicenter of the outbreak.

Health Minister Jane Ruth Asseng called this week for more international support. “Efforts made so far are important, but must be strengthened if we are to end this epidemic today,” she said. “I count on all of you to mobilize more resources in your respective capacities to end the Ebola pandemic in our country.”

The African Centers for Disease Control and Prevention, part of the African Union, said Uganda will host a ministerial meeting next week with neighboring countries and other African countries that have experienced Ebola outbreaks to explore ways to deal with them.

This is the first outbreak of the Sudanese strain of Ebola in Uganda since 2012. The country is still struggling with the consequences of the Covid pandemic, which closed schools for nearly two years.

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