Health Professionals

Clinical Updates

16 November 2012

Ebola haemorrhagic fever in Uganda

An outbreak of Ebola haemorrhagic fever has been reported in Luweero district, Central Uganda; this is the second outbreak of Ebola to be reported in Uganda in 2012. 

As of 15 November 2012, three people; all thought to be from the same family in Kakute sub-county, Sambu parish in Nyimbwa sub-county, have died and five close contacts of these cases are under medical observation. The Sudan strain of Ebola virus has been confirmed in two of the cases [1-2].

The Ugandan Ministry of Health is working with stakeholders and partners including the World Health Organization (WHO), Médecins Sans Frontières and the African Field Epidemiology Network (AFENET) to control the outbreak. All possible contacts of cases are being identified for active follow up [1].

Ebola is known to occur in Uganda; an outbreak was reported from November 2007 to January 2008 in Bundibugyo district in western Uganda and in May 2011 in Luweero district, central Uganda [3-5]. In July 2012, there were 24 probable and confirmed cases reported in Kibaale district, Western Uganda, including 17 deaths [6].

Ebola haemorrhagic fever

Ebola haemorrhagic fever is a severe disease caused by a virus of the Filoviridae family. The natural reservoir for Ebola is not known, but non-human primates can become ill with Ebola [6].

Following an incubation period of four to 10 days (range two to 21 days) illness presents with the sudden onset of fever, headache, joint and muscle aches, and weakness. As the infection progresses, nausea, vomiting and diarrhoea, shortness of breath, confusion, and haemorrhage can occur. This can lead to multi-organ failure, shock, and death. Ebola is transmitted via direct contact with the bodily fluids of an infected person. Ebola has also been reported following contact with the tissues of infected animals.

Advice for travellers

The risk to a traveller of contracting Ebola is very low in the absence of direct contact with the blood or body fluids of an infected person, animal, or objects, such as needles, that have been contaminated with blood or body fluids. There have been no known imported cases of Ebola in the United Kingdom.

Travellers should avoid all contact with infected patients. Those who are providing medical care or are involved in the evaluation of an outbreak should observe strict barrier precautions.

Travellers who have been potentially exposed to Ebola virus should seek medical attention immediately if they experience any symptoms consistent with Ebola within the first 21 days of return to the UK.

United Kingdom guidance on the management and control of viral haemorrhagic fevers (VHF) has been written by the Advisory Committee on Dangerous Pathogens.

Guidance for healthcare workers who will be working with VHF patients in African healthcare settings has been written by the CDC in conjunction with WHO.

References

1. The Government of Uganda.  Uganda Media Centre. Ebola outbreak in Luweero district. 15 November 2012, [Accessed 16 November 2012]. Available at:

http://www.mediacentre.go.ug/details.php?catId=3&item=1899

2. Integrated Regional Information Networks, Uganda: Fresh Ebola outbreak burdens health system, 15 November 2012. [Accessed 16 November 2012]. Available at:

http://www.irinnews.org/Report/96790/UGANDA-Fresh-Ebola-outbreak-burdens-health-system

3.  International Federation of Red Cross and Red Crescent Societies. Uganda: Ebola [Accessed 30 July 2012]. Available at: [Accessed 16 November 2012]. Available at: http://reliefweb.int/sites/reliefweb.int/files/resources/Full_

Report_741.pdf

4. World Health Organization. Ebola haemorrhagic fever in Uganda – update. 7 December 2007. [Accessed 16 November 2012]. Available at: http://www.who.int/csr/don/2007_12_07/en/index.html

5.  World Health Organization. Ebola in Uganda. 18 May 201. [Accessed 16 November 2012]. Available at:http://www.who.int/csr/don/2011_05_18/en/index.html

6. Beeching NJ, Fletcher TE, Hill DR, Thomson GL. Travellers and viral haemorrhagic fevers: what are the risks? Int J Anti Micro Agents 36:S26-S35, 2010.

7. World Health Organization. End of Ebola outbreak in Uganda. 4 October 2012. [Accessed 16 November 2012]. Available at: http://www.who.int/csr/don/2012_10_04/en/index.html

 

Links

Health Protection Agency

World Health Organization