H5N1

WHO DON: Sudan virus disease – Uganda

A Disease Outbreak News item from WHO: Sudan virus disease – Uganda. Excerpt:

Situation at a glance  

Since the outbreak of Sudan virus disease (SVD) was declared in Uganda on 30 January 2025, and as of 5 March 2025, a total of 14 cases (including 12 confirmed cases and two probable cases) including four deaths (two confirmed and two probable) have been reported.  

On 1 March 2025, the Ministry of Health released a press statement confirming the tenth case. The patient was a child under 5 years old who presented and died in the Mulago hospital on 23 February 2025. As of 5 March, two additional confirmed cases and two probable deaths have been reported that are linked to this case. Both of these cases are currently admitted to treatment facilities.  

Eight confirmed cases received care at treatment centres in the capital Kampala and in Mbale and were discharged on 18 February 2025. As of 5 March 2025, 192 new contacts have been identified and are under follow-up in Kampala, Ntoroko and Wakiso. In the absence of licensed vaccines and therapeutics for the prevention and treatment of SVD, the risk of potential serious public health impact is high.  

Description of the situation  

Since the second disease outbreak news on this event published on 21 February 2025, three additional laboratory-confirmed cases and two probable deaths of SVD have been reported in Uganda. As of 5 March 2025, 12 confirmed and two probable cases, among these four deaths (two confirmed, two probable) have been reported with a case fatality ratio (CFR) of 29%. The latest confirmed cases are reported to be epidemiologically linked to the two probable cases.   

The age range of confirmed cases is 1.5 years to 55 years, with a mean age of 27 years and males accounted for 55% of the total cases. The cases were reported from six districts in the country which include Jinja, Kampala, Kyegegwe, Mbale, Ntoroko and Wakiso. 

On 1 March 2025, the Ministry of Health released a press statement about the confirmation of a new case. The case was an under 5-year-old child identified at the Mulago Hospital where the patient presented with signs and symptoms meeting the suspect case definition. A laboratory sample was collected, and the child was confirmed with SVD on 26 February by PCR. Following investigations, two probable deaths linked to this case have been reported. This includes the child’s mother who was pregnant at the time of symptom onset on 22 January and died on 6 February. Her newborn child died on 12 February. The three deaths did not have a supervised burial.   

On 3 March, an 11th case was confirmed, an adult female, contact of case 10, and on 4 March, a 12th case was confirmed, an adult female, contact of the probable case (the mother of case 10). Both of these cases are currently admitted to treatment facilities.  

Since the start of the outbreak, eight cases have recovered and been discharged. 

As of 5 March, there are 192 new contacts listed around the new cases and 299 previously listed contacts who had completed the 21-day follow-up period.    

SVD alert levels reported from the community and the health facilities have been low and efforts are ongoing to improve this. Mortality surveillance has also been set up since the declaration of the outbreak and will continue in Jinja, Kampala, Mbale, Ntoroko and Wakiso districts.  

Retrospective epidemiological and laboratory investigations are ongoing to find the source of the outbreak while active case search in and around the community and health facilities linked to the case movements have been intensified. 

Sudan virus disease – Uganda

WHO has published a DON: Sudan virus disease – Uganda. Excerpt:

Situation at a glance  

On 30 January 2025, the Ministry of Health of Uganda declared an outbreak of Sudan virus disease (SVD) following confirmation from three national reference laboratories. The case presented with signs and symptoms between 20 and 21 January and died on 29 January at the National Referral Hospital in Kampala.  

As of 30 January 2025, 45 contacts have been identified, including 34 healthcare workers and 11 family members. Sudan virus disease belongs to the same family as Ebola virus disease. It is caused by Sudan virus (SUDV). It is a severe disease with high case fatality from 41% to 70% in past outbreaks.  

In the absence of licensed vaccines and therapeutics for the prevention and treatment of SVD, the risk of potential serious public health impact is high. Early supportive patient care and treatment may increase the chance of survival from severe disease.  

Description of the situation  

On 30 January 2025, the Ministry of Health of Uganda declared an outbreak of Sudan virus disease (SVD) following confirmation from three national reference laboratories.  

The confirmed case was an adult male nurse who initially developed fever-like symptoms and sought treatment from a traditional healer as well as at multiple health facilities.  

The patient presented with a history of high fever, chest pain, and difficulty in breathing with symptoms onset between 20 and 21 January, which later progressed to unexplained bleeding from multiple body sites. The patient experienced multi-organ failure and died at the National Referral Hospital on 29 January.   

Samples taken post-mortem were confirmed for Sudan virus (SUDV).  

Forty-five contacts have so far been identified, including 34 healthcare workers and 11 family members.

WHO accelerates efforts to support response to Sudan virus disease outbreak in Uganda

A news release from WHO AFRO: WHO accelerates efforts to support response to Sudan virus disease outbreak in Uganda.

Brazzaville/Kampala – Following the confirmation of an outbreak of Sudan virus disease – which belongs to the same family as Ebola virus disease – in Uganda today, World Health Organization (WHO) is mobilizing efforts to support the national health authorities to swiftly contain and end the outbreak.   

WHO is deploying senior public health experts and mobilizing staff from the country office to support all the key outbreak response measures. In addition, the Organization has allocated US$ 1 million from its Contingency Fund for Emergencies to help accelerate early action, and is readying medical supplies, including personal protective equipment to deliver to Uganda from its Emergency Response Hub in Nairobi.   

While there are no licensed vaccines for the Sudan virus disease, WHO is coordinating with developers to deploy candidate vaccines as an addition to the other public health measures. The vaccines will be deployed once all administrative and regulatory approvals are obtained.   

So far one confirmed case – a nurse from Mulago National Referral Hospital in the capital Kampala – has been reported. No other health workers or patients have shown symptoms of the disease.  A total of 45 contacts, including health workers and family members of the confirmed case (deceased) have been identified and are currently under close monitoring. The identification of the case in a densely populated urban requires rapid and intense response.   

“We welcome the prompt declaration of this outbreak, and as a comprehensive response is being established, we are supporting the government and partners to scale up measures to quicky identify cases, isolate and provide care, curb the spread of the virus and protect the population,” said Dr Matshidiso Moeti, WHO Regional Director for Africa. “Uganda’s robust expertise in responding to public health emergencies will be crucial in ending this outbreak effectively.”  

There have been eight previous outbreaks of the Sudan virus disease, with five occurring in Uganda and three in Sudan. Uganda last reported an outbreak of Sudan virus disease in 2022.   

“Banking on the existing expertise, we are accelerating all efforts, including expertise, resources and tools to save lives and bring the outbreak to a halt swiftly,” said Dr Kasonde Mwinga, WHO Representative in Uganda.   

Sudan virus disease is a severe, often fatal illness affecting humans and other primates that is due to Orthoebolavirus sudanense (Sudan virus), a viral species belonging to the same genus of the virus causing Ebola virus disease.  Case fatality rates of Sudan virus disease have varied from 41% to 100% in past outbreaks. There are no approved treatments or vaccines for Sudan virus. Early initiation of supportive treatment has been shown to significantly reduce deaths from Sudan virus disease. 

How we used machine learning to look where Ebola may strike

Via ProPublica: How We Used Machine Learning to Look Where Ebola May Strike. Excerpt:

ProPublica spent months teaching a computer to analyze past Ebola outbreaks linked to deforestation. What we found reveals a weakness in the way that governments and public health experts are preparing for future pandemics. 

The bright spots on the map struck us like a lightning bolt. 

We had spent months teaching a computer about the Ebola virus –– feeding it information about the landscapes and populations in places where the disease had previously emerged, showing it how to analyze those outbreaks for patterns, and then instructing it to flag other areas that looked similarly perilous.   

Some of the highlighted spots were predictable; the virus had repeatedly ravaged one of those countries.  

But we didn’t expect our model to light up Nigeria, the most populous country in Africa. The West African nation and international travel hub has never seeded an Ebola outbreak, but just a year ago, it served as the springboard for another virus to travel into Europe and the Americas and spread across the globe. However that virus, mpox, originally known as monkeypox, is rarely fatal.  

What if it had been Ebola, which kills about half of the people it infects?  

We asked Nigerian public health officials whether they were concerned.  

“Ebola is not part of our top concerns any more,” said Oyeladun Okunromade, the director of surveillance and epidemiology at the Nigeria Centre for Disease Control.  

In the aftermath of the 2014 West African Ebola epidemic, the worst on record, Nigerian officials were on high alert. But last year, they took the virus off the list of the top infectious diseases the country needed to prepare for, downgrading Ebola in relation to threats like mpox, which Nigeria was actively fighting.  

The disjoint between how our model sees Nigeria’s risk and how the nation’s health officials view it reveals a weakness in the way that governments and public health experts are preparing for future pandemics. The methods many countries use to rank threats focus mainly on factors that occur after an outbreak has already begun, such as the potential economic impact of an epidemic. Or they rely on past cases, looking at where a pathogen has previously struck.  

Neither approach considers the root causes.  

We’ve spent more than a year digging into the question of what causes outbreaks and what the world can do to prevent them. And we’ve learned that while science has advanced so we’re starting to understand the complex factors that trigger an outbreak, the world is not doing nearly enough to try to head off the next big one.

Kirundo-Muyinga: A mysterious disease with symptoms resembling those of the Ebola virus appears

Via SOS Médias Burundi, a March 27 report: Kirundo-Muyinga: a mysterious disease with symptoms resembling those of the Ebola virus appears. The Google translation:

An as yet unidentified disease killed three people in three days in the commune of Gitobe in the province of Kirundo and in the commune of Butihinda in the province of Muyinga (north-eastern Burundi). 

Symptoms developed by patients suffering from this disease resemble those of Ebola hemorrhagic virus or Marburg virus disease. In the case of Kirundo, the governor and the provincial doctor are waiting for the results of samples taken by specialists from the INSP (National Institute of Public Health) to decide.  

The ministry in charge of health has already confirmed for that of Muyinga that it is neither the Marburg virus disease nor Ebola. (SOS Media Burundi) This disease, not yet identified but having signs similar to those of Ebola, has just claimed the lives of two people in the commune of Gitobe. Both people died within 24 hours of showing the signs. All the patients come from the same Migwa hill, in the Baziro area.  

According to witnesses on the spot, "the symptoms include abdominal pain, nasal bleeding which increases after death, acute headaches, high fever, vomiting and dizziness". This disease kills very quickly, noted a nurse interviewed by SOS Media Burundi.  

“It's a disease that kills quickly. Within 24 hours, the infected person dies. It's terrible, we are all waiting for death," said a panicked nurse from the Migwa health center in the Gashoho health district in Muyinga province where patients were sent, including two women who died there.

When the population of Baziro wanted to bring the third person there, the population of Migwa blocked the entrances, fearing the spread of the disease. For the moment no one can leave the area of ​​Baziro which, it seems, has been confined. 

Samples were taken by the INSP to identify which disease it is.  

But until now the disease is not yet detected, according to doctors.  

In the morning of Friday, the governor of Kirundo, Albert Hatungimana, accompanied by the provincial doctor, carried out a raid in the commune of Gitobe, but they made no forecast.  

"We are awaiting the results of the swabs," a member of the governor's cabinet said.  

The population is worried because, she says, "So far no real prevention strategy against this disease has been communicated".  

“Apart from washing your hands and avoiding greeting each other, there are no strict measures, which can promote contamination,” residents insisted.  

Note that at Kirundo hospital, the first case was also admitted on Friday evening. In the commune of Ntega (same province), people with the same symptoms were reported on the same Friday evening.  

The population of the urban center of Kirundo lives in panic fear. She asks the government to declare the epidemic so that there is a rapid intervention.  

Another case was recorded in Giteranyi commune, Muyinga province (neighboring Kirundo). A student from Kobero Basic School not far from the border with Tanzania, died of this disease last Thursday.  

Tanzania declared a Marburg virus epidemic on March 21. A cousin of Ebola, this “filovirus” causes high fevers accompanied by virulent haemorrhages. So far, there is no vaccine or antiviral treatment for this disease, which can also attack primates. It is suspected that it is the Marburg virus which has spread in the Burundian provinces bordering Tanzania, the epidemic having been detected in the Kagera region in the north-west of Tanzania not far from Burundi and Rwanda .

Uganda: Family denies exhuming body of Ebola casualty

Via The Monitor, which has done an excellent job of covering the outbreak: Family denies exhuming body of Ebola casualty. Excerpt:

The family of an Ebola Virus Disease (EVD) victim, whose body was allegedly exhumed by unknown people, have asked the Ministry of Health and the security agencies to investigate the incident.  

The incident took place in Kitongo Village, Kalwana Sub-county Kassanda District about a month ago, according to district health officials.  

While meeting the Kassanda District Ebola taskforce, Health Minister Jane Ruth Aceng, and other officials at Kassanda District headquarters on Wednesday, a family representative, Mr Mubarak Muwade Kawuki, denied claims that they exhumed the body to perform Muslim burial rituals on it.  

He added that they are now being stigmatised, “causing a lot of distress to our family”.   

“Our own investigation reveals that nobody tampered with the grave,” he said.  

Mr Kawuki insisted that the rituals and the preparation of the grave were performed prior to their loved one being buried.  

He added that the interment was done by the burial team from the government.     

“There was no single reason as family members to have the body of a person presumed to have died of Ebola exhumed in the name of performing a religious burial,” he said.   

He added: “It is also interesting that when we asked the police to investigate the incident, they have failed to give us a report.”  

The family has asked the government to institute a special investigation to examine the grave and possibly exhume the body to find out if it was tampered with.  

But in an earlier interview with this paper, the Kassanda Resident District Commissioner, Ms Phoebe Namulindwa, revealed that the health officials have recovered some evidence but did not give any more details on the matter.  

She added that some people had also confessed to exhuming the body.  

“I only request the community to stop stigmatising the family because we are all focused on fighting the Ebola Virus Disease in Kassanda District,” she said.  

Meanwhile Dr Aceng urged the family to join the fight against Ebola and forget the past.  

“I will call the team and interact with them to find out what really happened. We have had some challenges in Kassanda District as we fight the Ebola pandemic. We should work as a team to stop the spread of Ebola,” she said.  

It was revealed at the meeting that the cumulative confirmed Ebola cases is now 50, while the cumulative death cases are now 18 in Kassanda District.

Uganda: MSF responds to Ebola outbreak

Via Doctors Without Borders USA: Uganda: MSF responds to Ebola outbreak.

NEW YORK, SEPTEMBER 23, 2022—Following the September 20 declaration of an Ebola outbreak in Uganda in the country’s central Mubende district, the ministry of health has asked the international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) to support its efforts in the fight against the spread of the disease.  

On September 21, an MSF team of six people—including doctors and logisticians—traveled to the town of Mubende to carry out an assessment of the situation and the needs at the regional referral hospital, where the first case was detected. The virus has been confirmed to be the rarer Sudan strain of Ebola for which there is no approved vaccine or treatment, unlike the Zaire strain that caused the last several outbreaks in the Democratic Republic of Congo.  

Since carrying out this assessment, MSF has begun setting up an Ebola isolation and treatment center in the Mubende hospital to help improve patient care. Teams are also exploring the possibility of setting up a second center in the town of Madudu, which is approximately 25 kilometers [15 miles] north of where the first person who died from Ebola originated and where several suspicious cases are reported.  

MSF is currently putting together a team of health workers, epidemiologists, and logisticians with experience in hemorrhagic fevers to start work next week.  

The last Ebola outbreak in the country occurred in 2019. MSF intervened at that time to support the Ugandan health authorities in the management of people who had been in contact with these confirmed cases, the establishment of an Ebola treatment unit, and the improvement of infection prevention and control measures in health facilities.

The Ugandan Ministry of Health has tweeted an update:

Uganda: Second suspected Ebola victim dies

Uganda's new Ebola outbreak hit the news yesterday, but it seems to have started several weeks ago. Via New Vision: Second suspected Ebola victim dies.

Another man suspected to be infected with Ebola has died at Mubende Regional Referral Hospital.  

He was part of the 14 people who checked into Mubende Regional Referral Hospital with symptoms of Ebola on September 20, 2022.  

Emmanuel Ainebyoona, the health ministry spokesperson, confirmed the death of suspected victim.  

"Yes, there is a child who died yesterday but we are waiting for test results  from UVRI. It is a suspected death at the moment," he said.  

According to Mubende RDC Rosemary Byabashaijja, a man from Madudu Sub County in Mubende died yesterday (September 20) after he was admitted at Mubende Regional Referral Hospital.  

The RDC is heading the Mubende Rapid Response team, which is working with Ministry of Health to track down contacts for the person who died on Monday and investigate the six deaths that occurred earlier in the month.  

The six deaths occurred suddenly and the local people say they died of strange illness.  

Byabashaijja said they had identified 14 contacts of the person who died on September 19, 2022. They included 10 people from Madudu Sub county including the one who passed on yesterday (September 20) and four people from neighbouring Kyegegwa district in Toro.  

“Since we registered the first case, we sent a surveillance team which goes around where they even sensitize the people. In Madudu, we have been asking those who were in touch with first victims to willingly come up and be tested and we are happy that some are turning up,” she said.  

On September 20, the team of medics took away the body of the first victims from Mubende hospital and buried. The body of the person who died on September 20 is awaiting burial today (September 21), according to sources.  

Byabashaijja noted that the six people expected to have died of Ebola form Madudu died because of self-medication.  

An isolation center has been set up at Mubende Regional Referral Hospital where suspected cases are being quarantined pending the results from samples picked from them.

August 2022 Ebola case in DRC linked to 2018-2020 Nord Kivu EVD outbreak

Thanks to Helen Branswell for tweeting the link to this excellent report at Virological.org: August 2022 EVD case in DRC linked to 2018-2020 Nord Kivu EVD outbreak. Excerpt:

The new case of Ebola Virus Disease in Beni is genetically linked to the 2018-2020 Nord Kivu/Ituri EVD outbreak and does not represent a new spillover event.**  

Context  

On Monday, August 15, 2022, the Institut National de Recherche Biomédicale (INRB) Beni mobile laboratory received an oropharyngeal secretion sample taken from a deceased patient who was being treated at the Beni General Reference Hospital (HGR-Beni). The sample tested positive for Ebola virus (EBOV) using the Cepheid Xpert Ebola assay with ct- values of 32.5 for viral glycoprotein (GP), and 28.2 for viral nucleoprotein (NP). For quality control and confirmation, samples were sent to the Rodolphe Mérieux INRB-Goma Laboratory on Tuesday August 16, 2022, where the analysis confirmed the EVD case.  

The patient was admitted on July 23, 2022 to the Internal Medicine department of the HGR-Beni for cough, headache, polyarthralgia, intense physical asthenia dating back several days and for which she had self-medicated with non-specified drugs. She was HIV-positive on antiretroviral treatment, and she had also presented with tuberculosis for which she was receiving anti-tuberculosis treatment.  

On August 13, 2022, her health condition deteriorated with the onset of bronchial congestion and kidney failure, which prompted her transfer to the intensive care unit for better care. She died on August 15, 2022. In total her hospitalization lasted 23 days. The body was collected by the family the same day for burial.  

On August 17, 2022, 131 contacts were listed, including 60 front-line healthcare workers and 71 co-patients. Of the 131 pre-listed contacts, 59 of the 60 HCWs are vaccinated. The vaccination status of the index case and 71 co-patients is not yet known.

The Democratic Republic of the Congo declares 14th Ebola outbreak over

Via WHO AFRO: The Democratic Republic of the Congo declares 14th Ebola outbreak over. Excerpt:

Brazzaville/Kinshasa – The Democratic Republic of the Congo today declared the end of the Ebola outbreak that erupted less than three months ago in Mbandaka, the capital of Equateur Province in the northwest. It was the third outbreak in the province since 2018 and the country’s 14th overall.  

With greater experience in Ebola control, national emergency teams, with the support from World Health Organization (WHO) and partners, mounted a swift response soon after the outbreak was declared on 23 April, rolling out key counter measures including testing, contact tracing, infection prevention and control, treatmentand community engagement. Vaccination – a crucial protective measure – was launched just four days after the outbreak was declared.  

In all, there were four confirmed cases and one probable case – all of whom died. In the previous outbreak in Equateur Province that lasted from June to November 2020, there were 130 confirmed cases and 55 deaths.  

“Thanks to the robust response by the national authorities, this outbreak has been brought to an end swiftly with limited transmission of the virus,” said Dr Matshidiso Moeti, WHO Regional Director for Africa. “Crucial lessons have been learned from past outbreaks and they have been applied to devise and deploy an ever more effective Ebola response.”  

The just ended outbreak saw a total of 2104 people vaccinated, including 302 contacts and 1307 frontline workers. To facilitate the vaccination rollout, an ultra-cold chain freezer was installed in Mbandaka which allowed for vaccine doses to be stored locally and safely and be delivered effectively.  

The Democratic Republic of the Congo has now recorded 14 Ebola outbreaks since 1976, six of which have occurred since 2018.  

“Africa is seeing an increase in Ebola and other infectious diseases that jump from animals to humans impacting large urban areas,” said Dr Moeti. “We need to be ever more vigilant to ensure we catch cases quickly. This outbreak response shows that by bolstering preparedness, disease surveillance and swift detection, we can stay a step ahead.”