TY - JOUR
T1 - Ebola disease outbreak caused by the Sudan virus in Uganda, 2022: a descriptive epidemiological study: a descriptive epidemiological study
AU - Kabami, Zainah
AU - Ario, Alex R.
AU - Harris, Julie R.
AU - Ninsiima, Mackline
AU - Ahirirwe, Sherry R.
AU - Ocero, Jane R.Aceng
AU - Atwine, Diana
AU - Mwebesa, Henry G.
AU - Kyabayinze, Daniel J.
AU - Muruta, Allan N.
AU - Kagirita, Atek
AU - Tegegn, Yonas
AU - Nanyunja, Miriam
AU - Kizito, Saudah N.
AU - Kadobera, Daniel
AU - Kwesiga, Benon
AU - Gidudu, Samuel
AU - Migisha, Richard
AU - Makumbi, Issa
AU - Eurien, Daniel
AU - Elyanu, Peter J.
AU - Ndyabakira, Alex
AU - Naiga, Helen Nelly
AU - Zalwango, Jane F.
AU - Agaba, Brian
AU - Kawungezi, Peter C.
AU - Zalwango, Marie G.
AU - King, Patrick
AU - Simbwa, Brenda N.
AU - Akunzirwe, Rebecca
AU - Wanyana, Mercy W.
AU - Zavuga, Robert
AU - Kiggundu, Thomas
AU - Bosa, Henry Kyobe
AU - Komakech, Allan
AU - Gonahasa, Doreen Nsiimire
AU - Bulage, Lilian
AU - Kyamwine, Irene Byakatonda
AU - Okethwangu, Denis
AU - Kayiwa, Joshua
AU - Nelson, Lisa J.
AU - Boore, Amy L.
AU - Nabatanzi, Sandra
AU - Nsibambi, Thomas
AU - Ntale, Jonathan
AU - Mwangi, Christina
AU - Fitzmaurice, Arthur G.
AU - Biribawa, Claire
AU - Jacob, Shevin
AU - Fletcher, Tom
PY - 2024/10/1
Y1 - 2024/10/1
N2 - Background: Uganda has had seven Ebola disease outbreaks, between 2000 and 2022. On Sept 20, 2022, the Ministry of Health declared a Sudan virus disease outbreak in Mubende District, Central Uganda. We describe the epidemiological characteristics and transmission dynamics. Methods: For this descriptive study, cases were classified as suspected, probable, or confirmed using Ministry of Health case definitions. We investigated all reported cases to obtain data on case-patient demographics, exposures, and signs and symptoms, and identified transmission chains. We conducted a descriptive epidemiological study and also calculated basic reproduction number (Ro) estimates. Findings: Between Aug 8 and Nov 27, 2022, 164 cases (142 confirmed, 22 probable) were identified from nine (6%) of 146 districts. The median age was 29 years (IQR 20–38), 95 (58%) of 164 patients were male, and 77 (47%) patients died. Symptom onsets ranged from Aug 8 to Nov 27, 2022. The case fatality rate was highest in children younger than 10 years (17 [74%] of 23 patients). Fever (135 [84%] of 160 patients), vomiting (93 [58%] patients), weakness (89 [56%] patients), and diarrhoea (81 [51%] patients) were the most common symptoms; bleeding was uncommon (21 [13%] patients). Before outbreak identification, most case-patients (26 [60%] of 43 patients) sought care at private health facilities. The median incubation was 6 days (IQR 5–8), and median time from onset to death was 10 days (7–23). Most early cases represented health-care-associated transmission (43 [26%] of 164 patients); most later cases represented household transmission (109 [66%]). Overall Ro was 1·25. Interpretation: Despite delayed detection, the 2022 Sudan virus disease outbreak was rapidly controlled, possibly thanks to a low Ro. Children (aged <10 years) were at the highest risk of death, highlighting the need for targeted interventions to improve their outcomes during Ebola disease outbreaks. Initial care-seeking occurred at facilities outside the government system, showing a need to ensure that private and public facilities receive training to identify possible Ebola disease cases during an outbreak. Health-care-associated transmission in private health facilities drove the early outbreak, suggesting gaps in infection prevention and control. Funding: None.
AB - Background: Uganda has had seven Ebola disease outbreaks, between 2000 and 2022. On Sept 20, 2022, the Ministry of Health declared a Sudan virus disease outbreak in Mubende District, Central Uganda. We describe the epidemiological characteristics and transmission dynamics. Methods: For this descriptive study, cases were classified as suspected, probable, or confirmed using Ministry of Health case definitions. We investigated all reported cases to obtain data on case-patient demographics, exposures, and signs and symptoms, and identified transmission chains. We conducted a descriptive epidemiological study and also calculated basic reproduction number (Ro) estimates. Findings: Between Aug 8 and Nov 27, 2022, 164 cases (142 confirmed, 22 probable) were identified from nine (6%) of 146 districts. The median age was 29 years (IQR 20–38), 95 (58%) of 164 patients were male, and 77 (47%) patients died. Symptom onsets ranged from Aug 8 to Nov 27, 2022. The case fatality rate was highest in children younger than 10 years (17 [74%] of 23 patients). Fever (135 [84%] of 160 patients), vomiting (93 [58%] patients), weakness (89 [56%] patients), and diarrhoea (81 [51%] patients) were the most common symptoms; bleeding was uncommon (21 [13%] patients). Before outbreak identification, most case-patients (26 [60%] of 43 patients) sought care at private health facilities. The median incubation was 6 days (IQR 5–8), and median time from onset to death was 10 days (7–23). Most early cases represented health-care-associated transmission (43 [26%] of 164 patients); most later cases represented household transmission (109 [66%]). Overall Ro was 1·25. Interpretation: Despite delayed detection, the 2022 Sudan virus disease outbreak was rapidly controlled, possibly thanks to a low Ro. Children (aged <10 years) were at the highest risk of death, highlighting the need for targeted interventions to improve their outcomes during Ebola disease outbreaks. Initial care-seeking occurred at facilities outside the government system, showing a need to ensure that private and public facilities receive training to identify possible Ebola disease cases during an outbreak. Health-care-associated transmission in private health facilities drove the early outbreak, suggesting gaps in infection prevention and control. Funding: None.
U2 - 10.1016/s2214-109x(24)00260-2
DO - 10.1016/s2214-109x(24)00260-2
M3 - Article
VL - 12
SP - e1684-e1692
JO - The Lancet. Global health
JF - The Lancet. Global health
IS - 10
ER -
