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The ongoing outbreak of Sudan Ebolavirus in Uganda is showing signs that transmission may now be under control.
On Monday, November 28, Uganda’s Ministry of Health reported the death of a stillborn infant infected during pregnancy. The mother is an Ebola survivor and was reported to be in good health.
Other than this unfortunate case, the news on Ebola has been largely positive for the last several weeks.
Cases have continued to decline according to World Health Organization situation reports and only six active cases are currently being treated in specialized Ebola treatment units.
By case fatality rate, Ebola is one of the deadliest known viruses. In the current outbreak, fifty-six people have died and eighty have recovered, for a raw case fatality rate of 39.4%. This is lower than the average 65.4% for Ebola outbreaks, and even lower than average for other outbreaks of Sudan Ebolavirus, which tends to be less deadly than the more common Zaire ebolavirus that was responsible for the 2014 – 2016 outbreak in West Africa.
Contact tracing is extremely important for containing Ebola outbreaks. It is estimated that the incubation period for acute infections — the delay between the time a person is infected and when they begin to show symptoms — may be as long as twenty-one days. One distressing statistic is that the follow-up rate for contacts has dropped to less than 70% from a high around 95% during most of October and November. Although declining cases in the last few weeks means that there have been fewer contacts to trace, a large number remain unaccounted for. If there are infections among this group, they could be the cause of a third transmission wave.
Uganda has also used lockdowns to control Ebola’s spread and recently extended the lockdowns in the districts of Mubende and Kassanda, where the most recent cases were found. The lockdowns — which include a dusk-to-dawn curfew, a ban on personal travel, and the closure of markets, bars and churches — are scheduled to be lifted on December 17 if no new cases are found. Schools across the country remain closed. The rapid control of this outbreak, which began in September and quickly spread to multiple districts, is an encouraging sign that health systems remain robust and devastating epidemics are not inevitable. However, to prevent a resurgence the Ministry of Health must remain vigilant and surveillance will need to continue at least through the end of the year.
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