Credit CDC
#17,047
Sixteen days ago Uganda announced their first outbreak of Ebola Sudan in a decade (see WHO: Uganda Declares Ebola Virus Disease Outbreak), now with reportedly more than 5 dozen cases and 29 deaths (including 4 Healthcare Workers).
While no cases have been detected outside of Uganda, today the US Embassy in Uganda announced that all US bound passengers with travel history to Uganda over the past 21 days will be rerouted to 5 specific airports where they will be screened for the disease.
First the Health Alert from the US Embassy, followed by excerpts from the HAN Advisory.
Location: UgandaHAN: Outbreak of Ebola Virus Disease (Sudan ebolavirus) in Central Ugan
Event: As of October 6, at 11:59 p.m. ET, all U.S.-bound passengers who have been in Uganda in the 21 days prior to their arrival will be routed to one of the following designated airports: New York (JFK), Newark (EWR), Atlanta (ATL), Chicago (ORD), or Washington (IAD) for enhanced screening. Out of an abundance of caution, the Centers for Disease Control and Prevention (CDC) and the Department of Homeland Security (DHS) Customs and Border Protection (CBP) will apply new layers of screening at these five U.S. airports in response to the Ebola outbreak in Uganda.To date in this outbreak, cases have only been confirmed in Uganda and no suspected, probable, or confirmed cases of Ebola have been reported in the United States, and the risk of Ebola domestically is currently low. The enhanced screening applies to all passengers, including U.S. citizens, lawful permanent residents, and visa holders (to include Diplomatic and Official visas).
You should contact your travel carrier if you have additional questions.
Actions to take:
For more information, please consult the CDC page.
Please be prepared for flight changes or cancellations.
If you are planning to travel to the United States and havespent time in Uganda, contact your airline with any questions and to confirm your flight and route.
The CDC uses their HAN (Health Advisory Network) to provide up-to-date information to a wide audience of health care professionals, including public information officers; federal, state, territorial, tribal, and local public health practitioners; clinicians; and public health laboratories.
While occasionally these systems are used for situations requiring immediate action (a HAN ALERT), most of the time they are fairly routine (HAN Advisories or Updates), and are used primarily to convey updated guidance to interested parties.
Today's announcement is a Health Advisory - a 2nd tier announcement - which, as the CDC describes: provides important information for a specific incident or situation; contains recommendations or actionable items to be performed by public health officials, laboratorians, and/or clinicians; may not require immediate action.
I've only posted an excerpt, so follow the link to read it in its entirety.
Outbreak of Ebola virus disease (Sudan ebolavirus) in Central Uganda
Distributed via the CDC Health Alert Network
October 6, 2022, 10:45 AM ET
CDCHAN-00477
Summary
The Centers for Disease Control and Prevention (CDC) is issuing this Health Alert Network (HAN) Health Advisory about a recently confirmed outbreak of Ebola virus disease (EVD) in Uganda caused by Sudan virus (species Sudan ebolavirus) to summarize CDC’s recommendations for U.S. public health departments and clinicians, case identification and testing, and clinical laboratory biosafety considerations. No suspected, probable, or confirmed EVD cases related to this outbreak have yet been reported in the United States. However, as a precaution and to remind clinicians about best practices, CDC is communicating with public health departments, public health laboratories, and healthcare workers in the United States to raise awareness of this outbreak.
Background
On September 20, 2022, the Ministry of Health of Uganda officially declared an outbreak of EVD due to Sudan virus (species Sudan ebolavirus)in Mubende District, Central Uganda.
The first confirmed case of EVD was a 25-year-old man who lived in Mubende District and quickly identified as a suspect case of viral hemorrhagic fever (VHF) and isolated in the Mubende Regional Referral Hospital. Blood collected from this patient tested positive for Sudan virus by real-time reverse transcription polymerase chain reaction (rRT-PCR) on September 19, 2022, at the Uganda Virus Research Institute (UVRI). The patient died the same day, and a supervised burial was performed by trained staff wearing proper personal protective equipment (PPE). Further investigation into this case revealed a cluster of unexplained deaths occurring in the community during the previous month. As of October 6, 2022, a total of 44 confirmed cases, 10 confirmed deaths, and 20 probable deaths of EVD have been identified in Uganda.This is the fifth outbreak of EVD caused by Sudan virus in Uganda since 2000. The current outbreak is in the same area as Uganda’s most recent EVD outbreak caused by Sudan virus, which occurred in 2012. During the 2012 outbreak, limited secondary transmission was reported, and the outbreak was effectively contained.As of October 6, 2022, no suspected, probable, or confirmed EVD cases related to this outbreak have been reported in the United States or other countries outside of Uganda. The geographic scope of this outbreak in Uganda is currently limited to five districts in central Uganda and not the capital Kampala or the travel hub of Entebbe. While there are no direct flights from Uganda to the United States, travelers from or passing through affected areas in Uganda can enter the United States on flights connecting from other countries.As a precaution, CDC is communicating with public health departments, public health laboratories, and healthcare workers in the United States, and educating travelers, to raise awareness of this outbreak. It is important for clinicians to obtain a detailed travel history from patients with suspected EVD, especially those that have been in affected areas of Uganda. Early consideration of EVD in the differential diagnosis is important for providing appropriate and prompt patient care, diagnostics, and to prevent the spread of infection. Healthcare providers should be alert for and evaluate any patients suspected of having EVD, particularly among people who have recently traveled to affected areas in Uganda.
It is a bit unusual to see a HAN Advisory released for an Ebola outbreak in Africa. Other than one issued in 2019 when a new Rapid Ebola test was released, you have to go all the way back to 2014's multi-country outbreak in West Africa (and imported cases to the United States) to find another (see 2014's CDC HAN: Evaluation Of US Patients Suspect Of Having Ebola Virus).
While these steps are likely due to an abundance of caution, the rapid spread of Ebola in Uganda and the lack of an effective vaccine makes this outbreak a little different from Ebola Zaire outbreaks we've seen since 2016.
Although the risk of importing cases of Ebola is probably low, it it is not zero. Just as the risks of seeing imported cases of Lassa Fever, MERS-CoV, or avian influenza.
Some past blogs on how U.S. hospitals and public health agencies are preparing to receive, and treat, these kinds of patients include:
