#18,602
Just over a week ago (January 3oth) the Ministry of Health of Uganda confirmed the outbreak of the Sudan Ebola virus in a 32 year-old nurse in Kampala, the Capital City. Since then, the outbreak has grown to 7 confirmed cases (and 1 fatality).
Uganda reported a large outbreak of Ebola Sudan in 2022, which resulted in 164 cases and 55 deaths (34%). In that outbreak, the CDC issued both travel warnings, and a HAN, and the US Began Targeted Airport Screening Of Travelers From Uganda.
While the risk of seeing imported case here in the United States are fairly low, they are not zero. In the past we've seen imported cases of Ebola, Lassa Fever, and Mpox carried by travelers from the region (see Dallas,Tx Patient Tests Positive For Ebola).
Today the CDC issued a HAN (Health Alert Network) advisory - primarily for clinicians and public health workers - on the Ugandan outbreak, along with recommendations for clinicians, public health departments, laboratory biosafety, and the public.
Due to its length, I've only posted some excerpts. Interested parties will want to follow the link to read it in its entirety. I'll have a postscript after the break.
Distributed via the CDC Health Alert Network
February 06, 2025, 11:15 AM ET
CDCHAN-00521Summary
The Centers for Disease Control and Prevention (CDC) is issuing this Health Alert Network (HAN) Health Advisory about a recently confirmed outbreak of Ebola disease in Uganda caused by the Sudan virus (species Orthoebolavirus sudanense) and to summarize CDC’s recommendations for U.S. public health departments and clinicians about case identification, testing, and biosafety considerations in clinical laboratories.
Currently, no suspected, probable, or confirmed Ebola cases related to this outbreak have been reported in the United States, or outside of Uganda. However, as a precaution and because there are other viral hemorrhagic fever (VHF) outbreaks in East Africa, CDC is sharing best practices for public health departments, public health and clinical laboratories, and healthcare workers in the United States to raise awareness about this outbreak.
On February 5, 2025, CDC issued a Travel Health Notice Level 2: Practice Enhanced Precautions for people traveling to Uganda. Currently, CDC has not issued any interim recommendations to health departments for post-arrival risk assessment and management of travelers, including U.S.-based healthcare workers, arriving from Uganda. CDC recommends that travelers monitor themselves for symptoms of Sudan virus disease (SVD) while in the outbreak area and for 21 days after leaving. Travelers should also self-isolate and contact local health authorities or a clinician if they develop symptoms (early “dry” symptoms may include fever, aches, pains, and fatigue and later “wet” symptoms may include diarrhea, vomiting, and unexplained bleeding).
Background
On January 29, 2025, the Ministry of Health of Uganda officially declared an Ebola outbreak caused by the Sudan virus (species Orthoebolavirus sudanense), in the nation’s capital, Kampala. This is the eighth Ebola outbreak in Uganda since 2000.
The confirmed case of SVD was in a 32-year-old man who worked as a nurse at the Mulago National Referral Hospital. The man initially developed high fever, chest pain, difficulty in breathing and bleeding from multiple body sites and sought treatment at multiple health facilities, including Mulago Referral Hospital in Kampala, Saidina Abubakar Islamic Hospital in Matugga in Wakiso District, and Mbale Regional Referral Hospital in Mbale City. He also sought treatment from a traditional healer. The patient died on January 29. Post-mortem samples were tested and confirmed positive for Sudan virus at three national reference laboratories. CDC is working closely with the Ministry of Health of Uganda to support the response to this outbreak.
Description of the situation
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 and clinical laboratories, and healthcare workers in the United States and educating travelers to raise awareness of this outbreak. Healthcare providers should be alert and evaluate any patients suspected of having SVD. It is important for clinicians to obtain a detailed travel history from patients with suspected SVD, especially those that have been in affected areas of Uganda. Early consideration of SVD in the differential diagnosis is important for providing appropriate and prompt patient care, diagnostics, and to prevent the spread of infection.
Ebola Disease
Ebola disease is caused by a group of viruses, known as orthoebolaviruses (formally ebolavirus). Ebola disease most commonly affects humans and nonhuman primates, such as monkeys, chimpanzees, and gorillas. There are four orthoebolaviruses that cause illness in people, presenting as clinically similar disease:
- Ebola virus (species Orthoebolavirus zairense) causes Ebola virus disease.
- Sudan virus (species Orthoebolavirus sudanense) causes Sudan virus disease.
- Taï Forest virus (species Orthoebolavirus taiense) causes Taï Forest virus disease.
- Bundibugyo virus (species Orthoebolavirus bundibugyoense) causes Bundibugyo virus disease.
A person infected with Ebola disease is not contagious until symptoms appear, including fever, headache, muscle and joint pain, fatigue, loss of appetite, gastrointestinal symptoms, and unexplained bleeding. Ebola disease is spread through direct contact (through broken skin or mucous membranes) with the body fluids (blood, urine, feces, saliva, droplet, semen, or other secretions) of a person who is sick with or has died from Ebola disease. Ebola disease is also spread by infected animals, or through direct contact with objects like needles that are contaminated with the virus. Ebola disease is not spread through airborne transmission.
There is currently no Food and Drug Administration (FDA)-licensed vaccine to protect against Sudan virus infection. The Ebola vaccine licensed in the United States (ERVEBO®) is indicated for preventing Ebola disease due to Ebola virus (species Orthoebolavirus zairense) only, and based on studies in animals, is not expected to protect against Sudan virus or other orthoebolaviruses. There is currently no FDA-approved treatment for SVD, but there are therapies in human clinical trials that are highly effective in animal models.
In the absence of early diagnosis and appropriate supportive care, Ebola disease has a high mortality rate. With intense supportive care and fluid replacement, mortality rates may be lowered. Previous outbreaks of SVD have had a mortality rate of approximately 50%.
One of the realities of life in this third decade of the 21st century is that the world is a lot smaller than was when I was a young man. Vast oceans and extended travel times no longer offer us much in the way of protection, and there is no technological shield that we can erect that would keep an emerging virus out.
Today you can literally hop on a plane and be in any corner of the world within 24 hours. Millions of airline passengers make international flights each day, and along with their luggage and cell phones, a small percentage will be carrying infectious diseases.
Most viral infections have a 2 to 7 day incubation period, giving an infected traveler a fairly long asymptomatic `window' for travel.
As we've seen with MERS-CoV, Mpox, H5N1, and Ebola - most of these viral introductions have failed to take root - but the rapid global spread of the SARS-CoV-2 virus in early 2020 illustrates how quickly a highly contagious disease can spread around the world.
