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Ebola in Uganda Outbreak Response Summary
On September 20, 2022, the Ugandan Ministry of Health confirmed an outbreak of Ebola (Sudan virus) in Mubende District, in western Uganda. The outbreak spread to a total of nine districts in Uganda, including the capital district of Kampala. In early October, CDC began notifying state health departments of travelers arriving in the US that had been in Uganda for symptom monitoring. Illinois was notified of the first traveler arriving to the state from Uganda on October 7, 2022. Local health departments (LHDs) were alerted of travelers that would be arriving in their jurisdiction from an internal REDCap project that was created by IDPH staff. LHDs attempted to contact the travelers to verify their travel and assess their exposures to determine their risk level. Based on the traveler’s risk level, monitoring was conducted on daily, twice weekly, or weekly frequency for the 21 days since they left Uganda. Monitoring surveys were completed via email, SMS messaging, or phone calls to the travelers by LHDs. On January 11, the outbreak in Uganda was declared over and monitoring of travelers from Uganda was ended. No travelers to the United States developed Ebola (Sudan virus).
During this response, Illinois received a total of 368 travelers that had been identified as traveling in Uganda. A total of 29 LHDs were notified of a traveler in their jurisdiction with a range of one to 131 travelers for each health department. On average it took 1.6 days for contact to be made with a traveler from the time the information was entered into the REDCap project (median 1 day). There were 56 travelers that health departments were not able to reach after several attempts to contact them and 9 travelers that were not reached before the response ended. Additionally, 5 travelers were found to have not traveled to Uganda. Of the travelers received, 245 initiated monitoring and 126 travelers completed monitoring for the full 21-day period after they left Uganda. Among the 119 travelers that did not complete monitoring, 25 were lost to follow up, 35 moved to another state/country during their monitoring period, and 59 were still in their monitoring period when the response ended. Overall, 19 travelers reported general symptoms at the time of their interview or on their monitoring surveys but were all found to have other causes for their symptoms, or their symptoms had resolved upon follow up by local health department staff. Of these travelers with symptoms, seven were diagnosed with other conditions-three had influenza, three had Covid-19, and one had Cryptosporidiosis. The reported symptoms by travelers were congestion (7), cough (6), headache (6), sore throat (3), diarrhea (3), fever (3-highest reported temp was 100.0), vomiting (2), chills (1), loss of appetite (1), muscle aches (1). CDC was consulted regarding Ebola virus testing for two symptomatic travelers. One was determined to not meet criteria for testing, and one was tested for Ebola virus disease with the results being negative at the IDPH lab. Final diagnosis for the traveler that was tested is unknown.
A great deal of time and resources were dedicated to this extensive monitoring response by a number of LHDs. These commendable efforts helped identify and manage symptomatic travelers, rapidly implement infection control precautions suitable for Ebola disease when necessary, as well as minimized delayed recognition and management of other potentially life-threatening conditions while ruling out Ebola disease.
Ebola Response Graphs and Images
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