An investigation into Uganda's latest Ebola Sudan patient, a 4-year-old boy who recently died, revealed that his mother and newborn sibling died a few weeks earlier from likely Ebola virus infections, the World Health Organization (WHO) African regional office said in its weekly health emergencies update.
The report also notes that the 4-year-old boy, who initially received care on February 15, was taken to four healthcare facilities as his condition worsened, before his Ebola Sudan infection was confirmed in tests after he died on February 24. This fact raises the risk of additional transmission.
Boy's mother, newborn sibling died earlier without testing
Investigators found that the 4-year-old's mother had given birth to a newborn at a hospital in Kampala on January 23. She died on February 6 from an acute illness, and the baby died about a week later. Lab tests were not conducted after they died, and both bodies have been buried.
The WHO said the mother and baby are considered probable case-patients, given their links to the 4-year-old boy whose fatal Ebola illness was recently confirmed.
The outbreak total now stands at 12 cases, 10 of them confirmed. Four deaths are now linked to the outbreak.
Undetected transmission suspected
The boy was not a known contact of earlier cases, and investigations are under way to determine how the boy was exposed. So far, 201 new contacts have been identified in connection to his illness.
In the middle of February, Uganda had discharged all of its Ebola patients, leading to hopes that the outbreak was nearing its end. The WHO said the new developments, however, highlight the risk of undetected transmission, especially given the delayed diagnosis and the child's movement across multiple healthcare facilities.
Health officials have also said the low case-fatality rate (CFR), previously at 11.1%, was another hopeful sign, much lower than the CFR of 41% to 100% seen in earlier outbreaks involving Ebola Sudan. Now the boy's death and those of his mother and sibling raise the CFR to 33.3%.
The WHO said the retrospective link to the primary outbreak cluster reveals gaps in contact tracing and surveillance and that the lack of testing in the child's deceased mother and newborn sibling raises more concerns about missed cases.
"With no active cases currently in admission and all previous patients discharged, there is a critical window of opportunity to interrupt transmission," the agency said.
The outbreak is Uganda's sixth involving Ebola Sudan and its first since 2022. The country's health officials are experienced in managing Ebola outbreaks and in the past have won praise from global health officials.
