Uganda has 2 more Ebola cases as WHO reconvenes experts

Ebola donning PPE
Ebola donning PPE

UNMEER, Martine Perret / Flickr cc

In quickly evolving developments today in an Ebola outbreak that now straddles two countries, Uganda's health ministry reported two more infections—both involving family members of the imported case-patient reported yesterday—and the World Health Organization (WHO) announced that it would reconvene its emergency committee on Jun 14.

Meanwhile, the US Centers for Disease Control and Prevention (CDC) today announced it has activated its emergency operations center (EOC) to support efforts to battle the DRC's Ebola outbreak, and the Democratic Republic of the Congo (DRC) yesterday reported nine more cases.

Two of boy's family members infected

The two newly confirmed cases in Uganda are both part of the family from the DRC that was stopped at a health checkpoint at the Ugandan border, some of whom escaped to Uganda. Health officials reported yesterday that they detected the virus in one of the them, a 5-year-old boy.

In its statement today, Uganda's health ministry said the boy died this morning.

One of the new cases is the boy's 50-year-old grandmother, and the other is his 3-year-old brother. They had several Ebola symptoms, including vomiting blood and bloody diarrhea, and they are being treated in isolation at Bwera Hospital Ebola treatment unit (ETU), located in Kasese district near the DRC-Uganda border.

In a weekly situation report today, the World Health Organization (WHO) said another suspected case has been admitted to the Bwera ETU, and test results are pending.

Eight contacts have been identified and are under monitoring, the Ugandan health ministry said. It also added that top health officials are in Kasese district and rapid response teams are on the ground to assess the situation and help district officials with response steps such as contact tracing, case management, surveillance, and risk communication.

Uganda's health ministry and the WHO will conduct ring vaccination of patient contacts and unvaccinated health workers beginning on Jun 14.

Emergency panel to meet for third time

The WHO today said Director-General Tedros Adhanom Ghebreyesus, PhD, has reconvened the Ebola emergency committee for Jun 14 to discuss the latest developments, assess if changes warrant declaring a public health emergency of international concern (PHEIC) under International Health Regulations, and to update any earlier recommendations.

The upcoming event marks the emergency committee's third meeting to discuss the DRC's latest Ebola outbreak. At its last meeting on Apr 12, the group said lack of international spread was one of the reasons it held off on recommending a PHEIC declaration. WHO emergency committees typically meet every 3 months, or more often, based on outbreak developments.

In a statement sent to journalists, the WHO said it would hold a media telebriefing after the emergency committee meets to announce the group's recommendations.

CDC steps up support

In a news release today, the CDC said its EOC activation is at level 3, the lowest level, but it paves the way to increase support for the CDC's expanded response team deployed in the DRC.

CDC Director Robert Redfield, MD, said in the release, "Through CDC's command center we are consolidating our public health expertise and logistics planning for a longer term, sustained effort to bring this complex epidemic to an end."

Yesterday in a press release on Uganda's first imported case linked to the DRC outbreak, Redfield said, "This is a sobering development that everyone has been working to avoid, and highlights the complexity of the Ebola outbreak in the Democratic Republic of the Congo."

Since August when the DRC's latest outbreak began, the CDC has been helping the DRC government with the outbreak response and has deployed experts on epidemiology, case management, infection control and prevention, laboratory science, border health, risk communication, community engagement, information technology, emergency management, and logistics. And since September the CDC has been helping the US Agency for International Development (USAID) Disaster Assistance Response Team (DART) and the American Embassy in Kinshasa.

As of Jun 11, 187 CDC staff have completed 187 deployments, not only to the DRC but also to Uganda, other neighboring countries, and WHO headquarters in Geneva.

DRC cases reach 2,071

In its daily update yesterday, the DRC health ministry announced nine new cases in six locations, all of them among the current hot spots.

One of the latest cases involves a member of a burial team in Musienene who had not been vaccinated. He had cared for his brother who died from Ebola. When he was recruited for the burial team, he told his superiors that he had already been vaccinated.

The latest illnesses boost the overall outbreak total to 2,071 cases, which include 1,977 confirmed and 94 probable cases. Health officials are still investigating 284 suspected cases. The WHO's online Ebola dashboard suggests the DRC's health ministry will likely announce 13 new cases today.

Six more people died from Ebola, two in community settings and four in Ebola treatment centers. The new developments put the fatality count at 1,396.

WHO: 115 health workers infected

In its weekly situation report, the WHO said the boy identified as Uganda's first patient and his mother are from Uganda and had been in the DRC's Mabalako health zone, where they attended the burial of the boy's grandfather, who had died from Ebola in the community on Jun 1.

The WHO said it and Uganda's health ministry have deployed a multisector rapid response team to the affected district.

Meanwhile, in the DRC, the number of new cases shows a decline, with 54 reported over the past week, compared with 88 the week before. Though some areas are seeing fewer cases—such as Katwa, Beni, and Kalunguta—the situation is more tenuous elsewhere. "Active transmission is ongoing in communities within 11 health zones in North Kivu and Ituri provinces," the WHO said.

Cases continue to rise among health workers, with 115 reported so far, which makes up 6% of the outbreak total. The DRC yesterday reported 113 cases among healthcare workers.

The WHO said the decline in cases in the two affected DRC provinces is encouraging, affirming the commitment of local, national, and international partners. It added, however, that Ebola's appearance in Uganda is of grave concern, highlighting the region's vulnerability to the spread of the disease.

See also:

Jun 12 Uganda health ministry statement

Jun 12 WHO situation report

Jun 11 CIDRAP News story "Uganda confirms first Ebola case linked to DRC outbreak"

Jun 12 CDC news release on EOC

Jun 11 CDC press release on first case in Uganda

Jun 11 DRC statement

Jun 12 WHO online Ebola dashboard

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