Zainah Kabami, Alex R Ario, Julie R Harris, Mackline Ninsiima, Sherry R Ahirirwe, Jane R Aceng Ocero, Diana Atwine, Henry G Mwebesa, Daniel J Kyabayinze, Allan N Muruta, Atek Kagirita, Yonas Tegegn, Miriam Nanyunja, Saudah N Kizito, Daniel Kadobera, Benon Kwesiga, Samuel Gidudu, Richard Migisha, Issa Makumbi, Daniel Eurien, Peter J Elyanu, Alex Ndyabakira, Helen Nelly Naiga, Jane F Zalwango, Brian Agaba, Peter C Kawungezi, Marie G Zalwango, Patrick King, Brenda N Simbwa, Rebecca Akunzirwe, Mercy W Wanyana, Robert Zavuga, Thomas Kiggundu
{"title":"Ebola disease outbreak caused by the Sudan virus in Uganda, 2022: a descriptive epidemiological study.","authors":"Zainah Kabami, Alex R Ario, Julie R Harris, Mackline Ninsiima, Sherry R Ahirirwe, Jane R Aceng Ocero, Diana Atwine, Henry G Mwebesa, Daniel J Kyabayinze, Allan N Muruta, Atek Kagirita, Yonas Tegegn, Miriam Nanyunja, Saudah N Kizito, Daniel Kadobera, Benon Kwesiga, Samuel Gidudu, Richard Migisha, Issa Makumbi, Daniel Eurien, Peter J Elyanu, Alex Ndyabakira, Helen Nelly Naiga, Jane F Zalwango, Brian Agaba, Peter C Kawungezi, Marie G Zalwango, Patrick King, Brenda N Simbwa, Rebecca Akunzirwe, Mercy W Wanyana, Robert Zavuga, Thomas Kiggundu","doi":"10.1016/S2214-109X(24)00260-2","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Uganda has had seven Ebola disease outbreaks, between 2000 and 2022. On Sept 20, 2022, the Ministry of Health declared a Sudan virus disease outbreak in Mubende District, Central Uganda. We describe the epidemiological characteristics and transmission dynamics.</p><p><strong>Methods: </strong>For this descriptive study, cases were classified as suspected, probable, or confirmed using Ministry of Health case definitions. We investigated all reported cases to obtain data on case-patient demographics, exposures, and signs and symptoms, and identified transmission chains. We conducted a descriptive epidemiological study and also calculated basic reproduction number (R<sub>o</sub>) estimates.</p><p><strong>Findings: </strong>Between Aug 8 and Nov 27, 2022, 164 cases (142 confirmed, 22 probable) were identified from nine (6%) of 146 districts. The median age was 29 years (IQR 20-38), 95 (58%) of 164 patients were male, and 77 (47%) patients died. Symptom onsets ranged from Aug 8 to Nov 27, 2022. The case fatality rate was highest in children younger than 10 years (17 [74%] of 23 patients). Fever (135 [84%] of 160 patients), vomiting (93 [58%] patients), weakness (89 [56%] patients), and diarrhoea (81 [51%] patients) were the most common symptoms; bleeding was uncommon (21 [13%] patients). Before outbreak identification, most case-patients (26 [60%] of 43 patients) sought care at private health facilities. The median incubation was 6 days (IQR 5-8), and median time from onset to death was 10 days (7-23). Most early cases represented health-care-associated transmission (43 [26%] of 164 patients); most later cases represented household transmission (109 [66%]). Overall R<sub>o</sub> was 1·25.</p><p><strong>Interpretation: </strong>Despite delayed detection, the 2022 Sudan virus disease outbreak was rapidly controlled, possibly thanks to a low R<sub>o</sub>. Children (aged <10 years) were at the highest risk of death, highlighting the need for targeted interventions to improve their outcomes during Ebola disease outbreaks. Initial care-seeking occurred at facilities outside the government system, showing a need to ensure that private and public facilities receive training to identify possible Ebola disease cases during an outbreak. Health-care-associated transmission in private health facilities drove the early outbreak, suggesting gaps in infection prevention and control.</p><p><strong>Funding: </strong>None.</p>","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":null,"pages":null},"PeriodicalIF":19.9000,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Lancet Global Health","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/S2214-109X(24)00260-2","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Uganda has had seven Ebola disease outbreaks, between 2000 and 2022. On Sept 20, 2022, the Ministry of Health declared a Sudan virus disease outbreak in Mubende District, Central Uganda. We describe the epidemiological characteristics and transmission dynamics.
Methods: For this descriptive study, cases were classified as suspected, probable, or confirmed using Ministry of Health case definitions. We investigated all reported cases to obtain data on case-patient demographics, exposures, and signs and symptoms, and identified transmission chains. We conducted a descriptive epidemiological study and also calculated basic reproduction number (Ro) estimates.
Findings: Between Aug 8 and Nov 27, 2022, 164 cases (142 confirmed, 22 probable) were identified from nine (6%) of 146 districts. The median age was 29 years (IQR 20-38), 95 (58%) of 164 patients were male, and 77 (47%) patients died. Symptom onsets ranged from Aug 8 to Nov 27, 2022. The case fatality rate was highest in children younger than 10 years (17 [74%] of 23 patients). Fever (135 [84%] of 160 patients), vomiting (93 [58%] patients), weakness (89 [56%] patients), and diarrhoea (81 [51%] patients) were the most common symptoms; bleeding was uncommon (21 [13%] patients). Before outbreak identification, most case-patients (26 [60%] of 43 patients) sought care at private health facilities. The median incubation was 6 days (IQR 5-8), and median time from onset to death was 10 days (7-23). Most early cases represented health-care-associated transmission (43 [26%] of 164 patients); most later cases represented household transmission (109 [66%]). Overall Ro was 1·25.
Interpretation: Despite delayed detection, the 2022 Sudan virus disease outbreak was rapidly controlled, possibly thanks to a low Ro. Children (aged <10 years) were at the highest risk of death, highlighting the need for targeted interventions to improve their outcomes during Ebola disease outbreaks. Initial care-seeking occurred at facilities outside the government system, showing a need to ensure that private and public facilities receive training to identify possible Ebola disease cases during an outbreak. Health-care-associated transmission in private health facilities drove the early outbreak, suggesting gaps in infection prevention and control.
期刊介绍：
The Lancet Global Health is an online publication that releases monthly open access (subscription-free) issues.Each issue includes original research, commentary, and correspondence.In addition to this, the publication also provides regular blog posts.
The main focus of The Lancet Global Health is on disadvantaged populations, which can include both entire economic regions and marginalized groups within prosperous nations.The publication prefers to cover topics related to reproductive, maternal, neonatal, child, and adolescent health; infectious diseases (including neglected tropical diseases); non-communicable diseases; mental health; the global health workforce; health systems; surgery; and health policy.
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