Uganda Witnesses Outbreak of Rare Ebola Strain – Health

When scientists discovered the Ebola virus in the middle of the rainforest of what was then Zaire in 1976, they hit something like the jackpot. In the country that is now called the Democratic Republic of the Congo again, they found the strain of the pathogen that has since triggered about 80 percent of all outbreaks. The devastating epidemic in West Africa, which claimed more than 10,000 lives from 2014 to 2016, also goes back to this tribe. As a consequence of this catastrophe, two vaccines and two drugs against the Zaire tribe have since been developed.

But also in 1976, and often only mentioned as a footnote in the history of the disease, researchers in Sudan discovered another strain of Ebola. This Sudan tribe is rare, it last appeared ten years ago; so far there are neither vaccines nor medicines against it. Now this type of virus is back; it is spreading in Uganda – and experts are worried. The World Health Organization (WHO) said there was a high risk that the outbreak would become a serious health problem for the country. The risk of international spread, on the other hand, is low. Nevertheless, the US has already begun to divert travelers returning to selected airports where they are to be screened for signs of Ebola.

In Uganda, statistics from the Ministry of Health on Friday showed a total of 44 confirmed cases of the Sudan virus. Ten of those infected have died. There are also a number of suspected cases. The infections have already spread to five districts in the country.

The outbreak became known on September 20, when a young man died with a severe fever and bleeding and the PCR test confirmed the Ebola virus on the same day. Subsequent research showed that the first infections probably occurred as early as August and went unnoticed for about three weeks. During this time, the virus probably spread via various chains of infection. The first symptoms of the disease are fever and flu-like symptoms – non-specific signs that are often attributed to other diseases such as malaria.

For doctors and nurses in Uganda, this means they are faced with an increasing number of conditions for which they can only provide supportive care. “This includes fluids and oxygen, pain medication, medication for any other medical conditions, and rest,” said John Johnson, an epidemic control and vaccines expert at Doctors Without Borders. Not everyone will be able to be saved: the Sudan tribe has killed between 40 and 100 percent of its victims in the seven outbreaks so far.

Nevertheless, Johnson emphasizes: “Even if we cannot offer a specific treatment, the sooner treatment begins, the higher the chance of survival.” This means that sick people must be identified as early as possible. And they have to feel safe that the doctors in the treatment centers are offering them a chance to recover – and that it’s not just about isolating the patients to prevent the further spread of the infection.

WHO is considering vaccine testing in the country

“That’s a big challenge when dealing with Ebola,” says the expert. When treatment options are few, patients may feel that they are being taken away to die. Such thoughts were not uncommon in the past.

To make matters worse, patients were often transferred to large, remote treatment centers, where they felt alienated and lonely in the presence of staff fully clothed in protective clothing. Patients have sometimes fled these facilities, and some have reacted hostilely to the staff. Rumors of appalling conditions in the centers swirled through affected areas, prompting families to hide Ebola disease.

MSF therefore advocates setting up small treatment and isolation units near the affected locations. Only seriously ill patients should then be transferred to larger centers with more medical options. In addition, the situation should be made easier for families as far as possible: through psychological help for patients and relatives, through the care of people in quarantine and the reimbursement of illness-related costs.

At the same time, WHO and partner organizations are considering using the current outbreak for vaccine testing. According to the agency, there are six vaccine candidates against the Sudan tribe. Three of them have already been tested on humans for their safety. It remains to be seen whether much more knowledge will be added in the current outbreak. It takes a relatively large number of infections to gather enough data on the effectiveness of vaccines. Johnson says while it’s unlikely to be able to accurately quantify the effectiveness after the first use, the situation does give a chance to see if the vaccines are having an effect on the outbreak.

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