Health officials ramp up Ebola response after first cases reported in Uganda

This story has been updated throughout.

With confirmation that the long-running outbreak in the Democratic Republic of the Congo had spilled across the country’s eastern border to enmesh Uganda in the epidemic, partners in the Ebola containment effort moved Wednesday to ramp up their responses.

The World Health Organization announced Director-General Tedros Adhanom Ghebreyesus has convened a panel of outside experts to advise him on whether the outbreak should be declared a public health emergency of international concern. The so-called emergency committee will meet on Friday.

In the U.S., the Centers for Disease Control and Prevention announced it was activating its emergency operations center to better coordinate its contribution to the containment effort.

The move allows the agency to dedicate staff full time to the response, and to shift people from other jobs if additional expertise is needed. But the move does not signify that the risk to the United States has risen in any way, said CDC Director Dr. Robert Redfield.

“The most important thing that we can do at CDC … is to detect, respond, and prevent outbreaks at their source,” Redfield told STAT. CDC has a large country office in Uganda and has 15 people deployed to DRC to help with the outbreak response.

Inger Damon, chief strategy officer for CDC’s Ebola response, said some staff from the Uganda office traveled with ministry of health officials to the area where the cases are being cared for to take part in the assessment of the situation.

“As that information comes back, there’ll be decisions made in terms of, are there additional areas where CDC can support, whether that’s in laboratory work, whether it’s in some of the response operations,” Damon said.

Redfield noted the CDC, the WHO, and other partners in the Ebola response have been preparing DRC’s neighbors for months to be ready in case the virus spread across their borders.

Those preparations were put to the test Monday when a family returning to Uganda after attending the funeral of a man who died from Ebola in DRC went to a hospital in Kagando looking for care for a 5-year-old boy. With the boy were his mother and father, his grandmother, two younger siblings, and another member of the party. A number of them were ill.

Staff at the hospital suspected Ebola and sent the group to an Ebola treatment center at Bwera that the health ministry had established in anticipation of cases coming across the border.

The 5-year-old was the first in the group to test positive; he died later Tuesday night. His grandmother, 50, and 3-year-old brother also tested positive. The rest of the group is under observation.

Somewhat remarkably, these are the first confirmed cases of Ebola linked to this outbreak that have been found outside of DRC, though the outbreak has raged for more than 10 months in two provinces located on the country’s borders with Uganda, South Sudan, and Rwanda. Thousands of people cross the border between DRC and Uganda daily.

To date, DRC has recorded 2,084 in the outbreak and 1,405 deaths. This is the second largest Ebola outbreak on record.

Health authorities from Uganda and DRC as well as leaders of the response effort met in Bwera on Wednesday to work on plans for a coordinated response. The DRC contingent brought 400 doses of the experimental Ebola vaccine, and Uganda’s health minister, Dr. Jane Ruth Aceng, said that vaccination of people who had contact with the family would begin on Friday.

Ugandan health authorities have been working for months to prepare health facilities along its border with DRC to respond to Ebola. Nearly 5,000 health workers in 165 health facilities have been vaccinated, including those at two health facilities where this boy and his family went for care.

The family lives in Uganda, but the boy’s mother is Congolese. They had traveled to Mabalako, one of the hot spots for Ebola transmission in DRC, to see her ailing father, who had contracted Ebola. He died in on June 1.

Earlier this week, a party of 14 members of this family, including seven children under the age of 12, set off to return to Uganda. A dozen of them were reportedly ill, and stopped at a health clinic on the DRC side of the border. From there they were taken to an isolation center, but six members of the group fled and crossed into Uganda.

Congolese health officials alerted Ugandan authorities to be on the lookout for the family.

The Congolese health minister reported Wednesday that five more members of the family group who had stayed in DRC tested positive for Ebola. Contact tracing to locate and monitor the health of 50 people in Uganda and 80 people in DRC has begun.