Past Lessons Can Help Contain Uganda’s Ebola Outbreak

ADF STAFF

With Ebola cases continuing to rise in Uganda, health officials are looking to the lessons learned from the 2014-16 West Africa outbreak to guide their strategy.

Mosoka Fallah, program manager for saving lives and livelihoods at the Africa Centres for Disease Control and Prevention (Africa CDC), has deep experience from the front line of the West African fight.

He said Uganda has a few advantages as it fights the outbreak. The country has well-trained medical staffers and good health infrastructure. It also has responded to four previous Ebola outbreaks, which gives it experience.

“Health systems are as effective as the response and support they can get from the community,” Fallah wrote.

The Ugandan outbreak, which killed 17 people in the first three weeks, produced about 48 confirmed cases and another 20 probable cases. The Ebola variety now spreading in Uganda, known as the Sudan strain, has no vaccine. A vaccine exists for the West African strain, known as Ebola Zaire.

As with earlier outbreaks on the continent, the spread of cases in Uganda has followed a highway, in this case the road from Kampala toward the Democratic Republic of the Congo (DRC). That puts both countries at risk, according to Fallah.

The International Rescue Committee (IRC) is working with Uganda’s Ministry of Health to raise awareness of the outbreak among front-line health workers and to boost IRC-related health centers to prepare for increased spread.

“We are concerned about the impact the spread of the virus could have,” Elijah Okeyo, the IRC’s Uganda country director, said in a statement.

Writing recently for The Conversation, Fallah laid out five steps that could bring Uganda’s outbreak under control:

• Set up a robust cross-border surveillance system: A system with simple communication and minimal bureaucracy using mobile apps can help health officials in both nations identify, test and isolate infections. “One of the biggest weaknesses we faced during the Ebola outbreak was that response workers in Liberia, Sierra Leone and Guinea weren’t able to communicate easily with colleagues in other countries,” Fallah wrote.
• Create an army of community contact tracers: It’s important that tracers know the people in their community and can visit homes and identify people who might try to hide their infections. During the West African outbreak, the World Health Organization recruited pastors, imams, teachers and other community leaders in Liberia who served as monitors. “These volunteers defeated Ebola because communities trusted them,” Fallah wrote.

• Recruit trusted messengers: Disinformation and misinformation can create hostility toward response teams. Therefore, recruiting influential people as messengers to share accurate information can develop trust and communicate the correct messages.
• Rapid field testing should be used: “Fast testing and short turnaround times are crucial to isolating cases and preventing further spread,” Fallah wrote. During West Africa’s outbreak, rapid testing enabled response teams to know, in a few hours, whether a patient was infected.
• Increase surveillance of all vehicles: Because Uganda’s outbreak is happening along a major highway linking Kampala and the DRC, monitoring passengers in vehicles is critical to preventing the spread. During the West African outbreak, transport drivers reported any of their fellow drivers who missed work so those people could be visited at home.

Ebola’s ability to spread should not be underestimated, Fallah wrote.

“It’s therefore crucial that the region be prepared to work together to contain the spread of the virus,” he added.