[KAMPALA] For days, Ezra Byegarazo lay in an isolation ward, his body wracked with fever and weakness.
A frontline health worker himself, he had treated many patients before—but now, he was the one fighting for survival. He knew about the deadly nature of the Ebola virus, but he wasn’t prepared to battle the virus firsthand.
“I thought I was going to die,” he said.
“Ebola is real, and I have tasted it. Had it not been for the doctors, I would be dead.”
“We must remain vigilant, strengthen surveillance, enhance infection prevention and control in health facilities, and continue engaging communities.”
Jane Ruth Aceng, Uganda’s health minister
Byegarazo is one of a group of survivors who contracted the Sudan strain of Ebola — also known as Sudan virus disease (SVD) — after exposure to the first identified case at the hospital in Kampala where he worked.
The outbreak was detected on 29 January when a 32-year-old male nurse at Mulago Referral Hospital tested positive. It spread rapidly within healthcare settings, infecting a number of health workers.
The 32-year-old nurse died from the disease but the other eight people who contracted it were successfully treated.
On 18 February, Byegarazo and seven others walked out of treatment centres in Kampala and Mbale, a city in Eastern Uganda, after being declared Ebola-free.
Not over yet
However, health authorities have stressed that the fight is not yet over and warned against complacency.
The country must go at least 42 days without a new case before the outbreak can be declared over, the World Health Organization (WHO) said.
Uganda’s Health Minister, Jane Ruth Aceng, said: “We must remain vigilant, strengthen surveillance, enhance infection prevention and control in health facilities, and continue engaging communities.”
The International Federation of the Red Cross and Red Crescent Societies (IFRC) has launched an Emergency Appeal for 6 million Swiss francs (US$ 6.6 million) to help contain the outbreak.
Aceng outlined Uganda’s three-pronged containment strategy: screening and quarantining all identified contacts, isolating symptomatic individuals, and intensifying public communication efforts.
Dr. Jane Ruth Aceng, Minister of health (second left) pause with discharged patients, WHO and Ministry of health officials giving the two ebola patients certificates of discharge PHOTO CREDIT JOHN MUSENZE
Health minister Jane Ruth Aceng (second left) in a group photo with discharged patients and officials from the WHO and Uganda’s Ministry of Health. Copyright: John Musenze.
Speaking to journalists on 18 February, she said authorities had identified and quarantined 265 contacts of the recovered patients.
So-called “ring vaccination” was being carried out – a public health strategy that involves vaccinating close contacts of someone who has contracted a disease.
Although none of the contacts had developed symptoms, Aceng said they would remain under observation for 21 days, the virus’s maximum incubation period.
Experimental vaccine
Uganda’s response to the outbreak includes an experimental vaccine targeting SVD, which has a mortality rate of about 50 per cent.
On 3, February, the WHO launched a clinical trial of a promising vaccine, to test its effectiveness in preventing the virus from spreading. It was administered to frontline healthcare workers and people who had been in contact with infected patients.
“In the absence of licensed vaccines and therapeutics for the prevention and treatment of SVD, the risk of potential serious public health impact is high,” the WHO said in a statement.
WHO director-general Tedros Adhanom Ghebreyesus called it a “critical achievement towards better pandemic preparedness”.
Bruce Kirenga, principal investigator of the trial vaccine, explained that the testing focused on people who already had been exposed to the virus.
Most eligible people who provided consent had been enrolled, though some declined vaccination, he said.
Mental health support
David Kaggwa, who leads the 33-member team of Ebola frontline workers at the Mulago Hospital isolation unit, says survivors of the Sudan ebolavirus have not only received medical treatment but also mental health support.
He said the disease “does not leave one’s state of mind”.
All eight survivors tested negative twice, with tests conducted 72 hours apart—the standard protocol for confirming recovery.
Kaggwa urged the public to welcome them back to their communities without stigma.
“They have been tested twice and are Ebola-free,” he said.
The WHO said strong public engagement, including campaigns to counter misinformation, has helped Uganda reduce fatalities from the virus. The mortality rate for the outbreak stands at 11.1 per cent.
The outbreak is the eighth in Uganda in 25 years. The first outbreak, in 2000, was the deadliest, with 425 cases and 224 deaths.
This piece was produced by SciDev.Net’s Sub-Saharan Africa English desk.