Uganda introduces trial vaccines as it struggles to control the Ebola outbreak


Mubende, Uganda
CNN

Joseph Singiringabo lost almost everything and everyone he cared about to Ebola. Within weeks, the 78-year-old lost his wife, son and a newborn granddaughter to the disease.

He has three grandchildren under the age of 13 to look after after their mother fled the village to escape the threat of Ebola. His cattle were stolen while he was in mandatory 21-day quarantine, leaving him destitute and desperate.


I don’t know where they got the virus from because I got checked out and left the hospital with no problems with these my children,” he said, sitting on a log in front of his modest home in Madudu, in Uganda’s central Mubende district.

“The problem I face now is getting food. Second, I never went to school, but I want these grandchildren to go on and get an education.”

Uganda is grappling with its deadliest Ebola outbreak in more than a decade, first detected in Mubende district in late September.

The deadly disease has devastated families and authorities have struggled to control its spread.

The 2012 Ebola outbreak in Kibaale district in the western region of the country resulted in 17 deaths out of 24 confirmed cases, but was declared over in less than 3 months.

Officials have launched aggressive contact tracing to track down relatives and friends who handled the bodies of the early victims or attended funerals.

Some fled quarantine facilities, others traveled as far as the capital, Kampala, and some instead sought treatment from traditional healers and witch doctors.

“Some of the patients are still in hiding and don’t know they have Ebola, so they’re out there in the community,” said public health physician Dr. Jackson Amone to CNN.

An Ebola treatment center in Mubende, Uganda.

He has been involved in every Ebola outbreak in Uganda as well as in Sierra Leone in 2017. “We need to conduct case investigations, follow up many contacts and engage in the community so that those who show Ebola symptoms are brought in for testing before we release them.”

Dr. Amone leads the teams running the Ebola treatment units at Mubende. The first was set up in haste on the outskirts of the Mubende Regional Referral Hospital.

A larger center run by medical non-profit Médecins Sans Frontières (MSF) is expanding with new intensive care beds across town.

Healthcare workers don extensive personal protective equipment (PPE) to enter the red zones where patients are being treated.

In one zone, a health worker weighs a three-month-old baby suspected of being infected. Her mother and another sibling are being treated for Ebola, and the disease has already claimed her father’s life.

It’s a cruel reception in the world for the child, who is wrapped in a blanket as steady rain falls on the makeshift treatment center.

It’s a well-known story in this region, as Ebola continues to spread despite the Ugandan government’s best efforts.

“This Ebola is much easier to manage than either Corona (virus) or AIDS. The key issue here is behavior change,” President Yoweri Museveni told the nation in an address Tuesday night, stressing the need to follow government procedures for those who come into contact with the disease.

Ebola can spread from person to person through direct contact with blood or other bodily fluids such as saliva, sweat, semen or feces, or through contaminated objects such as bedding or needles.

“It doesn’t spread through the air like COVID-19 and hide for a few months before showing up like AIDS,” Museveni said in his televised address.

The country has so far recorded 55 deaths from Ebola, 141 confirmed cases and 73 people have recovered, he said.

Health Minister Dr. Jane Ruth Aceng Ocero told CNN she expects Uganda to have the outbreak under control by April if communities cooperate with the government.

Healthcare workers don extensive personal protective equipment (PPE) to enter the red zones where patients are being treated

According to the World Health Organization, there are currently two approved Ebola vaccines, but they are designed to be safe and protective against the Zaire strain of the Ebola virus.

Unlike the earlier Zaire Ebolavirus, there is no known effective treatment or approved vaccine for the Sudan strain currently circulating in Uganda. However, the country is about to launch three experimental vaccines that have been certified safe by the World Health Organization (WHO) working group.

The WHO said the first doses would be shipped to Uganda next week and the country expects to expand vaccine trials after reviewing results from the initial phase.

They are being developed by the International Aids Vaccine Initiative (IAVI), the Sabin Vaccine Institute USA and a third by the University of Oxford and the Jenner Institute UK.

“Our further tests are about the effectiveness and how long it protects. We’re screening 3,000 contacts of confirmed cases, so we’re going to do a ring vaccination,” Aceng Ocero said, referring to a vaccination process where vaccines are only given to people who are in close contact with infected patients.

“If we have a confirmed case, then the contacts are the ones who will be given the vaccine and they will be followed up for 29 days because we want to see if they can build up antibodies quickly and protect themselves from going into full-blown disease . Added Aceng Ocero.

Public health officials believe cases are stabilizing due to increased vigilance, but tradition and religion are holding back progress. A community in central Uganda’s Kassanda district has exhumed a body that had been safely buried by health workers to perform religious rites.

It resulted in “an explosion of over 41 cases in 5 days and 10 deaths,” President Museveni said in his address. He has now blocked traditional healers and witch doctors from taking clients during the Ebola outbreak.

Infections are also on the rise as it is difficult to separate people in close-knit community settings. Robert Twinamasiko, a 30-year-old driver, is treated after helping an infected friend to an ambulance. The friend and another person involved died.

Driver Robert Twinamasiko, 30, is being treated for Ebola after helping an infected friend to an ambulance.

Twinamasiko has spent 17 days in hospital but says he has no regrets. Despite looking frail, he recovered and told CNN he was looking forward to going home.

“I’m just waiting for my blood work to be released, but the world out there should know that Ebola is real,” he said from a red zone.

Uganda is also trying to stem the spread of the disease by closing the school year early to avoid an Ebola outbreak in schools, which could be difficult to manage. “If a student in a class tests positive, the entire class has to be quarantined. But you also won’t be 100% sure that this student hasn’t had contact with other students outside of that class,” Minister Aceng Ocero said.

She said she is frustrated that Uganda is not getting enough international recognition for handling the Ebola crisis. “We have experience. This is our eighth Ebola outbreak. Every time we get an outbreak, our experience increases,” she said.

Some global health experts have criticized Uganda’s initial response to the outbreak as slow and inept. Some partners in the donor and diplomatic community have also resented how much information the Ugandan authorities are sharing with them.

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