Outbreak of Ebola Virus Disease (Sudan ebolavirus) in Uganda

Actions requested

• Be aware of an ongoing outbreak of Ebola Virus Disease (EVD, Sudan ebolavirus) in Uganda since September 2022
• Counsel patients planning travel to Uganda about EVD and health protection measures
• Be familiar with early signs and symptoms of EVD, which typically start 2 to 21 days following contact with an EVD case (average of 8-10 days). These include:
• Fatigue, fever, severe headache, muscle and joint pain
• Progression to diarrhea, vomiting, abdominal pain, and unexplained bruising and bleeding
• Obtain a thorough travel history at time of presentation for all patients with symptoms compatible with EVD for the 21 days preceding illness
• Consider EVD in patients with compatible signs and symptoms AND possible EVD exposure within 21 days prior to sign or symptom onset. Ebola virus is spread through direct contact with:
• Blood or body fluids (urine, saliva, sweat, feces, vomit, breast milk, amniotic fluid, and semen)
• Objects (clothes, bedding, needles, and medical equipment) contaminated with body fluids from a person who is sick with or has died from EVD
• Semen from a man who recovered from EVD (through oral, vaginal or anal sex). There is no evidence the virus can be spread through sex or other contact with vaginal fluids from a woman who has recovered from EVD.
• Infected fruit bats or nonhuman primates
• Isolate all suspected EVD cases and report suspected cases immediately to Public Health – Seattle & King County at (206) 296-4774
• Collect blood samples from patient suspected of EVD. Virus is usually detectable by RT-PCR from 3-10 days after symptom onset.
• Collect whole blood with EDTA in plastic containers
• For adults, collect minimum 4mL
• For pediatric patients, collect minimum 1mL
• Do not separate or remove serum or plasma from primary collection container
• Call Public Health at (206) 296-4774 for testing approval
• Route specimens to WA Public Health Laboratories
• Treatment with aggressive supportive care can improve patient chance of survival. Currently there are no FDA-approved vaccines or therapeutics for Sudan ebolavirus.
• Maintain hydration through oral or intravenous fluids
• Use medication to support blood pressure, reduce vomiting and diarrhea, and to manage fever and pain
• Treatment of secondary infections and pre-existing conditions
• Review healthcare facility infection prevention and control protocols to identify and manage patients with possible EVD
• Document a thorough travel history for all patients to identify diseases like EVD that need specific infection control precautions and/or treatment
• Evaluate patients who have consistent signs and symptoms AND risk factors for EVD
• Identify patients with fever and other signs and symptoms of infection that might warrant isolation pending further medical evaluation
• Post contact information for infection control personnel and the local public health jurisdiction in highly visible locations for rapid reporting of EVD
• Ensure recommended PPE is worn when evaluating and caring for a person under investigation for EVD