Control of Ebola Haemorrhagic Fever (EHF) Outbreak in Uganda,

The Ebola virus, belonging to the family of Filoviruses was first recognized in 1976 when it caused concurrent outbreaks in Yambuku in the Demcratic Republic of Congo (DRC), and in the town of Nzara in Sudan. Both countries share borders with Uganda. A total of 425 cases and 224 deaths attributed to Ebola haemorrhagic Fever (EHF) were recorded in Uganda in 2000/01. Although there was a delayed detection from the community level, prompt and efficient outbreak investigation led to the confirmation of the causative agent on October 14 2000 by the National Institute of Virology in South Africa, and the subsequent institution of control interventions. Public health interventions to contain the epidemic aimed at minimizing transmission in the health care setting and in the community, reducing the case fatality due to the epidemic, strengthening coordination for the response and building capacity for on-going surveillance and control. Coordination of the Control interventions was through the Interministerial Committee, National Ebola Task Force, District Ebola Task Forces, and the Technical Committees at national and district levels. World Health Organization under the Global Outbreak Alert and response Network coordinated international response. The post outbreak control interventions addressed weakness prior to outbreak detection and aimed at improving preparedness for future outbreak detection and response. Challenges to control efforts included in-adequate and poor quality of protective materials, especially at the beginning of the outbreak, nosocomial transmission of EHF. The quality of protective materials especially masks and goggles, in future outbreaks, needs to be taken into consideration. Other challenges to the outbreak control included deaths of health workers, numerous rumors and rejection of the convalescent cases by community members. This was the first recognized and the largest reported outbreak of EHF in the world ever. Control interventions were very successful in containing the epidemic. The community structures used to contain the epidemic have continued to perform well after containment of the outbreak and have proved useful in the identification of other outbreaks as well. This was also the first outbreak response coordinated by the WHO under the Global Outbreak Alert and Response Network, a voluntary organization recently created to coordinate technical and financial resources to developing countries during outbreaks.