<i>Notes from the Field:</i> Outbreak of Ebola Virus Disease Caused by <i>Sudan ebolavirus</i> — Uganda, August–October 2022

Kiggundu, Thomas; Ario, Alex Riolexus; Kadobera, Daniel; Kwesiga, Benon; Migisha, Richard; Makumbi, Issa; Eurien, Daniel; Kabami, Zainah; Kayiwa, Joshua; Lubwama, Bernard; Okethwangu, Denis; Nabadda, Susan; Bwire, Godfrey; Mulei, Sophia; Harris, Julie; Dirlikov, Emilio; Fitzmaurice, Arthur G.; Nabatanzi, Sandra; Tegegn, Yonas; Muruta, Allan; Kyabayinze, Daniel J; Boore, Amy L.; Kagirita, Atek; Bosa, Henry Kyobe; Mwebesa, Henry; Atwine, Diana; Ocero, Jane R. Aceng; Brown, Natalie E.; Agaba, Brian; Ahirirwe, Sherry Rita; Akunzirwe, Rebecca; Asio, Alice; Atuhaire, Immaculate; Elayeete, Sarah; Gonahasa, Doreen; Nsubuga, Edirisa Juniour; King, Patrick J.; Kizito, Saudah; Komackech, Allan; Masanja, Veronica; Migamba, Stella Martha; Mwine, Patience; Naiga, Hellen Nelly; Nakamya, Petranilla; Nampeera, Rose; Ninsiima, Mackline; Ndybakira, Alex; Oonyu, Lawrence; Simbwa, Brenda Nakafeero; Tendo, Hildah; Wanyana, Mercy Wendy; Zalwango, Jane Frances; Zalwango, Maria Gorette; Zavuga, Robert; Asiimwe, Immaculate; Mafigiri, Richardson; Muwanguzi, Esther Namukose; Balinandi, Stephen; Nyakarahuka, Luke; Baluku, Jimmy; Kyando, Jackson; Tumusiime, Alex; Cossaboom, Caitlin M.; Eggers, Carrie; Klena, John D.; Nelson, Lisa; Osinubi, Modupe; Sadigh, Katrin; Vosburgh, Waverly; Worrell, Mary-Claire; Kabagambe, Philimon; Okot, Charles; Nsereko, Godfrey; Namusisi, Olivia

doi:10.15585/mmwr.mm7145a5

Cited by 23 publications

(13 citation statements)

References 5 publications

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“…Previous research unequivocally documents that stress is a major issue in humanitarian fieldwork (e.g., Cardozo et al., 2012; Jachens, 2018; Panter‐Brick et al., 2020). This problem has become even more prominent during recent global crises, for example in humanitarian healthcare responses to the COVID‐19 pandemic and in recent Ebola outbreaks (Kiggundu, 2022). While healthcare workers are routinely exposed to stress, these levels are exacerbated during unusual events such as a pandemic (Irfan et al., 2020).…”

Section: Discussionmentioning

confidence: 99%

The effect of acute stress on humanitarian supplies management

Burkhardt

Nitsch

Spinler

et al. 2023

Production and Operations Management

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Humanitarian workers often operate under highly stressful conditions, view emotional scenes, and face high time pressures. This may bias managerial decision‐making in humanitarian logistics, but evidence is lacking. We model humanitarian logistics decisions in an adapted newsvendor setting. We experimentally expose participants to time pressure, noise, and emotional pictures. Using physiological and self‐reported data, we confirm that these manipulations have different effects on two components of the stress response (negative valence and arousal) and on decision‐making quality. Specifically, medium levels of arousal seem to boost decision‐making quality, independent of affective valence. However, high time pressure (characterized by high levels of arousal) leads to a collapse in decision‐making quality. Our results highlight that some level of stress may be beneficial for decision‐making owing to its action‐activating properties. However, excessive time pressure sharply overrides and outweighs these benefits. We discuss the generalizability of our results to other emergency situations (e.g., firefighters) and managerial contexts (e.g., crisis responses).

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Section: Discussionmentioning

confidence: 99%

The effect of acute stress on humanitarian supplies management

Burkhardt

Nitsch

Spinler

et al. 2023

Production and Operations Management

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“…SUDV disease (SVD) has been documented in nearly 1,000 human cases and has a combined case fatality rate (CFR) of 50% (3)(4)(5)(6)(7)(8)(9). The most recent SUDV outbreak was first detected in Uganda's Mubende district in September 2022 (9,10). During the months-long outbreak, there were 164 laboratory-confirmed cases and 77 deaths (CFR 47%).…”

Section: Introductionmentioning

confidence: 99%

A bivalent Adenovirus-Vectored Vaccine induces a robust humoral response, but does not protect cynomolgus macaques against a lethal challenge with Sudan virus

van Tol,

Fletcher,

Feldmann

et al. 2023

Preprint

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The most recent Sudan virus (SUDV) outbreak in Uganda was first detected in September 2022 and resulted in 164 laboratory-confirmed cases and 77 deaths. Currently, there are no approved vaccines or therapeutics against SUDV. In the current study, we investigated the protective efficacy of ChAdOx1-biEBOV in cynomolgus macaques using a prime or a prime-boost regimen. ChAdOx1-biEBOV is a replication-deficient simian adenovirus vector encoding SUDV and Ebola virus (EBOV) glycoproteins (GPs) at the E1 and E4 loci, respectively. Intramuscular vaccination induced SUDV and EBOV GP-specific IgG responses and neutralizing antibodies. Upon challenge with SUDV, vaccinated animals, regardless of vaccination scheme, showed signs of disease like those observed in control animals, and no difference in survival outcomes were measured among all three groups. Viral load in blood samples and in tissue samples obtained after necropsy were not significantly different between groups. Overall, this study highlights the importance of evaluating vaccines in multiple animal models, including nonhuman primates, and demonstrates the importance of understanding protective efficacy in both animal models and human hosts.

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“…On September 20, 2022, for the first time in over a decade, Uganda declared an outbreak of Sudan Virus Disease (SVD) caused by the Sudan virus (formerly called Sudan ebolavirus ). By the end of the outbreak, there were 142 confirmed cases and 22 probable cases from nine districts [14, 15]. Anecdotal reports from the epidemiologic investigations revealed that many patients had undergone treatment by traditional healers or religious leaders for their illnesses before they were diagnosed with SVD.…”

Section: Introductionmentioning

confidence: 99%

The Role of Community Beliefs and Practices on the Spread of Ebola in Uganda, September 2022

Naiga,

Zalwango,

Kizito

et al. 2023

Preprint

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BackgroundTraditional community beliefs and cultural practices can facilitate the spread of ebolaviruses during outbreaks. On September 20, 2022, Uganda declared a Sudan Virus Disease (SVD) outbreak after a case was confirmed in Mubende District. During September–November 2022, the outbreak spread to eight additional districts. We investigated the role of community beliefs and practices in the spread of SUDV in Uganda in 2022.MethodsA qualitative study was conducted in Mubende, Kassanda, and Kyegegwa districts in February 2023. We conducted nine focus group discussions (FGDs) and six key informant interviews (KIIs). FGDs included SVD survivors, household members of SVD patients, traditional healers, religious leaders, and community leaders. Key informants included community, political, and religious leaders, traditional healers, and health workers. We asked about community beliefs and practices to understand if and how they contributed to the spread of SUDV. Interviews were recorded, translated, transcribed, and analyzed thematically.ResultsFrequently-reported themes included beliefs that the community deaths, later found to be due to SVD, were the result of witchcraft or poisoning. Key informants reported that SVD patients frequently consulted traditional healers or spiritual leaders before seeking formal healthcare or visited them after formal healthcare failed to improve their health conditions. They also noted that traditional healers treated patients with signs and symptoms of SVD without protective measures. Additional themes included religious leaders conducting laying-on-of-hands prayers for SVD patients and symptomatic contacts, SVD patients and their symptomatic contacts hiding in friends’ homes, and exhumation of SVD patients originally buried in safe and dignified burials, to enable traditional burials.ConclusionVaried community beliefs and cultural practices likely promoted SVD outbreak spread during the 2022 outbreak in Uganda. Controlling ebolavirus outbreaks in Uganda could be aided by the involvement of formal public health systems, traditional healers, and religious leaders. Community engagement during inter-epidemic periods could aid in the effective management of future outbreaks in Uganda by identifying socially acceptable and scientifically supported alternatives for infection control.

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Notes from the Field: Outbreak of Ebola Virus Disease Caused by Sudan ebolavirus — Uganda, August–October 2022

Cited by 23 publications

References 5 publications

The effect of acute stress on humanitarian supplies management

The effect of acute stress on humanitarian supplies management

A bivalent Adenovirus-Vectored Vaccine induces a robust humoral response, but does not protect cynomolgus macaques against a lethal challenge with Sudan virus

The Role of Community Beliefs and Practices on the Spread of Ebola in Uganda, September 2022

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