Uganda Ebola Outbreak Update
The Ebola (Sudan virus) outbreak that started in Uganda on January 30, 2025 has been declared over as of April 26, 2025. The country announced a 210-day period of caution.
Public health students, below is an epi map and what was known (and not known) about cases and contacts. We will analyze this outbreak in upcoming courses.
Uganda friends, the outbreak has been declared over, but please continue to use caution in the seven regions on the map below as nearly 80 contacts have not been followed up with since exposure.
Uganda Ebola (Sudan virus) Epi Map (CDC, 2025).
CLUSTER 1 (January 30, 2025)
Case 1: male nurse (age 32), working at Mulago National Referral Hospital. Initial exposure is unknown. He went to three treatment facilities and one natural healer while symptomatic. Those sites included Mulago National Referral Hospital in Kampala, Saidina Abubakar Islamic Hospital in the Wakiso District, Mbale Regional Referral Hospital in Mbale, and a traditional healer. Symptoms included fever for at least five days, chest pain, difficulty breathing, and eventually bleeding from several parts of his body. He died on January 29th, and post-mortem samples confirmed Ebola.
Cases 2-9: Eight cases identified from cluster 1, which included mostly healthcare workers and relatives.
Contact Exposure: 264 verified (more expected)
Region: Densely populated areas, healthcare worker exposure, capital city
CLUSTER 2 (March 1, 2025)
Cases:
Case 10: young boy (4-5 years old), died on February 23 (reported March 1, 2025). He was not considered a contact from the first case, so this was considered a second cluster. He was treated at several hospital facilities before he died at Mulago Hospital in Kampala. Ebola was confirmed post-mortem. His exposure was identified as his mother and infant sibling.
Case 11-12: mother and infant. The mother gave birth to a newborn on January 23 in a hospital in Kampala. She died from an undiagnosed acute illness on February 6, and the baby died a week later. Both were buried without knowledge of Ebola.
Case 13-14: Two more cases were identified and recovered with no description.
Contact Exposure: 270+ verified, but more expected, especially with the mother and baby being cared for, treated, and buried with no knowledge of the disease.
*Cluster 1 & 2 Concern: Over 80 people were verified exposures and were lost to care. We do not know if they developed symptoms, got sick, recovered, exposed others, or anything.
IMPORTANT QUESTIONS TO CONSIDER
Where did the first case get infected? Was he traveling?
This outbreak ranged across the country from regions near DRC to the central capital to the eastern area near Kenya. How far were cases and contacts traveling?
Was cluster two a separate exposure? Could the mother have come in contact with case 1 when she was delivering the baby in a Kampala hospital? There was no information given to determine if they overlapped at the same hospital during birth and when case 1 was starting to feel ill.
How many exposures were missed?
How were more than 80 known exposures lost to follow-up on a deadly disease?
How can we improve systems to test earlier (before post-mortem), increase surveillance, assist with quarantine, and provide follow-up with exposures? We should not have unaccounted exposures and contacts when an outbreak is declared over.