Uganda to launch trial vaccines as it struggles to control Ebola outbreak

Mubende, Uganda

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

She is left caring for three grandchildren under the age of 13 after their mother fled the village to escape the danger of Ebola. His cattle were stolen while he was away on the required 21-day quarantine, leaving him destitute and desperate.

I don’t know where they got the virus from because I went and they checked me and I left the hospital without any problem with these children of mine,” he said, sitting on a log in front of his modest home in Madudu, central of Uganda’s Mubende district.

“The problem I’m facing now is getting food. Secondly, I never went to school, but I want these grandchildren to continue 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, leaving authorities scrambling 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 first victims or attended funerals.

Some escaped the quarantine facilities, others traveled to the capital Kampala and a few visited traditional healers and witch doctors for treatment.

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

An Ebola treatment unit in Mubende, Uganda.

He has been involved in all the Ebola outbreaks in Uganda and Sierra Leone in 2017. “We have to do case investigation, a lot of contact tracing and community engagement so that those with Ebola symptoms are taken to tests before us. set them free.”

Dr. Amone leads the teams operating the Ebola treatment units in Mubende. The first was hastily installed on the edge of the Mubende Regional Referral Hospital.

A larger center operated by the non-profit medical organization Doctors Without Borders (MSF) is being expanded with new ICU beds on the other side of town.

Healthcare workers wear extensive personal protective equipment (PPE) to enter red zones where patients receive treatment.

In one area, a health worker takes in a three-month-old baby suspected of being infected. His mother and another brother are being treated for Ebola and the disease has already claimed his father’s life.

It’s a cruel welcome to the world for the baby who is wrapped in a blanket as it rains steadily over the makeshift treatment center.

It’s a familiar story throughout this region as Ebola spreads despite the Ugandan government’s best efforts.

“This Ebola is much easier to treat than the corona (virus) or AIDS. The main problem here is behavior change,” President Yoweri Museveni told the nation in a speech on Tuesday night, underscoring the need to follow government procedures for those who come into contact with the disease.

Ebola can be spread from person to person through direct contact with blood or other body 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 it doesn’t hide for a few months before showing up like AIDS,” Museveni said in his televised address.

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

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

Healthcare workers wear extensive personal protective equipment (PPE) to enter red zones where patients receive treatment

There are currently two licensed Ebola vaccines, according to the World Health Organization, but they were developed to be safe and protective against the Zaire strain of the Ebola virus.

Unlike the previous Ebola virus from Zaire, the Sudanese strain currently circulating in Uganda has no known effective treatment or approved vaccine. However, the country is about to launch three trial vaccines that have been certified safe by the World Health Organization (WHO) task force.

The WHO said the first doses would be sent to Uganda next week and the country hopes to expand vaccine trials after reviewing the results of the initial phase.

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

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

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

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

It led to “an explosion of more than 41 cases in 5 days and 10 deaths,” President Museveni said in his speech. He has now banned traditional healers and witch doctors from taking clients during the Ebola outbreak.

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

Robert Twinamasiko, a 30-year-old driver, receives treatment for Ebola after helping an infected friend to an ambulance.

Twinamasiko has spent 17 days in hospital, but says he has no regrets. Although he appeared frail, he was on the mend and told CNN he was looking forward to coming home.

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

Uganda is also trying to contain the spread of the disease by closing the school year early to prevent an Ebola outbreak in schools that could be difficult to manage. “If you have a student in a class who tests positive, the whole class has to be quarantined. But also, you’re not going to be 100% sure that that student didn’t have contact with other students outside of that class,” Minister Aceng Ocero explained.

She said she was frustrated that Uganda did not have enough international credit to handle the Ebola crisis. “We have experience. This is our eighth Ebola outbreak. Every time we have an outbreak, our experience increases,” he said.

Some global health experts have criticized Uganda’s initial response to the outbreak as slow and inept. Some partners in the donor community and diplomats have also reported on the amount of information the Ugandan authorities share with them.

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