Current: Vol. 5, Issue 2 April - June, 2008

UGANDA DECLARED EBOlA FREE, BUT FOR HOW LONG?

Dr. Cecilia Watyema

Ebola is a highly contagious illness that usually presents with a hemorrhagic fever and is often fatal in humans, monkeys, gorillas and chimpanzees.
Ebola virus has four identified subtypes including Ebola-Zaire, Ebola- Sudan, Ebola -Ivory Coast and Ebola-Reston (in non-human primates). Since 1976 when the disease was first recognized, there have been 12 CDC confirmed human outbreaks in Uganda, Democratic Republic of Congo (DRC), Sudan, Ivory Coast, S. Africa, England and Gabon.

In Uganda there have been two outbreaks in the last 7 years. Ebola-Sudan (2000-2001) affected 425 people, mainly in Gulu district, with a case fatality
of 53% while the recent outbreak in Bundibugyo (2007-2008; strain still unknown) affected149 people with a case fatality of 25%. Both outbreaks
had huge death tolls including health personnel in the affected areas.
The declaration of an Ebola free Uganda on February 20th 2008 was welcome news. However it should not mask the work that still needs to be
done to rid our people of the wrath of this deadly virus. Ebola still has no treatment except for supportive therapy and yet prevention in Africa presents a real challenge. Existing social and economic factors such as the
use of some non-human primates for food, lack of adequate diagnostic tools for early detection of cases, and poor infection control measures all favor
the spread of the disease both in homes and health care facilities. Primary prevention from infection is also difficult due to the lingering questions of
the virus’ natural reservoir (habitat).
.
In the presence of these challenges, an Ebola vaccine remains an important tool in the prevention of this lethal disease. Scientists are actively studying an Ebola vaccine that has shown some promise in previous animal studies. In 2003 an Ebola research study evaluating safety of an experimental Ebola vaccine in humans began in the US. The vaccine is a DNA construct, made in a way similar to that of other investigational vaccines that hold promise for
controlling influenza, malaria and hepatitis. There are prospects of Uganda taking part in similar research studies in the near future.

As we return to an Ebola free country with our hand shakes, big African hugs, large African ceremonies and bank- tellers with no gloves, let’s
pause and ask what we are doing to stop the next outbreak. Rather than wait passively, we need to be proactive by participating in clinical trials when
they finally begin!