The tools Uganda is using to fight Ebola outbreak

New clinical trials of vaccines and drugs have helped bolster Uganda's arsenal of weapons to fight against an Ebola outbreak first detected two months ago. 

There have been 55 confirmed deaths and 22 probable deaths since the East African country's latest Ebola outbreak was declared on September 20, according to the World Health Organization.

Lockdowns, contact tracing
The government has put several districts under lockdown, including Mubende where the outbreak was first detected.

However President Museveni has ruled out a nationwide lockdown.

Last month Museveni ordered police to arrest anyone suspected of having Ebola who refused to self-isolate.

Yap Boum of Africa for Epicentre, the research arm of Doctors Without Borders, told AFP  contract tracing and community engagement were the biggest factors in bringing the outbreak under control.

"The community is extremely tired" of confinement measures after strict Covid lockdowns which included shutting schools for nearly two years, he said.

"A kind of distrust between the community and the government" has made tracing contact cases more difficult, said Boum, who has worked on Ebola responses in several countries including Uganda.

He said some contact cases have fled rather than undergo isolation measures for Ebola, an often deadly haemorrhagic fever that spreads through close contact with bodily fluids. 

Burial rules 
Another issue is that some people seek the advice of traditional healers before doctors, Boum added. Last month Museveni ordered traditional healers to stop treating sick people.

Another "huge challenge" is that families are often dissatisfied when loved ones who died of Ebola are buried under strict anti-transmission protocols.

"They exhume the corpse and then bury it according to their own practices," Boum said, and that is "definitely an opportunity to spread the virus even further".

He added that the latest outbreak "is quite surprising because Uganda has been one of the best countries in Africa in terms of responding to these outbreaks," pointing to recent success against the Marburg virus.

Vaccines 
While most previous Ebola outbreaks have been with the Zaire virus, Uganda has been hit with the Sudan Ebola strain. 

There are two vaccines for Zaire Ebola, but none for the Sudan strain -- though several candidates have been moving towards clinical trials.

Last week the WHO announced that three candidate vaccines would be shipped to Uganda for trials.

Expected to arrive this week, they will be used in a "ring" vaccination trial, where all contacts of confirmed Ebola patients, contacts of contacts, as well as frontline and health workers will be jabbed.

WHO emergencies director Michael Ryan emphasised that "this epidemic is controllable without vaccines."

But previous Zaire outbreaks have shown that "you can get control much quicker using effective vaccines," he added.

Treatments
Unlike the Zaire strain, there have also been no treatments available for Sudan Ebola.

However a combination of monoclonal antibodies has been shown to be effective against Sudan Ebola in primates and ferrets.

The US embassy in Uganda says it is supporting a trial on humans in the East African country combining the antiviral Remdesivir with monoclonal antibody MBP-134 to use against the Sudan strain.

The first shipment of MBP-134 arrived in Uganda in early October and was being administered to patients, the embassy said.