As Ebola outbreak grows in Uganda, US ramps up preparedness plans



CNN

Uganda has been struggling with an Ebola outbreak for months, and although no suspected or probable cases of Ebola have been identified in the United States, federal and local health officials are working together to prepare for the possibility that the virus will spread across the Atlantic.

The US Centers for Disease Control and Prevention and the Administration for Preparedness and Strategic Response have conducted tabletop exercises with officials from five jurisdictions where airline passengers arriving in the US from Uganda are transiting, the CDC confirmed Monday.

The agency said the exercise involves planning to manage suspected cases in each jurisdiction in three scenarios: when potential patients are identified at the airport funneling, identified when monitoring the condition of tourists returning from Uganda or seeking treatment in hospital.

“This is an opportunity to learn about jurisdictional plans and identify areas where CDC or our federal partners can offer technical or other assistance,” CDC spokeswoman Kristen Nordlund wrote in an email to CNN. However, he stated, “The risk of Ebola in the United States is low.”

Uganda’s health authorities declared an outbreak of the Ebola virus disease in September, and since early November, 136 confirmed cases, 21 probable cases and 53 confirmed deaths have been identified there, according to the World Health Organization.

Last week, Uganda’s Education Minister Janet Museveni announced that schools will end the current term two weeks earlier than scheduled in an effort to minimize contact between students and prevent the spread of the virus.

“All primary and secondary schools in Uganda are directed to be closed by November 25, 2022 for the third term holiday as a measure to contain the Ebola Virus Disease (EVD) in the country,” Museveni said in a statement. Eight students have died from Ebola since September, out of 23 confirmed cases at the school.

The general attitude among public health officials in the US is that as the outbreak in Uganda continues, it raises the possibility of the virus spreading to the United States, said Lori Tremmel Freeman, chief executive of the National Association of County and City Health Officers. .

“It’s probably just a matter of time,” Freeman said. “That’s why every minute is now spent improving preparedness and response to anticipate that single incident. But the more time and effort we put into this crisis stage, the better off we will be when we receive the first case.

Officials at the CDC have been conducting “tablet exercises” with local health departments deemed at higher risk of seeing cases in their jurisdictions, Freeman said.

“Jurisdictions where the probability of cases is the highest are because they represent the Ugandan community in this country, or they are close to the airport where Ugandan tourists are transited,” he said.

Since the beginning of October, all passengers arriving in the US from Uganda have been routed to the airport in New York; Newark, New Jersey; Atlanta; Chicago; or Washington, DC, for enhanced screening in response to the outbreak.

“So they’ll go through the plan, identify gaps and problems,” Freeman said. “One of the most difficult areas to manage for Ebola is what to do with an identified patient and how you support quarantine for that person and their close contacts.”

The plan also includes preparing community hospitals for possible cases, and “efforts will be made soon to assess community frontline hospitals to determine their capacity and gaps,” Freeman said.

The CDC estimates that 20% of tourists are from Uganda will arrive without a cell phone or US-based phone number. As of Monday morning, the CDC has distributed 163 cell phones to people arriving from Uganda who otherwise have no way to stay in touch with health officials.

The Chicago Department of Public Health is one of the agencies that is “participating in an exercise with the CDC to go over scenarios in which travelers develop symptoms suggestive of Ebola virus disease,” according to an emailed statement from the department.

“The City of Chicago and CDPH have revised Ebola response and operational plans to address this particular 2022 outbreak; from screening and assessment to transportation and clinical care as deemed appropriate,” the statement said.

“CDPH continues to work with our hospitals to screen patients for travel history and be alert for symptoms of Ebola virus disease or, more likely, malaria or a circulating respiratory virus. In addition, CDPH monitors travelers for 3 weeks after departure from Uganda and provides the These travelers contact CDPH, if they have symptoms.

As of Wednesday, 824 travelers have been screened at Chicago’s O’Hare airport, according to the department.

In Washington, health officials have monitored 100 travelers, of whom “19 are currently being monitored,” DC Health said Tuesday.

In New York, screening has been implemented at JFK airport, and the state health department has been working closely with the CDC.

“New York State is coordinating with the CDC and local health departments when screening people traveling from Uganda, where cases of Ebola have been identified,” Samantha Fuld, spokeswoman for the New York State Department of Health, wrote in an email to CNN.

“Although no infections have been reported outside of Uganda or in New York or the United States, proactive measures by CDC to monitor major travel hubs – including JFK International Airport, one of five US airports where CDC is currently traveling from Uganda – Alert public health laboratories, hospitals ready to be designated as Ebola treatment centers, and notifying health care providers will ensure we remain alert and prepared,” Fuld wrote.

The Ebola virus is contagious – but not as contagious as some other infectious diseases, such as Covid-19. “We need to remain vigilant but not panic” about the risk of the virus spreading outside of Uganda, said Dr. Dan Barouch, a professor at Harvard Medical School and Director of the Virology and Vaccine Research Center at Beth Israel Deaconess Medical Center.

Ebola can 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 bed sheets or needles.

Symptoms of Ebola include fever, aches and pains, and fatigue, which can then turn into diarrhea, vomiting and unexplained bleeding. There are two monoclonal antibody treatments for Ebola approved by the US Food and Drug Administration. Supportive care includes giving fluids and electrolytes, supporting the patient’s blood pressure, reducing vomiting and managing fever and pain.

“If we see a case in the United States, the hope is that it will be identified quickly before there is another spread,” Barouch said.

“We have to be ready. We need to make sure that our testing scheme is in place,” he said. “We need to have a protocol if there is an infected traveler who comes to the United States, for that person to get optimal medical care, but also to make sure that it does not spread again.”

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