Uganda used public health measures such as screening, testing temperatures and isolating suspected cases to contain the Ebola outbreak. Although these measures were successful, scientists warn that another outbreak could occur. Credit: Wambi Michael/IPS
  • by Wambi Michael (kampala & mubende)
  • Interpress service

Uganda used public health measures to end the outbreak. In the absence of vaccines and therapies, the threat of the next outbreak looms.

Scientists have yet to find answers to questions such as who was the first person to be affected? Or the index case, what viral host reservoir did the patient come into contact with?

“We don’t have the answers to those questions. And frankly, we’re hoping that Uganda will give us and the world those answers,” said Emmy Bore, program director for the CDC’s Division of Global Health Protection in Uganda.

“In every Ebola outbreak we’ve responded to, in West Africa, in the DRC, there have been efforts to trace the roots back to the very first person who was infected. When you find out where that person went and what they ate, you can find out on how they managed to get the virus. In most outbreaks, we don’t,” she said.

With these questions answered, Lt. Col. Dr. Kyobe Henry Bossa, who has been on the front lines of Ebola outbreaks and Covid-19, told IPS that there is an urgency to precisely track the viral host reservoir before the next outbreak.

“We know that the reservoir lives innocently in the jungle. We suspect that the viral host reservoir is a bat that circulates in the area, and the virus is preserved in the wild,” Kyobe said.

Bats have long been prime suspects for what scientists have called the “spillover” of new pathogens into humans. They are believed to have various viruses that are more deadly to humans than any other mammal.

Ugandan veterinarian and epidemiologist Dr. Monica Musenero Masanza is no stranger to fighting viruses like Ebola and Marburg in Uganda and West Africa. Musenero came to be commonly known as Dr. Kornya– loosely translated as a female warrior for her fight against Ebola in Port Loko in northern Sierra Leone. She told IPS that Ebola is categorized among new or reoccurring diseases.

“And those diseases show up with a lot of drama. Ebola, when it shows up, it’s a lot of drama. Now these new and re-emerging diseases are getting a lot of attention. Unfortunately, because we don’t know a lot about them, there’s usually little we can do about them in the immediate, apart from control, says Musenero.

According to Musenero, now that Uganda successfully ended Sudan’s Ebola virus, efforts should be focused on finding pathogen X, otherwise another outbreak is guaranteed. “It’s not a question of if, but when. That is why we should go to the jungle to find the host reservoir,” she said.

On 20 September 2022, Uganda declared an outbreak of the Ebola disease caused by the Sudan Ebola virus species in Mubende District.

It was the country’s first Ebola virus outbreak in Sudan in a decade and the fifth of its kind. There were 164 cases (142 confirmed and 22 probable), 55 confirmed deaths and 87 recovered patients.

The outbreaks over the years have occurred in a very similar region, where the suspected virus host reservoir is suspected to be a bat.

Dr. Trevor Shoemaker, an epidemiologist in the Division of High Consequence Pathogens and Pathology at the National Center for Emerging and Zoonotic Diseases at the Center for Disease Control (CDC), suspects that bats carrying the virus are circulating in that area.

“It’s not unexpected that there would be an outbreak where we’ve seen previous outbreaks in the central region of Uganda,” says Shoemaker.

According to Shoemaker, three of the samples tested negative for Ebola virus during testing for Ebola virus cases in the just-ended outbreak but tested positive for another viral hemorrhagic fever called Crimean-Congo hemorrhagic fever.

“There are pathogens that we know about, and there are those that we know about. So we need to track them down before they spread to humans,” Shoemaker said.

Researchers from the University of Bonn have previously confirmed the presence of Crimean-Congo virus in African bats and therefore suggest that bats may play a role in spreading the virus.

Other studies have linked Crimean-Congo virus to ticks. Although bats have been suspected to be reservoirs of the Sudan Ebola virus, there is no conclusive evidence.

District Mubende and Kasanda forest with indigenous trees. Some private plantation forests also thrive. Late in the evening, various species of bats fly into the darkening sky.

Forty-year-old Bright Ndawula is an Ebola survivor. He tells IPS that there are as many as ten types of bats that he knows of. Health workers told us that bats carry Ebola, but we don’t know of any,” said Ndawula, who lost his wife and three family members to the virus.

So far, scientists have been able to identify only one species of African fruit bat (R. aegyptiacus) positive for Marburg virus infection. No evidence of Marburg virus was identified in the other species of insectivorous or fruit bats tested.

A few kilometers from the town of Mubende, IPS encounters farmers and loggers who live on the edge of the forest and risk some of the infectious diseases that can be spread from bats to humans.

Dr. Charles Drago Kato leads a monitoring team with the USAID-funded project called Strategies to Prevent Spillover, or STOP Spillover. It targets viral zoonotic diseases – infections that originate in animals before they “spill over” to humans. His team has been in districts such as Mubende, Kibale and parts of the Rwenzori Mountains, specifically researching bats and humans.

He told IPS that during the project they are trying to trace pathogens in bats that could be dangerous when they cross over to humans.

IPS UN agency report

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