In response to an Ebola outbreak in Uganda, CDC on Thursday issued a health advisory recommending health providers prepare for patients infected with the Ebola virus and ordered all flights from Uganda be redirected to specific airports for health screenings.
On Sept. 20, Uganda's Ministry of Health declared an Ebola outbreak in the country. The first case was confirmed in a 25-year-old man who was diagnosed with a viral hemorrhagic fever and died the day before.
Following the patient's death, Uganda conducted an investigation that found "a cluster of unexplained deaths" over the past month. According to CDC, there have been 44 confirmed Ebola cases, 10 confirmed deaths, and 20 probable deaths in Uganda so far.
As of Oct. 6, there have been no suspected Ebola cases outside of Uganda, and the outbreak within the country has so far been limited to regions outside of Kampala, the capital of Uganda and the country's travel hub of Entebbe.
In a Health Alert Network advisory, CDC said providers should consider Ebola virus as a differential diagnosis if a patient has recently traveled to Uganda and has the symptoms of the disease or a viral hemorrhagic fever.
CDC recommends that providers take a travel history from any patients presenting symptoms and move the patient to a private room. Providers should contact local or state health departments if they suspect a patient has Ebola.
CDC also said it's important that patients infected with the strain of Ebola virus causing the outbreak in Uganda—called the Sudan strain—are identified early, in part because there isn't an FDA-approved vaccine or treatment for the Sudan strain. Currently, the only FDA-approved Ebola vaccine in the United States, Ervebo, treats the Zaire strain, and CDC does not expect it would protect against the Sudan strain.
The Sudan strain is not transmitted through the air, CDC noted, but instead spreads through direct contact with the body fluids of someone who has the virus and is symptomatic, or who has died from the disease.
In an order issued by CDC Director Rochelle Walensky, the agency said all flights from Uganda should be redirected to one of five airports in the United States so passengers can undergo health screenings.
The five airports are:
According to an administration official, 62% of all air passengers who have been to Uganda pass through one of the five airports. Any passengers who have been in Uganda over the past 21 days—the incubation time of the Ebola virus—will receive a temperature check and a risk assessment, CDC said. Uganda is also conducting screenings for the Ebola virus, as are other African countries in the region.
Rebecca Katz, director of the Center for Global Health Science and Security at Georgetown University, said she believes the risk to the American public is low and said she agrees with the government's plan to take preemptive measures.
"This is about putting solid surveillance practices in place," she said.
However, former U.S. Surgeon General Jerome Adams in a tweet disagreed with CDC's order to obtain a travel history from patients with Ebola-like symptoms.
"'Have you been to Africa recently' isn't an appropriate history question to assess Ebola risk, any more than 'have you been to America recently' [is] an appropriate question to assess risk of [Covid-19]," he said. (DePeau-Wilson, MedPage Today, 10/6; Bernstein, Washington Post, 10/6; Mandavilli/Stolberg, New York Times, 10/6)
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