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KeyHighlights

• 03cumulativecases(00probable03confirmed)• All(03)confirmedcaseshavedied(CFR=100%)• Todayisday3sincethedeathofthelastconfirmedcasewhopassedonthe13June2019whileontransfertothe

DRCforfurthermanagement• Thereare90contactsunderfollowup

o 88werefolloweduptodayo Nonehasdevelopedsymptomstodate

• 03suspectcasesonadmissioninETU,samplessenttoUVRI;2testednegativeforEbolabyPCRo ResultforthenewsuspectinETUstillpending

• Activecasesearchanddeathsurveillanceareongoinginthehealthfacilitiesandthecommunitiesasthedistrictresponseteamcontinuetoinvestigateallalerts

• 48contactshavebeenvaccinatedtoday• TheQueenMotherwasburiedtoday.Severalinterventionswereputinplace;handwashingfacilities,screening

ofallpeopleattendingtheburial,securingofallentrances,footbathssetupandeducationofthemassesaboutEVD

KeyChallengePoor logistics and supply chainmanagement causing delays in the response.Most of the challenges experienced arerelated to logistics and the supply chain including transport, equipment, medical sundries, WASH supplies, internetconnectivity,jobaidesandfinancialfacilitationofEVDresponseteamonduty.

EBOLA VIRUS DISEASE IN UGANDA

1. Situation update Cases

03

Deaths

03

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EPIDEMIOLOGICALSUMMARY

BackgroundOn11thJune2019,theMinistryofHealthofUgandadeclaredthe6thoutbreakofEbolaVirusDisease(EVD)inthecountryaffectingKasesedistrictinSouthWesternUganda.Thefirstcasewasafive-year-oldchildwitharecenthistoryoftraveltotheDemocraticRepublicofCongo(DRC).Thischildwasoneof6peoplethattravelledfromtheDRCwhilestillbeingmonitoredassuspectcasesfollowingaburialofthegrandfatherwhosuccumbedtoEVD.ThechildwasillbythetimehecrossedintoUgandaandthemothertookhimformedicalcareatKagandohospitalinKasesedistrictwithsymptomsofvomitingblood,bloodydiarrhea,musclepain,headache,fatigueandabdominalpain.ThechildtestedpositiveforEbolaZairebyPCRandhelaterdiedon11thJune2019.Twoothermembersofthefamily,agrandmotherand3-year-oldbrotheralsotestedpositiveforEbolaon12June2019andthegrandmotherdiedlaterthesameday.The3-year-oldbrotheralsodiedonthe13June2019.Asoftoday,thereisnoconfirmedEVDcaseinUganda,however3suspectcasesareadmittedatBweraEbolaTreatmentUnit.Ninety(90)contactsarebeingfollowedup.Figure1:MovementoftheEVDcasesfromCongointoUganda

CaseSummaryAsofthe16thJune2019,therearethree(03)confirmedcases,allofwhomhavedied.SUMMARYOFCASES(asof16/June/2019) Newsuspectcasestoday 01Newdeathstoday 00Cumulativecases 06*

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Suspectunderinvestigation 03Probable 00Confirmed 03

Cumulativedeaths(suspect,probableandconfirmed) 03**Healthfacilities 03Community 00Deathsamongconfirmedcases 03Numberofcasesonadmission 03Suspect 03Probable 00Confirmed 00Cumulativecasesdischarged 03Suspect 03Confirmed 00Caseswhoarehealthworkers 00Suspect 00Probable 00Confirmed 00Confirmedcasesofhealthworkerswhohavedied 00Currentadmissionsofhealthcareworkers 00Suspect 00Probable 00Confirmed 00Cumulativenumberofhealthworkersdischarged 00Runawaysfromisolation 00Numberofcontactslistedasoftoday 90***Numberofcontactsthathavecompleted21days 00Numberofcontactsunderfollowup 90Numberofcontactsfolloweduptoday 88Cumulativenumberofcontactswhodevelopedsymptoms 00Cumulativenumberofcontactsvaccinated 68Numberofcontactsvaccinatedtoday 48Specimenscollectedandsenttothelab.Today 03Cumulativespecimenscollected 15****Cumulativecaseswithlabconfirmation 03**Cumulativesamplestestednegative 06Specimenswithpendingresults 02Dateofdischarge/deathoflastconfirmedcase 13June2019

*dropped5thattestednegativeonsecondPCRtest**includes1deathintheDRC***numbersreducedaftercleaningcontacttracinglist****4arerepeatsamples

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CoordinationToday,theDistrictEVDTaskForcemeetingwasheldtodiscussactionpointsraisedduringtheDTFheldon15thJuneandthefeedbackfromthedifferentsub-committeesfollowingtheactivitiesconductedandothermattersarisinginresponsetoEVDoutbreakintheDistrict.Alistofpersonnelandvehiclessupportingtheresponsewasupdatedandsharedwiththedistrictfordiscussion.Thecompleteresponseplanandbudgetisplannedforsubmissiontomorrow.Keyissuesdiscussedincluded;

- SocialmobilisationteamtosharekeymessageswiththeDTFandalsoharmonisetheirmessagesacrossalltheirsubteams

- Continuewithmobilisationoflocalresourcesandredistributionofsurpluscommodities- Intensifysocialmobilizationtounderstandissuesofconcerninthecommunity- Encouragedriskcommunication,surveillanceandpsychosocialteamstomoveandworktogetherastheyaddress

relatedissues- Intensificationofsurveillanceforanupcomingcrossbordertraditionalmarriageceremony- Moreinvolvementofpoliticalleadersintheresponse

SurveillanceUgandastillrecords3cumulativeconfirmedcaseswhohavealldiedgivingacasefatalityrateof100%(3/3).Currentlythereare3suspectcasesadmittedintheETU.All3caseshavenorelationwiththeconfirmedcases.Two(2)alerts(1death,1alive)were received todayand investigatedwithin24hours.Thecases reportnoepidemiological link to theconfirmedcases;thecasesaredescribedbelow;Firstsuspect;a3-yearoldmaleresidentofSelelevillage,KasangaParish,Bwerasub-countyadmittedon14JuneonthepaediatricwardofKagandoHospital.Aprovisionaldiagnosisofsevereaspirationpneumoniaandseveremalariawasmadeonadmission.However,referringtohismedicalnotes,childwasbleedingfromthegums.Abloodsamplewaspickedfromthecase,resultsarepending;hediedon15Juneat14hours.Secondsuspect;3-yearoldboyadmittedatStPaulHCIV,fromKizunguvillage,NyakasangawardKasesemunicipality.Presentedwithfever,vomitingbloodandnosebleeding.VerifiedasasuspectedcaseandtransferredtoBweraETU.Abloodsamplehasbeencollectedfromhimandresultsarepending.Additionally,4newcontactswere listed today,givinga cumulative totalof90contacts to theconfirmedcases;61 inKagandoand29inBwera.Wefollowedup98%(88/90)ofcontactsinKagando,BweraandMpondweareasand2contactsdeclinedtemperaturemonitoringinKagando.NoneofthecontactshasdevelopedsymptomsconsistentwithEVD.Theteamscreened532peopleattendingaserviceatKathemboRomanCatholicChurch.Twenty-six(26)newporousentrypointshavebeenidentifiedandscreeningstartedLaboratoryCumulativesamplestestedtodateisfifteen.

• 3samplescollectedforreferraltoUVRI;2fromBweraETUand1fromKagandoHospital• Resultsfromyesterday’ssamplefromBweraETUreceived;oneofthesesampleswasarepeattestandbothare

negative

2. Public Health Actions to date

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• OrientationoflabstaffingeneralbioriskmanagementandfillingofcaseinvestigationformsatKagandohospitallaboratory

• AssessedthestockstatustoestablishcapacitytocollectEVDsamples• Onesamplewascollectedfromthe3-yearsuspectandtransportedtodaytothetestinglaboratory(UVRI),results

arepending

CasemanagementThereare3suspectcasescurrentlyisolatedintheETUatBweraHospital.Labresultsfortwosuspectcaseswerereceivedtoday.Bothwerenegative;onewasarepeatsampleandtheothera1stsample.Onesuspectcasewith2negativeresultswillbetransferredtothemedicalwardtomorrow.Anew3-yearoldsuspectcasewasadmittedtodayandhadtheirbloodsamplecollected;resultsawait.

RiskCommunication/SocialMobilization• SensitizedcommunitiesofBwerasub-county,MidValleyandBwerasecondaryschool,Kyowanga,Kalinga,

KasinkaandKasangatechnicalinstitute• SensitisedUPDFsoldiersinRukoki,Kilembe,officersmess• EngagedcommunitymembersinKiremboandKatholhuEVDvaccination

Psychosocialteam

• Offeredpsychosocialsupporttothetwopatients(23and27yearsold)whoweretransferredfromtheETUtothegeneralwardyesterdayaftertestingnegativeontwotests

• Counseledtherelativesofthe2youngmenandsensitizedthemonhowtotakecareofthepatients• Teamreachedthenurse(attendedtoaconfirmedcase)whoiscurrentlyunderisolation.Shewasvaccinated

yesterdayandreportsnosymptomstoday

VaccinationThevaccinationteamhavevaccinatedacumulativenumberof68contactswith48vaccinatedtodayintworings.LogisticsUgandaNationalMedicalStores(NMS)deliveredmedicalsuppliestosupporttheEbolaresponse.Operationalchallengesandconcerns

• Needmorevehiclestosupportactivecasesearchandcontacttracing• Needdigitalthermometersforthecontactstoself-monitoraswellasnon-contactinfraredthermometersforthe

contacttracingteam,healthfacilities,atairfieldandnewlysetupPOEs• FundstosupportcontacttracingespeciallypaymentsforsubcountysupervisorsandVHTs• Airtimetosupportoperationsofthealertdeskandinternetforthedatamanagementteam• Limitedstockof samplecollectionsupplies (vacutainer tubes,needles, swabs, ziplockbags, sharpscontainers,

biohazardbags,10%formalinandtriplepackagingmaterialsinKagandoHospital• Stockoutofchlorineandlackofsoapinschools• VHTsinvolvedinICCMareworriedabouttheirlackofsuppliessuchasglovesastheytrytomanagemalaria

cases• Hygienefacilitiesintaxiparks,bodabodastagesandmarketareasneedtobeprovided• UPDFpersonnelwhosupportinguidingpeopleandstoppingvehiclescrossingtheborderhavebeendemotivated

duetolackoffacilitation• CasedefinitionandIECmaterialsneedtobetranslatedtolocallanguages

KeyPlannedactivities

• Conductactivecasesearch,contactlistingandfollowupinhealthfacilitiesinallHealthSub-districts

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• Continuewithdatacleaninginthedatabaseespeciallyonthecontactsofcontacts• TheriskcommunicationteamtocontinueworkingwithvaccinationteaminBweraoncommunityengagement• EngagementofchurchesandcommunitymembersbyIPCandsocialmobilisationteamstointegrateEVD

messagesintheirteachings• EngagementofcommunityleadersinKilembeandMukunyuonhostilityagainstCongolesenationals• Continuewithradiotalkshows• IdentifyandreorientVHTstosupportcontactfollowup• Sensitisecommunitymembers,stopmassgatherings,alleviatefearsandanxietyamongthecommunitymembers

onEVDandencouragepeople tohandwashand stophandshaking.Thecommunitywill also sensitiseon theimportanceofsafeanddignifiedburialfollowingresistanceatSDBofasuspectcase.

• Continuewithsensitisationofschools

ThereisanEVDoutbreakinKasese,UgandawithitsoriginintheDRC.Thereare3confirmedcaseswith3deaths.Thereare3suspectcasestoday.Ninety(90)contactshavebeenidentifiedsofarandeighty-three(88)havebeenfolloweduptoday.Communitytovaccinationisremarkable.

The following Partners are supporting Ebola response in Kasese district;WHO, CDC, USAID CHC, UNICEF, Red Cross,AFENET,ECHO,DFID,UNHCR,IRC,IOM,Baylor,SavetheChildrenandMSF.

3. Conclusion

4. Partnerships