The recent Ebola outbreak in Uganda has raised significant concerns regarding its potential spread, given the virus's history of rapid transmission and high mortality rates. On January 29, 2025, a 32-year-old nurse in Kampala succumbed to the Sudan strain of the Ebola virus, marking the country's first Ebola-related death in two years. This incident underscores the persistent threat of Ebola in the region and the challenges associated with containing its spread [1].

The Sudan strain of Ebola, responsible for the current outbreak, is particularly concerning due to the absence of an approved vaccine. Unlike the Zaire strain, for which vaccines exist, the Sudan strain necessitates alternative containment strategies. In response, Ugandan health authorities have initiated a clinical trial for a vaccine targeting this specific strain. Developed by the International AIDS Vaccine Initiative (IAVI), the trial is being conducted by the Makerere Lung Institute, which has received approximately 2,460 doses. The primary focus is on vaccinating contacts of confirmed cases to curb further transmission [2].

The risk of Ebola spreading in Uganda is exacerbated by several factors. Kampala, the capital city, is densely populated and serves as a major travel hub, increasing the likelihood of rapid virus transmission. The mobility of the city's 4 million residents poses significant challenges for contact tracing and containment efforts. Health officials have identified 44 contacts associated with the deceased nurse, including 30 health workers, highlighting the critical need for effective monitoring and intervention strategies [3].

Key Drivers of the Outbreak

A study by Nanyonjo et al. (2023) analyzed the drivers of Ebola transmission in Uganda’s Mubende and Kassanda districts and identified several critical causes of the outbreak [6]:

• Delays in Seeking Medical Care – Fear, stigma, and lack of awareness led many infected individuals to avoid seeking timely medical attention, allowing the virus to spread within communities.
• Traditional Burial Practices – Cultural rituals involving direct contact with the deceased significantly contributed to the transmission of the virus.
• Mistrust in Health Authorities – Some community members were skeptical of government interventions, leading to reluctance in following containment measures such as quarantine and contact tracing.
• Mobility and Trade Routes – High population movement, particularly along trade corridors, facilitated the spread of the virus beyond the initial outbreak areas.
• Healthcare Worker Exposure – Inadequate personal protective equipment (PPE) and delayed case detection led to nosocomial transmission among healthcare workers, increasing the outbreak's severity.

These findings highlight the urgent need for community engagement, improved surveillance, and culturally sensitive public health interventions to mitigate the spread of Ebola and enhance outbreak response efforts.

Conclusion

The current Ebola outbreak in Uganda underscores the critical importance of swift and coordinated public health responses. While the initiation of vaccine trials offers hope, the absence of an approved vaccine for the Sudan strain necessitates reliance on traditional containment measures, including contact tracing, community engagement, and strict adherence to infection prevention protocols.

In your opinion, how can addressing the root causes of transmission, particularly delays in seeking care, traditional burial practices, and mistrust in health authorities be mitigated to prevent the spread of this current outbreak?

By ISID Scientific Manager, Aisha Abubakar

References

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3. Associated Press. Uganda health workers exposed to Ebola after nurse’s death [Internet]. 2025 [cited 2025 Feb 4]. Available from: https://apnews.com/article/fc33af48307c911c7771db825c159333
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7. Kupferschmidt K. Uganda’s Ebola outbreak underscores need for Sudan strain vaccine. Nature [Internet]. 2022 [cited 2025 Feb 4]. Available from: https://www.nature.com/articles/d41586-022-03192-8
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