Uganda has been battling an Ebola outbreak for months, and while no suspected or probable cases have been identified in the United States, federal and local health officials are working together to prepare for the possibility that the virus could spread across the Atlantic.
The U.S. Centers for Disease Control and Prevention and the Strategic Preparedness and Response Administration conducted tabled drills with officials from five jurisdictions where airline passengers arriving in the U.S. from Uganda were infected, the CDC confirmed Monday.
The agency said the exercises involved plans to manage a suspected case in each jurisdiction under three scenarios: when the potential patient is identified at an airport funnel, identified during state surveillance of travelers returning from Uganda or seeking care at a hospital .
“This is an opportunity to learn about jurisdictional plans and identify any areas where CDC or our federal partners could offer technical or other assistance,” CDC spokeswoman Kristen Nordlund wrote in an email to CNN. However, he noted, “The risk of Ebola in the United States is low.”
Ugandan health authorities declared an outbreak of Ebola virus disease in September, and by early November, 136 confirmed cases, 21 probable cases and 53 confirmed deaths had 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 among students and curb the spread of the virus.
Museveni said in a statement, “All primary and secondary schools in Uganda are requested to be closed by November 25, 2022 for the third term as a measure to contain the Ebola Virus Disease (EVD) in the country. Eight students have died of Ebola since September, out of 23 confirmed cases in schools.
Lori Tremmel Freeman, chief executive of the National Association of County and City Health Officials, said the general attitude among public health officials in the United States is that as the outbreak in Uganda continues, it increases the likelihood of the virus spreading to the United States. .
“It might just be a matter of time,” Freeman said. “That’s why every minute now has been spent to increase the preparation and response in anticipation of this one event that happens. But the more time and effort we put into this crisis stage, the better off we’ll be when we get that first case.”
Officials at the CDC have conducted “table exercises” with local health departments deemed most at risk of seeing a case in their jurisdiction, Freeman said.
“Jurisdictions where the probability of cases is highest are either because they represent the Ugandan community in this country, or they are near those airports where Ugandan travelers are channeled,” he said.
Since early October, all passengers arriving in the United States from Uganda have been directed to the airport in New York; Newark, New Jersey; Atlanta; Chicago; or Washington, DC, for enhanced screening in response to the outbreak.
“So they will walk through the plans, identify gaps and concerns,” Freeman said. “One of the most difficult areas of dealing with Ebola is what to do with a patient once they are identified and how you maintain quarantine for that person and their close contacts.”
Those plans also include preparing community hospitals for possible cases, and “efforts will soon be made to assess frontline community hospitals to determine their capabilities and gaps,” Freeman said.
CDC estimates that 20% of travelers 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 had no way to stay in touch with health officials.
The Chicago Department of Public Health is one of the agencies that “participated in an exercise with CDC to walk through the scenario of a traveler developing 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 specific 2022 outbreak; from screening and assessment to transport and clinical care as deemed appropriate,” the statement said.
“CDPH continues to work with our hospitals to screen patients for their travel history and watch for symptoms of Ebola virus disease or, more likely, malaria or circulating respiratory viruses. In addition, CDPH will monitor travelers for 3 weeks after their departure from Uganda and provide these travelers with CDPH contacts, should they develop symptoms.”
As of Wednesday, 824 travelers had been tested at Chicago’s O’Hare airport, according to the department.
In Washington, health officials monitored 100 travelers, of which “19 are currently being monitored,” DC Health said Wednesday.
In New York, screening is being done at JFK airport, and the state health department is working closely with the CDC.
Samantha Fuld, a spokeswoman for the New York State Department of Health, wrote in an email to CNN, “New York State is coordinating with CDC and local health departments as it screens travelers from Uganda, where Ebola cases have been identified. .
“While no infections have been reported outside of Uganda or in New York or the United States, the CDC has taken proactive measures to monitor key travel hubs — including JFK International Airport, one of five U.S. airports where the CDC is currently directing travelers from Uganda – alerting public health laboratories, ready hospitals designated as Ebola treatment centers, and informing health care providers will ensure we remain alert and prepared,” Fuld wrote.
The Ebola virus is contagious, but not as much as some other infectious diseases, such as Covid-19. “We should 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 Center for Virology and Vaccine Research at Beth Israel Deaconess Medical Center.
Ebola can spread from person to person through direct contact with blood or other bodily fluids such as saliva, sweat, sperm or discharge or feces, or through contaminated objects such as bedding or needles.
Symptoms of Ebola include fever, aches and pains, and fatigue, which can then progress to diarrhea, vomiting and unexplained bleeding. There are two monoclonal antibody treatments for Ebola approved by the US Food and Drug Administration. Other treatments include giving fluids and electrolytes, supporting the patient’s blood pressure, reducing vomiting and managing fever and pain.
“If we see any cases in the United States, the hope is that they will be identified quickly before there is more spread,” Barouch said.
“We need to prepare. We need to make sure that our testing programs are in place,” he said. “We need to have the protocols in place if there is an infected traveler arriving in the United States, so that person gets optimal medical care, but also to make sure it doesn’t spread further.”