The Ugandan President Declared an Emitting Three-Week Lockdown and Implications for the Spread of Ebola in the Enough Regions
Ugandan President Yoweri Museveni has declared an immediate three-week lockdown in two high risk districts as the country battles a rise in Ebola infections.
Although cargo trucks will be allowed to enter and leave the Mubende and Kassanda districts, all the movement will be halted, Museveni said in a televised address on Saturday.
The government has taken additional measures that need to be taken by all of us, given the gravity of the problem.
The CDC states that an HIV positive person should not be exposed to the disease until they experience symptoms such as achy joints, fatigue, and unexplained bleeding.
With effective, available vaccines against devastating diseases, governments could prevent escalation through contact tracing and ring vaccination: in the case of Ebola, perhaps a few dozen contacts of each infected person could be vaccinated. Drug companies are not profitable when it comes to producing small amounts of vaccine needed to prevent spread, and donor governments are unwilling to spend money on preventive vaccines that might never be used.
The outbreak began on September 15. A young man was taken to Uganda’s Mubende Regional Referral Hospital after he had convulsions and a high temperature. He had bleeding in his eyes and had been passing blood-stained vomit and diarrhea. The man passed away on September 19th. The next day, laboratory tests confirmed the worst fears of those caring for him: Ebola was back.
Cultural sensitivity was key as a major driver in the spread of the disease. The virus is at its peak in corpses. A drop of blood or saliva can be spread through a person if they have direct contact with bodily fluids. To protect the living, the bodies of those who have died of Ebola must be handled by workers in full PPE, and there must be a thorough case investigation that includes immediate contact tracing. The practice of washing the bodies of loved ones by hand is no longer being practiced.
On October 16, the ministry reported 60 cases of the disease, having received 11 new cases in the previous two weeks. In total, 24 deaths have been confirmed, including four among health workers, along with 24 recoveries.
Both current Zaire ebolavirus vaccines use technology that relies on another active virus, which limits who can receive them. The side effects of Ervebo can be unpleasant if you are older than 18. Johnson & Johnson’s regimen can be offered to people one year old and up, but it must be given in two doses, eight weeks apart, which is not ideal in a rapidly growing outbreak, Bukreyev says.
mRNA vaccines could remedy some of these challenges, says Norbert Pardi, a vaccinologist at the University of Pennsylvania in Philadelphia who specializes in mRNA technology. There are many delivery platforms, but the one that does not contain a virus is mRNA vaccines. They use the messenger RNA to convert a keyprotein found on a virus into a different one. When the mRNA enters a person’s cells, the cells start to make the protein, which triggers an immune response against the virus.
If the deal goes through, it will likely take three years of research on non-human primates to determine if the vaccine is effective in the animals, and then human clinical trials will need to be conducted.
Pardi hopes that Moderna and other firms will try the mRNA approach, and seek protection against multiple species. “We don’t know which Ebola virus will cause the next Ebola outbreak,” he says.
Climate Change, Science, and the Political Process: What do we really need to know to stop using GDP as a measure of prosperity? I’ll be at COP27
Between US$5 trillion and $29 trillion was lost due to global warming from 1992 to 1983, according to an analysis. The effect in low-income countries resulted in a decrease in their national income. The countries with an average decrease of 1.5% are high-income.
I’ll be at COP27 in Egypt as part of the Nature News team covering the event. We want to hear your views on climate change, science and the political process. Your comments will help us shape our coverage. Please e-mail me at briefing@nature
The leaders of the world agree that it is time to stop using GDP as a measure of prosperity. Instead, we could complement it with a dashboard of indicators on the economy, health, ecosystems, climate and more. If this happens, it would be the biggest shift in how economies are measured since nations first started using GDP in 1953, almost 70 years ago. “Absurdly, GDP rises when there is overfishing, cutting of forests or burning of fossil fuels,” wrote UN secretary-general António Guterres in 2021. “We are destroying nature, but we count it as an increase in wealth.”
Source: https://www.nature.com/articles/d41586-022-03661-0
Active Case Detection during the 1976 Uganda Ebola Outbreak: The Huxley Dynasty and Its Influence on Science and Society
The United States has long been a top location for early-career researchers to go to do their PhD or Postdoc training. Concerns over visas, affordability, health care, racism and gun violence were cited as reasons why researchers have chosen not to pursue positions in the United States.
Historian Alison Bashford’s multigenerational biography of the Huxley family illuminates a dynasty’s vexed influence on science and society. The central figures in this intergenerational study are the nineteenth-century naturalist Thomas Henry Huxley, an early promoter of Darwin, and his grandson Julian Huxley, the evolutionary biologist who in 1942 codified the modern evolutionary synthesis by combining population genetics, inheritance and natural selection. Bashford believes that they could be thought of as one very long-lived man because of their striking similarities.
Since the first Ebola outbreaks in 1976, control has relied on the same tools: contact tracing, quarantine of confirmed cases, safe and dignified burials, and lockdowns. These measures work best in the sparsely settled countryside, and alone are not viable in dense, complex urban settings.
I worked as head of case detection during that crisis. I am in Ethiopia, and I help the CDC with their response to the Ebola outbreak in Uganda.
We also faced the issues in Liberia as well. We found that contact tracing alone was not enough. To succeed, we had to deputize members of the public — 5,700 of them at the peak of the crisis. They were called active case finders.
They were able to trace all of the contacts and sick people in 1.6 million households. People needed to trust the messenger to believe the message. They wouldn’t trust a stranger if they had to choose between them and a neighbour.
Case finders were recruited by local chiefs, community leaders and religious leaders, who received stipends from the Ebola response team, funded by the World Health Organization (WHO) and the United Nations Development Programme. Each case finder received a stipend to do their job. Every day, they would visit these houses to find and report infections, contacts and unreported deaths. They visited the people at home to help with their psychological and social support.
Local youths would be told to leave rice and water for the house if there was a confirmed case or high-risk contact. To reduce stigma, local leaders hosted a community ceremony to welcome back anyone who had completed quarantine, with a reintegration package of food, cash and clothing.
It is not easy to give up practices that help people to grieve. In a country where 12% of the population is Muslim, we hired some of their religious leaders to help with the fight against the disease. The religious leaders permitted praying and washing dead bodies, but not from the side of the body.
Seven Years of COVID-19: Mapping the World to Address the Problems of Emerging Epidemics in the Era of Rwanda
Wealthy countries should take the lead. They should ensure that agencies such as the Coalition for Epidemic Preparedness Innovations (CEPI), based in Oslo, and the International AIDS Vaccine Initiative (IAVI), based in New York City, are fully funded to do this work, which will involve close collaboration with government research agencies as well as Gavi, the Vaccine Alliance, and the WHO.
We need to do something better. The world did not rely solely on lockdowns, quarantines and contact tracing to fight COVID-19. When rich countries are affected by a fatal infectious disease, there is a massive global effort to develop vaccines and therapeutics.
Seven years ago I wrote a Nature column about this problem. Despite the COVID-19 wake-up call, this still remains one of the biggest chinks in our preparedness armour.
What will it take to finally catalyse change, so that I’m not writing this again seven years from now? We have come far, from not talking about this issue and living through a Pandemic that daily highlighted its relevance. A change in mindset may be in sight.
It can be hard enough for someone who has relatives to care for to be separated from their families in an isolation facility or be forced to quarantining their home for 21 days just to make ends meet. But the measures we were forced to take in Kampala included 63 days of lockdown in two rural districts with a combined population of nearly one million.
The effect on people’s livelihoods and on the local timber industry was devastating. The societal disruptions that these interventions bring fuel people’s anger and distrust of public-health efforts. And they are not the only way to curb the spread of the disease.
Mapping would combine three techniques: testing human blood samples for Ebola, testing blood samples from domestic and wild animals and disease modelling. For human blood samples, there is a cheap, easy way to get started: testing stored samples from nationwide HIV surveys, which many of these countries already have. For example, Uganda has the 2004–05 HIV serosurvey. We could use the results of testing these samples for Ebola to target specific geographic areas for new surveys. Funding for reagents will need to be supported by African nations.