Public Health Details Response Plan to Recent Ebola Outbreak in Uganda

Risk of Ebola Virus Disease in LA County is Low

On September 20, 2022, the Ugandan Ministry of Health confirmed an outbreak of Ebola virus disease (EVD) (Sudan virus) in the Mubende District in western Uganda. Out of an abundance of caution, last week, the Federal Government announced that it will reroute all travelers who have been to Uganda during the past 21 days, the incubation period for the virus, through five US airports: JFK (NYC), Newark (NJ), Dulles (Washington DC), O’Hare (Chicago), and Hartsfield (Atlanta). The screening includes a temperature and symptom check conducted by the Centers for Disease Control and Prevention (CDC).

The risk of Ebola virus disease in LA County is low, as no travelers coming from Uganda within the past 21 days will be coming directly through LAX. Any such travelers will first be screened for EVD and cleared to continue travel at the five US airports above.

Travelers with LA County as their final destination who did not exhibit any symptoms at the five screening airports will be referred to LA County Public Health (Public Health) by the CDC with contact information for monitoring. Travelers without a local phone number will be provided a phone.

Upon arrival in LA County, Public Health will provide travelers with education and instructions for symptom monitoring for their 21-day incubation period. Travelers will also be provided a phone number to call a public health nurse if they have questions or at the first sign of symptoms.

Because malaria, typhoid and other travel related diseases can be acquired in Uganda and symptoms are non-specific, it is expected that a certain number of travelers will have symptoms that are compatible with EVD.  If travelers report symptoms, arrangements will be made immediately to evaluate them.

The LA County Public Health Hospital Outreach Unit is also working with all hospitals to make sure that they are on alert in the unlikely event that a patient walks-in without calling Public Health first.

Background Information about Ebola Virus Disease:

What is Ebola Virus Disease?

Ebola virus disease (EVD) is a rare disease caused by a virus (germ). This disease was first found in Africa. In 2014, the largest EVD outbreak (more disease than usual) in history was in West Africa caused by Ebola virus (species Zaire ebolavirus). In February 2021, outbreaks of Ebola virus disease (Zaire ebolavirus) were identified in the Guinea and the Democratic Republic of the Congo. Currently, there is an ongoing EVD outbreak in Uganda which began in September 2022 caused by Sudan virus (species Sudan ebolavirus).

How does Ebola Virus Disease spread?

A person can only spread Ebola to other people after they develop signs and symptoms of EVD. Ebola virus spreads from person-to-person by direct contact with a patient’s body fluids, like saliva, blood, vomit, urine, feces, and sweat. The virus gets into the body through broken skin or mucous membranes (spongy-like skin you find in your nose, eyes, or mouth). Ebola virus can also be spread by infected objects, like needles, that have been tainted with body fluids. Ebola virus can also spread after death, when preparing the patient’s body for burial.

Ebola is not spread through casual contact, air, food or water, but rather through direct person-to-person contact with persons in the later stages of the disease. People with early symptoms of Ebola are not highly contagious.

What are the symptoms of Ebola Virus Disease?

Symptoms include headache, vomiting, muscle pain, fever, stomach pain, joint pain, weakness, loss of appetite, sore throat, diarrhea, abnormal bleeding.

How is Ebola Virus Disease treated?

There are two treatments approved by FDA to treat Ebola, species Zaire ebolavirus, in adults and children. They are not approved for treatment of Sudan virus disease, and their clinical benefit for that disease, if any, is not known. Regardless of treatments available, supportive care, such as providing fluids, supportive medications and treating other infections can also help to improve chances of survival. Experimental vaccines and treatments are in development, and safety and efficacy testing is ongoing.

Are there vaccines to prevent EVD?

In the U.S. there is a vaccine approved for the Zaire ebolavirus species only available through the CDC and is recommended as pre-exposure prophylaxis vaccination for specific persons who are at potential occupational risk of exposure to Zaire ebolavirus (e.g. laboratorians working with Ebola virus, healthcare workers caring for EVD patients at designated Ebola treatment centers). The vaccine has been used to control EVD outbreaks in Africa. Currently there is no approved vaccine against the Sudan ebolavirus species.