Between 2010 and 2017, the Centers for Disease Control and Prevention (CDC) and Ugandan scientists identified 16 outbreaks of viral hemorrhagic fevers (VHFs) in an average of 2.5 days – down from the two-week average detection time over the previous 10 years. The program, the CDC-UVRI Viral Hemorrhagic Fever Surveillance and Laboratory Program, identified five times as many outbreaks between 2010 and 2017 as were documented in the decade before the program began.
This first-of-its-kind national VHF program is a collaboration between CDC, the Uganda Ministry of Health (MOH), and the Uganda Virus Research Institute (UVRI). It combines real-time surveillance with laboratory testing and emergency response to significantly decrease both intensity and length of VHF outbreaks in the country, potentially saving hundreds or thousands of lives. The program’s many successes have included:
- Building a high-containment laboratory at UVRI to quickly provide confirmatory testing for VHFs in Uganda as well as in the region.
- Detecting and responding to multiple outbreaks of VHFs, including Ebola and Marburg, through deployment of rapid response teams within 24 hours of outbreak confirmation.
- Serving as a regional center of excellence for VHF program training and technical assistance.
“Early detection and response are key to protecting the public,” said CDC epidemiologist Trevor Shoemaker, who led the program for six years and is the article’s lead author. “By increasing surveillance and working together to catch outbreaks soon after they start, we can keep outbreaks small, preventing illnesses and deaths. This saves lives locally and helps prevent the further spread of deadly diseases to other countries, including the United States.”
This program serves as a model for detecting, diagnosing, reporting and responding to VHFs and other emerging diseases spread between animals and people.
Since 2010, scientists at the laboratory have tested more than 11,000 human blood samples and have confirmed 16 outbreaks, including Ebola (3), Marburg hemorrhagic fever (3), Rift Valley Fever (4) and Crimean-Congo hemorrhagic fever (6). Half of the 16 outbreaks were stopped before they spread beyond the first patient identified.
Of particular importance, one Ebola outbreak involved only one patient – the first documented outbreak of Ebola in Uganda that did not spread to other contacts in the community or healthcare facility where the patient was treated. By comparison, two Ebola outbreaks in 2000 and 2007, before the program, affected 425 and 131 people respectively.
As part of the program, CDC and Ugandan staff also have developed technical and health communications materials now used in multiple African countries to educate healthcare providers and the public about how to prevent VHFs. They have also initiated research on how VHFs emerge and where the viruses circulate in the animal population.