Ebola, Marburg viruses outbreak in East Africa poses threat to Kenya's health system
Uganda this week confirmed an outbreak of the Ebola virus in the capital Kampala with the first confirmed patient dying from it.
Ebola outbreaks have historically sent waves of fear across communities, leaving behind a trail of devastation. The virus is notorious for its high fatality rate, ranging between 25% and 90%, depending on the strain, making it one of the deadliest viral infections known to humanity.
Unlike many other viruses, Ebola progresses rapidly, often leading to death within days. It triggers severe internal and external bleeding—known as hemorrhagic fever—resulting in organ failure and shock. Victims endure agonizing symptoms, including intense vomiting, relentless diarrhoea, extreme dehydration, and unbearable pain.
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What makes Ebola particularly terrifying is its lethal nature, rapid spread, and the limited treatment options available. The combination of its gruesome effects, the absence of a definitive cure, and the widespread panic it incites cements its place as one of the most feared diseases in human history.
Uganda this week confirmed an outbreak of the Ebola virus in the capital Kampala with the first confirmed patient dying from it, the health ministry said on Thursday.
It is the East African country's ninth outbreak since it recorded its first infection of the viral disease in 2000.
The patient, a male nurse at the Mulago National Referral Hospital in Kampala, had initially sought treatment at various facilities, including Mulago, as well as with a traditional healer, after developing fever-like symptoms.
Uganda last suffered an outbreak in late 2022 and that was declared over on January 11, 2023, after nearly four months in which it struggled to contain the viral infection.
The last outbreak killed 55 of the 143 people infected and the dead included six health workers.
With Ebola cases reported in Uganda and the Marburg virus in Tanzania, Kenya faces a significant health threat.
These highly lethal diseases, responsible for over 11,000 deaths worldwide, spread through direct contact with infected bodily fluids. Both viruses originate from bats and other wild animals, with transmission occurring from animals to humans before spreading among people.
Kenya is at significant risk of an Ebola outbreak following the recent resurgence of the virus in Uganda, as the two countries share a long border and frequent cross-border movement of people and goods.
The outbreak in Uganda, linked to the Sudan strain of Ebola, has raised alarms due to the virus’s high contagion rate through bodily fluids. With people frequently crossing the border for trade, tourism, and family visits, the virus can easily spread, especially if early symptoms are not recognised. This situation is further complicated by Kenya’s ongoing battle with other health threats, such as Mpox cases, which still strain the country's healthcare resources and attention.
An anti-Ebola advocacy van drives along Kyadondo road amid the Ebola outbreak and alert in Kampala, Uganda October 27, 2022. (Photo: REUTERS/Abubaker Lubowa)
In addition to the ongoing risk posed by Uganda’s Ebola outbreak, Kenya faces another potential danger from the Marburg virus, which has been reported in Tanzania. Marburg is a highly contagious hemorrhagic fever similar to Ebola, with similar transmission and symptoms, making it another serious health risk for Kenya. The proximity of Tanzania to Kenya and the movement of people between these nations heighten the possibility of the virus crossing into Kenyan borders. As both Marburg and Ebola are fatal and difficult to treat, the country remains vulnerable to a public health crisis if these viruses are not quickly contained.
Kenya’s role as a regional transport hub, combined with the intense movement of people within East Africa, makes it a key point of concern for the spread of these deadly diseases.
In response to the regional outbreaks of diseases such as Mpox and Marburg, Kenya's Ministry of Health has emphasised the seriousness of these viruses, which are closely related to Ebola and have the potential to cause devastating outbreaks.
The ministry reassured the public that ongoing surveillance and screening efforts are in place, with diagnostic capacities ready to detect and manage any potential cases. Efforts to prevent the spread of these diseases are a top priority, with infection prevention and control measures being actively implemented, including protocols for safe and dignified burials when necessary.
Preventive measures are considered essential to control the spread of the virus. The public is encouraged to maintain high standards of personal hygiene, avoid contact with bats and infected individuals, and seek medical attention promptly if they experience any symptoms.
The ministry also highlighted the importance of community involvement in managing outbreaks, noting that outbreaks begin and end with the actions of local communities. By raising awareness and taking preventive actions, it is possible to limit the spread of these deadly viruses effectively.
Ebola has multiple strains, and the variant currently circulating in Uganda is the Sudan strain, raising further concerns about regional containment and public health safety.
The Ebola virus has multiple strains, each with varying levels of severity and fatality rates. The five known strains include:
Zaire Ebola Virus (EBOV) – The most lethal strain, with a fatality rate of up to 90%. It was responsible for the 2014–2016 West Africa outbreak.
Sudan Ebola Virus (SUDV) – Causes severe disease with a fatality rate between 40% and 60%. The current outbreak in Uganda is linked to this strain.
Bundibugyo Ebola Virus (BDBV) – Has a lower fatality rate (25%–40%) compared to Zaire and Sudan strains. It caused outbreaks in Uganda and the Democratic Republic of Congo (DRC).
Taï Forest Ebola Virus (TAFV) – A rare strain with only one confirmed human case in Côte d'Ivoire. It appears less deadly than other strains.
Reston Ebola Virus (RESTV) – Primarily affects animals, especially pigs and monkeys. While it can infect humans, no human deaths have been reported from this strain.
A health worker administers Ebola vaccine in Mangina DRC, August 18, 2018. (Photo: REUTERS/Olivia Acland)
Each strain varies in its transmission, severity, and geographic distribution, making Ebola a complex and ongoing global health concern.
The ongoing Ebola outbreak in Uganda has been linked to the Sudan Ebola virus (SUDV) strain. One confirmed death has been reported—a 32-year-old nurse who exhibited symptoms associated with this strain.
The Sudan Ebola strain was first identified in 1976 in southern Sudan (now South Sudan). Since then, it has caused multiple outbreaks, primarily in Sudan and Uganda.
Sudan Ebola virus spreads through direct contact with:
Infected bodily fluids (blood, saliva, sweat, vomit, faeces, breast milk, urine, semen)
Contaminated surfaces or objects (such as medical equipment and bedding)
Infected animals, especially bats and forest game (monkeys, antelopes, and chimpanzees)
Unlike some other Ebola strains, Sudan Ebola has no approved vaccine, making outbreaks harder to control and increasing the risk of rapid spread.
Why Ebola is feared
1. Extreme fatality and rapid death
Ebola is one of the deadliest viral infections, with fatality rates ranging from 25% to 90%, depending on the strain. Unlike many diseases, it progresses rapidly, often killing victims within days. The speed of deterioration, coupled with severe hemorrhagic symptoms (bleeding from the eyes, nose, mouth, and internal organs), makes it a terrifying disease.
2. High contagion risk from the dead
One of the most feared aspects of Ebola is that even after death, a victim’s body remains highly infectious. The virus persists in bodily fluids, including blood, saliva, and sweat, making handling the dead extremely dangerous.
3. Preventing transmission
In many Ebola-affected regions, bodies of the deceased are tied down for several reasons:
Uncontrolled Movements: In the final stages, victims may experience seizures and convulsions, increasing the risk of spreading infected fluids.
Cultural and Ritual Practices: Some communities believe that the dead should not be moved too much before burial, while others tie their hands and feet to prevent movement during traditional rites.
Handling Precautions: Healthcare workers and burial teams secure bodies in plastic sheeting or specialized bags to limit contact and reduce exposure to bodily fluids.
4. Fear of outbreaks and social panic
Ebola outbreaks often lead to widespread fear, as the disease spreads through direct contact with infected individuals, contaminated surfaces, and even traditional burial practices where families wash and touch the deceased. Governments and health organizations impose strict containment measures, including isolation, restricted travel, and safe burials, to prevent further infections.
This combination of deadliness, rapid transmission, and fear of the deceased spreading the virus makes Ebola one of the most terrifying diseases in human history.
When symptoms of Sudan Ebola appear, it is crucial to seek immediate medical attention. According to the World Health Organization (WHO), early treatment greatly improves survival chances. This treatment typically involves intravenous (IV) or oral fluids and other supportive care within a hospital. Caring for an Ebola patient at home is dangerous, as it not only increases the risk of spreading the virus but also lacks the professional care that is necessary for effective treatment.
The symptoms of Sudan Ebola typically develop 5 to 10 days after exposure, and they often progress rapidly. These symptoms include a high fever, severe headaches, muscle pain, and extreme fatigue. Patients also experience vomiting, diarrhoea, and abdominal pain. Some may show unexplained bleeding, such as from the gums or eyes, and experience bruising and red eyes. As the disease progresses, the symptoms can lead to shock, organ failure, and eventually death if not treated promptly. The WHO stresses that immediate medical intervention is crucial to manage these severe symptoms and prevent complications.
Preventing the spread of Sudan Ebola requires several measures. First and foremost, avoiding direct contact with individuals infected with the virus and their bodily fluids is critical. Protective gear, such as gloves, masks, and gowns, should be worn when caring for patients. Individuals showing symptoms should be isolated in healthcare facilities to minimize the risk of transmission to others. Safe burial practices must be followed, as the virus can spread from the bodies of those who have died from Ebola. Additionally, it is essential to avoid hunting and consuming bushmeat, as the virus can be transmitted from animals like bats and other forest game. Finally, community education and awareness are vital to reduce stigma, encourage proper hygiene, and ensure that safety measures are followed in affected regions.
Currently, there is no licensed vaccine for Sudan Ebola, unlike the Zaire strain, which does have an effective vaccine. This lack of a vaccine makes Sudan Ebola particularly challenging to control, highlighting the importance of swift medical response and effective containment strategies in the event of an outbreak.
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