Last reviewed: 7 Nov 2022
Last updated: 11 Nov 2022
11 Nov 2022

Ebola outbreak in Uganda caused by Sudan ebolavirus

An outbreak of Sudan ebolavirus disease was declared in Uganda on 20 September 2022. This is the first outbreak in Uganda caused by Sudan ebolavirus since 2012.

As of 7 November 2022, 136 confirmed cases have been reported, including 53 confirmed deaths (a case fatality rate of 38.9%). Eighteen cases and seven deaths have been reported in healthcare workers. Over 1300 contacts are currently under surveillance in seven districts of the country, with the most affected district being Mubende.

The World Health Organization has assessed the risk of this outbreak as very high at the national level, high at the regional level, and low at the global level.

Currently available therapeutics and vaccines are approved only for the treatment and prevention of Zaire ebolavirus disease. Vaccine candidates against Sudan ebolavirus are currently in development and being considered for testing in randomised controlled trials in Uganda.

The case fatality rate in previous outbreaks of Sudan ebolavirus disease has varied from 53% to 65%, with the largest previous outbreak occurring in Uganda in 2000 (425 cases). Sudan ebolavirus is the second most common species responsible for outbreaks after Zaire ebolavirus.

See Epidemiology

Original source of update



History and exam

Key diagnostic factors

  • presence of risk factors
  • exposure to Ebola virus in previous 21 days
  • fever
  • myalgia
  • conjunctival injection

Other diagnostic factors

  • fatigue
  • anorexia
  • diarrhoea
  • vomiting
  • severe headache
  • abdominal pain or heartburn
  • cough, dyspnoea, chest pain
  • sore throat
  • prostration
  • tachypnoea
  • maculopapular rash
  • bleeding
  • hepatomegaly
  • lymphadenopathy
  • hiccups
  • tachycardia
  • hypotension
  • neurological signs

Risk factors

  • living or working in, or arrival from, endemic area in previous 21 days
  • contact with infected body fluids
  • occupational exposure
  • butchering or consumption of meat from infected (or potentially infected) animals
  • bioterrorism

Diagnostic investigations

1st investigations to order

  • reverse transcriptase-polymerase chain reaction (RT-PCR)
  • malaria investigations

Investigations to consider

  • serum electrolyte levels
  • serum creatinine and urea
  • blood lactate
  • ABG
  • FBC
  • coagulation studies
  • urinalysis
  • LFTs
  • serum amylase level
  • serum blood glucose
  • blood cultures
  • antigen-capture enzyme-linked immunosorbent assay (ELISA)
  • IgM and IgG antibodies
  • chest x-ray

Treatment algorithm



Nicholas J. Beeching, MA, BM BCh, FRCP, FRACP, FFTM RCPS (Glasg), FESCMID, DCH, DTM&H

Consultant and Emeritus Professor of Tropical and Infectious Diseases

Royal Liverpool University Hospital

Liverpool School of Tropical Medicine




NJB is partially supported by the National Institute of Health Research Health Protection Unit in Emerging and Zoonotic Infections at the University of Liverpool and Public Health England. Views expressed in this topic are those of the contributor and do not necessarily represent the official position of the National Health Service, the National Institute for Health Research, the Department of Health, or Public Health England. NJB is an author of references cited in this topic.

Manuel Fenech, MD, MRCP, DTM&H

Specialist Trainee in Infectious Diseases

Royal Liverpool University Hospital




MF declares that he has no competing interests.

Tom E. Fletcher, MBE, MBChB, MRCP, DTM&H

Wellcome Trust/MoD Research Fellow

Liverpool School of Tropical Medicine




TEF is an author of a number of references cited in this monograph. TEF is a consultant/expert panel member to the World Health Organization, and is funded by the UK Surgeon General and the Wellcome Trust. TEF has received research grants from the Medical Research Council and the UK Public Health Rapid Support Team (UK-PHRST).

Catherine F. Houlihan, MSc, MB ChB, MRCP, DTM&H

Clinical Lecturer

University College London

Honorary Clinical Lecturer

London School of Hygiene and Tropical Medicine




CFH declares that she has no competing interests.


Dr Nicholas J. Beeching, Dr Manuel Fenech, Dr Tom E. Fletcher, and Dr Catherine F. Houlihan would like to thank Dr Colin Brown (Infectious Disease Lead, Kings Sierra Leone Partnership) for his helpful comments and insights.


CB declares that he has no competing interests.

Peer reviewers

William A. Petri, Jr, MD, PhD, FACP

Wade Hampton Frost Professor of Epidemiology

Professor of Medicine, Microbiology, and Pathology


Division of Infectious Diseases and International Health

University of Virginia




WAP declares that he has no competing interests.

Luis Ostrosky-Zeichner, MD, FACP, FIDSA, FSHEA

Professor of Medicine and Epidemiology

UT Health Medical School

Medical Director of Epidemiology

Memorial Hermann Texas Medical Center




LO-Z declares that he has no competing interests.

Stephen Mepham, MRCP (UK), FRCPATH, DTM&H, MD

Consultant in Microbiology and Infectious Diseases

Royal Free London NHS Foundation Trust




SM declares that he has no competing interests.

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