Question Period Note: Ebola - Ebola virus disease in Uganda

N/A

• On September 20, 2022, Uganda health authorities declared an outbreak of Ebola caused by the Sudan ebolavirus species or Sudan Virus Disease (SVD). As of November 22, 2022, 141 confirmed cases of SVD have been reported across nine districts of Uganda.
• The Government of Canada is closely monitoring the situation and working with international partners to support the Ebola outbreak response.
• No cases of Ebola have ever been diagnosed and reported in Canada.
• Canadians should practise enhanced health precautions if travelling to Uganda.
• Enhanced screening measures are in place at Canada’s ports of entry to help identify travellers returning to Canada who may be ill or have had close contact with or exposure to a person infected with Ebola.
• New messaging is being put in place in airport arrival areas to educate travellers on what actions to take if they are feeling sick, and to raise awareness of the outbreak in Uganda.
• Travellers from Uganda will receive handouts at airports with information to monitor their health, the symptoms of Ebola, and how the disease is spread.

If pressed on Vaccination/Treatment
• There is currently no approved treatment specifically for Ebola virus disease.
• The sooner patients seek help, the better their chances of survival.
• In-hospital treatment would be necessary for the best standard of care, and to protect others from potential exposure to an Ebola virus.
• In Canada, a person infected with the Ebola virus would be treated in a hospital with the highest level of infection prevention and control measures in place and by highly trained and specialized staff.

If pressed on Risk to Canadians
• The overall risk of SVD introduction into Canada is currently assessed as low.

Ebola disease caused by Sudan virus is named Sudan Virus Disease (SVD) is a serious and sometimes fatal illness caused by species from the Ebola virus Disease (EVD). EVD is spread through direct contact with the bodily fluids of a person who is symptomatic or has died from EVD, contact with objects (such as bedding and medical equipment) contaminated with bodily fluids, or through close contact with infected or dead animals.

Outbreaks usually begin with transmission from an infected wild animal to a human. Following this event, SVD then spreads from person to person.

Symptoms develop between 2 to 21 days after exposure to the virus, with most cases displaying symptoms around 7 days after exposure.

Infected individuals only become infectious after symptoms develop. There is no risk of transmission from casual contact with asymptomatic individuals. However, the virus can survive in genital fluids for up to 40 months, and sexual transmission via semen has been documented.

Health care workers and those with close contact with sick or dead individuals are most at risk for contracting EVD.

EVD is initially characterized by flu-like symptoms, such as fever and aches and pains. This can progress to gastrointestinal symptoms, and in severe cases, bleeding. EVD can be fatal, with between 25 and 90% of cases succumbing to the disease.

The geographic distribution of EVD is limited to the African continent, however, imported cases in Europe and the United States were reported during the 2013-2016 West African outbreak. No cases of EVD have ever been reported in Canada.

There is currently no Health Canada-approved vaccine available to travellers to prevent SVD. However, Canada has a limited stockpile of the rVSV-ZEBOV vaccine (brand name Ervebo) for emergency use in treating infected Canadians and front-line workers specifically against the Zaire ebolavirus strain; however, there is no published evidence that this vaccine is effective against the Sudan virus. .

• SVD is a severe, often fatal illness affecting humans and other primates. Case fatality rates of SVD have varied from 41 to 100% in past outbreaks.
• Current evidence suggests that SVD is spread through person-to-person transmission via direct contact (through broken skin or mucous membranes) with: blood or body fluids of a person who is sick with or has died from SVD; objects that have been contaminated with body fluids (like blood, faeces, vomit) from a person sick with SVD; or the body of a person who died from SVD.
• Symptoms usually develop between 2 to 21 days after exposure to the virus and can include fever, fatigue, muscle pain, headache, and sore throat followed by vomiting, diarrhoea, rash, symptoms of impaired kidney and liver function. In some cases, the patient might present with both internal and external bleeding.
• On October 7 2022, the Public Health Agency of Canada issued a Level 2 travel health notice for Uganda. Level 2 indicates the need to practise enhanced health precautions if travelling to the area.
• Canada has no direct flights from Uganda and the volume of travelers arriving indirectly from Uganda is low.
• There is currently no approved treatment specifically for SVD.