Innovative Strategies and Adaptations for Containment of the 2025 Sudan Virus Disease Outbreak in an Urban Setting in Uganda: Lessons for Preparedness and Response to Future Filovirus Outbreaks
7 affiliations
- 1Ministry of Health, Kampala, Uganda
- 2Emergency Preparedness and Response, World Health Organisation, Country office, Kampala, Uganda
- 3Department of Disease Control and Environmental Health, Makerere University School of Public Health, P.O Box 7072, Kampala, Uganda
- 4Programme Management, World Health Organisation, Country office, Kampala, Uganda
- 5Department of Community Health and Behavioral Sciences, School of Public Health, Makerere University, Kampala, Uganda
- 6Integrated Epidemiology, Surveillance and Public Health Emergencies, Ministry of Health, Kampala, Uganda
- 7National Public Health Emergency Operations Center (PHEOC), Ministry of Health, Kampala, Uganda
Abstract
Background: Urban outbreaks of Ebola present heightened risks of rapid amplification and cross-regional spread. On 30 January 2025, the Uganda Ministry of Health declared an Ebola Sudan virus disease (SVD) outbreak first identified in a fatal case at a national referral hospital in Kampala, one of East Africa’s most densely populated and highly connected urban centres. The source of the index infection, presumed to be a zoonotic spillover event, was not established. Despite high transmission risk and major disruptions in global health financing, the outbreak was rapidly contained. We analysed the response to identify innovations and system adaptations that enabled control and to derive lessons for future preparedness in resource-constrained settings.
Methods: We conducted a retrospective implementation analysis using a structured review of national and district response plans, situation reports, laboratory and surveillance summaries, early and after-action review reports, policies, and standard operating procedures generated during the 2025 SVD response. Data were analysed using a framework-based thematic analysis organised around the World Health Organization (WHO) Strategic Preparedness and Response Plan (SPRP) response pillars, to identify innovations and intensified adaptations of existing approaches.
Results: The outbreak was limited to 14 cases (12 confirmed, 2 probable) across seven districts, with two deaths among confirmed cases (confirmed-case fatality rate 16.7% (2/12; 95% CI 4.7–44.8)) and all confirmed cases admitted to Ebola Treatment Units survived. Key implementation innovations included institutional quarantine of all identified contacts; decentralisation and early deployment of mobile laboratory services and district laboratory response teams; rapid deployment of candidate therapeutics and vaccines through pre-approved research readiness platforms; use of a real-time digital 4 W (who, what, where, and when) coordination and partner mapping dashboard; and intensified mortality surveillance linked to rapid laboratory confirmation. Despite mobilising only 29% of the estimated response budget (USD 16 million of an estimated USD 56 million required), coordinated resource allocation enabled rapid interruption of transmission.
Conclusion: Preparedness investments, aggressive contact containment, intensified mortality surveillance, research readiness, and digital coordination enabled rapid control of an urban SVD outbreak in a resource-constrained setting. These findings support institutionalising mortality-led surveillance, domestic emergency financing, research readiness, and establishing institutional quarantine of contacts as default policy for filovirus outbreaks in dense urban settings.
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BibTeX
@article{olaro2026innovative,
title = {{Innovative Strategies and Adaptations for Containment of the 2025 Sudan Virus Disease Outbreak in an Urban Setting in Uganda: Lessons for Preparedness and Response to Future Filovirus Outbreaks}},
author = {Charles Olaro and Elizabeth Adhiambo Mgamb and Trasias Mukama and Henry Kyobe and Andrew Bakainaga and Patrick Okumu Abok and Miriam Nanyunja and Alexander Chimbaru and Bernard Lubwama and Solome Okware and Annet Kisakye and Benjamin Sensasi and Edson Katushabe and Moses Rubangakene and Suraj Man Shrestha and Rawlance Ndejjo and Steven Ndugwa Kabwama and Esther Namukose Muwanguzi and Immaculate Atuhaire and Phionah Lillian Linda and Chris Columbus Opesen and Atek Kagirita Atwiine and Godfrey Bwire and Rhoda Wanyenze and Mwinga Kasonde},
journal = {Journal of Epidemiology and Global Health},
year = {2026},
month = aug,
doi = {10.1007/s44197-026-00620-0},
url = {https://doi.org/10.1007/s44197-026-00620-0},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Innovative Strategies and Adaptations for Containment of the 2025 Sudan Virus Disease Outbreak in an Urban Setting in Uganda: Lessons for Preparedness and Response to Future Filovirus Outbreaks
AU - Charles Olaro
AU - Elizabeth Adhiambo Mgamb
AU - Trasias Mukama
AU - Henry Kyobe
AU - Andrew Bakainaga
AU - Patrick Okumu Abok
AU - Miriam Nanyunja
AU - Alexander Chimbaru
AU - Bernard Lubwama
AU - Solome Okware
AU - Annet Kisakye
AU - Benjamin Sensasi
AU - Edson Katushabe
AU - Moses Rubangakene
AU - Suraj Man Shrestha
AU - Rawlance Ndejjo
AU - Steven Ndugwa Kabwama
AU - Esther Namukose Muwanguzi
AU - Immaculate Atuhaire
AU - Phionah Lillian Linda
AU - Chris Columbus Opesen
AU - Atek Kagirita Atwiine
AU - Godfrey Bwire
AU - Rhoda Wanyenze
AU - Mwinga Kasonde
PY - 2026
DA - 2026/08/11
JO - Journal of Epidemiology and Global Health
DO - 10.1007/s44197-026-00620-0
UR - https://doi.org/10.1007/s44197-026-00620-0
AB - Background: Urban outbreaks of Ebola present heightened risks of rapid amplification and cross-regional spread. On 30 January 2025, the Uganda Ministry of Health declared an Ebola Sudan virus disease (SVD) outbreak first identified in a fatal case at a national referral hospital in Kampala, one of East Africa’s most densely populated and highly connected urban centres. The source of the index infection, presumed to be a zoonotic spillover event, was not established. Despite high transmission risk and major disruptions in global health financing, the outbreak was rapidly contained. We analysed the response to identify innovations and system adaptations that enabled control and to derive lessons for future preparedness in resource-constrained settings. Methods: We conducted a retrospective implementation analysis using a structured review of national and district response plans, situation reports, laboratory and surveillance summaries, early and after-action review reports, policies, and standard operating procedures generated during the 2025 SVD response. Data were analysed using a framework-based thematic analysis organised around the World Health Organization (WHO) Strategic Preparedness and Response Plan (SPRP) response pillars, to identify innovations and intensified adaptations of existing approaches. Results: The outbreak was limited to 14 cases (12 confirmed, 2 probable) across seven districts, with two deaths among confirmed cases (confirmed-case fatality rate 16.7% (2/12; 95% CI 4.7–44.8)) and all confirmed cases admitted to Ebola Treatment Units survived. Key implementation innovations included institutional quarantine of all identified contacts; decentralisation and early deployment of mobile laboratory services and district laboratory response teams; rapid deployment of candidate therapeutics and vaccines through pre-approved research readiness platforms; use of a real-time digital 4 W (who, what, where, and when) coordination and partner mapping dashboard; and intensified mortality surveillance linked to rapid laboratory confirmation. Despite mobilising only 29% of the estimated response budget (USD 16 million of an estimated USD 56 million required), coordinated resource allocation enabled rapid interruption of transmission. Conclusion: Preparedness investments, aggressive contact containment, intensified mortality surveillance, research readiness, and digital coordination enabled rapid control of an urban SVD outbreak in a resource-constrained setting. These findings support institutionalising mortality-led surveillance, domestic emergency financing, research readiness, and establishing institutional quarantine of contacts as default policy for filovirus outbreaks in dense urban settings.
SN - 2210-6006
SN - 2210-6014
ER -