South Sudan holds five-day Bundibugyo Ebola drill; readiness at 72.5 percent, no case reported

South Sudan's Ministry of Health and National Public Health Institute (NPHI) ran a five-day full-scale simulation exercise for Bundibugyo virus disease (BVD) from 19 to 24 October in Juba, Yei and Yambio, the World Health Organization's Africa regional office said in a news release on 26 October. South Sudan has not reported any BVD case so far.

BVD is a severe form of Ebola disease caused by the Bundibugyo virus, one of the Ebola-causing virus species. A full-scale simulation exercise is a drill in which teams act out the response to hypothetical suspected cases in the field. The scenarios in this one involved multiple suspected Ebola cases.

Ten sites took part: four in Juba, three in Yei and three in Yambio. More than 100 participants came from the Ministry of Health, NPHI and health implementing partners. WHO, the Africa Centres for Disease Control and Prevention (Africa CDC), UNICEF and other partners supported the exercise.

The teams tested their ability to recognise suspected Ebola, investigate cases, refer patients and isolate credible cases. They also practised putting on and taking off personal protective equipment, collecting, packaging and transporting blood samples, terminal and vehicle disinfection, waste management at health centres, safe and dignified burials, screening of travellers at designated points of entry, and links with the Ebola hotlines. Coordination and communication between national and sub-national levels were tested as well.

South Sudan's surveillance system has so far detected 71 alerts. Twenty-three were verified as credible alerts meeting the standard BVD case definition, the set of criteria used to decide whether a patient counts as a case. Alerts meeting the definition were isolated in designated holding areas set up in the 15 high-risk counties and tested negative at the national public health laboratory. The 15 counties border the Democratic Republic of Congo (DRC) and Uganda; the national preparedness and readiness steering committee chose to prioritise them in order to focus limited resources.

Dr Ader Macar Aciek, Executive Director of NPHI, said South Sudan's "readiness level stands at 72.5 percent" as of October, with varying levels of readiness across 11 pillars.

The exercise was held in view of the ongoing BVD outbreak in the DRC and Kenya. Kenya's Ministry of Health reported the country's first laboratory-confirmed imported BVD case on 6 October, according to WHO's Disease Outbreak News of 8 October; the patient died on 5 October. The same notice assessed the risk for countries sharing land borders with the DRC as high.

The 8 October notice says BVD spreads from person to person through direct contact with the blood, secretions, organs or other bodily fluids of infected people, or with contaminated surfaces and materials, and that the incubation period ranges from two to 21 days. It says no approved vaccines or specific treatments currently exist for BVD. WHO advises against any restriction of travel to, or trade with, affected countries.

Dr Moses Ongom, WHO Representative (officer-in-charge) for South Sudan, said: "A lot has been done but more needs be done to close the remaining gaps." After the exercise, facilitators and participants reviewed the performance of all actors involved, in order to set immediate and short-term actions to close the gaps they found.