Uganda Lays Out Strategy to Combat Marburg admin Minister Elioda Tumwesigye has unveiled Ugandas plan to fight Marburg fever The Ministry of Health has rolled out its masterplan aimed at fighting the deadly Marburg fever that recently killed one health worker in Mpigi District before putting the country on teneterhooks. The State Minister for General Duties holding the portfolio of Minister for Health, Dr Elioda Tumwesigye, said the initial case follows laboratory tests done at the Uganda Virus Research Institute (UVRI) on September 30th 2014 which confirmed that one person, a health worker, had died of the viral hemorrhagic fever. “The index case is a 30-year-old male Radiographer, who originally was working in Mpigi Health Centre IV, Mpigi Town Council but had been recruited by Mengo Hospital two month ago as a Radiographer. He started feeling unwell on September 17th while at Mengo Hospital and travelled back to Mpigi HCIV on September 18th to seek treatment since he felt more comfortable with a facility that he had worked with for a long time,” said Tumwesigye. He was treated at Mpigi Health Center IV but when his condition worsened, he was transferred back to Mengo Hospital where he was admitted on September 23. Tumwesigye said the patient presented with headache, epistaxis, abdominal pain, vomiting blood and diarrhoea before his condition deteriorated on September 27 and a Viral Haemorrhagic fever was suspected. Blood samples were removed for further analysis on September 28 before dying on the same day. His body was taken to Munkunyu 1 Village, Munkunyu Sub-county, Kasese district for burial. Tumwesigye further stated in a statement seen by Chimpreports on Monday that preliminary reports also show that his brother, one of the contacts so far listed has developed signs. “He has been quarantined and isolated for further monitoring. Samples have been taken from him and are being tested at the Uganda Virus Research Institute. The public will be informed of his status. Altogether 80 contacts have been listed from Mengo, Mpigi and Kasese for follow u,” added the Minister. Marburg Viral Haemorraghic fever is a fatal illness caused by the Marburg virus which belongs to the filoviridae family together with the Ebola virus. The incubation period ranges from 2 to 21 days while the Case fatality rates vary from 24 percent to 88 percent. Fruit bats of the Pteropodidae family are considered to be the natural hosts of Marburg virus. The Marburg virus is transmitted to people from the fruit bats and spreads among humans through human-to-human transmission by direct contact with wounds and body fluids like blood, saliva, vomitus, stool and urine of an infected person. A person suffering from Marburg presents with sudden onset of high fever with headache, vomiting blood, joint and muscle pains, bleeding through the body openings, i.e. eyes, nose, gums, ears, anus and the skin. There is no specific antiviral treatment or vaccine available; patients are usually given supportive treatment. President Museveni on Sunday night appealed to the nation to remain but vigilant in the wake of the new threat. He cautioned against shaking hands. Plan The Ministry of Health said it is undertaking several measures to control the spread of the disease. Tumwesigye said on Sunday, a team of epidemiologists and surveillance officers were sent to Mpigi Health Center IV, Mengo Hospital and to Kasese district to investigate the case and list all people who got into contact with the dead. So far, a total of 80 people who got into contact with the initial confirmed case have been identified and isolated as a precautionary measure and for follow up for any signs and symptoms within the 21 days incubation period. These include 38 health workers from Mengo Hospital, including his brother and 22 health workers from Mpigi Health Center IV and 20 people from Kasese district. They are currently being monitored by a team of epidemiologists from the Ministry of Health. The Minister noted that arrangements have been put in place to transport all suspect cases to the National Isolation Facility in Entebbe should they occur and that the facility is already stocked with the necessary infection control materials and other supplies to handle any incoming patients. “Arrangements have also been made at Mengo Hospital to isolate any suspect with symptoms. Health workers have been asked to effect all infection control measures,” said Tumwesigye. Preparations are underway to train all health workers at Mengo Hospital and Mpigi Health Center IV on infection control starting Monday at 9.00am Government working with partners and specifically Medicens San Frontiers (MSF) are in the process of revamping the isolation facility at Mulago National Referral Hospital under the leadership of Kampala Capital City Authority in readiness and the facility will be ready in three days time. MSF is also mobilizing additional resources to assist with infection control and case management at all the isolation facilities that have been set up. “The World Health Organization (WHO) is providing technical assistance and logistical support (PPE’s) to all the affected facilities,” said Tuwesigye, adding, “In Kasese, a team has been dispatched to work with the district official and Kagando Hospital to trace for any other suspects.” Personal Protective Equipments (PPE’s) and other supplies have been mobilized and sent to Mengo and Mpigi health center IV and Kagando HCIV. Experts speak out Health Specialist Dr A. Mbonye says since 2000, Uganda has experienced repeated outbreaks of viral hemorrhagic fevers (VHF) in the districts of Gulu in 2000, Bundibugyo, 2007, Luwero, 2011, Kibaale in July 2012, Luwero in November 2012. Marburg VHF was earlier reported in Ibanda in 2007. More recently in 2012, two outbreaks of Marburg VHF occurred in Ibanda and Kabale districts. “The Marburg epidemic was reported in early September and by November 2012, a cumulative of 14 cases (9 confirmed and 5 probable) including 7 deaths had been registered, giving a case fatality rate (CFR) of 50 percent,” says Mbinye. “A total of 202 contacts had been listed; out of which 193 had completed the 21-day follow-up period. The index case was a 33-year old male, a teacher at Nyakatukura Secondary School in Ibanda district. He travelled to Ibanda from Kabale, his home district on 31st August 2012, reportedly healthy. He fell sick on 3rd September 2012 with complaints of fever, headache, loss of appetite and general body weakness,” he noted. “Overall, the dominant symptoms for all cases were fever, vomiting, loss of appetite, headache, abdominal pain, fatigue, diarrhoea, and the least in occurrence was bleeding which accounted for 35.5 percent of all the cases.” Mbonye says the source of infection for all the five Ebola Hemorrhagic fever outbreaks in Uganda and the recent Marburg VHF outbreak in Ibanda and Kabale is not known. “Currently there is suspicion that there could be an animal reservoir of the Ebola and Marburg viruses from where occasional spillage into the human population occurs resulting in disease outbreaks. This and other hypotheses require further investigation.”
Posted on: Mon, 06 Oct 2014 09:05:55 +0000
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