While we’ve been following reports of a Marburg virus outbreak in Uganda since late last week, the Ugandan government has had very little public comment. Even today, the front page of the Ugandan Ministry of Health makes no mention of the outbreak.
October 25th 2012 MINISTRY OF HEALTH
The Ministry of Health declared an outbreak of Marburg in Kabale district on October 19th 2012 after receiving laboratory results from the Uganda Virus Research Institute (UVRI) confirming that two family members had died of the highly infectious viral hemorrhagic fever. Three other members of the same family had earlier died of a strange disease in a period of one month.
The death of these people prompted the District Health Office to undertake further investigations of this strange disease that had ravaged Kitumba parish in Kitumba sub-county, Kabale district.
According to the reports, the patients presented with symptoms of diarrhoea, vomiting, fever, headache, dizziness and generalized convulsions. Initial samples of blood and cerebral spiral fluid taken from the sick people ruled out Malaria and Meningitis. The family then invited a cult leader, a retired Reverend from Rukungiri, district to visit their household and pray for the sick.
The index case is believed to have been a member of a family in Rwabirondo village, Kitumba parish in Kitumba sub-county which occurred on 20th September 2012. After the death of the index case, two other people, a sister and mother reportedly got sick and died.
This outbreak comes barely two weeks after the Ministry declared an end to another viral Hemorrhagic Fever (Ebola) on October 4th 2012. The last Marburg outbreak was witnessed in October 2007 in Kamwenge district.
Marburg is a highly infectious viral hemorrhagic fever which kills in a short time but can be prevented. Marburg is spread through direct contact with, 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 any of the following; headache, vomiting blood, joint and muscle pains and bleeding through the body openings, i.e. eyes (red eyes), nose, gums, ears, anus and the skin.
How is Marburg Spread?
- It is spread through;
- Direct contact with wounds, body fluids like blood, saliva, vomitus, droplets, stool and urine of a person suffering from Marburg.
- Unsterilised injections, contaminated linen, beddings and clothes.
- Using skin piercing instruments that have been used by an infected person.
- Direct physical handling of persons who have died of Marburg
Current Status (Update)
The Ministry of Health has developed a response plan and budget for the Marburg control amounting to sh2.3b of which sh1.75 is for central level activities including Ministry of Health, six general hospitals and Kampala Capital City Authority. This will be majorly for case management, surveillance, research and social mobilisation and procurement of protective gears. The district budget totals 651,047,576 and it covers case management, surveillance, research and social mobilisation.
- Out of the six people who have died so far, only three were confirmed positive for Marburg.
- Currently, there is only one confirmed case admitted in our isolation facility at Mulago National Referral Hospital. One convalescent case is detained at Rushoroza Health Center III while five suspect cases linked to the initial cases are admitted there awaiting blood results. Special teams of doctors and nurses have been assigned to attend to the patients in both the isolation facilities. The patient admitted at Mulago National Referral Hospital is from Kitumba sub-county and is a relative of the index case.
- The Ministry of Health surveillance team has listed up a total of 196 contacts for close monitoring. These contacts are mainly in Kabale, Rukungiri and Ibanda districts while 29 are from Kampala. Those being monitored reportedly got into contact with either the dead or confirmed cases. The team continues to monitor them on a daily basis for possible signs and symptoms of this highly infectious disease until they have completed 10 days without showing any signs and symptoms.
- A team of experts from the Ministry of Health, U.S Center for Disease Control and Prevention and World Health Organization have so far collected a total of 18 n samples from suspected cases for further investigations. The samples are being analyzed at the Uganda Virus Research Institute, Entebbe.
- The Ministry is conducting an orientation of local healthcare workers in Kabale Regional Referral Hospital and in the other peripheral health facilities on infection prevention and control, barrier nursing, surveillance and clinical case management. This is being done to build health workers’ capacity to handle such cases.
- In Rushoroza Health Centre, a burial committee has been set up to manage burials of people suspected to have died of Marburg. The committee has been oriented on burial procedures and infection prevention and control. This is one of the control measures to curb the spread of the highly contiguous disease. The committee has so far supervised two burials.
A team from the Centers for Disease Control (CDC) is expected in the country to undertake anthropological studies.
The Ministry of Health once again urges the public to take the following measures to avert the spread of the disease.
Report immediately any suspected patient to a nearby health unit
- Avoid direct contact with body fluids of a person suspected to be suffering from Marburg by using protective materials like gloves and masks
- Persons who have died of Marburg must be handled with strong protective wear and buried immediately
- Avoid eating dead animals
- Avoid unnecessary public gathering especially in the affected district
- Burial of suspicious community deaths should be done under close supervision of well trained burial teams
- Report all suspicious deaths to a nearby health facility
Once again the Ministry of Health calls upon the public to stay calm as all possible measures are being undertaken to control the situation.
Hon. Dr. Christine Ondoa
Minister of Health