Saturday, October 27, 2012

Press statement and update on the Marburg virus disease outbreak

Date: Thu 25 Oct 2012
Source: Office of the President, Uganda Media Centre [edited]

The Ministry of Health declared an outbreak of Marburg [virus disease] in Kabale district on 19 Oct 2012 after receiving laboratory results from the Uganda Virus Research Institute (UVRI) confirming that 2 family members had died of the highly infectious viral hemorrhagic fever; 3 other members of the same family had earlier died of a strange disease in a period of one month.
The deaths 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 20 Sep 2012. After the death of the index case, 2 other people, a sister and mother reportedly got sick and died. This outbreak comes barely 2 weeks after the Ministry declared an end to another viral haemorrhagic fever (Ebola virus disease) on 4 Oct 2012. The last Marburg outbreak [occurred] in October 2007 in Kamwenge district.
Marburg is a highly infectious viral haemorrhagic fever, which kills in a short time but can be prevented [avoided?]. Marburg virus infection is spread through direct contact with body fluids like blood, saliva, vomit, stool, and urine of an infected person. A person suffering from Marburg virus disease 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, that is, eyes (red eyes), nose, gums, ears, anus, and the skin. Virus can be spread also through use of unsterilised injection syringes, contaminated linen, beddings, and clothes; by the use of skin piercing instruments that have been used by an infected person. And also by direct physical handling of persons who have died of Marburg virus disease.
Current situation
- Of the 6 people who have died so far, only 3 [have been] confirmed positive for Marburg virus infection.
- Currently, there is only one confirmed case admitted in our isolation facility at Mulago National Referral Hospital. The patient admitted [there] is from Kitumba sub-county and is a relative of the index case.
- One convalescent case is detained at Rushoroza Health Center III, while 5 suspect cases linked to the initial cases have ben admitted there awaiting the results of diagnostic tests. Special teams of doctors and nurses have been assigned to attend to the patients in both isolation facilities.
- The Ministry of Health surveillance team has listed 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, the US Centers for Disease Control and Prevention and the World Health Organisation have so far collected a total of 18 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 virus disease. 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 2 burials.
- A team from the US Centers for Disease Control and Prevention (CDC) is expected in the country to undertake anthropological [sic; epidemiological?] 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 virus disease by using protective materials like gloves and masks
- Persons who have died of Marburg virus disease must be handled with strong protective wear and buried immediately
- Avoid eating dead animals [sic; presumably animals that died of disease]
- Avoid unnecessary public gatherings 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
Ugandan Minister of Health

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