Marburg Virus Human Case List

Updated 10/27/12

Case  #/Name/Age/Location/DOD/Confirmation/Relationship

#1   Lillian Banegura/Rwabirondo Vill/DOD Early Oct/Mother/Deceased

#2   Bernard Rutaro/32/Rwabirondo Vill/DOD Early Oct/Brother/Deceased

#3   Boaz Turyahikayo/28,/Rwabirondo Vill/Bur: 10/18/Brother/Deceased

#4   Mildred Ansasiire /26/Rwabirondo Vill./Bur: 10/18/Conf/Sister/Deceased

#5   Nathan Biryamurabaho/50/Hamuganda Vill/Bur: 10/20/Conf/Brother/Deceased

#6   Obed Tegyereize /32/Kiyonjo parish, Kitumba/Conf/Adm/Relative

#7   Edward Turyamureba /38/ Kicumbi, Kamugangu/Oct. 23/Conf/

#8   Female/18/Kabale/Adm/Conf/Sister Jason Tumukunde

#9   Sharon Twinomujuni/Kabale/Adm Mulago Hosp/Conf/Relative

#10  Lydia Rusanyuka/54/Kabale/Oct. 27/Conf/Mother Jason Tumukunde

#11  Jason Tumukunde/Kabale/DOD Mid-Oct./Mortuary Attendant Index Case

#12  Female/8/Kabale/Adm/Con/Daughter of Jason Tumukunde

#13  Female/?/Kabale/Adm/Con/Wife of Jason Tumukunde

• Declared Outbreak:  10/19
• 5 Family Members:  2 confirmed on 10/19, 3 others within 1 month.
• Where:  Kitumba Parish, Kitumba Sub-county, Kabale District.
• Index Case:  Family Member from Rwabirondo Village, Kitumba parish.
• Index Case DOD:  9/20/12
• Two Family Members died afterward:  Sister & Mother
• Family invited retired Reverend from Rukungiri Dist to visit household –
• Burial Committee @ Rushoroza HCC – As of 10/27 supervised 2 burials.

Name:  Lilian Banegura – Mother 

From:   Kiyonjo parish, Kitumba sub-county, Kabale, Uganda

DOD:  Since 10/4

Confirmed: 

Name:  Bernard Rutaro (32) Brother

From: Kiyonjo parish, Kitumba sub-county, Kabale, Uganda

DOD:  Since 10/4

Confirmed:  

Name:  Boaz Turyahikayo (28)  Brother

From: Kiyonjo parish, Kitumba sub-county, Kabale, Uganda

Buried:  10/18

Confirmed: 

Note:   a lecturer at Uganda Christian University.

Name:  Mildred Ansasiire (26),  Sister

From: Kiyonjo parish, Kitumba sub-county, Kabale, Uganda

Buried:  10/18

Confirmed:  positive

Note:   a primary school teacher

Name:  Nathan Biryamurabaho (50)  Relative
From:  Hamuganda Village, Bukora Kitumba, Kabale

Adm:  Kabale Regional Referral Hospital
Referred from:  Rugarama Hospital
DOD:  10/19  a few hours after being referred.  Buried 10/20.

Confirmed:  Positive
Notes:

• Relatives of the deceased sneaked the body out of the hospital after the authorities left them.
• Authorities are going to their residences to check on them.

Name:  Obed Tegyereize (32) –  Retired Reverend
From:    Rukungiri District

Adm:  10/22 Rushoroza HCC
Confirmed:   Positive
Notes: 

·       He escaped from the health facility on Wednesday.  Has been seen crossing the border into Rukungiri District, Nyamitoma Village, he has been located, is being monitored there.

·       10/25 – steadily recovering.  Tests on 10/23 are negative

Mulago Hospital

Name:  Sharon Twinomujuni   - Relative

From:  Kitumba Sub-county, Kabale District

Adm:  10/21 Mulago Hospital

Adm:  10/19 Hospital’s Isolation Camp

Reconciled:  Private Clinic in Kisugu, Kampala

Confirmed:  Positive

Notes: 

·       Pregnant

·       Treated for Malaria in Kisugu Clinic

·       Traveled back to Kabale, had a miscarriage

·       Diagnosed & confirmed in Mulago Hospital

·       Alerted by the MOH when she was arriving so they could take precautions

·       10/23 – responding to treatment.  Stable condition.

·       Hospital is monitoring 1 Nurse and 2 Doctors who handled Twinomujini as she bled after miscarriage.  Not known at that time that she had Marburg.

Name:   Lydia Rusanyuka (54) – Mother of Jason - 7^th death

From:     Kabale

Adm:   10/21  Rushoroza Healthcare Ctr

Confirmed:  positive

DOD:  10/27, buried 10/27

Notes:  Mother  to Jason Tumukunde, who died last week http://tinyurl.com/93353vv

Name:  Edward Turyamureba (38)

Adm:  10/22 Rushoroza HCC

From:  Kicumbi, Kamugangu sub-county

DOD:  10/23

Confirmed:  Positive

Notes:  6^th death.

Name: Female (18), Sister to Jason Tumukunde

From:  Kabale

Adm:   10/22  Rushoroza HCC

Confirmed:  positive

Note:  Her Brother died last week shortly after preparing the body of the first suspected Marburg victim at Kabale Regional Refeerral Hospital.  He was a mortuary attendant.

Name:  Jason Tumukunde

From:  Kabale

Adm:  

DOD:  October 14 – 20tth

Confirmed:  Positive

Note:  Mortuary Attendant to 1^st reported case of Marburg Virus, (Oct. 10). 

Name:  Female  (8) – Daughter of Jason Tumukunde

From:  Kabale

Adm:   

Confirmed:  Positive

Note:  Daugher to Jason Tumukunde

Name:  Female – Wife to Jason Tumukunde

From:  Kabale

Adm: 

Confirmed:  Positive

Note:  Wife of Jason Tumukunde

Monitored:

10/27  Sheila Ndyanabangi, MOH Senior Official, contact with  confirmed Sharon Twinomujuni

10/27 – 196  (Kabale, Rukungiri, Ibanda, Kampala (29)

10/26 – 177

10/24 – 132   http://tinyurl.com/93353vv

10/23 – 34

10/25:  Kampala (26 contacts of Sharon); Kabale (132); Rukungiri Dist. Nyamitoma Vill.

 (21 families)

10/25    196 People in Kabale, Rukungiri, Ibanda & Kampala.   http://tinyurl.com/97o3zf9

Total Suspected:

10/27 -  18 to date

10/24 – 7   http://tinyurl.com/93353vv

1^st Suspected Case  was reported October 10.

Marburg Erupts Inside Health Ministry

October 26, 2012 The Ministry of Health has been thrown into panic after it emerged some of its own are suspected to have contracted the deadly ebola-like Marburg virus, Red Pepper can authoritatively report. Sheila Ndyanabangi, the clinical officer in the ministry is reported to be one of the 29 contacts the ministry has quarantined and for that reason she has been asked to go on forced leave for fear of spreading the disease to other workers.

This comes after one of Ndyanabangi’s unidentified relatives visited her from Kabale recently. The relative developed signs of Marburg, and luckily, as a senior medic, she was able to tell that something unusual was happening to the former. The patient was rushed to Mulago for treatment and when her ‘superiors learnt of the shocking incident’ she was forced to stay home until she can be passed as free of the virus.

An insider in her home who preferred anonymity told our reporter. Red Pepper confirmed this development yesterday when she failed to turn up for the psychiatric conference she was expected to chair and present a paper. Instead she forwarded her written apologies through a workmate who represented her. The message reads in part; “First of all I begin by extending my sincere apologies, I was unable to chair this conference because a sick relative having Marburg visited me. And in turn I have been ‘forced’ to stay home until I am declared Marburg-free.”

The Ministry publicist Lukiah Nakamatte confirmed the news when we contacted her last night. “Yes Dr. Sheila is among the 29 contacts that are being monitored, we have taken her blood samples and we are waiting for the results,” Lukiah exclusively revealed.

However, she denied claims by Ndyanabangi that she was forced to stay home as written. “She was not forced to stay home but rather put under close watch,” Lukiah stated.

The news confirms our earlier story that the deadly Marburg has hit Kampala city. The country has been living in fear following the outbreak of Marburg Fever two weeks ago in the south western district of Kabale and has since claimed six lives. (Additional Reporting By Nicholas Mwesigwa)

MOH Official Dr Sheila Ndyanabangi in isolation over #Marburg Virus Under Marburg Observation

 [This title does not imply that Dr Ndyanabangi has been admitted to hospital.  They are referring to Sharon Twinomujuni, who is confirmed and admitted to Mulago hospital.]

October 27, 2012 

The ministry of health has confirmed that one of its senior officials is being monitored after getting into contact with a Marburg patient.

Dr Sheila Ndyanabangi, the principal medical officer mental health is said to have had contact with a patient in Mulago and she is currently in isolation.

The ministry’s public Relations officer Rukia Nakamatte says Dr Ndyanabangi has been advised to avoid public gatherings and direct contact with other people.

The ministry is calling for more vigilance from the public following the outbreak last week of the highly contagious Marburg virus.

#Marburg virus cases

Attempts to untangle the cases...from the previous article:

Lydia Rusanyuka died Saturday morning at Rushoroza health center three after spending less than a week under medical care inside the isolation center.

Has to be:

-->

Name:   Female (54)

From:     Kabale

Adm:   10/21  Rushoroza Healthcare Ctr

Confirmed:  negative

Notes:  Mother  to the deceased son, who died last week http://tinyurl.com/93353vv

Rusanyuka, the mother of a mortuary attendant who also succumbed to the disease had been tested positive with the virus prior to her death.

Her son, Jason Tumukunde also died of the same disease.

I don't know who that is.  I do have this victim, but he was just admitted on the 23rd, and that goes against a comment in a previous post:

The Kabale District Health Officer, Dr Patrick Tusiime, said on Friday that the new victims were the relatives of Kabale Regional Referral Hospital mortuary attendant Jason Tumukunde, who died four days after he treated bodies of people who had died of the virus on October 4.

-->

Name:  Edward Turyamureba (38)

Adm:  10/22 Rushoroza HCC

From:  Kicumbi, Kamugangu sub-county

DOD:  10/23

Confirmed:  Positive

Notes:  6^th death.

 Meanwhile, the wife of the late Tumukunde, his sister and their eight-year-old daughter remain in isolation at Rushoroza after testing positive.

-->

Name: Female (18) Secondary School Student

From:  Kabale

Adm:   10/22  Rushoroza HCC

Confirmed:  negative

Note:  Her Brother died last week shortly after preparing the body of the first suspected Marburg victim at Kabale Regional Refeerral Hospital.  He was a mortuary attendant.


So we have another Family Cluster of confirmed and one death.
The Mortuary Attendant of the 3rd or 4th Index Case Family.

Jason Tumukunde - confirmed, dead.
Mother to Jason - confirmed, dead.
Wife to Jason - confirmed, hospitalized
Sister to Jason - confirmed, hospitalized
Daughter to Jason - confirmed, hospitalized.

A revised list is coming up.

#Marburg death toll climbs to seven

By Goodluck Musinguzi

Another person has died of the Marburg viral disease in the southwestern district of Kabale, bringing the total number of such deaths to seven.

Lydia Rusanyuka died Saturday morning at Rushoroza health center three after spending less than a week under medical care inside the isolation center.

The deadly virus claimed its seventh victim just a little over a week since its outbreak in the district was first reported by health experts.

The medics had settled onto the conclusion after samples from two relatives taken to the Uganda Virus Institute had tested positive.

Rusanyuka, the mother of a mortuary attendant who also succumbed to the disease had been tested positive with the virus prior to her death.

Her son, Jason Tumukunde also died of the same disease.

Doctor Patrick Tusiime, the Kabale District health officer has said the deceased will be buried in Bukora, Kitumba sub-county Kabale district today.

Meanwhile, the wife of the late Tumukunde, his sister and their eight-year-old daughter remain in isolation at Rushoroza after testing positive.

3 more #Marburg cases confirmed

By Robert Muhereza
October 27,  2012

The new victims are relatives of a mortuary attendant who died after coming in contact with dead bodies.

 
Here is a previous reference to this person, the mortuary attendant.  The blog entry is located here.  The blog entry is Oct. 24th:

The two new cases reported on Monday are an 18-year-old female student from Kabale Secondary School, who was admitted at Kabale Regional Referral Hospital.
Her brother, a mortuary attendant at the hospital, died last week shortly after preparing the body of the first suspected marburg victim.

The same blog entry happens to mention that  1^st Suspected Case  was reported October 10.

So the death of Jason was somewhere from October 14 - 20th.



The 18-year-old is logged into my list as:  

Name: Female (18) Secondary School Student

From:  Kabale

Adm:   10/22  Rushoroza HCC

Confirmed:  negative

Note:  Her Brother died last week shortly after preparing the body of the first suspected Marburg victim. 

Continuing with the article:

Three patients admitted to the Marburg fever isolation centre at Rushoroza Health Centre III in Kabale Town have tested positive raising the number of confirmed cases to five.

The Kabale District Health Officer, Dr Patrick Tusiime, said on Friday that the new victims were the relatives of Kabale Regional Referral Hospital mortuary attendant Jason Tumukunde, who died four days after he treated bodies of people who had died of the virus on October 4.

“The mother, wife and eight-year-old daughter of Tumukunde have tested positive. The epidemic is real and people should join the experts to stop its further spread,” Dr Tusiime said. 

He added that the number of people that got in close contact with the confirmed Marburg virus victims has increased from 40 early this week to 177.

So if the mortuary attendant died on October 8th, I am not seeing him on my list.  I have the Mother, and "elderly brother" both dying in early October.  My next burial is Oct. 18th, and is a relative.  I'm missing something.
From the Health Ministers statement of 10/25, posted here, I have this summary: -->

5 Family Members:  2 confirmed on 10/19, 3 others within 1 month.

Where:  Kitumba Parish, Kitumba Sub-county, Kabale District.

Index Case:  Family Member from Rwabirondo Village, Kitumba parish.

Index Case DOD:  9/20/12

Two Family Members died afterward:  Sister & Mother

Tourism is starting to become affected:

Tourists cancel trip
Meanwhile, an official from Matooke Tours and Travel, one of the biggest tour companies in Uganda, Mr Gashom Arinaitwe, on Thursday said about 50 tourists from America, Europe and Asia had cancelled bookings because of the Marburg scare. This comes three days after the Uganda Wildlife Authority issued a warning to tourists visiting national parks, especially those that are habitats for primates.

The authority has put in place a multi-sectoral and multi-disciplinary national team to mobilise and sensitise the public on precautionary measures, including wearing protective gowns, gloves and masks and not to avoid sharing sharp objects.

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
–
Communicated by:
ProMED-mail
promed@promedmail.org


 http://www.geostrategicforecasting.com/proahedr-marburg-virus-disease-5/

Hesaraghatta Poultry Farms

From the previous post, located here:

A radius of 10 km has been demarcated as surveillance zone. As many as 15 commercial farms in 68 villages with a poultry population of one and half lakh come under this.

The Central Poultry Organisation (Southern Region), under Ministry of Agriculture, Department of Animal Husbandry & Dairying, Government of India formed after merging and restructuring of the Central Poultry Units located at Hessaraghatta, Bangalore viz. Central Poultry Training Institute, Central Poultry Breeding Farm, Central Duck Breeding Farm, Random Sample Poultry Performance Testing Centre, during June 2003.
Map:

OBJECTIVES:- Maintaining of Germ plasm of low input technology birds and multiplication and development of these stocks and supply for rural poultry development programmes.
 -snip-

Under diversification programme, Turkey Production and multiplication. This Organisations constitutes three major Units:-
Training Institute & Service Unit
Poultry Unit
Turkey Unit
Duck Unit
 -snip-
The initial progress which has been achieved at this organization indicates a very bright future for turkey production through controlled breeding and management.
From 1997-2004 the systematic approach of “Turkey activities” has resulted spectacular progress and create a good market with in the nation in a short period.
Turkey Hatching eggs and Birds sold during last three years are 9000,13000and 9000 up
to December 2004.
Estimate demand for per year is about 50000.
A market study shows that a male turkey sold at 24 weeks of age weighing 10 to 12 kg with expenditure of Rs 400 to 450 will give a profit of Rs 500 to 600. Likewise a female will give a profit of Rs300to 400 in a span of 24 weeks time. Besides, the turkey can be reared in scavenging and semi –scavenging conditions also

http://www.cpdosrbng.kar.nic.in/turkey.htm

Bangalore : #H5N1 Infects 3,600 Turkeys

 October 26, 2012

About 3,600 Turkeys have died of avian influenza (H5N1) at the Central Poultry Development Organisation at Hesaragatta on the city outskirts, a government official said here today.
"The remaining 700 Turkeys have been culled",Secretary in the Department of Animal Husbandry,Arvind Jannu,told PTI here.
CPDO has been quarantined,he said. Confirmation that these birds died following the influenza came from Bhopal-based high security animal disease laboratory two days ago.
A radius of one kilometre around CPDO has been declared as an infected zone. "We are watching other birds".
A radius of 10 km has been demarcated as surveillance zone. As many as 15 commercial farms in 68 villages with a poultry population of one and half lakh come under this.
Sale of poultry products by these farms as well as poultry preparation in non-vegetarian hotels in the surveillance zone has been banned for a week, Jannu said.
Department officials said 25 rapid response teams have been deployed in the surveillance zone to check traces of the virus in other birds. PTI RS BH APR BS 10261904 NNNN

http://www.dnaindia.com/india/report_bird-flu-claims-3600-turkeys-in-poultry-development-body-at-bangalore_1756508

Study: Fair-related swine and human H3N2 viruses closely match

CIDRAP

Robert Roos  News Editor

Oct 25, 2012 (CIDRAP News) – Researchers report that swine and human influenza A/H3N2 viruses associated with an Ohio county fair held in July make a nearly perfect genetic match, suggesting that there is almost no biological barrier to prevent such viruses from passing between humans and pigs.

The authors sequenced the genomes of H3N2 viruses isolated from pigs that were exhibited at the fair and from several people who were infected with strains of variant H3N2 (H3N2v, the term for the human version) after participating in or visiting the fair. They found that the genomes were more than 99% the same, according to their report in Emerging Microbes and Infections.

The human cases were among 306 H3N2v cases reported by the Centers for Disease Control and Prevention (CDC) since Jul 12 of this year. The vast majority of these occurred in young people who were involved in agricultural fairs.

The cases have mostly been fairly mild, and no sustained human-to-human transmission has been seen. But they have prompted health officials to warn people at risk for flu complications to stay out of swine barns at fairs, and fair visitors and participants have been urged to take special precautions if they have exposure to pigs.

Andrew S. Bowman, DVM, of The Ohio State University (OSU), first author of the new study, said it is the first study in a peer-reviewed journal to compare the genomes of H3N2 viruses recovered from people and pigs in connection with county fair-related cases. The research team also included scientists from Minnesota and Iowa.

The H3N2 viruses in the fair-related cases, both swine and human, carry the M or matrix gene from the 2009 H1N1 pandemic virus. In the current study, the authors call the swine-origin strain H3N2pM.

In the study, the research team gathered nasal swabs from 34 pigs that were randomly selected on the last day of the fair, Jul 28, about a week after the pigs arrived there. The fair was not identified. None of the pigs had obvious signs of illness at the time of the sampling, although exhibitors said some pigs had been sick 3 to 5 days earlier and a few had been sent home.

Using polymerase chain reaction, the team found that 31 of the 34 pigs were infected with the H3N2pM virus, and they isolated viruses from 29 of these. The researchers also gathered samples from 5 of 22 people who had H3N2v infections associated with the fair, and they ran several analyses to compare the genomes of the swine and human strains.

Analysis of the hemagglutinin genes showed that all the viruses belong to "Cluster IV" H3 viruses circulating in US swine, the report says. Findings for the neuraminidase, polymerase complex, nucleoprotein, and non-structural genes were similar, with near-99% similarity between the swine and human isolates.

Also, the M genes from the swine and human viruses fit in a clade with the M genes from 2009 H1N1 viruses isolated in 2009 and 2012.

"This study presents clear molecular evidence that pigs and humans were concurrently infected with the same strain of influenza A virus at an Ohio county fair in July 2012," the authors write.

"The lack of difference between the genotypes of these isolates suggests that there are virtually no innate species barriers preventing bidirectional interspecies transmission of H3N2pM/H3N2v viruses between humans and pigs," they add.

The report says that H3N2pM and H3N2v viruses are probably the product of reassortment, or gene-swapping, events in pigs, because the most recent ancestors of all the genetic segments of the viruses can be found in triple-reassortant H3N2, H1N2, and H1N1 viruses that have been identified in North American swine.

Bowman and his colleagues note that sustained human transmission of the viruses has not been observed, but they say that in view of the growing number of human cases in recent months, "the continuing evolution [of] H3N2v is a concern."

They conclude by calling for "appropriate steps to prevent and/or reduce" flu transmission among pigs and between pigs and humans at fairs, "while considering short- and long-term implications for the cultural value of livestock exhibitions."

According to an OSU press release yesterday, the team has suggested that fairs consider such preventive strategies as shortening the pig exhibition period, avoiding movement of pigs from one fair to the next, and vaccinating exhibition swine for appropriate influenza A viruses.

Bowman AS, Sreevatsan S, Illian ML, et al. Molecular evidence for interspecies transmission of H3N2pM/H3N2v influenza A viruses at an Ohio agricultural fair, July 2012. Emerg Microbes Infect 2012;1 [Full text]

See also:

Oct 24 OSU press release

CDC information on H3N2v cases

CDC weekly flu activity update with information on the number of H3N2v cases

Oct 2 CIDRAP News story "Study: Most flu infections in fair pigs were unapparent" 

http://www.cidrap.umn.edu/cidrap/content/influenza/swineflu/news/oct2512h3n2v.html 

These Are The Airports Most Likely To Start A Pandemic

Oct. 24, 2012

When a new or dangerous virus breaks out in a small town in Africa, it isn't likely to go far. But, if that same disease travels through a large international airport, there's no way to stop it from spreading to multiple cities.

Read more: http://www.businessinsider.com/airports-most-likely-to-start-pandemic-2012-10#ixzz2AP5k7kPU

#Marburg Virus: 196 Under Surv.; CDC Team Arrives Next Week

 
Despite having one person admitted at Mulago Hospital with Marburg Haemorrhagic fever, health minister, Dr Christine Ondoa has assured Ugandans that the city is safe from the deadly virus.

The World Health Organisation has also said it will not recommend travel restrictions within or outside the country at the moment, since the epidemic is under control.

A team of health experts from the US Centres for Disease Control (CDC) arrives in the country next week to carry out a study on wild animals in districts where suspected cases of the Marburg virus has been reported.

Addressing journalists at the media centre Thursday, Ondoa said the CDC team would help to confirm the cause of the outbreak which was confirmed this month.

She warned that communities living near forest areas in western Uganda were susceptible to infection from the Marburg virus since they often come into contact with wild animals.

The last Marburg outbreak in Uganda was reported in October 2007 in Kamwenge district, and studies linked the virus to bats and wild game in Imaramagambo forest.

Marburg fever is caused by a virus that easily spreads through direct contact with wounds, body fluids like blood, saliva, vomitus, stool and urine of an infected person.

A person suffering from Marburg presents symptoms such as high fever, vomiting blood, joint and muscle pains and bleeding through the body openings like eyes, nose, gums, ears, anus and the skin.

Ondoa confirmed that four of the six suspected cases had from suspected Marburg fever, while 196 people are under surveillance for possible contact with the infected in Kabale, Rukungiri, Ibanda and Kampala.

One of the two confirmed Marburg victims is admitted at Mulago Hospital and in stable condition while another person is recovering at Rushoroza Health Centre III in Kabale district.

Dr Joachim Saweka, the WHO country representative said Uganda had one of the best surveillance teams in the region, but decried Government’s slow commitment to funding such interventions.

The health ministry urgently needs sh2.3b to stem the epidemic, of which sh1.7b will be used to for surveillance, research and procurement of protective gear while sh650m is to be spent in the affected districts.

#Marburg Virus: 6th Death; 2 Recovering, 2 Adm's Neg. & Over 180 Under Survelliance

One of the two people, who were admitted on Monday with signs of the deadly marburg fever, has died.

Edward Turyamureba, a 38-year-old resident of Kicumbi Cell, Kamuganguzi sub-county, succumbed to severe bleeding and vomiting on Tuesday evening.

He is the sixth person suspected to have died from the disease since it was reported earlier this month. He was laid to rest at a brief funeral yesterday.

Two people were admitted to an isolation centre at Rushoroza Health Centre III in Kabale district on Monday.

However, the Ministry of Health spokesperson, Rukia Nakamatte, yesterday said samples from the patients tested at the Uganda Virus Research Institute laboratory in Entebbe were negative.

Since the marburg virus was first reported in the country, only one person has been confirmed to have contracted it since the five suspected victims were buried before tests were carried out.

Meanwhile, Obed Ntegyereize, the first confirmed victim, is steadily recovering, after tests conducted on him on Tuesday turned out negative, health officials disclosed.

Ntegyereize is related to the five people who died from a mysterious disease linked to the marburg fever two weeks ago.

Dr. Patrick Tusiime, the Kabale district director of health services, said a surveillance team was monitoring the bereaved family to ascertain whether they are not infected.

Panic engulfed residents yesterday after one of the patients at Kabale Hospital, initially suspected to have marburg, passed away. However, Tusiime said the deceased succumbed to a stroke.

At Mulago Hospital, Sharon Twinomujuni, who tested positive for Marburg, is steadily improving. The hospital’s spokesperson, Enock Kusasira, said doctors had recommended a strict diet to aid her recovery.

He also said the hospital had not registered any new case of Marburg although the 26 people who came into contact with her were under surveillance. An additional 132 people are being monitored in Kabale district.

In Rukungiri district, health officials have put at least 21 families on surveillance in Nyamitoma village, Bikurungu parish, on suspicion that they came into contact with the first victim during prayers in a church. Authorities have since closed the church to prevent the spread of the virus.

Compiled by Isaac Nuwagaba, Goodluck Musinguzi, Caleb Bahikaho, Taddeo Bwambale and Viola Nabatanzi

Indonesia: #H5N1 Poultry in Mukomuko & Nusa Indah Bengkulu

October 25, 2012
Excerpt:
Bengkulu (ANTARA News) - Outbreaks of avian influenza virus (H5N1) began to attack the city of Bengkulu up to several villages and caused the death of chickens owned by residents continues to grow. "bird flu affected poultry growing in October, we returned to find the last dead chickens Kelurahan Nusa Indah suddenly," said Head of the Department of Agriculture and Livestock of Bengkulu, Arif Gunadi Thursday. Chickens that died suddenly in Kelurahan Nusa Indah Kecamatan Ratu Agung was the Queen of seven tails. Its owner, Rudi, after finding cattle died suddenly immediately report to the Department of Agriculture and Livestock of Bengkulu. "chickens that died suddenly was positive for bird flu after testing with a rapid test.

Meanwhile, Chairman of the Bird Flu Disease Control (PPFB) Bengkulu province, Emran Kuswadi, said that in addition to the eight villages in Bengkulu city, as many as 10 birds were also found dead suddenly in the Desa Bandaratu Kabupaten Mukomuko result of bird flu.

Full article:  http://www.antaranews.com/berita/340456/wabah-flu-burung-serang-bengkulu

Indonesia: 103 positive poultry bird flu in Bengkulu

October 24, 2012 Bengkulu (ANTARA News) - Tim Bird Flu Disease Control Bengkulu province recorded as many as 103 birds in the area tested positive for the bird flu virus (H5N1) in October 2012. "Some 103 birds in the area tested positive for the bird flu virus since the beginning of October 2012 , "said Chairman Tim Bird Flu Disease Control (PPFB) Bengkulu province, Emran Kuswadi Wednesday.

Hundreds of birds were found positive for bird flu in Bengkulu city consists of 15ekor in Kelurahan Lingkar Barat Kecamatan Gading Cempaka, 18 ekor di Kelurahan Kebun Tebeng Kecamatan Ratu Agung dan sembilan ekor di Kelurahan Bentiring Kecamatan Muara Bangkahulu. then the spread of the bird flu virus resulted in the death of as many as 11 head of poultry in Kelurahan Kebun Beler Kecamatan Ratu Agung, the nine ekor in Kelurahan Sidomulyo Kecamatan Gading Cempaka, 15 tails in Kelurahan Dusun Besar Kecamatan Singaran Pati dan tiga ekor di Kelurahan Timur Indah Kecamatan Singaran Pati.  

"In addition to the seven villages in Bengkulu city, as many as 10 birds in the village of Desa Bandar Ratu Kabupaten Mukomuko also died suddenly due to positive bird flu," he said. To prevent the spread of bird flu virus Agricultural Department and Livestock Bengkulu City seeks spraying with disinfectant on the area known cases of bird flu.

In addition, they requested that citizens hand over their chickens to be burned. however, most people are still reluctant to hand over the surviving poultry to be destroyed because it voluntarily for reasons still care for their animals alive. "Besides residents reluctant to give up his pet birds because they do not receive compensation for the destruction of officers conducted en masse, "said Head of the Department of Agriculture and Livestock of Bengkulu, Arif Gunadi. Arif explained that the bird flu virus is dangerous because it can kill all poultry, spread quickly to a farm and can cause illness and death in humans. "When birds seen having some signs of bird flu such as shortness of breath, and face, comb and bluish chest muscles, swollen head, red legs and claws like scraped, diarrhea, mucus from the mouth and nose, sudden death and high mortality rate, immediately report it to us / paramedic animals in this area, "he said. poultry order not infected with bird flu, especially during the rainy season it asks the citizens to keep the cage, avoid high humidity in the cage and sprayed disinfectant that has been provided Distanak Bengkulu city. (ANT)

Coincidence? Health Ministry Launches “House to House” Vaccination Campaign

24/10/2012

The exercise that started on October 20 is planned to last two days in the districts.
According to the Director General Health Services, Jane Ruth Aceng, during the exercise, the Ministry will reach out to every child under the age of five especially those who missed the routine immunization exercise in the selected districts.  

The campaign targets 21 total Of 2,178,039 children in Karamoja, eastern and Western regions and in districts along the border with Kenya and the DR Congo.

The campaign is funded by the Government of Uganda with support from the World Health Organization and UNICEF. “The house to house campaign is intended to reach out to the children whose parents cannot take them to health facilities or community outreaches due to various reasons,” Aceng told press on Wednesday in Kampala. “These include children born at home, those whose parents and caretakers feel reluctant to take them to facilities, migrant populations and those whose parents fear or mistrust the vaccine.”

Under the campaign, the Ministry of Health is working closely with village local councils and Village Health Teams to register children and administer the vaccines. 

Polio is a communicable disease that spreads from one infected person to another through the oral - feacal route.

It is a complex disease and more than 99% Who carry the polio virus go undetected. 

The Ministry notes that failure to eradicate polio allows for resurgence leading to death and disablement of thousands of children. 

The selected districts are; Abim, Amudat, Bududa, Bugíri, Buikwe, Bukwo, Bulambuli, Bundibugyo, Busia, Buvuma, Iganga, Isingiro, Jinja, Kaabong, Kabale, Kabalore, Kamwenge and Kanungu.

Others include Kapchorwa, Kasese, Kísoro, Kotìdo, Kween, Kyegerwa, Kyenjojjo, Manfwa, Mayuge, Moroto, Nakapirípìrít, Namayingo, Napak, Ntoroko, Ntungamo, Rubìrizi, Rukungíri, Sironko and Totoro 

“The Ministry of Health appeals to all parents and caretakers to welcome the health Workers into their households to immunize all the children in the recommended age group whether they have been immunized before or not,” said Aceng.