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Uganda declares end of Marburg virus disease outbreak

Sarah Opendi

The State Minister for Primary Health Care Hon. Sarah Opendi has this morning declared Uganda a Marburg free state.

Speaking to journalists during a press conference held at Media Center, Minister Sarah Opendi revealed the all the contacts had completed their 21 days of monitoring to account for the 21-day incubation period of the virus.

The Ministry of Health urged the public to reduce the risk of wildlife-to-human transmission by avoiding contact with wild bats, including visits to caves inhabited by bats.

The public is also implored to reduce the risk of human to-human transmission in the community by avoiding direct or close contact with suspected patients should any suspected cases occur.

Marburg virus disease is a highly infectious viral haemorrhagic fever that is spread through direct contact with body fluids such as blood, saliva, vomitus, stool and urine of an infected person.

She added that the additional 21 days of intensive surveillance was carried out in the affected districts to comply with the WHO requirement for management and control of viral Haemorrhagic fevers and registered no other confirmed MVD patients.

The Marburg Virus Disease (MVD) outbreak was declared by the Ministry of Health on 19 October, 2017 following laboratory tests conducted at the Uganda Virus Research Institute (UVRI) which confirmed that one person had succumbed to MVD on 13 October 2017.

The first patient, who will remain a probable case, was 35-year-old herdsman from Kween district that made frequent hunting missions to Kaptum sub-county, where there are caves with large populations of Egyptian fruit bats, and died on September 25th, 2017.

[A probable case is any person who died from ‘suspected’ MVD and had an epidemiological link to a confirmed case but did not have laboratory confirmation of the disease].

The first confirmed case was a 50-year-old woman from Chemuron village, Moyok Parish, Moyok sub county, Kween District in Eastern Uganda, who presented with signs and symptoms of a viral haemorrhagic fever and died on October 13, 2017 at Kapchorwa Hospital, having been referred from Kaproron Health Center IV in Kween district. She had nursed her 35-year-old brother, mentioned above, who died with similar signs and symptoms and had closely participated in the cultural preparation of the body for burial.

The second confirmed case, a 38-year-old man, was the brother of the two previous cases. Due to his close contact with the probable and confirmed cases, he was listed as a high-risk contact. He initially objected to a review and follow up by the contact tracing/surveillance team despite several attempts.

On October 24, 2017, however, he accepted to speak to the contact tracing team
which noted that he had developed MVD-like symptoms. He wastransported to the isolation unit at Koproron Health Center IV with fever, body weakness, abdominal pain, loss of appetite, joint pains and history of vomiting blood while at home.

Despite the tireless efforts of the case management team, he died on 26 October 2017. Since 19th October 2017 to date, a total of 311 people have been followed up from Kween (230) and Kapchorwa (81) districts.

These are people who had come into contact with the confirmed cases either during their sickness or after death. Of these, 18 developed symptoms similar to those of MVD. However, their results tested negative for the disease at UVRI. The rest did not develop
symptoms indicating that none contracted the virus.
By 16th November,

Kween and Kapchorwa districts has been contained. MOH is therefore pleased to officially declare the country free from the Marburg Viral Disease.

The declaration comes after completion of 42 days of the post-MVD surveillance
countdown period for the contacts of the last confirmed case, as per the World Health Organization (WHO) requirement for declaring an end to an outbreak of any Viral Haemorrhagic Fever (VHF).

Efforts undertaken to combat the MVD outbreak. From 19 October 2017, when the MVD 2017 outbreak was declared, the Public Health Emergency Operations Centre (PHEOC) was immediately activated for response to this outbreak, and the National Task Force (NTF) on epidemics took up the coordination of all interventions to combat the outbreak.

Additionally, the district taskforces of Kween and Kapchorwa were alerted to trace all people who could have got into contact with the confirmed or probable cases. Two isolation centers were setup at Koproron Health Center IV and Kapchorwa Hospital for treatment of any suspected MVD patients.

A mobile laboratory was deployed at Kapchorwa Hospital during the MVD outbreak to perform real-time testing of samples for MVD and strengthen surveillance and response to the Marburg virus disease outbreak.

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