Uganda’s first Marburg outbreak was in 2007, in Kamwenge district. It involved 4 miners at the Kitara mine, western Uganda. Since then 3 more outbreaks of the viral disease were registered.
The last of those 3 was the case of a 30yr-old radiographer attached to Mengo hospital. It is believed he acquired the viral disease while part-timing at Mpigi Health centre IV. He died on September 28.
Thursday’s confirmation of yet another Marburg disease outbreak is the 5th outbreak in Uganda – in 2007, 2012, 2008, 2014 and now 2017.
The 19 oct 2017 outbreak is a referral case to Kapchorwa Hospital from Kaproron HCIV of a 50yr-old female in Chemuron, a village in Kween district for further management where she later died in the night of 11 oct 2017. Marburg was confirmed 17 oct 2017.
The woman had lost her 42yr-old brother on 25 Sept 2017 with similar signs and symptoms whose dead body she also helped culturally prepare for burial. MoH notes that no samples were ever taken before his death. The brother was a hunter in caves with bats.
Marburg Viral Disease (MVD) is caused by marburg virus. The virus shares it’s family – filoviridae – with the Ebola virus. Both present with similar signs and symptoms.
Marburg was first discovered in 1967 after simultaneous outbreaks in (1) Marburg and Frankfurt, Germany, and (2) Belgrade, Serbia. The viral disease was thereby named after the town of Marburg in Germany.
The outbreak was after laboratory workers had gotten infected by monkeys imported from Uganda.
The rousettus aegypti fruit bats are known natural hosts of the Marburg virus though the bats don’t present with signs or symptoms of the disease.
And with incubation period of 2 to 21 days and a case-fatality rate of 24% – 88%, the viral disease has been registered in — South Africa (3 case), Kenya (3 case), the Democratic Republic of Congo (154 cases), Angola (374 cases), Netherlands (1 case), United States of America (1 case) and Uganda (4 cases).
After infection, the disease presents with — sudden onset of high grade fever, bleeding through body orifices, severe headache, sever malaise, muscle aches, watery diarrhoea, abdominal pain, nausea and vomiting.
With differential diagnoses that include — malaria, typhoid fever, shigellosis, cholera, leptospirosis, hepatitis, and other viral haemorrhagic fevers, the WHO notes that proper diagnosis can only be done in a laboratory under maximum biological containment conditions.
The MoH has sent a rapid responce team, set-up isolation wards at Kapchorwa Hospital as well as Kiprororo HCIV, and embarked on training of health workers there.
For the time being though, vigilance and observance of proper infection prevention measures like wearing gloves and appropriate personal protective equipment (PPE) for health workers is MoH’s recommendation.