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Sunday, October 5, 2014

Uganda Health ministry issues alert after Marburg death

Health ministry issues alert after Marburg death
Publish Date: Oct 05, 2014


By Vision Reporter
The Ministry of Health has today announced one fatal case of Marburg disease. The victim is a 30 year old health worker.
The victim had been a radiographer, or X-ray technician, at the Mpigi Health Centre IV, but was recruited two months ago for a similar position at Mengo Hospital. When he felt ill on September 17, he traveled back to Mpigi for treatment since “he felt more confortable with a facility that he had worked with for a long time.”
Marburg is one of the five members of the family of filoviruses, to which Ebola belongs. Like Ebola, a person infected with Marburg will experience a sudden onset of fever.
The most common additional signs are headache, joint and muscle pains, vomiting blood, and bleeding through body openings. The disease has a two to 21-day incubation period and, like Ebola, has no cure other than supportive treatment.
Today’s statement from Elioda Tumwesigye, Minister of State for General Duties & Holding the Portfolio of Minister for Health, describes a total of 80 people who were in contact with the man have been identified and isolated to follow for signs and symptoms.
President Yoweri Museveni immediately called for vigilance. "The Ministry of health is tracing all the people including relatives who may have been in close contact. Please report suspicious cases," Museveni said on twitter.
"Stay calm but vigilant. Avoid shaking hands and cooperate with health workers."
Prime Minister Ruhakana Rugunda reassured the country of measures to control the disease.
"Marburg is a Viral Hemorrhagic fever caused by the Marburg virus. Ministry of Helath has put in place rigorous surveillance and disease control measures.  Uganda has experience and adequate capacity to deal with this health threat & World Health Organisation has been informed," Prime Minister Ruhakana Rugunda said.
"The public has also been alerted to report any suspected cases on the Ministry hotline on +256750996034, " he added.
"Uganda has previously successfully handled similar situations of health threats involving Hemorrhagic fevers."
FULL STATEMENT
Ministry of Health Press Statement on confirmed Marburg Fever death
The Ministry of Health would like to inform the general public that there is a confirmed case of Marburg in the country. 
This initial case follows laboratory tests done at the Uganda Virus Research Institute (UVRI) on September 30th 2014 which confirmed that one person, a health worker, had died of the viral hemorrhagic fever.

The index case is a 30-year-old male Radiographer, who originally was working in Mpigi Health Centre IV, Mpigi Town Council but had been recruited by Mengo Hospital two month ago as a Radiographer. He started feeling unwell on September 17th while at Mengo Hospital and travelled back to Mpigi HCIV on September 18th to seek treatment since he felt more comfortable with a facility that he had worked with for a long time. 
He was treated at Mpigi Health Center IV but when his condition worsened, he was transferred back to Mengo Hospital where he was admitted on September 23rd. He presented with Headache, Epistaxis, abdominal pain, vomiting blood and diarrhea. His condition deteriorated on September 27th and a Viral Haemorraghic fever was suspected. Blood samples were removed for further analysis on September 28th; unfortunately he died on the same day. His body was taken to Munkunyu 1 Village, Munkunyu Sub-county, Kasese district for burial.

Preliminary reports also show that his brother, one of the contacts so far listed has developed signs. He has been quarantined and isolated for further monitoring. Samples have been taken from him and are being tested at the Uganda Virus Research Institute. The public will be informed of his status. Altogether 80 contacts have been listed from Mengo, Mpigi and Kasese for follow up. 

Marburg Viral Haemorraghic fever is a fatal illness caused by the Marburg virus which belongs to the filoviridae family together with the Ebola virus. The incubation period ranges from 2 to 21 days while the Case fatality rates vary from 24% to 88%. Fruit bats of the Pteropodidae family are considered to be the natural hosts of Marburg virus. The Marburg virus is transmitted to people from the fruit bats and spreads among humans through human-to-human transmission by direct contact with wounds and 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; 
1. Headache
2. Vomiting blood
3. Joint and muscle pains
4. Bleeding through the body openings, i.e. eyes, nose, gums, ears, anus and the skin. 
There is no specific antiviral treatment or vaccine available; patients are usually given supportive treatment.
The Ministry of Health is undertaking the following measures to control the spread of the disease;
• Yesterday, a team of epidemiologists and surveillance officers were sent to Mpigi Health Center IV, Mengo Hospital and to Kasese district to investigate the case and list all people who got into contact with the dead. 
• So far, a total of 80 people who got into contact with the initial confirmed case have been identified and isolated as a precautionary measure and for follow up for any signs and symptoms within the 21 days incubation period. These include 38 health workers from Mengo Hospital, including his brother and 22 health workers from Mpigi Health Center IV and 20 people from Kasese district. They are currently being monitored by a team of epidemiologists from the Ministry of Health. 
• Arrangements have been put in place to transport all suspect cases to the National Isolation Facility in Entebbe should they occur. The facility is already stocked with the necessary infection control materials and other supplies to handle any incoming patients. 
• Arrangements have also been made at Mengo Hospital to isolate any suspect with symptoms. Health workers have been asked to effect all infection control measures. 
• Preparations are underway to train all health workers at Mengo Hospital and Mpigi Health Center IV on infection control starting tomorrow 6/10/2014 at 9.00am
• Government working with partners and specifically Medicens San Frontiers (MSF) are in the process of revamping the isolation facility at Mulago National Referral Hospital under the leadership of Kampala Capital City Authority in readiness and the facility will be ready in three days time. 
• MSF is also mobilizing additional resources to assist with infection control and case management at all the isolation facilities that have been set up.
• The World Health Organization (WHO) is providing technical assistance and logistical support (PPE’s) to all the affected facilities.
• In Kasese, a team has been dispatched to work with the district official and Kagando Hospital to trace for any other suspects. 
• Personal Protective Equipments (PPE’s) and other supplies have been mobilized and sent to Mengo and Mpigi health center IV and Kagando HCIV.
• National Medical Stores will supply additional infection control materials to Mengo Hospital and Mpigi HCIV by tomorrow morning. 
The Ministry of Health however informs the general Public that Mengo Hospital is safe and all measures have been taken to ensure that there is no further spread of infection. Patients are encouraged to continue to receive services from there. 
Ministry of Health urges the general public to observe the following protective measures;
• Report any suspected patient to a nearby health unit 
• Avoid direct contact with body fluids of a person presenting with bleeding tendencies or symptoms of Marburg. 
The Ministry of Health once again calls upon the public to remain calm and be on alert amidst this epidemic. All suspect cases can be reported on the Ministry hotline on +256750996034.  http://www.newvision.co.ug/news/660425-health-ministry-issues-alert-after-marburg-death.html