Marburg virus disease outbreak in Kween District Uganda, 2017: Epidemiological and laboratory findings.

Autor: Nyakarahuka L; Department of Arbovirology, Emerging and Re-emerging Infections, Uganda Virus Research Institute (UVRI), Entebbe Uganda.; Department of Biosecurity, Ecosystems, and Veterinary Public Health, Collage of Veterinary Medicine, Animal Resources and Biosecurity, Makerere University, Kampala Uganda., Shoemaker TR; Viral Special Pathogens Branch, US Centers for Disease Control and Prevention (CDC), Atlanta, GA United States of America., Balinandi S; Department of Arbovirology, Emerging and Re-emerging Infections, Uganda Virus Research Institute (UVRI), Entebbe Uganda., Chemos G; Kween District Health Team, Kween District Local Government, Kween, Uganda., Kwesiga B; Uganda Public Health Fellowship Program, Ministry of Health, Kampala, Uganda., Mulei S; Department of Arbovirology, Emerging and Re-emerging Infections, Uganda Virus Research Institute (UVRI), Entebbe Uganda., Kyondo J; Department of Arbovirology, Emerging and Re-emerging Infections, Uganda Virus Research Institute (UVRI), Entebbe Uganda., Tumusiime A; Department of Arbovirology, Emerging and Re-emerging Infections, Uganda Virus Research Institute (UVRI), Entebbe Uganda., Kofman A; Viral Special Pathogens Branch, US Centers for Disease Control and Prevention (CDC), Atlanta, GA United States of America., Masiira B; African Field Epidemiology Network, Kampala, Uganda., Whitmer S; Viral Special Pathogens Branch, US Centers for Disease Control and Prevention (CDC), Atlanta, GA United States of America., Brown S; Viral Special Pathogens Branch, US Centers for Disease Control and Prevention (CDC), Atlanta, GA United States of America., Cannon D; Viral Special Pathogens Branch, US Centers for Disease Control and Prevention (CDC), Atlanta, GA United States of America., Chiang CF; Viral Special Pathogens Branch, US Centers for Disease Control and Prevention (CDC), Atlanta, GA United States of America., Graziano J; Viral Special Pathogens Branch, US Centers for Disease Control and Prevention (CDC), Atlanta, GA United States of America., Morales-Betoulle M; Viral Special Pathogens Branch, US Centers for Disease Control and Prevention (CDC), Atlanta, GA United States of America., Patel K; Viral Special Pathogens Branch, US Centers for Disease Control and Prevention (CDC), Atlanta, GA United States of America., Zufan S; Viral Special Pathogens Branch, US Centers for Disease Control and Prevention (CDC), Atlanta, GA United States of America., Komakech I; World Health Organization - Country Office, Kampala, Uganda., Natseri N; World Health Organization - Country Office, Kampala, Uganda., Chepkwurui PM; Kween District Health Team, Kween District Local Government, Kween, Uganda., Lubwama B; Ministry of Health, Kampala, Uganda., Okiria J; Ministry of Health, Kampala, Uganda., Kayiwa J; Public Health Emergency Operations Center, Ministry of Health, Kampala, Uganda., Nkonwa IH; Uganda Public Health Fellowship Program, Ministry of Health, Kampala, Uganda., Eyu P; Uganda Public Health Fellowship Program, Ministry of Health, Kampala, Uganda., Nakiire L; Uganda Public Health Fellowship Program, Ministry of Health, Kampala, Uganda., Okarikod EC; Kween District Health Team, Kween District Local Government, Kween, Uganda., Cheptoyek L; Kween District Health Team, Kween District Local Government, Kween, Uganda., Wangila BE; Kween District Health Team, Kween District Local Government, Kween, Uganda., Wanje M; Kween District Health Team, Kween District Local Government, Kween, Uganda., Tusiime P; Ministry of Health, Kampala, Uganda., Bulage L; Uganda Public Health Fellowship Program, Ministry of Health, Kampala, Uganda., Mwebesa HG; Ministry of Health, Kampala, Uganda., Ario AR; Uganda Public Health Fellowship Program, Ministry of Health, Kampala, Uganda., Makumbi I; Public Health Emergency Operations Center, Ministry of Health, Kampala, Uganda., Nakinsige A; Ministry of Health, Kampala, Uganda., Muruta A; Ministry of Health, Kampala, Uganda., Nanyunja M; World Health Organization - Country Office, Kampala, Uganda., Homsy J; Viral Special Pathogens Branch, US Centers for Disease Control and Prevention (CDC), Atlanta, GA United States of America., Zhu BP; Uganda Public Health Fellowship Program, Ministry of Health, Kampala, Uganda., Nelson L; Viral Special Pathogens Branch, US Centers for Disease Control and Prevention (CDC), Atlanta, GA United States of America., Kaleebu P; Department of Arbovirology, Emerging and Re-emerging Infections, Uganda Virus Research Institute (UVRI), Entebbe Uganda., Rollin PE; Viral Special Pathogens Branch, US Centers for Disease Control and Prevention (CDC), Atlanta, GA United States of America., Nichol ST; Viral Special Pathogens Branch, US Centers for Disease Control and Prevention (CDC), Atlanta, GA United States of America., Klena JD; Viral Special Pathogens Branch, US Centers for Disease Control and Prevention (CDC), Atlanta, GA United States of America., Lutwama JJ; Department of Arbovirology, Emerging and Re-emerging Infections, Uganda Virus Research Institute (UVRI), Entebbe Uganda.
Jazyk: angličtina
Zdroj: PLoS neglected tropical diseases [PLoS Negl Trop Dis] 2019 Mar 18; Vol. 13 (3), pp. e0007257. Date of Electronic Publication: 2019 Mar 18 (Print Publication: 2019).
DOI: 10.1371/journal.pntd.0007257
Abstrakt: Introduction: In October 2017, a blood sample from a resident of Kween District, Eastern Uganda, tested positive for Marburg virus. Within 24 hour of confirmation, a rapid outbreak response was initiated. Here, we present results of epidemiological and laboratory investigations.
Methods: A district task force was activated consisting of specialised teams to conduct case finding, case management and isolation, contact listing and follow up, sample collection and testing, and community engagement. An ecological investigation was also carried out to identify the potential source of infection. Virus isolation and Next Generation sequencing were performed to identify the strain of Marburg virus.
Results: Seventy individuals (34 MVD suspected cases and 36 close contacts of confirmed cases) were epidemiologically investigated, with blood samples tested for MVD. Only four cases met the MVD case definition; one was categorized as a probable case while the other three were confirmed cases. A total of 299 contacts were identified; during follow- up, two were confirmed as MVD. Of the four confirmed and probable MVD cases, three died, yielding a case fatality rate of 75%. All four cases belonged to a single family and 50% (2/4) of the MVD cases were female. All confirmed cases had clinical symptoms of fever, vomiting, abdominal pain and bleeding from body orifices. Viral sequences indicated that the Marburg virus strain responsible for this outbreak was closely related to virus strains previously shown to be circulating in Uganda.
Conclusion: This outbreak of MVD occurred as a family cluster with no additional transmission outside of the four related cases. Rapid case detection, prompt laboratory testing at the Uganda National VHF Reference Laboratory and presence of pre-trained, well-prepared national and district rapid response teams facilitated the containment and control of this outbreak within one month, preventing nationwide and global transmission of the disease.
Competing Interests: The authors have declared that no competing interests exist.
Databáze: MEDLINE
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