December 09, 2017
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WHO praises Uganda’s ‘exemplary’ response to Marburg outbreak

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Matshidiso Moeti
Matshidiso Moeti

WHO touted Uganda’s “exemplary” response to control its fifth outbreak of the highly fatal Marburg virus disease in the last 10 years.

All three people who were infected during the outbreak in two districts near the border with Kenya died, WHO said. The agency credited health officials with acting quickly to ensure that the virus did not spread after first notifying the world health agency of the outbreak on Oct. 17.

According to WHO, health workers followed up with 316 close contacts of the three patients in Uganda and Kenya to confirm they had not been infected. The agency said it deployed a rapid response team to the remote mountainous area where the outbreak occurred and released $623,000 from a contingency fund for emergencies to finance the response.

Ugandan health official declared the outbreak contained after the contacts of the last confirmed patient completed 21 days of follow up — accounting for the 21-day incubation period of the virus — and an additional 21 days of intensive surveillance was completed in affected districts, WHO said.

“Uganda has led an exemplary response,” Matshidiso Moeti, MBBS, MSc, WHO regional director for Africa, said in a statement. “Health authorities and partners, with the support of WHO, were able to detect and control the spread of Marburg virus disease within a matter of weeks.”

The outbreak is believed to have begun with a man aged 35 years who frequently hunted in an area known for bat-infested caves, according to WHO. Contact with the blood, body fluids or tissue of bats is one of the ways Marburg virus is transmitted to humans. Human-to-human transmission usually occurs through direct contact with blood and bodily fluids from infected patients.

The disease, which can cause massive hemorrhaging and multiorgan dysfunction in severe cases, has a case-fatality rate of up to 90%. The index patient’s sister, who cared for her brother after he became sick, was the first confirmed patient. A second brother also died from the disease, but not before travelling to Kenya to visit relatives and a traditional healer, WHO said.

Uganda has experience responding to outbreaks of Marburg virus disease. Cases have historically occurred among miners and travelers who visited caves inhabited by bat colonies, according to WHO.

Neighboring Kenya has less experience with the disease, WHO said, but surveillance and contact tracing led by the Kenyan Ministry of Health helped prevent spread across the border.

“The response to the Marburg virus disease outbreak demonstrates how early alert and response, community engagement, strong surveillance and coordinated efforts can stop an outbreak in its tracks before it ravages communities,” Peter Salama, executive director of the WHO Health Emergencies Program, said in statement. “This was Uganda’s fifth [Marburg virus disease] outbreak in 10 years. We need to be prepared for the next one.”

Disclosures: Moeti and Salama work for WHO.