31 October 2012
Marburg haemorrhagic fever in Uganda - update
This updates the areas affected and case numbers reported in the Clinical Update of 23 October 2012.
On 19 October 2012, the Ministry of Health in Uganda reported an outbreak of Marburg haemorrhagic fever in Kabale district in South-western Uganda . As of 29 Oct 2012, the outbreak has extended to the neighbouring districts of Ibanda and Mbarara . Twelve patients remain in hospital (eight in Kabale, two in Kampala and two in Mbarara). A total of eight deaths have been reported. A further seven suspected cases have been quarantined in Ibanda. So far, 45 samples have been tested of which nine have been confirmed as positive. A total of 436 contacts are under observation .
The Ministry of Health, World Health Organization (WHO) and Centers for Disease Control and Prevention (CDC) have deployed teams to the affected areas to support the outbreak investigation and response, including case contact tracing [1-3].
Marburg haemorrhagic fever
Marburg haemorrhagic fever is a severe disease caused by a virus of the Filoviridae family. It is highly transmissible by direct contact with blood, secretions, or other bodily fluids of dead or living infected persons. Transmission can also occur by contact with infected animals (through bats in mines or caves).
Marburg virus causes an acute febrile illness accompanied by severe haemorrhagic manifestations. The disease presents with the sudden onset of fever, headache, joint and muscle aches, and weakness. As infection progresses, nausea, vomiting and diarrhoea, shortness of breath, confusion, and haemorrhage can all occur. This can lead to multi-organ failure, shock, and death in severe cases (25% to 90% cases).
Advice for travellers
The likelihood of travellers contracting Marburg is low, unless there has been direct contact with the blood or body fluids of infected persons, or with objects, such as needles, that have been contaminated with body fluids .
Travellers who think they may have been exposed to Marburg virus should seek medical attention immediately if they experience any of the above symptoms within the first 21 days of return to the UK or 21 days after exposure.
WHO does not recommend that any travel or trade restrictions are applied to Uganda .
United Kingdom guidance on the management and control of viral haemorrhagic fevers (VHF) has been written by the Advisory Committee on Dangerous Pathogens:
Guidance for healthcare workers who will be working with VHF patients in African healthcare settings, has been written by the CDC in conjunction with WHO:
1. World Health Organization. Marburg haemorrhagic fever in Uganda. 22 October 2012. [Accessed 31 October 2012]. Available at: http://www.who.int/csr/don/2012_10_22/en/index.html
2. Ministry of Health Uganda. Press Statement on the Update of Marburg Outbreak 29 October 2012. [Accessed 31 October 2012]. Available at: http://www.mediacentre.go.ug/details.php?catId=3&item=1882
3. The World Health Organization. Regional Office for Africa. Uganda: Marburg (situation as of 21 October 2012). [Accessed 31 October 2012]. Available at: http://www.afro.who.int/en/clusters-a-programmes/dpc/epidemic-a-pandemic-alert-and-response/outbreak-news.html
4. Field VF, Ford L, Hill DR eds. Health Information for Overseas Travel, National Travel Health Network and Centre, London, UK, 2010.