By Davis Buyondo
Kyotera –Uganda
Uganda is on high alert following the death of five people in Tanzania from Marburg Virus Disease (MVD). The outbreak has prompted the government to take swift action to prevent the spread of the disease across the border and ensure the safety and health of its citizens.
The Tanzanian Health Ministry has confirmed the presence of this highly contagious disease through the National Laboratory. The disease was first detected last week in Maruku and Kanyangereko villages in Bukoba Rural district within the Kagera region, but the health authorities were initially unaware of what it was.
It exhibited severe symptoms such as sudden fever, vomiting, body aches, bleeding from various parts of the body, and kidney dysfunction.
The deceased are among the eight patients who were reportedly admitted to a health facility for special attention while investigations by health experts continue.
The samples from the victims had been taken for laboratory tests to determine the illness which later confirmed MVD. Authorities said that 161 contacts have been identified and are under observation.
The Insight Post-Uganda has established that Benson Rutabingwa, one of the deceased, passed away on March 15, 2023. Preliminary findings, he continued, revealed that Rutabingwa acquired the illness from his three deceased brothers.
According to Tanzania’s Minister of Health, Ummy Mwalimu, there is currently no specific cure for the Marburg Virus Disease (MVD), but patients can receive treatment to alleviate their symptoms.
Since the affected Kagera region is bordering Uganda, the Kyotera District Health Department in collaboration with the Mutukula border authorities has reinforced the border controls to prevent any potential occurrences.
With the world still healing from the effects of the COVID-19 pandemic, the outbreak in Tanzania clearly highlights the need for vigilance and swift action to prevent the spread of disease across borders.
According to Dr. Edward Muwanga, the Kyotera District Health Officer, they received a warning about the outbreak on Tuesday but the information from their Tanzanian counterparts was still scanty. He stated that measures had been taken to protect Ugandans from the disease.
“While the situation is tense in Tanzania, it is still calm on our side (Uganda) but the district health team is not seated,” Muwanga said, noting that any new disease outbreak at this time is cause for concern since the world is still grappling with the COVID-19 pandemic.
To be sure, he added, they have deployed additional health workers to Mutukula border post and Kasensero town council to screen all incoming travellers for symptoms of the disease.
The district, also, has promptly revived the District Taskforce to boost surveillance and awareness initiatives to ensure that its residents are informed about the outbreak in the neighbouring country and how to prevent infection.
“The Taskforce has placed emphasis on increasing screening of incoming travellers and being more vigilant. Still, the surveillance activities within the health facilities and the surrounding communities will be among the key strategies,” he explained.
Using this strategy, he said, they will try to spot the illnesses and deaths from unknown causes or MVD so that they are not taken by surprise.
However, the World Health Organization (WHO) and International Organization for Migration (IOM) have joined Uganda in an effort to limit MVD in case it spreads from Tanzania. “We can able counter any emergent issues with the joint effort,” Muwanga stated.
Refresher For Health Workers
The District Taskforce has made arrangements for health professionals to take a refresher course to adequately prepare them to handle MDV case.
According to the DHO-Muwanga, the refresher course will be rigorous to equip the health workers with the skills and knowledge they need to tackle the deadly disease with confidence and competence.
The training is meant to cover a wide range of topics, from identifying the signs and symptoms of disease to effective prevention and control of haemorrhagic diseases.
“Through hands-on training, health workers are set to learn how to work together as a team, to communicate effectively with other health professionals and the public, to make fast, evidence-based decisions,” he noted.
Ministry of Health
Emmanuel Ainebyona, the Ministry of Health’s Public Relations Officer, said that the Centers for Disease Control, WHO, UNICEF, and other organisations have confirmed their support in the effort to spread awareness and prevent the MVD outbreak,
To understand exactly how they will confront the disease, he noted, they had to wait for Tanzania to confirm its existence.
The ministry and other teams are putting a focus on risk communication and risk assessment in the meantime to protect its citizens, particularly those near the Mutukula border.
Ainebyona said that Dr. Jane Ruth Acheng, the Minister of Health, has ordered that the mobile laboratories that were transferred to Mubende be relocated to Kyotera district to support their activities.
Mutukula Immigration
Kenneth Byaruhanga, the Senior Immigration Officer in Charge of the Mutukula Border, stated that they have already ramped up their control measure by thoroughly screening the travellers, similar to how it was with the Corona Virus Disease (COVID19) outbreak.
In addition to closely monitoring the Tanzanian side to prevent any unforeseen circumstances, extra attention has been placed on hand-washing by all entering travellers and all the facilities have been put in place, according to Byaruhanga.
“Uganda should remain alert at all times during such strange and contagious disease outbreaks in the neighbouring country,” he said, noting that staying vigilant is important. He further urged the travellers to adhere to every control measure in place.
“We are really strict because MVD killed people in Tanzania and it can kill people in Uganda if we are not cautious,” he said.
Apart from Mutukula customs and Kasensero, there are other porous borders that could obstruct the anti-epidemic efforts. They include Kyakatuuma, Nangoma, Miziiro, and Kagera rivers which are not patrolled regularly.
But Byaruhanga said that border patrols have been stepped up in an effort to arrest those trying to enter the country (Uganda) illegally.
‘Let Us take this opportunity to warn anyone with intentions to enter the country illegally that we shall arrest them, prosecute or even deport them’ he stated.
WHO response
The World Health Organization is collaborating with the Ministry of Health to deploy an emergency team to conduct further epidemiological investigations and to implement control measures to halt the virus’s spread. Although Tanzania has not previously recorded a Marburg case, it has responded to other health emergencies, including COVID-19, cholera, and dengue, in the past three years.
The Marburg virus is highly virulent, causing haemorrhagic fever, and is transmitted to humans through contact with the bodily fluids of infected people or materials. While no vaccines or antiviral treatments have been approved to treat the virus, supportive care can improve survival rates.
Previous Marburg Outbreak In Uganda
Uganda has encountered MVD in the past. On October 19, 2017, the Ministry of Health officially declared the outbreak in Kween District, Eastern Uganda.
By October 24, there had been five reported cases, one confirmed, one probable case with an epidemiological link to the confirmed case, and three suspected cases, including two health workers while 155 contacts were listed.
Response
The Ugandan Ministry of Health, along with WHO and other partners, responded quickly to the outbreak. A rapid response field team was deployed to the affected districts within 24 hours of the confirmation to coordinate response activities.
The National Task Force convened to oversee response efforts, an Incident Management System (IMS) framework has been implemented, and an Incident Manager has been appointed.
A District Task Force was established, and an emergency rapid response plan has been developed. Various MVD response activities were initiated, including surveillance, active case search, contact tracing and follow-up, and monitoring within affected communities and healthcare centres.
Still, personal protective equipment was availed in the affected districts, and healthcare workers were put on high alert.
Healthcare workers underwent training sessions including a thorough review of infection prevention and control (IPC) protocols and capacity in addition to establishing an isolation facility prepared at the health centre and hospital to handle cases.
World Health Organization Advise Public
WHO advises that preventive measures should be taken to avoid any exposure to blood and body fluids, and unprotected contact with possibly contaminated environments.
Strengthened surveillance activities and raising awareness of the risk factors for Marburg infection and the protective measures individuals can take to reduce human exposure to the virus are critical in controlling the outbreak.
Additionally, measures should be taken to reduce the risk of bat-to-human transmission and human-to-human transmission in the community, and communities affected by Marburg should be well-informed and educated to prevent community stigmatization and promote early presentation to treatment centers.
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