KYOTERA: Ministry of Health Officials and partners led by the Minister Dr. Jane Ruth Aceng on Friday, 24th March 2023 travelled to Kyotera District to assess the readiness and preparedness at Mutukula border point in screening and identifying Marburg cases following the confirmation of Marburg in Tanzania.
On 21 March 2023, the Ministry of Health (MoH) of the United Republic of Tanzania declared an outbreak of Marburg virus disease (MVD) in the country.
As of 22 March, a total of eight cases, including five deaths (case fatality ratio [CFR]: 62.5%) had been reported from two villages in Bukoba district, Kagera region, Northern United Republic of Tanzania bordering Kyotera District of Uganda. Two of these cases were healthcare workers, one of whom had died. This is the first ever Marburg virus disease outbreak reported in the country
The Minister of Health Dr. Jane Ruth Aceng said they are going to embark on training Health workers in all aspects with special emphasis on surveillance infection prevention and control, case management on psychosocial support and other areas that require training.
“We are going to put emphasis on 5 districts bordering with Northern Tanzania. Our teams are on ground and intensifying preparedness to prevent importation of the virus.” Dr. Ruth Aceng said.
The Minister of Health Dr. Ruth Aceng and the team also inspected Mutukula border post and urged health workers to take precautions when dealing with travelers following Marburg outbreak at Tanzania border
Dr. Daniel Kyabayinze, a Clinical Epidemiologist and an expert in Surveillance, Research, diagnostics, Quality of Care, Health Emergencies & Response at the Ministry of health said the Ministry and Kyotera District are going to put in place a screening laboratory to identify Marburg cases at the border point instead of taking the samples to Kampala or Entebbe.
Kyotera Resident District Commissioner Mr. Apollo Mugume asked residents and travellers to abide by the ministry of Health regulations and restrictions to avoid getting infected with the disease.
The Kyotera District LC5 boss Mr. Patrick Kintu Kisekulo asked the government to provide the district with necessary equipment which can easily screen body temperatures.
Residents urged government to think about the Mutukula-Kyotera-Masaka road because its current poor state cannot allow the district to handle emergency cases to Masaka Regional Referral Hospital and also find ways of mitigating the spread of the disease in Uganda to avoid consequences just like it was during the Covid-19 period.
Marburg virus disease is an epidemic-prone disease associated with high case-fatality rates (CFR 24-90%). It is caused by the same family of viruses (Filoviridae) as Ebola virus disease and is clinically similar. The current CFR for this outbreak is relatively high, at 62.5%.
Marburg virus infection often results from prolonged exposure to mines or caves inhabited by Rousettus bat colonies. Once an individual is infected with the virus, it can spread through human-to-human transmission via direct contact with the blood, secretions or other body fluids of infected or deceased people. Healthcare workers have previously been infected while treating patients with suspected or confirmed MVD. Burial ceremonies that involve direct contact with the body of the deceased can also contribute to the transmission of Marburg.
The incubation period varies from two to 21 days. Illness caused by Marburg virus begins abruptly, with high fever, severe headache, and severe malaise. Severe watery diarrhoea, abdominal pain and cramping, nausea, and vomiting can begin around the third day. Severe hemorrhagic manifestations may appear between five and seven days from symptom onset, and fatal cases usually have some form of bleeding, often from multiple areas. In fatal cases, death occurs most often between eight and nine days after symptom onset, usually preceded by severe blood loss and shock.
Clinical diagnosis of MVD is difficult in the early phase as symptoms are similar to other febrile illnesses. The differential diagnosis for MVD may include other filovirus diseases, Lassa fever, malaria, typhoid fever, dengue, rickettsia infections, leptospirosis and plague.