HON. SARAH OPENDI
STATE MINISTER OF HEALTH – GENERAL DUTIES
27th May, 2018
The Ministry of Health has noted with concern reports of an Ebola outbreak in Mubende district making rounds across the different media platforms. We would like to inform the public that there is no Ebola outbreak in Mubende or any other part of the country.
What was quoted in the media is rather a case of Crimean-Congo Haemorrhagic Fever (CCHF). It is worth noting that the CCHF outbreak in the districts of Luwero and Nakaseke - which share a boarder with Mubende district - was declared on January 4th this year, and efforts to contain it are still ongoing.
Crimean-Congo Haemorrhagic Fever (CCHF) is a viral zoonosis (Animal to Human) caused by infection with a tick-borne virus. The hosts of the CCHF virus are mostly wild and domestic animals including cattle, sheep and goats. These animals become infected after being bitten by infected ticks and the virus remains in their bloodstream for about two weeks after infection, allowing the tick-animal-tick cycle to continue when another tick bites.
Human transmission may occur when human beings get into contact with infected ticks (through tick bites) or direct contact with blood or tissues of an infected animal. CCHF can be transmitted from one infected human to another by contact with infectious blood or body fluids. In humans, CCHF can present with several symptoms including sudden onset of high-grade fever, muscle aches, neck pains, neck stiffness, backache, headache, sore eyes, vomiting, diarrhoea, abdominal pain, and sometimes bleeding from body openings.
In Uganda, the risk of acquiring and spread of CCHF is high among communities within the cattle corridor (occupational exposure). CCHF is known to be ENDEMIC (always present) in Africa among cattle, and OCCASIONALLY shows up in humans.
There is no known effective vaccine or definitive treatment among humans.
General supportive care with treatment of symptoms is the main approach to managing CCHF infected patients.
Prevention of human to human transmission is through isolation of patients, use of Personal Protective Equipment (PPE), and application of universal precautions for Infection Prevention and Control (IPC) including hand-washing hygiene, safe injection practices, in healthcare setting as well as safe and dignified burial of deceased cases.
THE CRIMEAN-CONGO HEMORRHAGIC FEVER (CCHF) SITUATION IN MUBENDE DISTRICT
On the night of 21st May 2018, a 35-year-old male from Nkoko subcounty in Bugangaizi county, Kakumiro district presented at Melt Care Clinic with a high fever and vomiting and was admitted for two days.
Since he was not improving, the relatives transferred him to Galde medical clinic in Kakumiro district on 23rd May from where he was referred to Mubende Regional Referral Hospital.
The clinician on duty at Mubende RRH immediately transferred the patient to the hospital isolation room where he received intravenous fluids.
Unfortunately, he died during that same night at around 1am. Samples were taken off the body and were sent to the Uganda Virus Research Institute (UVRI).
The attendants of the diseased who included his expectant wife and 4 others were immediately quarantined and they are closely being monitored.
To mitigate any possible exposure from contact with the suspect, all material used by the deceased, including a trolley and beddings used by the deceased were burnt.
All the hospital staff who got in contact with the deceased were provided with digital thermometers and were instructed to take their body temperatures on a daily basis twice.
The following actions have been undertaken to mitigate the spread of CCHF:
A National Rapid Response Team jointly from Ministry of Health and World Health Organization has been dispatched to Mubende with clear terms of reference to collect more information and assist the district to mount an appropriate response.
Sensitization programs to educate communities about the signs, symptoms and dangers of CCHF have been initiated to raise awareness across the cattle corridor districts
We appeal to the general public to observe the following measures:
Immediately report any cases presenting with high grade fevers and bleeding tendencies to the nearest health facility. Reporting can be done by sending a free-text message to 8228 OR calling the Ministry of Health toll-free line: 0800-100-066
Bodies of people who may have died from CCHF should be handled only by trained burial teams, who are equipped to properly bury the dead, safely and with dignity.
Use protective wear while slaughtering and handling animals to prevent transmission of animal diseases to humans
Always wash your hands with soap and water
The Government of Uganda is working towards the control of ticks which are the main agents in the transmission of CCHF from animals to humans.
The Ministry of Health continues to intensify its efforts to prevent any possible spread of the Ebola epidemic to Uganda, through the following:
Screening of travelers at Entebbe International Airport; All travelers from Democratic Republic of Congo (DRC) are being screened at the Health desk for Ebola signs and symptoms. The screening targets all passengers who have had a history of travel of not less than 21 days to the DRC.
The passengers complete a screening form and an information leaflet about Ebola and contact numbers of surveillance are given to all non-symptomatic passengers. A private Medical Centre in the airport has been equipped to provide counselling and clinical screening of all suspects. A standby ambulance with driver and relevant protective gear has been provided by the Civil Aviation Authority (CAA) and is available twenty-four-seven.
The Ministry of Health has instructed leaders in the districts of Kampala, Wakiso, Kisoro, Kanungu, Kasese, Bundibugyo, Hoima, Bulisa, Nebbi, Arua, Maracha, Koboko, Kibaale, Kabaale, Mubende,
Luwero and Nakaseke to reactivate the District Task Forces in preparations for any possible outbreak. These taskforces are assigned to conduct a rapid risk assessment on importation of Ebola Virus Disease (EVD) cases through their districts, review and update district EVD preparedness and response plans, and establish ground crossing requirements (temperature screening/verbal screening/hand washing/IEC materials) to limit the risk of EVD importation while avoiding unnecessary interference in trade and travel. They are also expected to ensure adequate community information and heightened surveillance by front line health workers in all health facilities.
An Isolation facility has been set up at Mubende Regional Referral Hospital to attend to any suspected cases. The hospital staff have all been oriented on handling suspected VHF patients including Infection control and supportive care.
The Ministry of Health re-echoes its call on the general public to cooperate with the Immigration, Health and Security officials to ensure effective screening at all entry points, and keep Uganda free of Ebola.
The public is advised to report any suspected cases to the nearest health facility, or call our toll-free number 0800- 100-066 For God and my country