The confirmed case and death of a Ugandan health worker from Marburg Virus Disease (MVD) has got the attention from neighboring countries as preventive measures are being increased to prevent Marburg into their respective countries.
In Uganda’s neighbor to the east, Kenya reports being on “high alert”, urging citizens to be vigilant and avoid contact with anyone who has traveled from Uganda. Health care facilities and ports of entry are prepared according to officials, “Kenyan health workers have been provided with a case definition and instructions on screening all persons who have traveled to Kampala or have had contact with someone from Uganda if they present Marburg-like syndrome.”
On Friday, the World Health Organization (WHO) reported that one contact with the fatal Ugandan case, Kenyan mortician who traveled back to Kenya, developed a fever and cough but tested negative for both Marburg and Ebola virus. The contact in Kenya continues to be followed up by the Kenyan Rapid Response Team. In addition, a second possible case was ruled out.
Uganda’s neighbor to the northwest, South Sudan is screening people for the virus entering South Sudan from Uganda. “Given the proximity of Uganda to South Sudan and given the high level of movement between the people and goods to and from Uganda, I think it is a big concern to the public and to the government and to the people,” said health minister Riek Gai Kok at a press conference in Juba.
Public education and social mobilization is ongoing in the country. However, their is a shortage isolation and laboratory testing facilities in the country and these needs to be improved to enhance preparedness.
Marburg hemorrhagic fever is a rare, severe type of hemorrhagic fever which affects both humans and non-human primates. Caused by a genetically unique zoonotic (that is, animal-borne) RNA virus of the filovirus family, its recognition led to the creation of this virus family. The five species of Ebola virus are the only other known members of the filovirus family.
Recent scientific studies implicate the African fruit bat (Rousettus aegyptiacus) as the reservoir host of the Marburg virus. The African fruit bat is a sighted, cave-dwelling bat which is widely distributed across Africa. Fruit bats infected with Marburg virus do not to show obvious signs of illness. Primates, including humans, can become infected with Marburg virus, which can progress to serious disease with high mortality.
Just how the animal host first transmits Marburg virus to humans is unknown.
After an incubation period of 5-10 days, the onset of the disease is sudden and is marked by fever, chills, headache, and myalgia. Around the fifth day after the onset of symptoms, a maculopapular rash, most prominent on the trunk (chest, back, stomach), may occur. Nausea, vomiting, chest pain, a sore throat, abdominal pain,and diarrhea then may appear. Symptoms become increasingly severe and may include jaundice, inflammation of the pancreas, severe weight loss, delirium, shock, liver failure, massive hemorrhaging, and multi-organdysfunction. The case-fatality rate for Marburg hemorrhagic fever outbreaks is between 23-88%.
Confirmed cases of Marburg HF have been reported in Uganda, Zimbabwe, the Democratic Republic of the Congo, Kenya, and Angola. Cases of Marburg HF have occurred outside Africa, though infrequently.
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