Tuesday, March 15, 2016

Rift Valley Fever outbreak in Uganda

By Esther Nakkazi

Two cases of the Rift Valley Fever have been confirmed in Kabale district, Western Uganda. The two people; a 45-year old butcher and a 19-year-old student from Kabale town council are admitted in Kabale Regional Referral Hospital.

Rift Valley Fever is an important Notifiable and Zoonotic Disease. The disease has never been reported in humans and animals in Uganda before this outbreak.

The Rift Valley Fever outbreak has been confirmed by the Ministry of Health today 15th March and the declaration follows laboratory tests done at the Uganda Virus Research Institute (UVRI) which confirmed two samples positive of this infectious viral haemorrhagic fever. 

Preliminary reports further indicate that three new suspect cases have been identified and their blood samples are yet to be tested but no deaths have been recorded since the onset of the outbreak on 4th March.

The Ministry of Agriculture Animal Industry and Fisheries is raising public awareness on the clinical signs of the disease in animals and humans and owing to the dangers that this disease poses to animals and  population, the Ministry has declared this outbreak to all international animal health organisations.

Rift Valley Fever is an acute, fever causing viral disease that affects domestic animals like cattle, sheep, goats, buffalo, camels and humans. It is most commonly associated with mosquito-borne epidemics during years of unusually heavy rainfalls. 

A person suffering from Rift Valley Fever may have either no symptoms or a mild illness associated with fever and liver abnormalities. However, in some patients, the illness can progress to haemorrhagic fever, inflammation of the brain which can lead to headaches, coma or seizures or eye disease.

People who become ill usually experience fever, generalised weakness, back pain, dizziness and weight loss at the onset of the illness. Typically patients recover within two days to one week after onset of the illness. Approximately 1% of people that become infected with the Rift Valley Fever die of the disease.

In animals, the disease is characterized by abortions, occasionally bloody nasal discharges in mature animals, haemorrhagic diarrhoea and jaundice. There is high morbidity and mortality in young animals.

The disease is transmitted from animals to humans through close contact with infected animals and their products such as milk, meat and body fluids.  Animals become infected with the disease through the bites of infected mosquitoes. Other insects that can transmit the disease are ticks and biting midges.

Prevention and control of this disease in animals relies on maintaining a strong surveillance system. In case of outbreaks, appropriate biosecurity and biosafety measures must be exercised.

A Multi-sectoral National Task Force has been set up to coordinate all efforts towards the control and management of the outbreak under the One Health Approach. This task force is composed of officials from the Ministries of; Health; Agriculture, Animal Industry and Fisheries; Water and Environment; Uganda Wildlife Authority together with development partners; the World Health Organization and the US Centers for Disease Control and other implementing partners like MSF.

The Task Force has put in place a number of measures to control and limit the spread of the disease.
Investigations: A multi sectoral rapid response team of experts has been dispatched to the district to support both clinical and public health investigations.

The Ministry of Agriculture is undertaking a detailed investigation to confirm the virus in susceptible animal species.

Surveillance; the Multi Sectoral National Task force has boosted up surveillance programs in Kabale district, Rwanda and DRC borders. So far a total of 59 animal and 11 human samples have been collected for testing at the Uganda Virus Research Institute. Results will be available by Friday 18th this week.

Case management; The team has already conducted a training for health workers at Kabale Regional Referral Hospital on the Rift Valley Fever and developed a new triage protocol.

Research; The multi-sectoral team is to undertake a risk assessment of human exposure from animals. The team will also determine the current prevalence of RVF infection among exposed asymptomatic individuals in affected areas in Kabale district

Social Mobilisation; A Committee is developing sensitisation messages on preventive measures to raise awareness about the disease.

The Government of Uganda urges the general public to observe the following protective measures;
report any suspected RVF patient to a nearby health facility; report any suspected sick animals to the nearest veterinary or local authority; avoid direct contact with body fluids of animals suspected to be suffering from RVF by using protective materials like gloves.

Avoid eating dead animals or animals not certified by veterinarians. The Government calls upon the public to stay calm as all possible measures are being undertaken to control the situation. The country will be kept informed on the outcome of this health emergency.

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