Marburg virus disease outbreak in Kween District Uganda, 2017: Epidemiological and laboratory findings

Details

• Alternative Title:
  PLoS Negl Trop Dis
• Personal Author:
  Nyakarahuka, Luke ; Shoemaker, Trevor R. ; Balinandi, Stephen ; Chemos, Godfrey ; Kwesiga, Benon ; Mulei, Sophia ; Kyondo, Jackson ; Tumusiime, Alex ; Kofman, Aaron ; Masiira, Ben ; Whitmer, Shannon ; Brown, Shelley ; Cannon, Debi ; Chiang, Cheng-Feng ; Graziano, James ; Morales-Betoulle, Maria ; Patel, Ketan ; Zufan, Sara ; Komakech, Innocent ; Natseri, Nasan ; Chepkwurui, Philip Musobo ; Lubwama, Bernard ; Okiria, Jude ; Kayiwa, Joshua ; Nkonwa, Innocent H. ; Eyu, Patricia ; Nakiire, Lydia ; Okarikod, Edward Chelangat ; Cheptoyek, Leonard ; Wangila, Barasa Emmanuel ; Wanje, Michael ; Tusiime, Patrick ; Bulage, Lilian ; Mwebesa, Henry G. ; Ario, Alex R. ; Makumbi, Issa ; Nakinsige, Anne ; Muruta, Allan ; Nanyunja, Miriam ; Homsy, Jaco ; Zhu, Bao-Ping ; Nelson, Lisa ; Kaleebu, Pontiano ; Rollin, Pierre E. ; Nichol, Stuart T. ; Klena, John D. ; Lutwama, Julius J.
• Description:
  Introduction
  
  In October 2017, a blood sample from a resident of Kween District, Eastern Uganda, tested positive for Marburg virus. Within 24 hour of confirmation, a rapid outbreak response was initiated. Here, we present results of epidemiological and laboratory investigations.
  
  Methods
  
  A district task force was activated consisting of specialised teams to conduct case finding, case management and isolation, contact listing and follow up, sample collection and testing, and community engagement. An ecological investigation was also carried out to identify the potential source of infection. Virus isolation and Next Generation sequencing were performed to identify the strain of Marburg virus.
  
  Results
  
  Seventy individuals (34 MVD suspected cases and 36 close contacts of confirmed cases) were epidemiologically investigated, with blood samples tested for MVD. Only four cases met the MVD case definition; one was categorized as a probable case while the other three were confirmed cases. A total of 299 contacts were identified; during follow- up, two were confirmed as MVD. Of the four confirmed and probable MVD cases, three died, yielding a case fatality rate of 75%. All four cases belonged to a single family and 50% (2/4) of the MVD cases were female. All confirmed cases had clinical symptoms of fever, vomiting, abdominal pain and bleeding from body orifices. Viral sequences indicated that the Marburg virus strain responsible for this outbreak was closely related to virus strains previously shown to be circulating in Uganda.
  
  Conclusion
  
  This outbreak of MVD occurred as a family cluster with no additional transmission outside of the four related cases. Rapid case detection, prompt laboratory testing at the Uganda National VHF Reference Laboratory and presence of pre-trained, well-prepared national and district rapid response teams facilitated the containment and control of this outbreak within one month, preventing nationwide and global transmission of the disease.
  
  
• Subjects:
  Adult Animals Clinical Laboratory Techniques Cluster Analysis Communicable Disease Control Disease Outbreaks Disease Transmission, Infectious Family Health Female High-Throughput Nucleotide Sequencing Humans Male Marburgvirus Marburg Virus Disease Middle Aged Mortality Virus Cultivation

  More +
• Source:
  PLoS Negl Trop Dis. 13(3)
• Pubmed ID:
  30883555
• Pubmed Central ID:
  PMC6438581
• Document Type:
  Journal Article
• Place as Subject:
  Uganda
• Volume:
  13
• Issue:
  3
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:be6c17ac5a12da98925354e62dc09639f314a23a5ca44a101919ae44bcaa051c
• Download URL:
  https://stacks.cdc.gov/view/cdc/77768/cdc_77768_DS1.pdf
• File Type:
  [PDF - 2.31 MB ]