Dutch woman infected with Marburg in Uganda

[Gert van der Hoek]

Re: Dutch woman infected with Marburg in Uganda

News | July 14, 2008

Uganda investigates Marburg scare

Evelyn Lirri

Kampala

The World Health Organisation has warned people against visiting the bats/python caves in Maramagambo Forest in western Uganda after a tourist suspected to have contracted the Marburg virus died on Friday.

But Ugandan officials say they are still investigating whether the 40 year old Dutch woman who visited Uganda on June 6 and among other places visited two caves with bats and pythons in Maramagambo Forest died of the deadly Marburg haemorrhagic fever.

Uganda Wildlife Authority Executive Director Moses Mapesa said in a statement yesterday that a team of experts is investigating whether the Maramagambo caves is the source of the Marburg disease which reportedly killed the Dutch woman on July 11.

As a result, Mr Mapesa said the Uganda Wildlife Authority has temporarily stopped visits to the caves in Maramagambo forest to allow a proper investigation.

?UWA has also requested the National Taskforce on Marburg and Ebola, Ministry of Health and other stakeholders to cross-check with UWA staff who were with the tourist and other people who have recently visited the cave, although no death or illness has been reported to date,?? Mr Mapesa said.

http://www.monitor.co.ug/artman/publish/news/Uganda_investigates_Marburg_scare_68210.shtml

 

[Gert van der Hoek]

Re: Dutch woman infected with Marburg in Uganda

Uganda: Marburg Virus Suspect Cleared


New Vision (Kampala)

15 July 2008
Posted to the web 16 July 2008

Anne Mugisa
Kampala

THE guide who assisted the Dutch tourist who died of Marburg after visiting Maramagambo forest did not get in touch with the bats suspected to carry the deadly virus, according to the Ministry of Health.

The director general of health services, Dr. Sam Zaramba, yesterday said the guide was not in danger.

According to Zaramba, the only person who was affected was the female tourist who was hit by a fruit bat in the cave in the forest.

He explained that the bat could have scratched the Dutch tourist and introduced the virus into her body fluids.

The woman, whose three-week trip ended on June 28, suffered from fever and chills, four days after getting to Netherlands. She was admitted to Leiden University Medical Centre on July 2 where she died on July 11.

Marburg fever is a severe haemorrhagic illness characterised by sore throat, skin rush and rush in the mouth. It is spread through contact with infected body fluids, like blood, saliva, urine and stool, from animals and humans.

http://allafrica.com/stories/200807160327.html

 

[Giuseppe]

Re: Dutch woman infected with Marburg in Uganda

Imported Marburg fever case in the Netherlands [ECDC]

ECDC activities - Updated 16 July 2008

In relation to the imported Marburg fever case in the Netherlands, the National Institute for Public Health and the Environment (RIVM) of the Netherlands is coordinating a programme of contact tracing and temperature monitoring.

The programme is for around 100 people who have been in contact with the patient during the period when she was symptomatic, such as friends and family and health care workers.

The public health authority in the Netherlands updates the Member States, the European Commission, the ECDC and the WHO through the Early Warning and Response System on a regular basis.

The patient first experienced symptoms on 2 July and was admitted to hospital on 5 July.

She subsequently died in hospital on 11 July.

People who have had contact with the woman during this period are being advised to take their temperature twice a day and report any symptoms that develop during 3 weeks after the contact.

The incubation period for Marburg fever is usually from 2 to 21 days.

In this case, it appears that the woman contracted the infection 13 days prior to the onset of symptoms.

The programme of contact tracing and temperature monitoring will end on 1 August.

ECDC?s assessment of the case is that the threat to public health is limited and mainly focussed on the people who have been unprotected in close contact with the woman after the onset of her symptoms on 2 July.

People intending to travel to Uganda should be aware that the woman is thought to have contracted the infection through exposure to fruit bats while visiting caves in the Maramagambo forest.

ECDC therefore advises people to avoid visiting caves where bats may be present.

ECDC and Member State authorities are working with organisations representing tour operators to warn them of the risks associated with visits to bat caves in the Maramagambo forest.

ECDC is also in close contact with the European Commission and WHO.

For more information on Marburg, please see: Ebola and Marburg Haemorrhagic fever factsheet http://www.ecdc.europa.eu/Health_topics/Ebola_Marburg_fevers/factsheet.html

Link to press release from the authorities in the Netherlands in English: http://www.rivm.nl/en/persberichten/dutch_tourist_infected_with_marburg_virus.jsp

Link to Dutch Centre for Infectious Disease Control: http://www.rivm.nl/cib/over_cib/english/what_we_do/

Link to Bernhard Nocht Institute in Hamburg, Germany which confirmed the
diagnosis:
http://www15.bni-hamburg.de/bni/bni2/neu2/getfile.acgi?area=welcome&pid=01
-
http://www.ecdc.europa.eu/Health_topics/Ebola_Marburg_fevers/marburg/080716.html
------

 

[Oracle]

Re: Dutch woman infected with Marburg in Uganda

Something doesn't jive here.

http://www.fabuloustravel.com/ww/bats/bats.html

Bat's don't accidentally collide with humans.

Bats are thought to be passive carriers of the virus.

The only other person to share space in the suspected disease exposure environment - the Egyptian Fruit Bat cave in QENP, is the tour guide.

He has been cleared of 'danger' by a medical professional.

If the bat who is said to have collided with the deceased were not healthy, it might have been actively shedding virus that had virulence factors activated.

In that case, the guide would bear close watching, because in large bat enclaves, there is no such thing as 'one sick bat'.

From the ProMed post:

"The [patient's] partner recalls bats flying all around in the cave, large amounts of droppings on the ground, and bats bumping into the visitors."

Large amounts of droppings (bat guano) is to be expected.

Several human-bat physical contacts is a very, very abnormal circumstance.

Therefore, if the deceased's 'partner' is to be believed (and this can be verified by the tour guide, eh?) there is a potentially lethal animal health problem in this well-known tourist attraction.

It would be useful if trained veterinarians at the Park took a closer look at these bats, take guano and use simple air samplers (operated on battery, for a 24-48 hour sampling period) to determine if an outbreak is in progress within the bats.

This is an excellent opportunity to delve into a little medical mystery.

 

[Gert van der Hoek]

Re: Dutch woman infected with Marburg in Uganda

Uganda tourism ?not shaken? by Marburg scare

By BENON HERBERT OLUKA

Special Correspondent

Ugandan authorities have suspended tourist visits to the caves in the western Ugandan forest of Maramagambo following claims a tourist who visited the site contracted the Marburg virus.

The authorities describe it as an isolated incident that should not discourage tourists from visiting other tourist sites in the country.

?The case reported in the press is the first of its kind and is therefore isolated. We still hold our reservations till a team of experts confirm that the said tourist contracted the disease from the bats in Maramagambo,? said Uganda Wildlife Authority executive director, Moses Mapesa.

UWA publicist, Lilian Nsubuga, told The EastAfrican that the sector was yet to record any immediate setbacks as a result of the latest reported case.

?According to our guide at the time, she went with four other tourists but none of the other three has the virus. In addition, she did not even enter the cave. Still it doesn?t rule the fact that she might have got it from our cave, but it reduces the possibility,? she said.

The Marburg virus, which causes haemorrhagic fever and bleeding, is described by medical experts as a rare but contagious syndrome that spreads through body fluids.

Mr Mapesa said the bat and python caves in Maramagambo forest had until the incident been visited by both foreign and local tourists, including school groups, for the past 10 years without any reported cases of infection to visitors or UWA staff.

The director of General Health Services in the Ministry of health ministry, Dr Sam Zaramba, said in a statement last week that he had assigned the national task force on Marburg and Ebola to undertake further investigations because caves and mines infested with bats in western Uganda could still be a reservoir for the Marburg virus.

Ongoing ecological studies have shown that about five per cent of the fruit bats in Kitaka mines in Kamwenge district harbour evidence of prior Marburg virus infestation,? said Dr Zaramba.

?In Kitaka Mines for instance, 23 out of 400 bats were found to have evidence of previous infection with Marburg virus. The mine has since been closed to the public and occupational access since August 2007. No further infections have been reported.?

In August last year, the Marburg virus struck three gold miners in the Kitaka mines, killing one ? and subsequently led to the closure of the mines.

The Kitaka mines incident and the latest at Maramagambo have led many to conclude that bats in western Uganda?s caves and mines are a reservoir for the Marburg virus.

However, Mr Mapesa argues that there are still no known natural reservoirs for both Marburg and Ebola diseases to date. He said: ?There are millions of bats in Uganda and their range at night when they go to feed is wide. This implies that there are lots of interaction between bats and humans indirectly and occasionally directly and therefore if they were Marburg carriers we would have seen an epidemic in Uganda, but this does not stop on-going investigations.?

Mr Mapesa added that UWA has already taken the necessary precautionary measures to ensure the safety of all visitors to any of Uganda?s other tourist sites, especially those in the western part of the country which is home to 80 per cent of the national parks in Uganda.

?The UWA veterinary team undertakes periodic wildlife disease surveillance and purposive disease search to ensure the health of wild animals and humans (tourists, visitors, staff, local communities) especially in cases of zoonoses (diseases shared between humans and animals such Ebola, Marburg, bird flu, anthrax, brucellosis, tuberculosis and others),? he explained.

?We have a very strong veterinary unit with well qualified staff, based at both headquarters and in the field including Queen Elizabeth National Park,? Mr Mapesa added.

This is the second time in the past 12 months that Uganda?s tourism sector is taking a hit from a viral disease outbreak. In November last year, shortly after Uganda had hosted the Commonwealth Heads of Government Meeting (Chogm), the country suffered an outbreak of the Ebola virus in Bundibugyo district, which killed 37 people before it was contained.

Ms Nsubuga however says Uganda?s tourism sector did not suffer greatly due to the Ebola outbreak. She said: ?That time of the year is usually low on tourists anyway so it is difficult to say whether Uganda?s tourism took a hit.?

http://www.nationmedia.com/eastafrican/current/News/news2107200817.htm