Endemic plague in Uganda

[Shiloh]

Source: http://www.newvision.co.ug/D/8/13/662400

Plague kills 14 in Nebbi, Arua
Tuesday, 2nd December, 2008
By Frank Mugabi

AT least 14 people have died of bubonic plague in Nebbi and Arua districts, local health authorities have said.

The Arua health officer, Dr. Patrick Anguzu, said at least 68 cases of the disease had been registered since the beginning of the year.

?We were originally receiving isolated cases, but the numbers started picking up between July and August until this month (November) when the outbreak hit its peak,? he said.

He identified Vurra and Logiri sub-counties in Arua district and Kango sub county in Nebbi as the most affected areas.

?Almost all the deaths are as a result of people delaying to seek medical treatment because in the early stages, they associated the disease with witchcraft,? he said.

Anguzu said the infected people initially opted for traditional herbs and only went to the health centres when it was too late to save their lives.

He said most patients are being treated at Kuluva Hospital, as well as Vurra, Logiri, Obia and Anyavu health centres.

Although plague is not a common disease, it continues to occur in West Nile, especially on the DR Congo border with Arua and Nebbi districts annually.

Anguzu said the Centres for Disease Control and scholars from Makerere University were carrying out research on the persistence of the disease in the area.

 

[Shiloh]

Re: Endemic plague in Uganda

Source: http://allafrica.com/stories/200907131172.html

Uganda: Arua in Plague Outbreak Alert
Warrom Felix Okello
13 July 2009


Arua ? The community in Arua District has been put on high alert over an outbreak of a deadly bubonic plague disease that killed 17 people last year.

In this regard, the Ministry of Health in collaboration with the Arua health team launched a campaign on Friday to sensitise the community on causes, signs and symptoms and prevention of the deadly disease.

The District Health Officer, Dr Patrick Anguzu, said the campaign is a precautionary measure in case of any outbreak.

"Our community must keep their environment clean especially the houses because the rats that transmit the disease thrive in unclean environment."

In bubonic plague, the most common form, bacteria infects the lymph system and becomes inflamed. The lymph or lymphatic system is a major component of the body's immune system.

Dr Anguzu told Daily Monitor that no new case of the disease has yet been reported in the district this year.

Last years' statistics from Arua health office indicate that 73 cases of human infections and 17 deaths were reported, the highest figure in two years.

Dr Anguzu added that 29 cases have since been confirmed to be of bubonic strain.

"This is the season that we highly suspect the outbreak of the disease. So we need to keep the community on alert," he added.
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Within three to seven days of exposure to the plague bacteria, a person develops flu-like symptoms such as fever, headache, chills, weakness, and swollen, tender lymph glands.

The community sensitisation campaign is being carried out in the disease prone areas of Vurra and Logiri. But even then, the surrounding area of Kango Sub-county in Nebbi, which borders Logiri, must not be left out.

Historically, the bubonic plague is reported to have originated from the Democratic Republic of Congo especially from Aru and Ariwara.

The campaign, Dr Anguzu said, is aimed at educating residents who keep pets like cats, which are also susceptible to plague.

In this case, infected cats become sick and may directly transmit plague to people who handle or care for them.

 

[Shiloh]

Re: Endemic plague in Uganda

Source: http://allafrica.com/stories/200910261069.html

Uganda: Plague- Poor Hygiene Sparks Outbreak in Nebbi, Arua

Thomas Pere

25 October 2009

Kampala ? KANGO is one of the eight sub-counties in Nebbi district that has been severely hit by plague. The disease, which attacks rodents, is caused by bacteria.

It is transmitted when an infected flea bites a person. Dogs, cats, guinea pigs and rats are potential hosts of fleas.

"The plague is locally known as zukpa. It usually occurs at the end of the dry season and because its victims die in a short time, the locals believe it is a result of witchcraft," James Jamoro, a health assistant in charge of the sub-county, said.

Plague is a vector-borne disease that contributes to significant illnesses and deaths in the communities.

Ben Munguni, a Red Cross volunteer in Kango Health Centre III, says: "When someone complains of headache, diarrhoea, general body pain and vomiting, it is advisable to test for plague immediately."

Plague manifests in three forms depending on the route of infection. The most common is bubonic plague.

Patients develop swollen, tender lymph glands called buboes. This form does not spread from person-to-person.

The second form is septicemic plague.

It occurs when plague bacteria multiply in the blood. Patients get a fever, abdominal pain, and bleeding from the skin and other organs. This also does not spread from person-to-person.

The third type is pneumonic plague. It is the most virulent and least common. It infects the lungs. This type can spread from person-to-person through the air, especially if one is in direct contact with an infected person or animal.

It also occurs if untreated bubonic or septicemic plague bacteria spreads to the lungs.

Richard Ndyomugenyi, the programme manager of the National Malaria Control Programme, at the launch of a plague prevention campaign in Nebbi, said the last outbreak occurred in November 2008. There is fear of another outbreak in 2009 with the coming of El-Nino rains.

"The fatality rate of plague in the region is 20%, which is very high for a preventable and curable disease.

Children, women and the elderly are the most affected though all age groups are vulnerable to the disease," Ndyomugenyi added.

Causes

Sharing houses with animals, sleeping on dusty cracked floors.

Hunting wildlife for meat.

Poor food storage practices.

Seeking health attention late for those exposed to flea bites.

Poor housing construction that allows rats to enter houses.

Symptoms

Flu.

Fever, chills, head and body aches.

General body weakness.

Vomiting and nausea.

Challenges

Dr. Jakor Oryema, the district health officer, says plague has been around from the 1930s and then cases have continued to occur annually during the rainy season and the dry period from around September.

"The worst epidemic was in 1993 where all the three types manifested," he added. He says the causes leading to persistent epidemics in Okoro are related to the low socio-economic standards of the people.

"Much as we know what needs to be done, resources for doing those things remain a big challenge," he said.

Low literacy and socio-economic levels of people, poor housing infrastructure and food storage practices also compound the problem.

Launching the plague prevention campaign at Kango sub-county Nebbi, Simon Ejua, the state minister for transport, said plague is a priority disease by WHO because of its quick spread.

"Outbreaks occur annually in spite of public awareness, chemical spraying and human quarantine measures."

"The ministry of health, with other partners, has come up with a multi-sectoral approach to prevent, control and eliminate the disease in the region," he added.

He says the new approach brings together individuals with diverse expertise and combined effort to fight and control plague.

The Centres for Disease Control (CDC) recommends diagnosis of patients with suspected plague. The patient should be isolated and the health departments notified.

Confirmatory laboratory work should be done including blood cultures and examination of lymph node specimens.

Treatment using antibiotics begins immediately, CDC recommends.

Individuals who take care of the patient, should be traced and evaluated to avoid further spread of the disease.

Way forward

Oryema suggests the following:

Indoor residual spraying, using ICON which also kills mosquitoes.

Community sensitisation through radio talkshows on plague prevention.

Deworming livestock.

Promotion of proper food storage methods and clearing bushes around homesteads.

Rid houses of dust where fleas live and breed.