Outbreaks and Emergencies Bulletin, Week 21: 20 - 26 May 2019
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Yellow fever Uganda
2 Cases
0 Deaths
0.0% CFR
EVENT DESCRIPTION
On 14 May 2019, the Ugandan Ministry of Health notified WHO of a yellow
fever outbreak in two separate districts Koboko and Masaka located in the
Northern and Central region of the country respectively. The yellow fever
outbreak was declared in-country on 6 May 2019 following laboratory
confirmations from the regional yellow fever reference laboratory, the
Uganda Virus Research Institute (UVRI).
In March 2019, two samples collected from different districts as part
of the routine viral haemorrhagic and the sentinel acute febrile Illness
(AFI) surveillance programme tested positive for yellow fever by both
serology (IgM) and plaque reduction neutralization test (PNRT). The
first sample was collected on 1 March 2019 from an 80-year-old female
from a village in Koboko District and the second sample was collected
on 21 March 2019 from a 10-year-old female student from a second
village in Masaka District. Both cases presented with symptoms of fever,
malaise and joint pain. Neither had a history of yellow fever vaccination,
nor exhibited symptoms of jaundice, however the older woman had
hemorrhagic signs.
Following the confirmation of the two cases, a district rapid response
team was sent to the affected localities to conduct further investigation.
The team sampled several households and found a substantial population
of unvaccinated individuals due to immigration and missing the yellow
fever reactive vaccination campaign, which was conducted in 2016.
Seven additional samples were collected from suspected cases who met
the case definition for yellow fever.
PUBLIC HEALTH ACTIONS
A rapid response team was deployed to Masaka for further
investigation. Response activities undertaken included enhanced
surveillance, entomologic surveys, and active case search in both
Masaka and Koboko.
Samples collected from suspected cases were shipped and tested
at the arboviral laboratory in Uganda Virus Research Institute
(UVRI).
A national rapid response team (formed jointly by the Epidemiology
and Surveillance Division, the Public Health Fellowship Programme
and UVRI) was constituted and dispatched to the affected districts
to conduct further investigations to support the response activities.
The district surveillance team in Masaka opened an alert desk to
receive and follow up any alerts.
A community yellow fever case definition has been provided
to community members who are advised to report to the health
facility for further assistance if needed.
Risk communication to sensitize the populations on preventive
measures against yellow fever are being conducted in the affected
districts.
SITUATION INTERPRETATION
Uganda is designated as a high-risk country in the Eliminate Yellow Fever Epidemics (EYE)
strategy with a history of recent outbreaks in 2010 and 2016. The country has not yet
introduced the yellow fever vaccination into the routine immunization programme and the
last reactive yellow fever vaccination campaign was conducted in 2016 with coverage in
three districts including of Kalangala, Masaka and Ruukunguri. One of the affected district
during this outbreak, Koboko district, is located along the border with the Democratic
Republic of the Congo and South Sudan and the presence of the vector in the affected
areas, as well as frequent population movements between the countries, presents the
potential for international spread of the outbreak. Thus, cross border surveillance has
been heightened alongside the ongoing Ebola virus disease preparedness activities in
Uganda.
https://apps.who.int/iris/bitstream/handle/10665/324950/OEW21-2026052019.pdf
https://www.afro.who.int/publications/outbreaks-and-emergencies-bulletin-week-21-20-26-may-2019
