WEEKLY BULLETIN ON OUTBREAKS
AND OTHER EMERGENCIES
Week 19: 3-9 May 2021
Data as reported by: 17:00; 9 May 2021
...
Crimean-Congo haemorrhagic fever in Uganda
Cases 2
Deaths 0
A case of Crimean-Congo haemorrhagic fever (CCHF) was
confirmed on 28 April 2021 in a 16-year-old female from
Munsiinsa-A village in the Kyangwali Refugee Settlement,
Kikuube district on 27 April 2021. She presented at the Kagoma
health facility with a two-day history of fever, with a temperature
of 38?C, as well as a history of headache, fatigue, vomiting blood
and nose bleeds. There was no history of recent travel to a place
with a CCHF outbreak, but her family raises goats. She was
isolated in the Kasonga Treatment Centre as a suspected viral
haemorrhagic fever case. Laboratory results returned positive for
CCHF by polymerase chain reaction (PCR) testing at the Uganda
Virus Research Institute (UVRI) on 28 April 2021.
A second case, epidemiologically linked to the case patient as a
primary contact, is a 13-year-old male from Busisa-Kyangwali,
who was admitted on 29 April 2021 with a high grade fever, blood
in his urine and vomiting blood. A sample was shipped to the
UVRI and returned PCR positive for CCHF on 4 May 2021.
Both patients are currently stable and showing signs of
improvement, and samples have been taken for repeat PCR
testing.
As of 4 May 2021, there are two confirmed cases of CCHF and
no deaths. No new suspected cases have been reported. A total
of 144 contacts have been listed for both cases and are being
followed up. Samples from patients admitted in the isolation unit
have been sent for CCHF PCR testing.
PUBLIC HEALTH ACTIONS
Coordination meetings are being held and WHO and UNHCR
are coordinating the inter-agency response in the refugee
settlement.
The Animal Health and food production sector are active
in the refugee camp and a joint plan of action has been
established across pillars and agencies.
There is ongoing surveillance, with contact tracing and follow
up, along with an alert system in the camp, that includes
rumour monitoring and reporting.
Households in Munsiinsa-A are being mapped, identifying
households with animals.
There is ongoing sensitization of voluntary community
workers on CCHF surveillance, risk communication, and
infection prevention and control practices.
Personal protective equipment is available, with sufficient
stock for one month.
Stocks of ribavirin have been procured and delivered.
Environmental assessment is underway, with listing of
households with animals and livestock, along with random
sampling of cows and goats for analysis at UVRI.
UNHCR has scheduled mass spraying of domestic livestock
from Munsiisa A and B villages within the refugee camp, led
by the district veterinary officer.
Infection prevention and control activities included training
health workers on CCHF IPC measures, with the support of
WHO and Care Uganda.
Risk communication and community engagement (RCCE)
activities have reached eight villages, with ongoing
community drives through communication teams.
SITUATION INTERPRETATION
Crimean-Congo haemorrhagic fever is known to be present in
livestock in Uganda and the country is experienced in responding
to outbreaks of infectious diseases, as evidenced by the
prompt diagnosis, isolation and treatment of the two cases so
far. In addition, a One Health approach has immediately been
implemented, with inter-Agency collaboration including animal
health and veterinary authorities in the response. Stocks of
personal protective equipment and the drug ribavirin are available
and health workers are being trained in case management and
IPC measures. However, challenges remain in timely sample
transportation, the need for a contingency plan for the treatment
unit in Kasonga in the event of any other disease outbreak in
the refugee camp and the need for more medical and logistical
supplies for the outbreak. More RCCE materials are needed and
funding needs to be supplied for district outbreak response.
https://apps.who.int/iris/bitstream/handle/10665/341246/OEW19-0309052021.pdf
