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Uganda - Outbreak of Rift Valley fever 2023

Pathfinder

Editor, Senior Moderator
WEEKLY BULLETIN ON OUTBREAKS
AND OTHER EMERGENCIES

Week 10: 27 February to 5 March 2023

Data as reported by: 17:00; 5 March 2023
...

All events currently being monitored
by WHO AFRO

...

Uganda Rift Valley fever Ungraded

Date notified to WCO 1-Mar-23
Start of reporting period 2-Mar-23
End of reporting period 2-Mar-23

Total cases 12
Cases Confirmed 12
Deaths 0
CFR 0.0%


On 1 March 2023, UVRI VHF laboratory confirmed twelve (12) human cases in the greater Mbarara areas (Mbarara district, Mbarara City, Kazo and Isingiro districts). Nine (9) human cases in one sub-county, Rwanyamahembe, Mbarara district, One (1) human case in Nyakayojo, Mbarara City linked to Mbarara City Abattoir, One (1) human case in the Isingiro district and One (1) human case in the Kazo district.
...

https://apps.who.int/iris/bitstream/handle/10665/366418/OEW10-270205032023.pdf
 
WEEKLY BULLETIN ON OUTBREAKS
AND OTHER EMERGENCIES

Week 11: 6 to 12 March 2023
Data as reported by: 17:00; 12 March 2023

...

Uganda Rift Valley fever

20 Cases
4 Deaths
0,9% CFR


EVENT DESCRIPTION

Uganda has reported a confirmed outbreak of Rift
Valley Fever (RVF) in Mbarara District. On 10 February
2023, a butcher from Bwizibwera, a township in Kashari
County, Mbarara District, presented to a private clinic
with a history of fever and nosebleeding. The clinic staff
suspected viral hemorrhagic fever and referred him to
Mbarara Regional Referral Hospital (MRRH). The patient
died on arrival and was buried before samples could be
collected.

On 23 February 2022, the district surveillance team
and the Uganda Virus Research Institute (UVRI) team
collected samples from farm workers. Of the 51 samples
collected, five tested positive for RVF by polymerase
chain reaction. These five individuals had been involved
in the slaughter of a dead cow on a farm a village in
Kashari District.

As of 9 March 2023, 20 human cases have been reported,
including 19 confirmed cases and one probable case.
There have been four deaths among the reported cases,
two in the community and two in the health facility.
The outbreak was first confirmed in animals in December
2022 when the veterinary sector reported cases of
abortion in cows at one of the main farms in Kashari,
Rwanyamahembe, Mbarara District. Blood samples
collected and sent to the National Animal Disease
Diagnostics and Epidemiology Center (NADDEC) for
analysis were positive for RVF and leptospirosis by
serology.

PUBLIC HEALTH ACTIONS

The District Task Force and all response structures
were activated. A One Health approach has been
adopted.

Active case finding in community and health facilities
is ongoing.

Mapping of more farms in communities where most
cases have been identified is ongoing

Sample management by the District Laboratory team
has been undertaken.

Radio talk shows with support from partners are
ongoing. Residential District Commissioner radio talk
time has been utilized and one radio talk show has
been conducted on UBC radio

Identification of more partners willing to support Risk
Communication and community engagement is still
ongoing

Mild cases are being managed at home, while severe
cases are managed at MRRH

Vector surveillance to be conducted and a plan
for vector control is underway (use of fly repellant
acaricides for animal spraying).

SITUATION INTERPRETATION

The first five confirmed cases of RVF were reported to
have been involved in the slaughter of a dead cow. This
highlights the importance of awareness of risk factors
for RVF infection and protective measures to reduce
human infections and deaths. As outbreaks of RVF in
animals precede human cases, implementing preventive
measures in animals and strengthening the active animal
health surveillance system are essential to prevent human
cases and provide early warning to veterinary and public
health authorities of future outbreaks.

https://apps.who.int/iris/bitstream/handle/10665/366504/OEW11-0612032023.pdf
 
WEEKLY BULLETIN ON OUTBREAKS
AND OTHER EMERGENCIES

Week 39: 25 September - 1 October 2023
Data as reported by: 17:00; 1 October 2023

...

Uganda

Rift Valley fever


181 cases
13 Deaths
7.2% CFR
Ungraded Grade


EVENT DESCRIPTION

Rift Valley fever (RVF) outbreaks in humans have mainly
been reported from the Western and Central regions of
Uganda, mainly within the cattle corridor districts, since
the beginning of 2023. From week 1 to week 36 (ending
10 September 2023), a total of 181 suspected cases of
RVF including 53 confirmed and 13 deaths (CFR 7.2%)
were reported from eight districts; Kabale, Rubanda,
Mbarara and Mbarara city, Isingiro, Bushenyi, Nakaseke,
Kazo and Kakumiro districts.

During week 36, three districts, including Nakaseke
in central Uganda, Mbarara and Kakumiro in western
Uganda, were still reporting active RVF outbreaks, with
the most recent cases reported in Kakumiro district.
Between 25 August and 10 September 2023, three RVF
cases (two confirmed and one probable) and two deaths
(CFR 66.7%) were reported from Kakumiro district.

The first case was a 29-year-old butcher from Nkooko
town council. He had onset of symptoms of fever,
headache, abdominal pain and intense fatigue on 10
August 2023 and on 18 August 2023, he sought medical
care at a private clinic where he was referred to the
regional referral hospital. He died the same day on his
way to the hospital. No sample was collected for testing.
The second case was a 36-year-old butcher from
Kyolobezi village in Mpasana sub-county, who developed
a febrile illness on 11 August 2023. On 16 August 2023,
he developed severe nose bleeding and received a
symptomatic treatment at home, which was followed
with noticeable clinical improvement. A blood specimen
collected prior to his death returned positive for RVF by
reverse transcription-polymerase chain reaction (RTPCR)
on 25 August 2023.

The third case is a 50-year-old butcher residing from the
same subcounty as the second case, who had onset of
symptoms on 26 August 2023. On 30 August 2023, he
was referred and isolated at a Health Centre III. A blood
sample collected returned positive for RVF virus on 4
September 2023.

The common features observed among the three cases
are that they all are all animal handlers and presented with
similar symptoms, including fever, headache, abdominal
and joint pain, as well as intense fatigue. In addition, two
cases initially sought care through traditional methods
and one received self-medication at home.

Laboratory testing was performed on collected blood
samples at the Uganda Virus Research Institute (UVRI)
using the reverse transcription-polymerase chain reaction
(RT-PCR) method.

PUBLIC HEALTH ACTIONS

The District Rapid Response Teams, with support
of partner organizations providing technical and
financial support, are actively carrying out response
activities in the affected districts.

Uganda runs a routine Viral Haemorrhagic Fever
(VHF) surveillance program, where a total of 2 036
samples had been collected by Week 36 (ending
10 September 2023), both from cadavers and alive
people.

Surveillance activities, including ongoing VHF
surveillance program in the high-risk districts, active
case searching, contact tracing, case investigation,
case confirmation are ongoing in the affected districts.

Risk communication and community sensitization on
RVF infection prevention are ongoing in the affected
districts.

Infection Prevention and Control assessment and
mentorship is being conducted in health facilities in
the affected districts.

Active animal case search on farms in affected
districts is ongoing.

SITUATION INTERPRETATION

Integrated prevention and control measures that address
both human and animal health are to be reinforced to
prevent livestock losses and human fatalities and help
mitigate the socioeconomic impacts of RVF outbreaks in the
country. This includes early reporting and management of
animal and human cases, sensitization trainings targeting
people at high-risk of exposure during RVF outbreaks,
enhanced vector control, preventive animal vaccination,
and control of animal movements.

The reported tendency to resort to traditional methods of
care or self-medication observed in the last three patients
during this outbreak suggests a continuous need to
strengthen and maintain sensitization within the communities.

Uganda has technical capacities for confirming RVF cases, which
are a crucial asset for epidemic response activities
and should be supported, especially in the context of
the ongoing systematic surveillance of VHFs in the country.



https://www.afro.who.int/health-topics/disease-outbreaks/outbreaks-and-other-emergencies-updates
 
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