Ebola-like virus hits Kamwenge
Aug 01, 2007
TWO suspected cases of Marburg haemorrhagic fever, a virus similar to Ebola, have been reported in western Uganda, according to the Ministry of health.
By Fred Ouma
TWO suspected cases of Marburg haemorrhagic fever, a virus similar to Ebola, have been reported in western Uganda, according to the Ministry of health.
“The Ministry of Health would like to inform the general public that two suspected cases of Marburg haemorrhagic fever have been reported, of whom one has died,†a press release by the director general of health services, Dr. Sam Zaramba, said.
“Both cases were mine workers in Kitaka mine, located in Kakasi Forest Reserve in Kamwenge district.â€
Kamwenge is about 250km west of Kampala with a population of 295,000, according to the 2002 census.
“The first test was positive. We are waiting for the results of the confirmatory test, which we shall have at 9:00am tomorrow,†Dr. Zaramba told The New Vision last night.
“But it is most probably the Marburg virus. We thought we should send out this information early enough.â€
Marburg, like Ebola, is a severe and highly fatal disease. It is characterised by sudden bleeding and high fever, resulting into death within a few days.
Transmission is through close contact with blood and other body fluids from patients with clinical signs of the illness. It can also be transmitted following exposure to contaminated items, such as bedding and clothing of patients.
The virus is named after Marburg, a city in Germany where the first outbreak occurred in 1967 among laboratory workers who had been doing research on monkeys which were imported from Uganda in order to prepare a polio vaccine.
“The Ministry of Health has set up a national task force that is tracing all potential contacts of the above cases for further investigations and tests,†the statement added.
It advised people to report any suspicious cases to the nearest heath unit. The ministry asked the public not to panic “as no new cases have been reported in the last two weeksâ€.
What is Marburg hemorrhagic fever?
Marburg hemorrhagic fever is a rare, severe type of hemorrhagic (internal bleeding) fever, which affects both humans and monkeys. Caused by a genetically unique animal-borne RNA virus of the ‘filovirus’ family, its recognition led to the creation of this virus family. The four species of Ebola virus are the only other known members of the filovirus family.
Where have cases occurred?
Marburg virus was first recognized in 1967, when outbreaks of hemorrhagic fever occurred simultaneously in laboratories in Marburg and Frankfurt (Germany) and in Belgrade (Yugoslavia). A total of 37 people became ill. They included laboratory workers as well as several medical personnel and family members who had cared for them. The first people infected had been exposed to African green monkeys. In Marburg, the monkeys had been imported for research and to prepare a polio vaccine.
Recorded cases have appeared in only a few locations. While the 1967 outbreak occurred in Europe, the disease agent had arrived with imported monkeys from Uganda. No other case was recorded until 1975, when a traveler most likely exposed in Zimbabwe became ill in Johannesburg, South Africa – and passed the virus to his traveling companion and a nurse. 1980 saw two other cases: one in Western Kenya not far from the Ugandan source of the monkeys implicated in the 1967 outbreak.
This patient’s attending physician in Nairobi became the second case. Another infection was recognized in 1987 when a young man who had traveled extensively in Kenya became ill and later died. In 1998, an outbreak occurred in Durba, the Democratic Republic of the Congo. Cases were linked to individuals working in a gold mine. After the outbreak subsided, there were still some sporadic cases that occurred in the region.
Where does the Marburg virus originate from?
Marburg virus is indigenous to Africa. While the geographic area to which it is native is unknown, this area appears to include at least parts of Uganda and Western Kenya, and perhaps Zimbabwe. As with Ebola, the actual animal host for Marburg virus also remains a mystery. Both of the men infected in 1980 in western Kenya had traveled extensively, including making a visit to a cave in that region. The cave was investigated by placing sentinels animals inside to see if they would become infected, and by taking samples from numerous animals and arthropods trapped during the investigation. The investigation yielded no virus and the sentinel animals remained healthy.
How do humans get it?
Just how the animal host first transmits Marburg virus to humans is unknown. However, humans who become ill with Marburg hemorrhagic fever may spread the virus to other people. This may happen in several ways. Persons who have handled infected monkeys and have come in direct contact with their fluids or cell cultures, have become infected. Spread of the virus between humans has occurred in a setting of close contact, often in a hospital. Droplets of body fluids, or direct contact with persons, equipment, or other objects contaminated with infectious blood or tissues are all highly suspect as sources of disease.
What are the symptoms?
After an incubation period of 5 to 10 days, the onset of the disease is sudden and is marked by fever, chills, headache, and myalgia. Around the fifth day, a rash most prominent on the chest, back or stomach may occur. Nausea, vomiting, chest pain, a sore throat, abdominal pain, and diarrhea then may appear. Symptoms become increasingly severe and may include jaundice, inflammation of the pancreas, severe weight loss, delirium, shock, liver failure, and multi-organ dysfunction. Because many of the signs and symptoms of Marburg hemorrhagic fever are similar to those of other infectious diseases, such as malaria or typhoid fever, diagnosis of the disease can be difficult, especially if only a single case is involved.
How is it treated
A specific treatment is unknown. However, supportive hospital therapy should be utilised. This includes balancing the patient’s fluids and electrolytes, maintaining their oxygen status and blood pressure, replacing lost blood and clotting factors and treating them for any complicating infections. Sometimes treatment also has used transfusion of fresh-frozen plasma and other preparations to replace the blood proteins important in clotting.
Who is at risk?
People who have close contact with a human or non-human primate infected with the virus are at risk. Such persons include laboratory or quarantine facility workers who handle non-human primates that have been associated with the disease. In addition, hospital staff and family members who care for patients with the disease are at risk if they do not use proper techniques to prevent direct physical contact with the patient. Precautions should include wearing of protective gowns, gloves and masks; placing the infected individual in strict isolation; and sterilization or proper disposal of needles, equipment and patient excretions.
How to prevent it from spreading?
Increasing awareness among health-care providers of clinical symptoms in patients that suggest Marburg fever is critical. Better awareness can help lead to taking precautions against the spread of virus infection to family members or health-care providers.
Improving the use of diagnostic tools is another priority. With modern means of transportation that give access even to remote areas, it is possible to obtain rapid testing of samples in disease control centers equipped with Biosafety Level 4 laboratories in order to confirm or rule out Marburg virus infection.
TWO suspected cases of Marburg haemorrhagic fever, a virus similar to Ebola, have been reported in western Uganda, according to the Ministry of health.
“The Ministry of Health would like to inform the general public that two suspected cases of Marburg haemorrhagic fever have been reported, of whom one has died,†a press release by the director general of health services, Dr. Sam Zaramba, said.
“Both cases were mine workers in Kitaka mine, located in Kakasi Forest Reserve in Kamwenge district.â€
Kamwenge is about 250km west of Kampala with a population of 295,000, according to the 2002 census.
“The first test was positive. We are waiting for the results of the confirmatory test, which we shall have at 9:00am tomorrow,†Dr. Zaramba told The New Vision last night.
“But it is most probably the Marburg virus. We thought we should send out this information early enough.â€
Marburg, like Ebola, is a severe and highly fatal disease. It is characterised by sudden bleeding and high fever, resulting into death within a few days.
Transmission is through close contact with blood and other body fluids from patients with clinical signs of the illness. It can also be transmitted following exposure to contaminated items, such as bedding and clothing of patients.
The virus is named after Marburg, a city in Germany where the first outbreak occurred in 1967 among laboratory workers who had been doing research on monkeys which were imported from Uganda in order to prepare a polio vaccine.
“The Ministry of Health has set up a national task force that is tracing all potential contacts of the above cases for further investigations and tests,†the statement added.
It advised people to report any suspicious cases to the nearest heath unit. The ministry asked the public not to panic “as no new cases have been reported in the last two weeksâ€.
What is Marburg hemorrhagic fever?
Marburg hemorrhagic fever is a rare, severe type of hemorrhagic (internal bleeding) fever, which affects both humans and monkeys. Caused by a genetically unique animal-borne RNA virus of the ‘filovirus’ family, its recognition led to the creation of this virus family. The four species of Ebola virus are the only other known members of the filovirus family.
Where have cases occurred?
Marburg virus was first recognized in 1967, when outbreaks of hemorrhagic fever occurred simultaneously in laboratories in Marburg and Frankfurt (Germany) and in Belgrade (Yugoslavia). A total of 37 people became ill. They included laboratory workers as well as several medical personnel and family members who had cared for them. The first people infected had been exposed to African green monkeys. In Marburg, the monkeys had been imported for research and to prepare a polio vaccine.
Recorded cases have appeared in only a few locations. While the 1967 outbreak occurred in Europe, the disease agent had arrived with imported monkeys from Uganda. No other case was recorded until 1975, when a traveler most likely exposed in Zimbabwe became ill in Johannesburg, South Africa – and passed the virus to his traveling companion and a nurse. 1980 saw two other cases: one in Western Kenya not far from the Ugandan source of the monkeys implicated in the 1967 outbreak.
This patient’s attending physician in Nairobi became the second case. Another infection was recognized in 1987 when a young man who had traveled extensively in Kenya became ill and later died. In 1998, an outbreak occurred in Durba, the Democratic Republic of the Congo. Cases were linked to individuals working in a gold mine. After the outbreak subsided, there were still some sporadic cases that occurred in the region.
Where does the Marburg virus originate from?
Marburg virus is indigenous to Africa. While the geographic area to which it is native is unknown, this area appears to include at least parts of Uganda and Western Kenya, and perhaps Zimbabwe. As with Ebola, the actual animal host for Marburg virus also remains a mystery. Both of the men infected in 1980 in western Kenya had traveled extensively, including making a visit to a cave in that region. The cave was investigated by placing sentinels animals inside to see if they would become infected, and by taking samples from numerous animals and arthropods trapped during the investigation. The investigation yielded no virus and the sentinel animals remained healthy.
How do humans get it?
Just how the animal host first transmits Marburg virus to humans is unknown. However, humans who become ill with Marburg hemorrhagic fever may spread the virus to other people. This may happen in several ways. Persons who have handled infected monkeys and have come in direct contact with their fluids or cell cultures, have become infected. Spread of the virus between humans has occurred in a setting of close contact, often in a hospital. Droplets of body fluids, or direct contact with persons, equipment, or other objects contaminated with infectious blood or tissues are all highly suspect as sources of disease.
What are the symptoms?
After an incubation period of 5 to 10 days, the onset of the disease is sudden and is marked by fever, chills, headache, and myalgia. Around the fifth day, a rash most prominent on the chest, back or stomach may occur. Nausea, vomiting, chest pain, a sore throat, abdominal pain, and diarrhea then may appear. Symptoms become increasingly severe and may include jaundice, inflammation of the pancreas, severe weight loss, delirium, shock, liver failure, and multi-organ dysfunction. Because many of the signs and symptoms of Marburg hemorrhagic fever are similar to those of other infectious diseases, such as malaria or typhoid fever, diagnosis of the disease can be difficult, especially if only a single case is involved.
How is it treated
A specific treatment is unknown. However, supportive hospital therapy should be utilised. This includes balancing the patient’s fluids and electrolytes, maintaining their oxygen status and blood pressure, replacing lost blood and clotting factors and treating them for any complicating infections. Sometimes treatment also has used transfusion of fresh-frozen plasma and other preparations to replace the blood proteins important in clotting.
Who is at risk?
People who have close contact with a human or non-human primate infected with the virus are at risk. Such persons include laboratory or quarantine facility workers who handle non-human primates that have been associated with the disease. In addition, hospital staff and family members who care for patients with the disease are at risk if they do not use proper techniques to prevent direct physical contact with the patient. Precautions should include wearing of protective gowns, gloves and masks; placing the infected individual in strict isolation; and sterilization or proper disposal of needles, equipment and patient excretions.
How to prevent it from spreading?
Increasing awareness among health-care providers of clinical symptoms in patients that suggest Marburg fever is critical. Better awareness can help lead to taking precautions against the spread of virus infection to family members or health-care providers.
Improving the use of diagnostic tools is another priority. With modern means of transportation that give access even to remote areas, it is possible to obtain rapid testing of samples in disease control centers equipped with Biosafety Level 4 laboratories in order to confirm or rule out Marburg virus infection.