Published Date: 2013-01-26 00:00:26
Subject: PRO/AH/EDR> Undiagnosed fatalities - Uganda: (MD), RFI
Archive Number: 20130126.1515447
UNDIAGNOSED FATALITIES - UGANDA: (MUBENDE), REQUEST FOR INFORMATION
A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases
Date: 25 Jan 2013
Mubende residents worried as strange disease kills 5
Ministry of Health officials say blood samples have been taken for tests, and locals have now resorted to witchcraft for cure.
Five people have so far died while 30 others are admitted to different health centres as a result of a strange disease that has hit Mubende District.
According to residents, the disease that broke out a few weeks ago, causes heat around the chest and itching in the neck, and within a few hours, the patient starts vomiting and bleeding through the nose and the mouth. It also causes diarrhoea and a high fever.
Residents claim that the disease is as a result of witchcraft, since some of the patients have sought help from witch doctors and allegedly felt better.
The district health officer, Dr Wilson Mubiru, explained that the 1st patients registered with symptoms of the disease suspected they were suffering from Ebola.
"We have forwarded blood tests to the Uganda Virus Research Institute (UVRI) in Entebbe. Although we are yet to get the results, we highly doubt whether this is Ebola," Dr Mubiru said.
Ministry of Health permanent secretary, Dr Asuman Lukwago, yesterday [24 Jan 2013]confirmed that cases of the strange illness had been reported to them, saying they were following it up.
Just last week, Uganda was again declared Ebola-free after an outbreak in Luweero District killed 4 people [see prior ProMED-mail post Ebola virus disease - Uganda (02): (LO) declared Ebola-free 20130117.1502950].
However the government is still grappling with the nodding syndrome disease in northern Uganda that has killed scores of children and left others helpless.
[Byline: Sarah Tumwebaze]
ProMED-mail Rapporteur Mary Marshall
[According to the description of the clinical picture provided in the above newswire, there appears to be an outbreak of an as yet undiagnosed febrile illness with onset of hemorrhagic manifestations later in the course of the disease. Thusfar there are reports of 5 deaths out of 35 ill individuals for a case fatality rate (CFR) of 14.3 percent.
During the course of 2012, there were 2 separate outbreaks of Ebola virus disease in Uganda, earlier in the year (July through September 2012), in Kitgum district in the northernmost reaches of the country bordering with Sudan, and more recently (November-December 2012) in Loweero District, a district bordering with Mubende district (see below geographic description). There was also an outbreak of Marburg virus disease (October - November 2012) involving 5 districts -- Kabale in southwestern Uganda bordering with Rwanda, Kampala (the capital city), Ibanda, Mbarara and Kabarole districts. In September 2012, there was a case of yellow fever in Agago District (Agago District is bordered by Kitgum District to the north, Kotido District to the northeast, Abim District to the east, Otuke District, to the south, and Pader District to the west. It is located 230 miles to the north of Kampala.) The reported CFR of 14.3 percent of this current outbreak is relatively low for the hemorrhagic fever outbreaks that have been recently affecting Uganda, but does not necessarily rule out a hemorrhagic fever etiology. Of interest, in using the GideonOnline website to identify a differential diagnosis (http://www.gideononline.com, chikungunya was identified as highly likely, albeit the reported CFR of 14.3 percent would be considered high for chikungunya virus associated disease.
It should be mentioned that in addition to the viral hemorrhagic fevers mentioned above, Uganda has had recurrent outbreaks of plague through the years.
ProMED-mail would greatly appreciate more information on this outbreak from knowledgeable sources in the region, as well as information on the results of laboratory studies.
Mubende District borders with Kyankwanzi District to the north, Kiboga District to the northeast and Mityana District to the east. Gomba District and Sembabule District lie to the south, Kyegegwa District to the southwest and Kibaale District to the northwest of Mubende District. Mubende, the district headquarters, is located approximately 172 kilometres (107 mi), by road, west of Kampala, the capital of Uganda, and the largest city in that country. The district also shares a short border to the northeast with Luweero District where the recent outbreak of Ebolavirus was.
For a map of Uganda showing districts, see http://www.ugandamission.net/aboutug/map1.html.
For the interactive HealthMap/ProMED map of Uganda, see http://healthmap.org/r/1wa6 - Mod.MPP]