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MSF teams take measures following cases of Marburg Kampala – On July 13, a man, 29, died in a hospital in Kampala, Uganda. All the clinical signs he showed immediately raised the concern of the medical staff. By the end of the month, the positive result of the test for Hemorrhagic Fever of Marburg type was confirmed. Another hospitalised patient, 21, tested positive for Marburg Hemorrhagic Fever. He was discharged on July 9 and since then no more cases have been detected. Both patients worked in a mine located in Kamwenge District (about 250 km west from Kampala) After the first case was reported, a task force with the World Health Organisation (WHO), Uganda Ministry of Health, Centre for Disease Control (CDC), MSF and others was organized to follow up the people who had potentially been in touch with the confirmed case. The incubation time (time between getting infected and the first symptoms) is considered to be of maximum 21 days. However, the task force agreed to continue the follow-up and the search for eventual new cases for the double of this time, so for 42 days, before declaring the end of the outbreak. An isolation area in the Mulago hospital in Kampala and a second in a health structure close to Kamwenge, where the cases had originated, have been prepared, and the health staff in these facilities has been trained to be able to respond to this type of emergencies. Experience from the pastMSF has been monitoring the situation carefully using our experience in previous Marburg epidemics. In Uige, Angola, in 2005, the MSF teams had to deal with a huge growth of the disease that had a high mortality. Only supportive treatment for Marburg HF can be offered to the patients and the case fatality is high (50-90%). Outbreak control procedures are effective at controlling its spread. Currently, the national data has two confirmed cases (positive laboratory result for Marburg Hemorrhagic Fever); out of these, one death and one survivor. So far 202 contacts have been followed (105 in Kamwenge / Ibanda; 97 in Kampala / Kayunga). MSF teams have supported the control and surveillance of the possible Marburg cases in Kampala and Kamwenge. In Mulago National Hospital, located in Kampala, MSF has provided support with technical assistance in case management of the “alert patients” who arrived at the hospital, meaning patients with symptoms that are similar to the ones in Marburg HF. No more positive cases have been detected. In addition MSF has provided comprehensive case management training to the core staff of Mulago Hospital. In Kamwenge and Ibanda district, MSF has provided information sessions to the health structures and medical material, drugs and related supplies based on an estimation for an isolation Unit for three to five patients for 25 days. In Ibanda Missionary Hospital and in one of the Kicheche health centres MSF set up an isolation unit with all the means needed for responding to alert cases. MSF has sent four international volunteers to give additional support to the teams already on the ground and hired five new local staff. Also MSF paid 18 of the core staff for Mulago Hospital of Kampala to work in the Isolation Unit, from August 13 to August 28.
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