Impact of enhanced viral haemorrhagic fever surveillance on outbreak detection and response in Uganda

Crimean-Congo hemorrhagic fever (CCHF) is a virus-mediated hemorrhagic disease that occurs over a wide geographic region. In recent years, a variety of active and passive surveillance networks have improved our knowledge of areas with existing circulation of Crimean-Congo hemorrhagic fever virus (CCHFV), the etiologic agent of CCHF. These investigations aid in better defining the distribution of the virus. Expansion of a virus into new areas can occur through a variety of means, including introduction of infected humans, vectors, or animals. Here, these potential contributors to expansion of CCHFV into neighboring countries and geographically distant locations are reviewed, and the likelihood and possible implications of these events, based on known characteristics of the virus and its natural maintenance and transmission cycles are explored. Furthermore, this report discusses limitations in the currently described distribution of CCHFV, and the challenges in assessing viral circulation identified in a new region as geographic expansion of the virus.

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“…Enhanced viral hemorrhagic fever surveillance has pronounced impact [80]. Active and passive surveillance for known tick vectors (e.g.…”

Section: Conclusion and Future Considerationsmentioning

confidence: 99%

Crimean-Congo hemorrhagic fever and expansion from endemic regions

Spengler

Bergeron

Spiropoulou

2019

Current Opinion in Virology

102

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“…Blood from patient B tested negative for Ebola virus disease and other hemorrhagic fever viruses at UVRI using established methods (5). Sputum yielded the maximal positive reaction (4+) on a commercial rapid diagnostic test (RDT) (New Horizons Diagnostics) for detection of Yersinia pestis fraction 1 (F1) antigen.…”

Section: Investigation and Findingsmentioning

confidence: 99%

Intervention To Stop Transmission of Imported Pneumonic Plague — Uganda, 2019

Apangu¹,

Acayo²,

Atiku³

et al. 2020

MMWR Morb. Mortal. Wkly. Rep.

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Plague, an acute zoonosis caused by Yersinia pestis, is endemic in the West Nile region of northwestern Uganda and neighboring northeastern Democratic Republic of the Congo (DRC) (1-4). The illness manifests in multiple clinical forms, including bubonic and pneumonic plague. Pneumonic plague is rare, rapidly fatal, and transmissible from person to person via respiratory droplets. On March 4, 2019, a patient with suspected pneumonic plague was hospitalized in West Nile, Uganda, 4 days after caring for her sister, who had come to Uganda from DRC and died shortly thereafter, and 2 days after area officials received a message from a clinic in DRC warning of possible plague. The West Nile-based Uganda Virus Research Institute (UVRI) plague program, together with local health officials, commenced a multipronged response to suspected person-to-person transmission of pneumonic plague, including contact tracing, prophylaxis, and education. Plague was laboratory-confirmed, and no additional transmission occurred in Uganda. This event transpired in the context of heightened awareness of cross-border disease spread caused by ongoing Ebola virus disease transmission in DRC, approximately 400 km to the south. Building expertise in areas of plague endemicity can provide the rapid detection and effective response needed to mitigate epidemic spread and minimize mortality. Cross-border agreements can improve ability to respond effectively.

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“…Both countries have been able to detect and respond much faster to outbreaks. In Uganda, improvements in public health surveillance have been shown to substantially improve the response time for Viral Haemorrhagic Disease epidemics, thus reducing the scale and length of epidemics [21]. Similarly, Nigeria is strengthening implementation of the IHR.…”

Section: Discussionmentioning

confidence: 99%

Spatial and temporal distribution of infectious disease epidemics, disasters and other potential public health emergencies in the World Health Organisation Africa region, 2016–2018

et al. 2020

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Background: Emerging and re-emerging diseases with pandemic potential continue to challenge fragile health systems in Africa, creating enormous human and economic toll. To provide evidence for the investment case for public health emergency preparedness, we analysed the spatial and temporal distribution of epidemics, disasters and other potential public health emergencies in the WHO African region between 2016 and 2018. Methods: We abstracted data from several sources, including: the WHO African Region's weekly bulletins on epidemics and emergencies, the WHO-Disease Outbreak News (DON) and the Emergency Events Database (EM-DAT) of the Centre for Research on the Epidemiology of Disasters (CRED). Other sources were: the Program for Monitoring Emerging Diseases (ProMED) and the Global Infectious Disease and Epidemiology Network (GIDEON). We included information on the time and location of the event, the number of cases and deaths and counterchecked the different data sources. Data analysis: We used bubble plots for temporal analysis and generated graphs and maps showing the frequency and distribution of each event. Based on the frequency of events, we categorised countries into three: Tier 1, 10 or more events, Tier 2, 5-9 events, and Tier 3, less than 5 or no event. Finally, we compared the event frequencies to a summary International Health Regulations (IHR) index generated from the IHR technical area scores of the 2018 annual reports. Results: Over 260 events were identified between 2016 and 2018. Forty-one countries (87%) had at least one epidemic between 2016 and 2018, and 21 of them (45%) had at least one epidemic annually. Twenty-two countries (47%) had disasters/humanitarian crises. Seven countries (the epicentres) experienced over 10 events and all of them had limited or developing IHR capacities. The top five causes of epidemics were: Cholera, Measles, Viral Haemorrhagic Diseases, Malaria and Meningitis.

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Impact of enhanced viral haemorrhagic fever surveillance on outbreak detection and response in Uganda

Cited by 42 publications

References 11 publications

Crimean-Congo hemorrhagic fever and expansion from endemic regions

Crimean-Congo hemorrhagic fever and expansion from endemic regions

Intervention To Stop Transmission of Imported Pneumonic Plague — Uganda, 2019

Spatial and temporal distribution of infectious disease epidemics, disasters and other potential public health emergencies in the World Health Organisation Africa region, 2016–2018

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