Ebola virus surveillance in pigs presenting for slaughter in Uganda
EBOLA VIRUS DISEASE IN UGANDA - WHO · 2019-08-05 · EBOLA VIRUS DISEASE IN UGANDA 18 SitRep #June...
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1 Key Highlights • 03 cumulative cases (00 probable 03 confirmed) • All (03) confirmed cases have died (CFR =100%) • Today is day 5 since the death of the last confirmed case who passed on the 13 June 2019 while on transfer to the DRC for further management • There are 93 contacts under follow up o 86 were followed up today o None has developed symptoms to date • 02 suspect cases on admission in ETU • Active case search and death surveillance are ongoing in the health facilities and the communities as the district response team continue to investigate all alerts • 147 contacts have been vaccinated today • High level community engagement was done in Karambi subcounty to address community hostility against response teams • Welfare of ETU health workers need urgent attention EPIDEMIOLOGICAL SUMMARY Background On 11 th June 2019, the Ministry of Health of Uganda declared the 6 th outbreak of Ebola Virus Disease (EVD) in the country affecting Kasese district in South Western Uganda. The first case was a five-year-old child with a recent history of travel to the Democratic Republic of Congo (DRC). This child was one of 6 people that travelled from the DRC while still being monitored as suspect cases following a burial of the grandfather who succumbed to EVD. The child was ill by 1. Situation update Cases 03 Deaths 03 EBOLA VIRUS DISEASE IN UGANDA 18 June 2019 as of 20 00 Hrs SitRep #07 Situation Report
Transcript of EBOLA VIRUS DISEASE IN UGANDA - WHO · 2019-08-05 · EBOLA VIRUS DISEASE IN UGANDA 18 SitRep #June...
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KeyHighlights
• 03cumulativecases(00probable03confirmed)• All(03)confirmedcaseshavedied(CFR=100%)• Todayisday5sincethedeathofthelastconfirmedcasewhopassedonthe13June2019whileontransferto
theDRCforfurthermanagement• Thereare93contactsunderfollowup
o 86werefolloweduptodayo Nonehasdevelopedsymptomstodate
• 02suspectcasesonadmissioninETU• Activecasesearchanddeathsurveillanceareongoinginthehealthfacilitiesandthecommunitiesasthedistrict
responseteamcontinuetoinvestigateallalerts• 147contactshavebeenvaccinatedtoday• High level community engagement was done in Karambi subcounty to address community hostility against
responseteams• WelfareofETUhealthworkersneedurgentattention
EPIDEMIOLOGICALSUMMARY
BackgroundOn 11th June 2019, theMinistry of Health of Uganda declared the 6th outbreak of Ebola Virus Disease (EVD) in thecountryaffectingKasesedistrictinSouthWesternUganda.Thefirstcasewasafive-year-oldchildwitharecenthistoryoftraveltotheDemocraticRepublicofCongo(DRC).Thischildwasoneof6peoplethattravelledfromtheDRCwhilestillbeingmonitoredassuspectcasesfollowingaburialofthegrandfatherwhosuccumbedtoEVD.Thechildwasillby
1. Situation update Cases
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Deaths
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EBOLA VIRUS DISEASE IN UGANDA 18 June 2019 as of 20 00 Hrs SitRep #07 Situation Report
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thetimehecrossedintoUgandaandthemothertookhimformedicalcareatKagandohospitalinKasesedistrictwithsymptoms of vomiting blood, bloody diarrhea,muscle pain, headache, fatigue and abdominal pain. The child testedpositiveforEbolaZairebyPCRandhelaterdiedon11thJune2019.Twoothermembersofthefamily,agrandmotherand3-year-oldbrotheralsotestedpositiveforEbolaon12June2019andthegrandmotherdiedlaterthesameday.The3-year-oldbrotheralsodiedonthe13June2019. Asoftoday,there isnoconfirmedEVDcase inUganda,however2suspectcasesareadmittedatBweraEbolaTreatmentUnit.Ninety-three(93)contactsarebeingfollowedup.Figure1:MovementoftheEVDcasesfromCongointoUganda
Table1:SummaryofEbolavirusDiseaseoutbreakinKasese,June2019SUMMARYOFCASES(asof17/June/2019) Newsuspectcasestoday 01Newdeathstoday 00Cumulativecases(probableandconfirmed) 03
Probable 00
Confirmed 03Cumulativedeaths(probableandconfirmed) 031Healthfacilities 03Community 00Deathsamongconfirmedcases 03Numberofcasesonadmission(probableandconfirmed) 00Probable 00Confirmed 00Suspectcasesonadmissionunderinvestigation 022
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Cumulativeconfirmedcasesdischarged 00Caseswhoarehealthworkers 00Runawaysfromisolation 00Cumulativenumberofcontactslistedasoftoday 93Numberofcontactsthathavecompleted21days 00Numberofcontactsunderfollowup 93Numberofcontactsfolloweduptoday 86Cumulativenumberofcontactswhodevelopedsymptoms 00Cumulativenumberofcontactsvaccinated 2753Numberofcontactsvaccinatetoday 1473Specimenscollectedandsenttothelab.Today 2Cumulativespecimenscollected 184Cumulativecaseswithlabconfirmation 03Cumulativesamplestestednegative 09Specimenswithpendingresults 00Dateofdischarge/deathoflastconfirmedcase 13June20191includes1deathintheDRC2ExcludestwocaseswithrepeatnegativePCRplannedfordischargetomorrow.3Includescontactsofcontacts46arerepeatsamplesFigure2:EpidemiccurveofEbolaVirusDiseaseoutbreakinKasese,June2019
CoordinationToday the EVD District Task Forcemeeting was chaired by Deputy Resident District Commissioner. ThemeetingdiscussedactionpointsraisedduringtheDTFmeetingheldthepreviousday.Italsoreceivedfeedbackfromthesub-committeesfollowingtheactivitiesconductedthepreviousday.AcommunityengagementmeetinginKarambiSub-countywasheldtointensifysocialmobilizationandriskcommunicationsincethecommunitywasbecominghostile
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2. Public Health Actions to date
June 2019
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duetoEbolaresponse.ThepoliticalleadershipemphasizedcommunityledEbolaresponseandaskedallcommunityleaderstocooperateandsupportresponseteams.
Otherkeyissuesdiscussedincluded;
- TheneedforadequatecoordinationbetweenthesurveillanceteamsinDRCandthoseinUgandatounderstandclearlytheoutbreakpatterns.
- TheneedformoreRadioAirtimetocoverotherradiostationsascurrenteffortsarefocusingononlytwoRadiostations(MessiahFMandGuideFM)Leavingoutotherradiostations.
- DelayedpaymentofstaffwhoweretrainedsinceEbolapreparednessphase.ThesepeopleweretobepaidbyWHO.ThisisdemoralizingstafffromparticipatinginongoingactivitiesinResponse.
- Theurgentneed to stopVHTsactivities in communitymalariadiagnosis andoffering familyplanning services(injectable)incommunitiesuntilfurthernoticebecauseoftheincreasedriskofEbola.
Surveillance
• Onealertwasreceivedthatwasverifiedasanon-case.Cumulatively,9alertshavebeenregisteredofwhich3wereverifiedassuspectcases,5verifiedasnonecaseand1asaknowncontactwithnosymptoms.
• Screened317mournersataburialinNyabugandotownduringEventbasesurveillance.• CommunityBasedDiseasesurveillancegroupre-oriented29VHTsand7localleadersin12outof15villagesin
IsangosubcountyfocusingonfactsaboutEbolaandnotificationmechanismsandIECmaterialsonEVD.• Fromactive case search the team identified five casesofbloodydiarrhoeadiagnosedasdysenteryatKabirizi
KatweHCIIofwhichonewasfollowedupandconfirmedthatsymptomsresolvedupontreatment.Theotherfourcasescouldnotbetracedastheyaremobilecommunities.
• Activecasesearchinschoolsyieldednosymptomaticcases.• Screened12886peopleat6pointofentry(POEs).However,therearenoscreeningservicesat18PoEand6bus
terminalsduetoshortageofmanpowerandlogistics(handwashing,tents,thermometersandchlorine)LaboratoryCumulativenumberofreportedsamplestodateis12(excluding6repeatsamples),threepositiveandninenegative
• Procuredservicesforelectricalandfurniturefittingintothemobilelabworkroom• StartedonthesetupofthemobilelabatBwerahospitaluponstaffdecontaminatingtheworkspace• Results for yesterdays’ two referred sampleswere reported.Onewas a repeat and the otherwas for a new
admission.AllarePCRnegative.Plannedactivities
• Electricalandfurniturefittinginthemobilelabworkroom• Developstandardguidelinesonmanagementofsamplesandwasteinthemobilelaboratory.• Securepowerbackup(GeneratorandUps)tosupportconstantlabworkoperations.Procurementoftheseitems
hasbeeninitiatedandismovingforwardCasemanagementToday,theETUhasfouradmissionsincludingonenewsuspectcasewhowasadmittedlastnightat8:30pm,andthreepatientswhowerecarriedonfromthepreviousdayassummarizedinthetablebelow.
Table2.0SummaryofpatientsadmittedinETUasof18-June-2019
Case Description 1sSample 2ndSample 1stResult 2ndResult CommentCase1 45year/Male Taken to be taken
tomorrowNegative - Investigationongoing
Case2 3year/Male Taken taken Negative Negative To be discharged afterpsychosocial team has preparedhisvillagetoreceivehim
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Case3 3year/Male taken
to be takentomorrow
Negative - Investigationongoing
Case4 7year/Male taken taken Negative Negative To be discharged tomorrow,awaitingpsychosocial topreparehiscommunity
TheCoordinationteamheldameetingwithETUmemberstodiscusstheirgrievancewithrespecttotheirfacilitation.ItwasobservedthattheyhaveneverbeenpaidsinceAugust2018andtheyaretotallyfrustrated.Weadvisedonthelogisticsmanagementandincreasedhumanresourcemanagement.Theremaining4nonvaccinatedhealthworkersinETUwillbevaccinatedtomorrow.ETUsecurityhasbeenbeefedupwithMilitary.
Riskcommunicationandsocialmobilization
• Sensitised201sub-countycouncilors,localcouncilonechairpersonsandUPDFsoldiersonEVD• Communitydriveswithfilmvansensitisedanapproximateof385people,625Marketvendors,1,812pupilsin6
schools,oneononediscussionsensitized105people,conducted37smallgroupleveldiscussions,sensitisedand36householdvisitssensitised175people
• Distributed110posters,219leafletstargetingmarketvendorsandUPDFsoldiers
Psychosocialteam• Conductedafollow-upvisitwiththe2youngmenwhoweretransferredfromtheETUandarecurrentlyreceiving
treatmentonthegeneralwardatBwerahospital.Theyarerecoveringandtheirfamiliesarenowmoresupportive.• Counselledthenursewhoisacontactandshehasnotreportedanysymptomstoday• Offeredpsychosocialsupporttoattendantsof2patientstransferredfromETUtothegeneralwardVaccinationThevaccinationteamhasvaccinatedacumulativenumberof275contactswith147vaccinatedtodayintwomainrings.The147vaccinatedincluded51healthworkers.Theteamcontinuestoidentifynewcontactsandcontactsofcontacts.WASH
• TheWASHteamassessedtheWASHinterventionsin6schools,landingsiteofKigendoandNationalWaterandSewerageCorporationofficesinKatweT.C
• Trained101EarlyChildDevelopmentcentreHeadTeachersandcaregiversonhandwashingandwatertreatingstrategy
• Assessedtheavailabilityandfunctionalityofhandwashingfacilitiesandwater;7schools,7restaurants,3healthfacilities,2churchesand1marketinKabatoroTownCouncil,HimaTownCouncil, MpondweLhubirihaandIbandaKyanaTownCouncils
• Keyobservationsmade;Outofthe26institutionsvisited,only15hadhandwashingfacilitiesprovidedwithjikorchlorineasadisinfectant
Infectionpreventionandcontrol
Theteamorientedhealthworkersonimportanceofcleanenvironment,useofprotectivewear,wastedisposalat6healthfacilities;BikunyaHCII,BubotyoHCII,BuhungamuyaghaHCIII,IhandiroHCIIIandBweraGeneralHospital
Logistics• ConductedEVDvaccinesupply inventory.Thedistrict logisticsmanagement teamwastrained inpublichealth
emergencesupplychainmanagementbyMSH
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Keyplannedactivities• Conductactivecasesearch,contactlistingandfollowupinhealthfacilitiesinallHealthSub-districts• Thewashcommitteetogetherwithallenvironmentalhealthstaffinthedistrictwillvisitmoreinstitutions
(schools,markets,healthfacilities)toassesstheWASHinterventionstowardsEVDpreventionandcontrol• TheriskcommunicationteamtocontinueworkingwithvaccinationteaminBweraoncommunityengagement
toaddressrumorsthroughcommunitydialoguemeetings• EngagementofcommunityleadersinKilembeandMukunyuonhostilityagainstCongolesenationals• Sensitisecommunitymembers, stopmassgatherings,alleviate fearsandanxietyamongcommunitymembers
onEVDandencouragepeople tohandwashand stophandshaking.Thecommunitywill also sensitiseon theimportanceofsafeanddignifiedburialfollowingresistanceatSDBofasuspectcase.
• CommunityengagementatmarketstoenhancealertnessandenablereportingofanyEbola-relatedeventstothedistrictauthorities
• TheriskcommunicationteamwillvisitthemarketsandotherpublicplacestoconductsensitizationandengagementmeetingsonEVDalertness
• InvolvementofVHT/volunteerstosupportriskcommunicationatPOEswithriskcommunicationteamsChallenges
• TheETUmembersarerequestingforPerdiemsincetheyrenttheiraccommodationtobeclosetothetreatmentUnit.
• Inadequatescreeningservicesat18PoEand6busterminals• Oneofthecontactsundergoingpsychosocialsupporthasrefusedtobevaccinated• PeopleinKatirivillage,KyanjukiparishinBulembyapeoplehaveabeliefthatifyoutakefirewoodashyouwould
betreatringEbola.Alsobelievethateatingbushmeetyoulivelonger• ScreeningatMiramimwanalhobeingdoneinopenwithnotentandchairs•
CommunityawarenessoftheriskofEbolainfectionishighandthecommunityisverysuspiciousofanyonewitharecent travel to the DRC. Supplies of response items have improved but more forecasting is needed to avoidstockouts of essential items like PPEs and other sundries. TheWelfare of the healthworkers in ETU need to beurgentlyaddressed.
The following partners are supporting Ebola response in Kasese district;WHO, CDC, USAID CHC, UNICEF, Red Cross,AFENET,ECHO,DFID,UNHCR,IRC,IOM,Baylor,BRACUganda,MSH,SavetheChildrenandMSF.
3. Conclusion
4. Partnerships
