EBOLA VIRUS DISEASE IN UGANDA - WHO...Ebola and notification mechanisms and IEC materials on EVD....
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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 6 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 106 contacts under follow up o 103 were followed up today • 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 • 181 contacts have been vaccinated today 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 the time he crossed into Uganda and the mother took him for medical care at Kagando hospital in Kasese district with symptoms of vomiting blood, bloody diarrhea, muscle pain, headache, fatigue and abdominal pain. The child tested positive for Ebola Zaire by PCR and he later died on 11 th June 2019. Two other members of the family, a grandmother and 3-year-old brother also tested positive for Ebola on 12 June 2019 and the grandmother died later the same day. The 1. Situation update Cases 03 Deaths 03 EBOLA VIRUS DISEASE IN UGANDA 19 June 2019 as of 20 00 Hrs SitRep #08 Situation Report
Transcript of EBOLA VIRUS DISEASE IN UGANDA - WHO...Ebola and notification mechanisms and IEC materials on EVD....
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KeyHighlights
• 03cumulativecases(00probable03confirmed)• All(03)confirmedcaseshavedied(CFR=100%)• Todayisday6sincethedeathofthelastconfirmedcasewhopassedonthe13June2019whileontransferto
theDRCforfurthermanagement• Thereare106contactsunderfollowup
o 103werefolloweduptoday• 02suspectcasesonadmissioninETU• Activecasesearchanddeathsurveillanceareongoinginthehealthfacilitiesandthecommunitiesasthedistrict
responseteamcontinuetoinvestigateallalerts• 181contactshavebeenvaccinatedtoday
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.ThechildwasillbythetimehecrossedintoUgandaandthemothertookhimformedicalcareatKagandohospitalinKasesedistrictwithsymptoms of vomiting blood, bloody diarrhea,muscle pain, headache, fatigue and abdominal pain. The child testedpositiveforEbolaZairebyPCRandhelaterdiedon11thJune2019.Twoothermembersofthefamily,agrandmotherand3-year-oldbrotheralsotestedpositiveforEbolaon12June2019andthegrandmotherdiedlaterthesameday.The
1. Situation update Cases
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EBOLA VIRUS DISEASE IN UGANDA 19 June 2019 as of 20 00 Hrs SitRep #08 Situation Report
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3-year-oldbrotheralsodiedonthe13June2019. Asoftoday,there isnoconfirmedEVDcase inUganda,however2suspectcasesareadmittedatBweraEbolaTreatmentUnit.Onehundred-sixcontactsarebeingfollowedup.Figure1:MovementoftheEVDcasesfromCongointoUganda
Table1:SummaryofEbolavirusDiseaseoutbreakinKasese,June2019SUMMARYOFCASES(asof19/June/2019) Newsuspectcasestoday 00Newdeathstoday 00Cumulativecases(probableandconfirmed) 03
Probable 00Confirmed 03
Cumulativedeaths(probableandconfirmed) 031Healthfacilities 03Community 00Deathsamongconfirmedcases 03Numberofcasesonadmission(probableandconfirmed) 00Probable 00Confirmed 00Suspectcasesonadmissionunderinvestigation 02Cumulativenumberofhealthworkersdischarged 00Runawaysfromisolation 00Cumulativenumberofcontactslistedasoftoday 106
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Numberofcontactsthathavecompleted21days 00Numberofcontactsunderfollowup 106Numberofcontactsfolloweduptoday 103Cumulativenumberofcontactsvaccinated 456Numberofcontactsvaccinatedtoday 181Specimenscollectedandsenttothelab.Today 2Cumulativespecimenscollected 203Cumulativecaseswithlabconfirmation 03Cumulativesamplestestednegative 09Specimenswithpendingresults 2Dateofdischarge/deathoflastconfirmedcase 13-June-20191includes1deathintheDRC2includescontactsofcontacts3includes6arerepeatsamplesFigure2:EpidemiccurveofEbolaVirusDiseaseoutbreakinKasese,June2019
CoordinationTheDistrictchairpersonsocialservicescommitteechairedtoday’sEVDDistrictTaskForcemeeting.ThecommunitydialogueinKarambisubcountyyesterdaytaskedthecommunityleaderstoinformthecommunitymembersabouttheEbolavirusdiseasesituationinthedistrict.Theyurgedthecommunityleaderstoembracetheinterventionsputinplace.ThemeetingdiscussedactionpointsraisedduringtheDTFmeetingheldthepreviousday.Italsoreceivedfeedbackfromthesub-committeesfollowingtheactivitiesconductedthepreviousday.A4Wmatrixwasdevelopedandwillbepresentedtothedistrictfordiscussion.
Otherkeyissuesdiscussedincluded;- TheneedforconsistentsharingofcontactslistsbetweenDRCandUgandaofUgandaforadequatefollow-upof
contacts.- Theneedformoresupportfromthecorporatecompaniesinthedistrict- ProvisionofrefreshmentsforstaffworkingintheETU- Re-structuringtheETUtorelocatetheentranceormortuarylocationtobeaddressedbyMSF
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Deathof5-year,grandmotherand3-year-oldrespectivelypectively
2. Public Health Actions to date
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- ThecoordinationteamsupervisedPoEsitesandassessedcurrentpracticesSurveillance
• Contacttracingteamandvaccinationteammettoharmonizetheiroperations• Received two alert reports. One as a sudden death of a seemingly healthy 40-year-old man. Verification
including sample collection is underwaywithburial planned for tomorrow. The secondalert is a 40-year-oldman fromKatungulu subcounty;was verified and found to be a non-case. Cumulatively, 11 alerts have beenregisteredofwhich4wereverifiedassuspectcases,6verifiedasnonecaseand1asaknowncontactwithnosymptoms.
• Screened292peoplewhohadgatheredatachurchchoirpracticeatNsenyicatholicparish.• Conducted community engagement and sensitized people in Nsenyi parish focusing on EVD prevention and
notification.• Re-oriented64VHTsand12localcouncilleadersfrom15villagesinKathulhosubcountyfocusingonfactsabout
EbolaandnotificationmechanismsandIECmaterialsonEVD.• A team fromWHO country office trained the data teamonGoData software and installed it on the district
computers.• Theactive case search reviewed recordsat5health facilities includingKasangaHC III,MBHMarternity clinic,
KyambogoClinic,MpondweHCIIIandNyabugandoHCIII.Nocasewasidentified.• Atotalof106contactshavebeenlinelisted.Ofthese,103havebeenfollowedtoday.Threepeoplewerenot
followedbecause,onecouldnotbe located,onemovedtoKamwokya inKampalaandtheotherhadgonetotradeinthemarketandcouldnotbelocated.
• Oneofthecontactsofaconfirmeddead50-year-oldwomandevelopedahightemperature.However,shehadbeenvaccinatedthepreviousday.SheiscurrentlymanagedwithantipyreticsandIVfluidsinthegeneralward.
• Atotalof13newcontactswereidentifiedtoday.• Screeningwasconductedat6PoEsand6porouspoints.Atotalof3271men,2,204womenand821children
excludingMpondwescreeningpointswhichhasahugepopulationmovement.• Received8tentsfromBRAC-UGANDAforsomeporouspointsofentry.
Laboratory
• Securedelectricalandfurniturefittingintothemobilelabroom.• Twosampleswerereferredtothecentraltestinglaboratory(UVRI).Theyarebothrepeatsamples.• Twopendingresultsfortherepeatsamplescollectedtoday.• Cumulativenumberofreferredandtestedsamplesis20including6repeats.Threepositiveandninenegative.• Developed standard guidelines on sample and waste (both solid and liquid) management during mobile lab
operations.
LaboratoryPlannedactivities• Deliveryofpowerbackupequipment(generatorandUPS)toBwerafromUVRI.• Setupoftheequipmentinthemobilelab.
Casemanagement
• Today,theETUhastwoadmissionsof2suspectedcasescarriedonfromthepreviousday.Twopersonsweredischargedandintegratedintotheircommunities.
RiskCommunicationandCommunityEngagement
• Engaged35VHTsinMalibaSub-countyonEVD• strategicallydistributed75postersand16fliers• EngagedleadershipofMubukuprisontopmanagementandagreedonasensitisationprogram• ReachedMpondweLhubirihaandMpondweporousborderentrypointsandriskcommunicationisstillongoing
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• Engaged6healthworkersat2drugshopsand2pharmaciesandtheyweresensitisedonEVDprevention• Reached1410studentsand33teachersinNyamwambadivisionwithmessagesonEVD• Reached 736 individuals in Muhokya Sub-County and Mubuku Town Council with messages on EVD and
Sensitized122UPDFsoldiersinKayanzibarracks• Developedaradiotalk-showscheduleandconductedonradiotalk-show
InfectionPreventionandControl
Theteamoriented32healthworkersonimportanceofcleanenvironment,useofprotectivewear,mixingofchlorine,wastedisposalat6healthfacilities;KamasasaHCII,KambukamabweHCII,BukangaraHCII,KarambiHCIIIandKanyatsiandKitholhuHCIII.
Psychosocial• ConductedafollowupcounsellingvisitatSt.PaulHealthCenterIVwheresomehealthworkersweredistressed
followingcontactwithasuspectcase• Wealsodidcommunitypsycho-sensitizationinacommunityatKitanothatwashostiletooneofthecontacts• Wevisitedacontactwhohadrefusedtoreceiveavaccinebuthasfinallyagreedtoday• Wevisitedoneofthepatients(23-year-old)whowastransferredfromtheETUtogeneralward.Heisstillweak
andbeingmanaged.• Wewere able to resettle the two children that have been admitted at the ETU atMirami and Ihandiro. The
communitiesandtheirfamilieshavereceivedthemwell.Logistics
• Continued with training the district logistics management team in public health emergence supply chainmanagement.ThetrainingwasconductedbyMSH
• Carriedoutvaccinessupplyinventory• Issued100IECmaterials• Received02motorcyclesandonevehiclefromMOHdedicatedforEbolaresponse• Received100tinsofJIK(5litres)fromBRACand08infrathermometers
WASH
• ConductedinspectionofpublicplacesandassessedthelevelofsanitationandhygieneconditionsinregardtotheselectedwashaspectsgearedtowardstheEVDcontrolandprevention:inKatweKabatoroTownCouncil(3schools,1church,1hoteland1companyestablishment),KinyamasekeTownCouncil;6bars,KyarumbaTownCouncil;3schools,2hotels,1marketand3barswerevisited.
• The team also visited 1 school, 1 church, 2 hotels and 1marketwere also inspected in Bulembia Division, 4schoolswerevisitedinIbandaKyanaTownCouncil,4schoolsinNyamwambaDivisionand3privateschools,3hotelsand5barswerealsovisitedandinspectedinMpondweLhubirihaTownCouncilrespectively
• Mpondwe lhubiriha screening point, Kayanzi screening point, Katwe screening point and Kyakitale screeningpointwerevisitedtoassessthelevelofsanitationandtheavailabilityofwaterandhandwashingfacilities
Vaccination• 181contactswerevaccinated(ofthese92areHCWs/FLWsand3high-riskcontacts.Therestwerecontactsof
contacts)Theteamcontinuestoidentifynewcontactsandcontactsofcontacts.Keyplannedactivities
• Conductactivecasesearch,contactlistingandfollowupinhealthfacilitiesinallHealthSub-districts• Thewashcommitteetogetherwithallenvironmentalhealthstaffinthedistrictwillvisitmoreinstitutions
(schools,markets,healthfacilities)toassesstheWASHinterventionstowardsEVDpreventionandcontrol
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• TheriskcommunicationteamtocontinueworkingwithvaccinationteaminBweraoncommunityengagementtoaddressrumorsthroughcommunitydialoguemeetings
• EngagementofcommunityleadersinKilembeandMukunyuonhostilityagainstCongolesenationals• Sensitisecommunitymembers, stopmassgatherings,alleviate fearsandanxietyamongcommunitymembers
onEVDandencouragepeople tohandwashand stophandshaking.Thecommunitywill also sensitiseon theimportanceofsafeanddignifiedburialfollowingresistanceatSDBofasuspectcase.
• CommunityengagementatmarketstoenhancealertnessandenablereportingofanyEbola-relatedeventstothedistrictauthorities
• TheriskcommunicationteamwillvisitthemarketsandotherpublicplacestoconductsensitizationandengagementmeetingsonEVDalertness
• InvolvementofVHT/volunteerstosupportriskcommunicationatPOEswithriskcommunicationteamsChallengesandobservations
• NegativeattitudesofhealthworkersonuseofPPEs.EginKarambiHCIII• ThecommunitiesstillhavefearsabouttheEVDvaccine• Prisonsneedinfra-redthermometers• Inadequatescreeningservicesat18PoEand6busterminals• Oneofthecontactsundergoingpsychosocialsupporthasrefusedtobevaccinated• Reluctancebymostprivateinstitutionstoprovidethenecessarysanitaryfacilitiessuchashandwashingfacilities• StockoutofIECmaterials• Inadequateriskcommunicationpersonnelonthegroundaswellastransportfortheteam
o NeedmoreriskcommunicationpersonnelfromMoH• Patientsgoingtoatraditionalhealer
o Needtoengagetraditionalhealersintheresponse
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Surveillancehasbeen intensified in thedistrict andCommunity awarenesshas alsoheightened. Transport challengeshavelessenedandthereismorepoliticalinvolvementintheresponse.
WeacknowledgethesupportfromthefollowingpartnersinresponsetoKaseseEbolaoutbreak.ThematicArea Partner
Coordination WHOSurveillance IRC,AFENET,WHO,CDC,UgandaRedCross
3. Conclusion
4. Partnerships
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Laboratory CDCUganda
RiskCommunication UNICEF,WHO,UPDF,BRAC-Uganda,USAIDCHC-Obulamu,URC,SavetheChildren,St.John’sAmbulance,
CaseManagement WHO,MSFInfectionPrevention&Control/WASH WHO,UNICEF,BaylorUganda,St.John’sAmbulance,Save
theChildren,UgandaRedCross,IRCPsychosocialSupport AFENET
Logistics WHO,UNICEF,BaylorUganda,WFP,UgandaRedCross,BRACUganda
Security UPDF,UgandaPolicePointsofEntry WHO,AFENET,UgandaRedCross,IRC,IOM
Vaccineandtherapeutics WHO,MSF
Screening at PoE Psychosocial team addressing the community
5. Pictorial
