Area hospitals designated isolation units for screening and isolating patients with suspected cases and collecting blood samples for testing at UVRI
. Health care workers were trained in patient management and infection control; and district veterinary officers reached out to farmers, especially those whose farms had seropositive animals, regarding tick control (e.g., dipping livestock in acaricide concentrates).
CDC-trained UVRI laboratory staff located in the town of Arua (in the Arua District) performed microbiological testing on clinical specimens, including blood cultures and bubo aspirates or sputum when available.
Upon notification from health facilities or community members regarding a suspected plague case, UVRI plague program staff immediately notified local public health officials and traveled to the reporting health facility to obtain additional information on the patient.
The authors are grateful to Professor Ogwal-Okeng of the Faculty of Medicine, Gulu University for technical advice; to Ms Namaganda of Department of Botany at Makerere University for plant identification; and to Dr Mukwaya of the Entomology Department of (UVRI
), Entebbe for the provision of mosquito larvae and Neemazal F extract.
After laboratory confirmation, a multidisciplinary team from UVRI and CDC-Uganda performed the initial outbreak investigations at Mengo Hospital and Mpigi Health Center IV.
We thank the staff at Mengo Hospital, Kampala, and Mpigi Health Center IV; the initial investigation team, which included members from UVRI and CDC-Uganda for field and laboratory investigation of the outbreak; the Ministry of Health National Task Force on Epidemic Preparedness and Response; World Health Organization; Kampala City Council Authority; Kasese and Mpigi local governments; CDC Uganda, CDC, and UVRI Motorpool for transportation; and Medecins Sans Frontieres for establishing an isolation ward at Mulago Hospital.
We thank UVRI
, the Uganda Ministry of Health, and UWA for their assistance during the outbreak investigation.
A blood sample collected at the hospital before the patient's death was transported to the US Centers for Disease Control/Uganda Virus Research Institute (CDC/ UVRI
) laboratory in Entebbe for diagnostic testing by reverse transcription PCR (RT-PCR), antigen-detection ELISA, and IgM for filoviruses as described (1-5).
The WHO Regional Measles Laboratory at Uganda Virus Research Institute (UVRI
) undertook the present study to isolate and characterize circulating measles strains in Uganda.
Mean (range) percentage of pairwise nucleotide divergence stratified by time period, subtype, and clinic (district) % Mean (range) Subtype by clinic (district) 1994-95 1997 Subtype A(a) UVRI(b) (Mpigi) 5.0 (3.6- 9.5) 7.7 (3.9-12.6) Mulago (Kampala) 7.3 (3.9-10.4) 8.3 (4.2-14.0) Nsambya (Kampala) 7.3 (3.9-11.7) 10.8(3.9-22.3) Subtype D UVRI
(Mpigi) 5.9 (3.1- 8.8) 8.0 (2.8-12.4) Mulago (Kampala) 7.9 (3.6-12.4) 6.7 (3.1- 9.8%) Nsambya (Kampala) 6.4 (3.3- 9.5) 8.5 (3.9-12.5) Subtype by clinic (district) Overall Subtype A(a) UVRI(b) (Mpigi) 6.4 (3.6-12.6) Mulago (Kampala) 7.8 (3.9-14.0) Nsambya (Kampala) 9.1 (3.9-22.3) Subtype D UVRI
(Mpigi) 6.9 (2.8-12.4) Mulago (Kampala) 7.2 (3.1-12.4) Nsambya (Kampala) 7.4 (3.3-12.5)