Rift Valley fever (RVF) cases have simultaneously been confirmed in two districts in the western region of Uganda, with further investigation of another case in third district going on.
The first case-patient was a 47-year-old male from Kanyatsi village in Munkunyu sub-county, Kasese District, whose main occupation was as a butcher. He fell ill on 20 June 2018 with symptoms of fever and headache, and self-administered antimalarial treatment. The case-patient died at home on the evening of 21 June 2018, with the body oozing blood from multiple orifices. The district health authority collected a nasal swab (posthumous) on notification of the death and the specimen was sent to the Uganda Virus Research Institute (UVRI) on 25 June 2018. The test result released on 28 June 2018 was positive for RVF by reverse transcriptase-polymerase chain reaction (RT-PCR).
The second case-patient was a 35-year-old male casual labourer and herdsman from Kabare village in Isingiro town council, Isingiro District. The village is located near Lake Nakivale and borders Lake Mburo National park. On 25 June 2018, he developed fever, headache, and anorexia, which was followed by epistaxis. He presented to the local health facility the same day, but was immediately referred to the regional referral hospital because of the severity of his illness and suspicion of a viral haemorrhagic disease. The case-patient was admitted in the isolation unit. A blood specimen was obtained and shipped to UVRI on 26 June 2018. The test result released by UVRI on 28 June 2018 was positive for RVF on RT-PCR. The case-patient died on 30 June 2018 and a supervised burial was carried out.
There is a report of another confirmed RVF case in Ibanda District, on which more information is being sought. Two other suspected cases are reportedly being investigated in Mbarara (1) and Kasese (1) districts.
This outbreak has occurred at a time when Kenya is reporting a large RVF outbreak and Rwanda is experiencing an epizootic, with suspected human cases. The affected districts in Uganda fall within the cattle corridor, stretching from the south-western, through central to north-eastern parts of the country.
Rift Valley Fever is mosquito-borne virus that is endemic in parts of Africa. It primarily infects animals like sheep, cattle and goats and it can have an economic impact on a community due to the loss of livestock.
Humans get infected through contact with infected animal blood or organs. Butchering and slaughtering of animals is a primary cause of transmission to humans. Certain occupations are at a higher risk of getting Rift Valley Fever like farmers, herders and veterinarians.
It can also be transmitted to humans through mosquito bites and the bites of blood-sucking flies.
Most cases of Rift Valley Fever are mild and symptoms include fever, headaches and muscle pain. However, a small percentage of people can get serious disease which includes retinitis, encephalitis and a hemorrhagic fever. Fatalities happen in less than 1 percent of those infected.