title: Multidistrict Outbreak of Marburg Virus Disease-Uganda, 2012.
abstract: In October 2012, a cluster of illnesses and deaths was reported in Uganda and was confirmed to be an outbreak of Marburg virus disease (MVD). Patients meeting the case criteria were interviewed using a standard investigation form, and blood specimens were tested for evidence of acute or recent Marburg virus infection by reverse transcription-polymerase chain reaction (RT-PCR) and antibody enzyme-linked immunosorbent assay. The total count of confirmed and probable MVD cases was 26, of which 15 (58%) were fatal. Four of 15 laboratory-confirmed cases (27%) were fatal. Case patients were located in 4 different districts in Uganda, although all chains of transmission originated in Ibanda District, and the earliest case detected had an onset in July 2012. No zoonotic exposures were identified. Symptoms significantly associated with being a MVD case included hiccups, anorexia, fatigue, vomiting, sore throat, and difficulty swallowing. Contact with a case patient and attending a funeral were also significantly associated with being a case. Average RT-PCR cycle threshold values for fatal cases during the acute phase of illness were significantly lower than those for nonfatal cases. Following the institution of contact tracing, active case surveillance, care of patients with isolation precautions, community mobilization, and rapid diagnostic testing, the outbreak was successfully contained 14 days after its initial detection.
authors.affiliation: Viral Special Pathogens Branch, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Barbara
authors.initials: B
authors.lastname: Knust
authors.affiliation: Viral Special Pathogens Branch, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Ilana J
authors.initials: IJ
authors.lastname: Schafer
authors.affiliation: Uganda Ministry of Health.
authors.forename: Joseph
authors.initials: J
authors.lastname: Wamala
authors.affiliation: Uganda Virus Research Institute.
authors.forename: Luke
authors.initials: L
authors.lastname: Nyakarahuka
authors.affiliation: World Health Organization.
authors.forename: Charles
authors.initials: C
authors.lastname: Okot
authors.affiliation: Viral Special Pathogens Branch, Centers for Disease Control and Prevention, Entebbe.
authors.forename: Trevor
authors.initials: T
authors.lastname: Shoemaker
authors.affiliation: Viral Special Pathogens Branch, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Kimberly
authors.initials: K
authors.lastname: Dodd
authors.affiliation: Viral Special Pathogens Branch, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Aridth
authors.initials: A
authors.lastname: Gibbons
authors.affiliation: Viral Special Pathogens Branch, Centers for Disease Control and Prevention, Entebbe.
authors.forename: Stephen
authors.initials: S
authors.lastname: Balinandi
authors.affiliation: Viral Special Pathogens Branch, Centers for Disease Control and Prevention, Entebbe.
authors.forename: Alex
authors.initials: A
authors.lastname: Tumusiime
authors.affiliation: Viral Special Pathogens Branch, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Shelley
authors.initials: S
authors.lastname: Campbell
authors.affiliation: Microbiology Services- Research, Public Health England, Porton Down, United Kingdom.
authors.forename: Edmund
authors.initials: E
authors.lastname: Newman
authors.affiliation: Médecins Sans Frontières, New York, New York.
authors.forename: Estrella
authors.initials: E
authors.lastname: Lasry
authors.affiliation: Médecins Sans Frontières, Brussels, Belgium.
authors.forename: Hilde
authors.initials: H
authors.lastname: DeClerck
authors.affiliation: EpiCentre, Mbarara, Uganda.
authors.forename: Yap
authors.initials: Y
authors.lastname: Boum
authors.affiliation: Uganda Ministry of Health.
authors.forename: Issa
authors.initials: I
authors.lastname: Makumbi
authors.affiliation: Uganda Ministry of Health Uganda People Defense Force, Kampala.
authors.forename: Henry Kyobe
authors.initials: HK
authors.lastname: Bosa
authors.affiliation: Uganda Ministry of Health.
authors.forename: Anthony
authors.initials: A
authors.lastname: Mbonye
authors.affiliation: Uganda Ministry of Health.
authors.forename: Jane Ruth
authors.initials: JR
authors.lastname: Aceng
authors.affiliation: Viral Special Pathogens Branch, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Stuart T
authors.initials: ST
authors.lastname: Nichol
authors.affiliation: Viral Special Pathogens Branch, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Ute
authors.initials: U
authors.lastname: Ströher
authors.affiliation: Viral Special Pathogens Branch, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Pierre E
authors.initials: PE
authors.lastname: Rollin
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008379:Marburg Virus Disease / Q000453:epidemiology* / Q000821:virology; D029024:Marburgvirus / Q000302:isolation & purification*; D008875:Middle Aged; D014454:Uganda / Q000453:epidemiology; D055815:Young Adult
keywords: Marburg virus; filoviruses; hemorrhagic fever; outbreak response; zoonotic disease