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Barely a month after the World Health Organization (WHO), declared Uganda Ebola-free, scores of people in Luweero have been isolated following another outbreak. The outbreak was confirmed by the Uganda Virus Research Institute (UVRI) after two people belonging to the same family and a health worker died in Sombwe parish, Nyimbwa sub-county, Luweero district.

Currently, there are five suspects closely monitored by the ministry of Health surveillance team. This outbreak comes on the heels of a Marburg outbreak in Uganda that left over five people dead in south-western Uganda.

However, with the country’s on-and-off attacks, no drug has been approved to treat the Ebola or Marburg viruses. People diagnosed with Ebola or Marburg simply receive supportive care and treatment for complications.

WHO’s revised international health regulations require that countries establish core capacities to address such emergencies at national, sub-national, health facility and community level, as well as at border crossings. In effect, health experts have approved a “one-health approach” which integrates human, animal and environmental health in curbing such outbreaks.

“Previously, different professionals responded to disease outbreaks differently and in isolation but a one-health approach will promote integration of these sectors to ensure holistic and exhaustive management of the diseases,” Dr David Mukanga, the executive director of the African Epidemiology Network (AFENET), says.
He adds that the approach is necessary since 60% of the infectious diseases affecting humans like Ebola, Marburg, anthrax and brucellosis originate from animals. A case in point where the approach has proven effective is in the prevention of tuberculosis and scabies in Bwindi.

However, implementation of the concept requires a new calibre of professionals with skills to monitor, detect, report, manage and prevent diseases which cut across the three sectors.

Dr Thomas Easley, the country coordinator for the Emerging Pandemic Threats (EPT) programme says  such a solution must centre on education. Government and its stakeholders must train professionals in the one-health approach.

“It is clear that no one discipline has enough knowledge to prevent the emergence or re-emergence of diseases,” he said.

“Only by breaking down the barriers among agencies, individuals and specialities can we unleash the innovation and expertise needed to meet the integrity of eco systems.”

In June this year, AFENET graduated six professionals trained in one-health approach.

Ebola

Ebola haemorrhagic fever may be caused by any of four of the five known Ebola viruses, namely:  the Zaire Ebola Virus, the Sudan Ebola Virus, the Taï Forest virus, more commonly called Côte d’Ivoire Ebola Virus and more recently the Bundibugyo Ebola Virus.

The Zaire virus has the highest fatality rate (up to 90% in some epidemics.) There have been more outbreaks of Zaire Ebola virus than of any other species. Transmission has been attributed to reuse of unsterilized needles and close personal contact.

On 24 November 2007, the Uganda ministry of Health confirmed an outbreak of Ebola Virus in the Bundibugyo district and this time it is being contained in Luweero district, Bombo and Mulago hospital.

Marburg

Marburg haemorrhagic  fever is a severe illness caused by the Marburg virus. It was first described in 1967 during outbreaks in Germany and the former Yugoslavia that were linked to monkeys imported from Uganda.

The largest Marburg outbreak recorded to date began in late 1998 in north-eastern Democratic Republic of the Congo (DRC). The natural reservoir for the Marburg virus remains unknown, although it is presumed to be of animal origin.

“Primary transmission of the virus from the natural reservoir appears to occur only in sub-Saharan Africa and is sometimes followed by secondary person-to-person transmission in both community and health facility settings,” Dr Ambrose Talisuna, former head of the Epidemiology and Surveillance Division at the ministry of Health, says.

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