Prompt response to a cross-border plague outbreak in Zombo District, minimized spread, Uganda, March 2019

Introduction: Plague, which is caused by the bacterium Yersinia pestis, is a priority zoonotic disease targeted for elimination in Uganda. On 6 March 2019, the Uganda Ministry of Health was notified of a patient in Zombo District with clinical presentation similar to pneumonic plague, and a positive plague rapid diagnostic test (RDT). We determined the scope of the outbreak, determined the mode of transmission, and recommended evidence-based control and prevention measures. Methods: A suspected pneumonic plague case was one with two or more of the following signs and symptoms: cough (bloody or wet), chest pain, difficulty in breathing, or fever in a resident of Zombo District during February 1-March 31, 2019. A confirmed case was a suspected case testing positive for Yersinia pestis by rapid diagnostic test, culture or serology. We actively searched for case-patients, traced contacts and took samples as appropriate. We performed descriptive epidemiology of the outbreak. Results: We identified one suspected and one confirmed pneumonic plague case. On February 26, 2019, a 4-year-old boy was buried in DRC near the Uganda border after succumbing to bubonic plague. Case-patient A (35-year-old mother to the boy), fell ill with suspected pneumonic plague while attending to him. She was referred to a health facility in Uganda on February 28 but died on arrival. On March 4, Case-patient B (23-year-old sister to Case-patient A), presented with pneumonic plague symptoms to the same Uganda facility and tested plague-positive by RDT, culture, and serological tests. Contacts (n=114) were traced and given prophylaxis; no new cases were reported. Conclusion: This fatal plague outbreak started as bubonic and later manifested as pneumonic. There was cross-border spread from DRC to Uganda with no cross-border efforts at prevention and control. Person-to-person transmission appears to have occurred. The quick and effective response likely minimized spread

Anthrax bio-surveillance of livestock in Arua District, Uganda, 2017-2018

Altres ajuts: acords transformatius de la UABThe authors would like to express their gratitude to the local Sub-County chiefs, district veterinary officers, community elders, and kraal leaders for being supportive during data collection. Author JG has received mobility support from Universitat Autònoma de Barcelona (action Erasmus+ KA107 Mobility Fellowship) and was supported by the Generalitat de Catalunya, Agency for Management of University and Research Grants co-financed with the European Social Found (grants for the recruitment of new research staff 2018 FI_B 00236). Authors RAO, ME, MA, MFN, MI, EI, MM, LP, BS, and SAA were funded by Livestock Disease Control project II.Anthrax, caused by Bacillus anthracis, is a widespread zoonotic disease with many human cases, especially in developing countries. Even with its global distribution, anthrax is a neglected disease with scarce information about its actual impact on the community level. Due to the ecological dynamics of anthrax transmission at the wildlife-livestock interface, the Sub-Saharan Africa region becomes a high-risk zone for maintaining and acquiring the disease. In this regard, some subregions of Uganda are endemic to anthrax with regular seasonal trends. However, there is scarce data about anthrax outbreaks in Uganda. Here, we confirmed the presence of B. anthracis in several livestock samples after a suspected anthrax outbreak among livestock and humans in Arua District. Additionally, we explored the potential risk factors of anthrax through a survey within the community kraals. We provide evidence that the most affected livestock species during the Arua outbreak were cattle (86%) compared to the rest of the livestock species present in the area. Moreover, the farmers' education level and the presence of people's anthrax cases were the most critical factors determining the disease's knowledge and awareness. Consequently, the lack of understanding of the ecology of anthrax may contribute to the spread of the infection between livestock and humans, and it is critical to reducing the presence and persistence of the B. anthracis spores in the environment. Finally, we discuss the increasingly recognized necessity to strengthen global capacity using a One Health approach to prevent, detect, control, and respond to public threats in Uganda