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Paul Edward Okello, MSc, is an Epidemiologist/Microbiologist; Benon Kwesiga, MPH, is Field Supervisor; Susan Kizito, MSc, Steven N. Kabwama, MPH, and Daniel Kadobera, MSc, are Epidemiologists; all with the Uganda Public Health Fellowship Program, Ministry of Health, Kampala, Uganda. Robert Kaos Majwala, MA, is an Epidemiologist and Data Analyst, National Disease Control, Uganda Ministry of Health, and University Research Co, LLC, Center for Human Services, Kampala. Rosalia Kalani, MSc, is a Public Health Specialist, Disease Surveillance and Epidemic Response, Ministry of Health, Nairobi, Kenya. Lilian Bulage, MSc, is an Epidemiologist and Scientific Writer, African Field Epidemiology Network-Uganda Public Health Fellowship Program. Linus K. Ndegwa, PhD, is an Epidemiologist; Elizabeth Hunsperger, PhD, is Laboratory Director, Division of Global Health Protection; Sandra S. Chaves, MD, is Director, Influenza Program; and Marc-Alain Widdowson, VetMB, is Director, CDC-Kenya; all with CDC, Nairobi, Kenya. Dr. Widdowson is also Director, Institute of Tropical Medicine, Antwerp, Belgium. Henry Kajumbula, PhD, is Chair, Clinical Microbiology, Makerere University College of Health Sciences, Kampala, Uganda. Melvin Ochieng is a Biochemical Research Assistant, Kenya Medical Research Institute (KEMRI), Nairobi. Julie R. Harris, PhD, is Resident Advisor, Uganda Public Health Fellowship Program, Division of Global Health Protection, US Centers for Disease Control and Prevention (CDC), Kampala, Uganda. Bao-Ping Zhu, MD, is a Medical Epidemiologist, Center for Global Health, CDC, Atlanta, GA. Alex Riolexus Ario, PhD, is Director, Uganda National Institute of Public Health, Kampala. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the US Centers for Disease Control and Prevention.
Published: September 2020
AI Article Synopsis
Article Abstract
On February 22, 2017, Hospital X-Kampala and US CDC-Kenya reported to the Uganda Ministry of Health a respiratory illness in a 46-year-old expatriate of Company A. The patient, Mr. A, was evacuated from Uganda to Kenya and died. He had recently been exposed to dromedary camels (MERS-CoV) and wild birds with influenza A (H5N6). We investigated the cause of illness, transmission, and recommended control. We defined a suspected case of severe acute respiratory illness (SARI) as acute onset of fever (≥38°C) with sore throat or cough and at least one of the following: headache, lethargy, or difficulty in breathing. In addition, we looked at cases with onset between February 1 and March 31 in a person with a history of contact with Mr. A, his family, or other Company A employees. A confirmed case was defined as a suspected case with laboratory confirmation of the same pathogen detected in Mr. A. Influenza-like illness was defined as onset of fever (≥38°C) and cough or sore throat in a Uganda contact, and as fever (≥38°C) and cough lasting less than 10 days in a Kenya contact. We collected Mr. A's exposure and clinical history, searched for cases, and traced contacts. Specimens from the index case were tested for complete blood count, liver function tests, plasma chemistry, Influenza A(H1N1)pdm09, and MERS-CoV. Robust field epidemiology, laboratory capacity, and cross-border communication enabled investigation.
