Uganda isolates six in monkeypox scare

Uganda is flying to South Africa samples taken from six individuals – two of them Congolese refugees aged 2 and 12 – suspected to have contracted monkeypox ravaging non-endemic countries.

The samples are being taken for laboratory analysis to SA, some 4,800 kilometres away, because Uganda has no reagents and officials confirmed attempts to secure them from the neighbouring DR Congo are still unsuccessful.

Uganda Virus Research Institute (UVRI), an otherwise premier laboratory and virological research institute, said it commenced preliminary investigations after receiving information that half-a-dozen individuals had presented with signs and symptoms similar to that of monkeypox.

Two of the suspected cases have been isolated in the south-western Kisoro District, which borders the DR Congo and Rwanda, while four persons have been taken into isolation in Kampala City. 

Health workers managing the patients said they presented with elevated body temperatures and blisters, prompting them to take samples for tests to confirm or rule out monkeypox.

Prof Pontiano Kaleebu, the UVRI director, told this newspaper yesterday that they are sending the samples to South Africa for analysis because Uganda doesn’t have reagents to test them.

“We are making arrangements to send. There are four samples. We still don’t have reagents to test for the monkeypox virus here; that is why we are sending the samples [to South Africa],” he said.

Dr Julius Lutwama, a virologist at the Institute, said earlier that they have made a request to their partner institute at the University of Kinshasa in the DR Congo, to give them reagents for testing the monkeypox virus.  DR Congo has been grappling with the disease for years.

He saidt even after getting the reagents, they don’t plan to test everybody entering the country because it is not necessary.  “We will only test suspected cases,” Dr Lutwama said.

Dr Allan Muruta, the commissioner in charge of Epidemics at  the Ministry of Health, said they have registered “many suspected cases”.

“You should engage me after the laboratory test results. These are suspected cases. Monkeypox symptoms are similar to so many things including chicken pox. The suspected cases have been isolated,” he said.

But like Dr Lutwama, the commissioner said Ugandans do not have to worry much about the disease.

“It is a well-known virus. It has been around [in the neighbouring DR Congo] and it doesn’t cause much of a scare, it can be managed,” Dr Muruta said.

Two of the suspected cases have been registered among Congolese refugees, who have fled an onslaught by M23 rebels, and are camped at Nyakabande Refugee Transit Camp in Kisoro District.

Taking samples

The district health officer, Dr Stephen Nsabiyunva, on Thursday said the individuals have been isolated at Kisoro Hospital and their samples dispatched to UVRI for further examination.

“The suspected cases are of a child of about two years and another one is of a 12-year-old girl … their samples have been taken to the UVRI for examination,” he said.  News about the suspected cases is unsurprising, according to officials, citing detection in the country in the past of antibodies against the virus.

“Uganda is near the DR Congo and there are people who have antibodies [against monkeypox in Uganda], meaning there are people who crossed from there [DR Congo with the virus],” Dr Charles Olaro, the director of clinical services at the Ministry of Health, told this newspaper. 

This presence of antibodies against monkeypox means someone has been exposed to the virus, but their bodies defeated the bug. The details about the suspected cases in Kampala were scarce by press time.

In Kisoro, Dr Nsabiyunva said although they have not had any suspected cases of monkeypox among residents, they increased surveillance and screening of Congolese refugees that enter Uganda through Bunagana border post as a preventive measure and for early case detection.

“We are using temperature guns and the team of clinicians have been deployed to screen Congolese refugees that enter Uganda. Our thermo-scanner at Bunagana is faulty and we are waiting for the ministry of Health officials to help us in repairing it,” he revealed.

Kisoro Resident District Commissioner Shafique Sekandi warned locals to limit interactions with Congolese who cross through undesignated routes.

“Accommodating refugees in your homes is an offence because they can be a security, or a health, threat to the community members. Please encourage all the Congolese refugees that are staying in your communities to relocate to the Nyakabande Refugee Transit Camp where they are always screened for health and security before they are fully accommodated at the camp,” he said.

The RDC, who chairs the district security committee, added: “Anyone found hosting a refugee in his/her home shall be charged with aiding illegal entry while the Congolese refugees found staying in border communities shall be charged with illegal entry.”

He said about 169 Congolese refugees were on Wednesday received at Nyakabande after entering Uganda through Bunagana border post and a total number of Congolese refugees accommodated at the transit camp is 9,912.

Official records show that the cumulative number of Congolese refugees processed through Nyakabande Transit Camp since March 28 when heavy fighting erupted between the M23 rebels and the Congolese government soldiers is 28,531.

Security has been bolstered at Nyakabande camp with more law enforcement personnel, following reports that hundreds of Congolese escaped from the camp undetected.

Prevention

The World Health Organisation (WHO) has categorised monkeypox as a disease which is containable.

According to the Africa Centres for Disease Control (CDC) and the global health watchdog, monkeypox virus is transmitted to humans through close contact with blood, body fluids, respiratory droplets and contaminated materials such as bedding. Africa CDC notes that human infections also occur through the handling of infected monkeys, giant rats and squirrels, with rodents being the most likely reservoir of the virus.

The US and European countries with confirmed cases have reportedly ordered vaccines to inoculate their population against the virus. Last week, WHO said: “vaccination against smallpox has been shown to be protective .... While one vaccine (MVA-BN) and one specific treatment (tecovirimat) were approved for monkeypox in 2019 and 2022, respectively, these counter-measures are [not] yet widely available”.

    In an update, the UN health watchdog noted that 27 of its member countries in four regions that are not endemic for monkeypox virus, reported 780 laboratory confirmed cases and zero monkeypox death between May 13 and June 2, 2022.

   The WHO African Region, where the virus is endemic, between January 1 and June 1, reported sixty-six deaths out of the 1,408 suspected and 44 laboratory-confirmed cases.

Many countries in Africa lack facilities to test for the virus and they have not accessed the vaccines and drugs being used in developed countries to confront the bug.

  Health experts in Africa say there has been discrimination in the response to monkeypox response as the drugs and vaccines have been availed for people in developed countries in less than a year, yet African countries that have been grappling with the disease for decades didn’t get such remedies. The mortality rate of monkeypox is also higher than that of Covid in Africa, but health experts say the transmission rate is far below that of Covid-19.