Nebbi, Arua districts battle plague

There have been over 150 recorded cases of bubonic plague in Nebbi and Arua Districts, northwestern Uganda, as of the end of October, and at least 25 deaths, according to the latest humanitarian update from the UN office for the Coordination of Humanitarian Affairs (OCHA) in the Ugandan capital, Kampala. From 11 September, a plague outbreak in Nebbi has accounted for 82 or more cases, with 18 recorded deaths, mainly in the sub-counties of Zeu, Kango and Nyapea in Okoro County, according to the agency's humanitarian update to 31 October. In neighbouring Vurra County, Arua District, there were nine cases and two deaths in September, rising to 63 cases and four deaths by the end of October, it said. There was also a minor outbreak in Logiri sub-county (Arua District), which borders Nebbi and the Democratic Republic of Congo (DRC), with six cases and two deaths, it added. Bubonic plague is an acute infection - characterised by chills, exhaustion, delirium and inflammation of the lymph nodes - caused by the bite of a rat-flea infected by plague bacteria. There is no practical vaccination programme, but the disease is treatable, with 100 percent survival odds when detected and treated at an early stage. Sam Okware, a specialist in communicable diseases, said the Ministry of Health had sent a team of workers to the area to dust it with insecticides in an effort to kill the fleas that spread the plague, according to AFP news agency. "Our efforts are geared towards environmental sanitation, with the communities along the border [with DRC] being sensitised and mobilised to hunt down rats, but we have got some people from across the border coming to seek medication, which means that this problem exists there too," he said. Okware said heavy rains in the region bordering the DRC had aggravated the situation, which could only be fully addressed with cooperation from the authorities there. He said the Ugandan authorities were trying to coordinate their activities - particularly in in Zeu, Kango, Nyapea, Ayak and Pageya sub-counties of Nebbi District - with some international relief agencies active inside eastern DRC. The Ugandan Ministry of Health's Rapid Response Team, together with district health teams, had searched for and treated all cases, including their contacts; taken measures to control rats and fleas; and set up plague-control task forces at the district and village levels, OCHA reported in its October humanitarian update. The ministry had also conducted intensive health education, sanitation and environmental health/domestic hygiene campaigns; mobilised communities on plague prevention and control measures; and imposed quarantines on schools and markets in affected villages, it said. While there was no travel ban into or through these counties and sub-counties, OCHA advised that precautions to be taken should include: avoiding contact with rodents, as well as wild and domestic animals; avoid being bitten by fleas or bedbugs by using appropriate insecticides; aerating and ventilating sleeping quarters; and avoiding overcrowded places. Anyone attending to a plague patient, or suspected patient, should use a face-mask and protective gloves; and anyone who developed a high fever while in or after visiting a plague outbreak area should get an immediate health checkup and/or appropriate antibiotics, it added. Officials from the Uganda National Virus Institute were currently in the area concerned, sensitising the population and monitoring the situation, OCHA stated. One major need that had been highlighted was the chemicals needed to spray households to get rid of fleas, it said. "We're not yet out of danger and, therefore, remain vigilant," according to Okware.