1. Rapid establishment of a frontline field laboratory in response to an imported outbreak of Ebola virus disease in western Uganda, June 2019
- Author
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Stuart T. Nichol, Amy J. Schuh, Fredrick Masereka, Joshua Kayiwa, Loice Kabyanga, Vance Brown, Lisa J. Nelson, Markus H Kainulainen, Oren Mayer, Celine H. Taboy, Esther Businge, Sophia Mulei, Joel M. Montgomery, James Graziano, Alphonse Gatare, Stephen Balinandi, Luke Nyakarahuka, Issa Makumbi, Samuel Muhindo, Julius J. Lutwama, Joseph Ojwang, Rastus Masereka, Jackson Kyondo, Raymond Mugabe, Monica Millard, William Lonergan, Milton Makoba Wetaka, Jimmy Baluku, John D. Klena, and Alex Tumusiime
- Subjects
Male ,RNA viruses ,Viral Diseases ,Research Facilities ,Epidemiology ,Disease ,Pathology and Laboratory Medicine ,Global Health ,medicine.disease_cause ,Disease Outbreaks ,Geographical Locations ,Medical Conditions ,Communicable Diseases, Imported ,Medicine and Health Sciences ,Global health ,Uganda ,Public and Occupational Health ,Child ,Travel ,GeneXpert MTB/RIF ,Academies and Institutes ,Middle Aged ,Infectious Diseases ,Medical Microbiology ,Child, Preschool ,Filoviruses ,Viral Pathogens ,Viruses ,Biological Assay ,Female ,Medical emergency ,Pathogens ,Ebola Virus ,Research Laboratories ,Research Article ,Neglected Tropical Diseases ,medicine.medical_specialty ,Universities ,Disease Surveillance ,World Health Organization ,Research and Analysis Methods ,Microbiology ,Ebola Hemorrhagic Fever ,World health ,Viral hemorrhagic fever ,parasitic diseases ,medicine ,Humans ,Microbial Pathogens ,Viral Hemorrhagic Fevers ,Ebola virus ,Biology and life sciences ,Hemorrhagic Fever Viruses ,business.industry ,Public health ,Organisms ,Public Health, Environmental and Occupational Health ,Outbreak ,Hemorrhagic Fever, Ebola ,Tropical Diseases ,medicine.disease ,United States ,People and Places ,Africa ,Laboratories ,business ,Government Laboratories - Abstract
The Democratic Republic of the Congo (DRC) declared an Ebola virus disease (EVD) outbreak in North Kivu in August 2018. By June 2019, the outbreak had spread to 26 health zones in northeastern DRC, causing >2,000 reported cases and >1,000 deaths. On June 10, 2019, three members of a Congolese family with EVD-like symptoms traveled to western Uganda’s Kasese District to seek medical care. Shortly thereafter, the Viral Hemorrhagic Fever Surveillance and Laboratory Program (VHF program) at the Uganda Virus Research Institute (UVRI) confirmed that all three patients had EVD. The Ugandan Ministry of Health declared an outbreak of EVD in Uganda’s Kasese District, notified the World Health Organization, and initiated a rapid response to contain the outbreak. As part of this response, UVRI and the United States Centers for Disease Control and Prevention, with the support of Uganda’s Public Health Emergency Operations Center, the Kasese District Health Team, the Superintendent of Bwera General Hospital, the United States Department of Defense’s Makerere University Walter Reed Project, and the United States Mission to Kampala’s Global Health Security Technical Working Group, jointly established an Ebola Field Laboratory in Kasese District at Bwera General Hospital, proximal to an Ebola Treatment Unit (ETU). The laboratory consisted of a rapid containment kit for viral inactivation of patient specimens and a GeneXpert Instrument for performing Xpert Ebola assays. Laboratory staff tested 76 specimens from alert and suspect cases of EVD; the majority were admitted to the ETU (89.3%) and reported recent travel to the DRC (58.9%). Although no EVD cases were detected by the field laboratory, it played an important role in patient management and epidemiological surveillance by providing diagnostic results in, Author summary Following an imported outbreak of Ebola virus disease in Uganda’s western Kasese District, the Uganda Virus Research Institute and the United States Centers for Disease Control and Prevention jointly established a frontline field laboratory to test specimens collected from alert and suspect cases for Ebola virus disease. Using a single room equipped with a rapid containment kit to safely inactivate patient specimens and a GeneXpert to perform the Xpert Ebola Assay, the field laboratory rapidly ruled-out Ebola virus disease as the cause of illness in 76 patients during its 46 operational days. All specimens were also referred to Uganda Virus Research Institute (Entebbe) for confirmatory Ebola virus testing and testing against a panel of viruses known to cause hemorrhagic fever in Uganda, in line with the National Viral Hemorrhagic Fever Program’s testing protocol and mandate. The Ebola field laboratory served as a valuable asset in the outbreak response by supporting patient management and epidemiological surveillance.
- Published
- 2021
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