Public health surveillance, outbreak investigations and response to an outbreak of a bleeding illness in Hoima and Buliisa districts, Western Uganda, Sep-Oct 2015

Introduction : on 17th September 2015, the Ugandan Ministry of Health received reports from Buliisa District about mysterious death of people. The predominant symptom was hematemesis (vomiting of blood). By September 24, 2015, there had been 4 deaths. We investigated to verify existence of an outbreak, determine mode of disease transmission, and identify risk factors. Methods : we conducted a community-based active case-finding in Hoima and Buliisa districts, Western Uganda between 3 and 17 October 2015. A suspected case was defined as a resident of Hoima, Buliisa or neighbouring districts who had onset of hematemesis between 1 June 2015 and 15 October 2015. A control was an individual without any history of hematemesis. Biological specimens were collected from 19 cases and tested for viral haemorrhagic fevers (VHFs), including Ebola, Marburg, Crimean-Congo Haemorrhagic Fever and Rift Valley Fever viruses. Histopathology and bacterial examinations were also conducted. In a case-control study, we compared exposures of 21 cases and 81 controls. We used Mantel-Haenszel method to estimate odds ratios (OR) associated with exposures.