Investigation of Highly Pathogenic Avian Influenza (HPAI) Outbreak at the Shores of Lake Victoria, Uganda

Tuesday, 6 June 2017 - 11:10am
OHCEA Network Country: 

On 16th January 2017, the Ministry of Health declared an outbreak of Highly Pathogenic Avian Influenza, HPAI (H5N1) that was later confirmed to be H5N8 and on 30th January 2017. In order to offer support to field teams and also train students through experiential learning, on the 26th of January 2017 the One Health Central and East Africa (OHCEA) sent out multidisciplinary team of students. The objective of this multidisciplinary team of One Health Club students was to conduct a risk assessment of the HPAI problem in suspected districts using a one health approach. Students acquired skills in outbreak planning, community mobilization and sensitization, alerts investigation, PPE donning and doffing and reporting and communication.

On January 2rd, 2017, Uganda Wild Life  Education  Center  (UWEC) received reports from fishermen about  the  massive  death  of  wild  birds  (White Winged Black Terns) at Lutembe bay in Wakiso district. The Zoonotic Disease Coordination Office (ZDCO) was alerted on January 3rd, 2017. On January 5th, 2017 a multi-disciplinary team from the Ministry of Health (MOH), Ministry of Agriculture, Animal Industry and Fisheries (MAAIF), Ministry of Water and Environment, Ministry of Internal Affairs, Government Analytical Laboratory, Uganda Wildlife Authority, Makerere University Walter Reed Project and UWEC visited the suspected areas. The objective was to establish the magnitude of the problem, affected species, cause of death and to collect samples for laboratory analysis.  

On January 13th, 2017, another report was received from Masaka about the death of wild birds and poultry in Bukakata sub-county, Bukibanga Parish and Kachanga village. Carcasses of the wild birds from both Masaka and Wakiso were delivered to the National Animal Disease Diagnostic and Epidemiology Center (NADDEC) and Uganda Virus Research Institute (UVRI) in Entebbe and all were positive for Highly Pathogenic Avian Influenza (HPAI). Similar reports of massive death of both domestic and wild birds were reported through the Ministry of Health from Kalangala district (On 16th January 2017), Nakasongola district (On 23rd January) and in Mukono (24th January).

On 16th January 2017, the Ministry of Health declared an outbreak of HPAI (H5N1) through the Director General Health Services as per attached press release. However, this was later confirmed to be H5N8 and an outbreak of HPAI (H5N8) was declared on 30th January 2017. In order to offer support to field teams and also train students through experiential learning, on the 26th of January 2017 the One Health Central and East Africa (OHCEA) sent out multidisciplinary team of students. The objective of this multidisciplinary team of One Health Club students was to conduct a risk assessment of the HPAI problem in suspected districts using a one health approach.

List of students and areas of specialization

  1. Obwoya Jimmy - Veterinary Medicine (Undergraduate)
  2. Jonah Ainembabzi - Law
  3. Kizito Kakule - Wild Life Health & Management (MSc)
  4. Atianjoh Walters Asonoh- Veterinary Preventive Medicine (Msc)
  5. Ekuka Godfrey- Infectious Disease Management (Msc)
  6. Mawejje Charles- Public Health
  7. Namata Jessica - Public Health

The students were supervised by Makerere University faculty and other experts from Ministry of Health National One Health Platform. They included; Dr. Musa Sekamatte, Ms. Edwinah Atusingwize, Dr. Kato Charles Drago.

The key objective for this activity was to conduct a risk assessment of the Highly Pathogenic Avian Influenza (HPAI) outbreak in suspected districts using a One Health approach.

The key achievements are highlighted under each theme as here below;

Participation in stakeholders planning meetings: The One Health club students had the opportunity to participate in stakeholders planning meetings in Nakasongola district. These meetings were attended by multidisciplinary teams that were key at different levels of the outbreak investigation and law enforcement. The team comprised members from UWEC, UVRI, NADDEC, MAAIF, MOH, farmers, fishermen, the police and poultry product traders. Such meetings prior to field escalations were important for students to appreciate the diverse roles of multidisciplinary teams during disease outbreak investigation

Risk factor assessment:   The One Health club students participated in interviewing key members in the community so as to investigate the risk factors to the outbreak. The team visited a number of sites that had reported death of wild birds and on investigation especially in Nakasongola found that birds had died of other causes related to mining. This training was important to equip students with skills in investigation of outbreak alerts and advising the ministry accordingly.

Use of protective gear (PPE) during sample collection: At every site, samples of dead wild and domestic birds were collected for onsite post-mortem analysis and others transported to UVRI and NADDEC for laboratory analysis.  The One Health team started with a training on donning and doffing of Personal Protective Equipment (PPE) that was a must before any sample collection could be done. The students were also trained in the preparation of disinfectants for field use by following the recommended dilutions. This activity was important in equipping students with skills the biosafety measures during outbreak investigations.

Report writing skills: The One Health club students were tasked with writing daily situation reports during the outbreak so as to support the district team. The students further participated in compiling the different situation reports so as to produce a final report.