Uganda’s Swift Response to Monkeypox Outbreak: A Model for Disease Control
By The Public Lens
Uganda’s health authorities have demonstrated a swift and effective response to the detection of two imported cases of Monkeypox in Kasese District.
The Ministry of Health’s rapid confirmation of the cases, followed by the deployment of a rapid response team to the affected area, highlights the country’s commitment to disease control and prevention.
The two cases, identified among six suspected cases at Bwera border, were confirmed on July 24, 2024, after testing by the Uganda Virus Research Institute (UVRI).
The infected individuals, a 37-year-old Ugandan woman and a 22-year-old Congolese woman, exhibited symptoms consistent with Mpox, including skin rashes, swollen lymph nodes, and general malaise.
According to the Ministry of Health, the cases were imported from the Democratic Republic of Congo (DRC), where Mpox has been reported in nearly all provinces.
However, the Ministry has assured that no local transmission of the virus has occurred in Uganda, and no secondary cases have been linked to the two imported cases.
The rapid response team, sent to Kasese District, is working closely with local teams to manage and control the situation.
Nine contacts of the confirmed cases are being monitored, and the Ministry is maintaining a close watch on the situation in the DRC to prevent further spread of the virus.
Uganda’s swift response to the Monkeypox outbreak serves as a model for disease control, demonstrating the importance of prompt action and collaboration between health authorities and local communities.
As Mpox continues to spread globally, Uganda’s proactive approach may help prevent further transmission and protect public health.
Overview of Mpox
Mpox (monkeypox) is an infectious disease caused by the monkeypox virus. It can cause a painful rash, enlarged lymph nodes and fever. Most people fully recover, but some get very sick.
Anyone can get mpox. It spreads from contact with infected:
- persons, through touch, kissing, or sex
- animals, when hunting, skinning, or cooking them
- materials, such as contaminated sheets, clothes or needles
- pregnant persons, who may pass the virus on to their unborn baby.
Transmission
Person-to-person transmission of mpox can occur through direct contact with infectious skin or other lesions such as in the mouth or on genitals; this includes contact which is
- face-to-face (talking or breathing)
- skin-to-skin (touching or vaginal/anal sex)
- mouth-to-mouth (kissing)
- mouth-to-skin contact (oral sex or kissing the skin)
- respiratory droplets or short-range aerosols from prolonged close contact
The virus then enters the body through broken skin, mucosal surfaces (e g oral, pharyngeal, ocular, genital, anorectal), or via the respiratory tract. Mpox can spread to other members of the household and to sex partners. People with multiple sexual partners are at higher risk.
Animal to human transmission of mpox occurs from infected animals to humans from bites or scratches, or during activities such as hunting, skinning, trapping, cooking, playing with carcasses, or eating animals. The extent of viral circulation in animal populations is not entirely known and further studies are underway.
People can contract mpox from contaminated objects such as clothing or linens, through sharps injuries in health care, or in community setting such as tattoo parlours.
Signs and symptoms
Mpox causes signs and symptoms which usually begin within a week but can start 1–21 days after exposure. Symptoms typically last 2–4 weeks but may last longer in someone with a weakened immune system.
Common symptoms of mpox are:
- rash
- fever
- sore throat
- headache
- muscle aches
- back pain
- low energy
- swollen lymph nodes.
For some people, the first symptom of mpox is a rash, while others may have different symptoms first.
The rash begins as a flat sore which develops into a blister filled with liquid and may be itchy or painful. As the rash heals, the lesions dry up, crust over and fall off.
Some people may have one or a few skin lesions and others have hundreds or more. These can appear anywhere on the body such as the:
- palms of hands and soles of feet
- face, mouth and throat
- groin and genital areas
- anus.
Some people also have painful swelling of their rectum or pain and difficulty when peeing.
People with mpox are infectious and can pass the disease on to others until all sores have healed and a new layer of skin has formed.
Children, pregnant people and people with weak immune systems are at risk for complications from mpox.
Typically for mpox, fever, muscle aches and sore throat appear first. The mpox rash begins on the face and spreads over the body, extending to the palms of the hands and soles of the feet and evolves over 2-4 weeks in stages – macules, papules, vesicles, pustules. Lesions dip in the centre before crusting over. Scabs then fall off. Lymphadenopathy (swollen lymph nodes) is a classic feature of mpox. Some people can be infected without developing any symptoms.
In the context of the global outbreak of mpox which began in 2022 (caused mostly by Clade IIb virus), the illness begins differently in some people. In just over a half of cases, a rash may appear before or at the same time as other symptoms and does not always progress over the body. The first lesion can be in the groin, anus, or in or around the mouth.
People with mpox can become very sick. For example, the skin can become infected with bacteria leading to abscesses or serious skin damage. Other complications include pneumonia, corneal infection with loss of vision; pain or difficulty swallowing, vomiting and diarrhoea causing severe dehydration or malnutrition; sepsis (infection of the blood with a widespread inflammatory response in the body), inflammation of the brain (encephalitis), heart (myocarditis), rectum (proctitis), genital organs (balanitis) or urinary passages (urethritis), or death. Persons with immune suppression due to medication or medical conditions are at higher risk of serious illness and death due to mpox. People living with HIV that is not well-controlled or treated more often develop severe disease.
Self-care and prevention
Most people with mpox will recover within 2–4 weeks. Things to do to help the symptoms and prevent infecting others:
Do
- stay home and in your own room if possible
- wash hands often with soap and water or hand sanitizer, especially before or after touching sores
- wear a mask and cover lesions when around other people until your rash heals
- keep skin dry and uncovered (unless in a room with someone else)
- avoid touching items in shared spaces and disinfect shared spaces frequently
- use saltwater rinses for sores in the mouth
- take sitz baths or warm baths with baking soda or Epsom salts for body sores
- take over-the-counter medications for pain like paracetamol (acetaminophen) or ibuprofen.
Do not
- pop blisters or scratch sores, which can slow healing, spread the rash to other parts of the body, and cause sores to become infected; or
- shave areas with sores until scabs have healed and you have new skin underneath (this can spread the rash to other parts of the body).
To prevent spread of mpox to others, persons with mpox should isolate at home, or in hospital if needed, for the duration of the infectious period (from onset of symptoms until lesions have healed and scabs fall off). Covering lesions and wearing a medical mask when in the presence of others may help prevent spread. Using condoms during sex will help reduce the risk getting mpox but will not prevent spread from skin-to-skin or mouth-to-skin contact.
