Bubonic plague outbreak intensifies in Uganda

Saturday December 20 2008

By EVE MASHOO

The death toll from the bubonic plague in Uganda continues to rise as the government struggles to come up with a clear response even though early signs of the disease were detected at the beginning this year.

At least 68 people have died since February when the plague was first reported, and now health experts warn that it could spread rapidly in the absence of an adequate response from health workers and local communities. About 32,000 people are at risk of catching the disease if they do not take precautions.

The outbreak was initially restricted to one district but has now spread to two others, where 73 cases have been reported.

Arua District Health Officer Dr Patrick Anguzu said the area has been registering a few cases every year, but this year the numbers started rising, reaching alarming levels in August.

All the deaths are as a result of delays in seeking medical treatment as victims associate the disease with witchcraft and opt for traditional medicine, health officials claim.

Critics, however, say the government’s response, whose main thrust is behaviour change, is uncoordinated. It lacks the means to adequately educate the public, and funds have also not been allocated for these initiatives.

Dr William Mbabazi of the World Health Organisation said the rising rates of the epidemic are due to poor hygiene and sanitation because people do not clean their houses, allowing germ infected wild rats to find a conducive environment in dirty homes, thus spreading the deadly fleas.

Domestic rats then picking the fleas and due to their contact with humans, they pass on the disease.

Bubonic plague is not usually spread from one person to another, but rather from small rodents such as rats and mice to human beings.

Fleas that live on these animals act as ‘vectors’ and carry the infection from the rodents to humans once they are exposed to the bacteria from flea bites or from direct contact with an infected animal.

The plague, which mainly affects women and children, has spread into the districts of Arua and Nebbi, where residents still live in mud huts.

WHO says the casualties in these districts are victims of a cultural belief that women and children must sleep on the floor while the men sleep on beds.