The warning by the World Health Organisation that Tanzania and Kenya are likely hotspots for the plague that has hit Madagascar, coupled with the resurgence of the Marburg virus in eastern Uganda, should jolt the region’s health systems into immediate action.
The plague, which historically was responsible for high mortality — including causing more than 50 million deaths in Europe in the 14th century — is still a deadly disease. In Madagascar, more than 1,100 people have been infected, with 124 deaths reported since the disease broke out.
Fortunately, antibiotic treatment is effective against the plague bacteria, and it is possible to save lives with early diagnosis and early treatment.
The Marburg virus too is a highly fatal disease, caused by a virus from the same family as the one that causes Ebola, which claimed thousands of lives in Liberia in 2014 and 2015.
At least five cases of the Marburg virus have been reported in Kween district in eastern Uganda where an outbreak was declared on October 19.
Fortunately, Uganda’s Health Ministry quickly activated its systems to respond to the outbreak. With support from international partners, it moved to round up and place under observation people who have been in contact with those infected with the highly contagious disease. It has also put healthcare workers on high alert and provided protective equipment and initiated training for healthcare.
With the threat of the spread of the Marburg virus and the plague to East Africa, governments must be better prepared to not only prevent an outbreak, but to also manage any outbreak in an effective way to prevent deaths.
Screening and surveillance must be enhanced not only at airports and major border posts, but also within communities. Well-trained medical and community health workers should be vigilant within their communities to detect and present for quick diagnosis any patients who exhibit symptoms of the two diseases.
The threat also calls for governments to work with their partners to stockpile emergency drugs, including antibiotics for the plague, so that any outbreak is contained fast.
The situation also calls for increased investment in public health education. Citizens of the region must be made aware of the risk, and how to protect themselves from infection.
In Uganda, where there is a link between people who visited caves infected with bats and the disease, there is a need for public awareness campaigns to warn residents to avoid this kind of contact. In addition, traditional burial rites that cause contamination, both in the case the Marburg virus and the plague, should be discouraged.
Above all, the situation calls for effective and efficient health systems. This cannot be said of some of the countries in the region where prolonged labour disputes are threatening to roll back all the gains in primary health care.
Thus, in Kenya, a protracted strike by nurses has nearly crippled immunisation services, exposing children to preventable childhood diseases. A health emergency would be catastrophic.