Multidistrict Outbreak of Marburg Virus Disease - Uganda, 2012

Barbara Knust*, Ilana J. Schafer, Joseph Wamala, Luke Nyakarahuka, Charles Okot, Trevor Shoemaker, Kimberly Dodd, Aridth Gibbons, Stephen Balinandi, Alex Tumusiime, Shelley Campbell, Edmund Newman, Estrella Lasry, Hilde Declerck, Yap Boum, Issa Makumbi, Henry Kyobe Bosa, Anthony Mbonye, Jane Ruth Aceng, Stuart T. NicholUte Ströher, Pierre E. Rollin

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

30 Citations (Scopus)


In October 2012, a cluster of illnesses and deaths was reported in Uganda and was confirmed to be an outbreak of Marburg virus disease (MVD). Patients meeting the case criteria were interviewed using a standard investigation form, and blood specimens were tested for evidence of acute or recent Marburg virus infection by reverse transcription-polymerase chain reaction (RT-PCR) and antibody enzyme-linked immunosorbent assay. The total count of confirmed and probable MVD cases was 26, of which 15 (58%) were fatal. Four of 15 laboratory-confirmed cases (27%) were fatal. Case patients were located in 4 different districts in Uganda, although all chains of transmission originated in Ibanda District, and the earliest case detected had an onset in July 2012. No zoonotic exposures were identified. Symptoms significantly associated with being a MVD case included hiccups, anorexia, fatigue, vomiting, sore throat, and difficulty swallowing. Contact with a case patient and attending a funeral were also significantly associated with being a case. Average RT-PCR cycle threshold values for fatal cases during the acute phase of illness were significantly lower than those for nonfatal cases. Following the institution of contact tracing, active case surveillance, care of patients with isolation precautions, community mobilization, and rapid diagnostic testing, the outbreak was successfully contained 14 days after its initial detection.

Original languageEnglish
Pages (from-to)S119-S128
JournalJournal of Infectious Diseases
Publication statusPublished - 1 Oct 2015

Bibliographical note

Publisher Copyright:
© 2015 Published by Oxford University Press on behalf of the Infectious Diseases Society of America 2015. This work is written by (a) US Government employee(s) and is in the public domain in the US.


  • Marburg virus
  • filoviruses
  • hemorrhagic fever
  • outbreak response
  • zoonotic disease


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