Browsing by Author "Bwogi, Josephine"
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Item Achieving measles control: lessons from the 2002–06 measles control strategy for Uganda(Health policy and planning, 2002) Mbabazi, William B.; Nanyunja, Miriam; Makumbi, Issa; Braka, Fiona; Baliraine, Frederick N.; Kisakye, Annet; Bwogi, Josephine; Mugyenyi, Possy; Kabwongera, Eva; Lewis, Rosamund F.The 2002–06 measles control strategy for Uganda was implemented to strengthen routine immunization, undertake large-scale catch-up and follow-up vaccination campaigns, and to initiate nationwide case-based, laboratory-backed measles surveillance. This study examines the impact of this strategy on the epidemiology of measles in Uganda, and the lessons learnt. Methods Number of measles cases and routine measles vaccination coverage reported by each district were obtained from the National Health Management Information System reports of 1997 to 2007. The immunization coverage by district in a given year was calculated by dividing the number of children immunized by the projected population in the same age category. Annual measles incidence for each year was derived by dividing the number of cases in a year by the mid-year projected population. Commercial measles IgM enzyme-linked immunoassay kits were used to confirm measles cases.Item Descriptive epidemiology of rubella disease and associated virus strains in Uganda(Journal of Medical Virology, 2020) Tushabe, Phionah; Bwogi, Josephine; Abernathy, Emily; Birungi, Molly; Eliku, James P.; Seguya, Ronald; Bukenya, Henry; Namuwulya, Prossy; Kakooza, Proscovia; Suppiah, Suganthi; Kabaliisa, Theopista; Tibanagwa, Mayi; Ampaire, Immaculate; Kisakye, Annet; Bakainaga, Andrew; Byabamazima, Charles R.; Icenogle, Joseph P.; Bakamutumaho, BarnabasRubella virus causes a mild disease; however, infection during the first trimester of pregnancy may lead to congenital rubella syndrome (CRS) in over 80% of affected pregnancies. Vaccination is recommended and has been shown to effectively reduce CRS incidence. Uganda plans to introduce routine rubella vaccination in 2019. The World Health Organization recommends assessing the disease burden and obtaining the baseline molecular virological data before vaccine introduction. Sera collected during case‐based measles surveillance from January 2005 to July 2018 were tested for rubella immunoglobulin M (IgM) antibodies. Sera from confirmed rubella outbreaks from January 2012 to August 2017 were screened using real‐time reverse‐transcription polymerase chain reaction (RT‐PCR); for positive samples, a region within the E1 glycoprotein coding region was amplified and sequenced. Of the 23 196 suspected measles cases serologically tested in parallel for measles and rubella, 5334 (23%) were rubella IgM‐positive of which 2710 (50.8%) cases were females with 2609 (96.3%) below 15 years of age. Rubella IgM‐positive cases were distributed throughout the country and the highest number was detected in April, August, and November. Eighteen (18%) of the 100 sera screened were real‐time RTPCR‐ positive of which eight (44.4%) were successfully sequenced and genotypes 1G and 2B were identified. This study reports on the seroprevalence and molecular epidemiology of rubella. Increased knowledge of former and current rubella viruses circulating in Uganda will enhance efforts to monitor the impact of vaccination as Uganda moves toward control and elimination of rubella and CRS.Item Emerging epidemic of iatrogenic Acute Flaccid Paralysis in children under 15 years in Uganda(Pan African Medical Journal, 2012) Kisakye, Annet; Ndungutse, David; Byarugaba, Justus; Naddumba, Edward.K.; Mbabazi, William; Bakamutumaho, Barnabas; Bwogi, Josephine; Bakainaga, Andrew; Seruyange, Rachel; Mwesigye, Innocent; Ndugwa, Christopher M.Poliomyelitis a differential diagnosis of Acute Flaccid Paralysis (AFP) is a major disability. The prevalence of AFP associated with an intramuscular gluteal injection (s) among children below 15 years of age with fever reported through the AFP surveillance system between 2002 and 2008 in Uganda was studied. Methods A cross sectional study using AFP surveillance data. Any child aged below 15 years, who developed sudden flaccid paralysis between 1st January 2002 and 31st December 2008 was enrolled. NPEC conducted a desk review of completed AFP investigation forms for final classification. A case of an Injection Related Paralysis was defined as sudden onset of flaccid paralysis setting in within 72 hours of receipt of a gluteal intramuscular injection.Item Epidemiology and Surveillance of Influenza Viruses in Uganda between 2008 and 2014(PLoS ONE, 2016) Wabwire-Mangen, Fred; Mimbe, Derrick E.; Erima, Bernard; Mworozi, Edison A.; Millard, Monica; Kibuuka, Hannah; Lukwago, Luswa; Bwogi, Josephine; Kiconco, Jocelyn; Tugume, Titus; Mulei, Sophia; Ikomera, Christine; Tsui, Sharon; Malinzi, Stephen; Kasasa, Simon; Coldren, Rodney; Byarugaba, Denis K.Influenza surveillance was conducted in Uganda from October 2008 to December 2014 to identify and understand the epidemiology of circulating influenza strains in out-patient clinic attendees with influenza-like illness and inform control strategies. Methodology Surveillance was conducted at five hospital-based sentinel sites. Nasopharyngeal and/or oropharyngeal samples, epidemiological and clinical data were collected from enrolled patients. Real-time reverse transcription polymerase chain reaction (RT-PCR) was performed to identify and subtype influenza strains. Data were double-entered into an Epi Info 3.5.3 database and exported to STATA 13.0 software for analysis. Results Of the 6,628 patient samples tested, influenza virus infection was detected in 10.4% (n = 687/ 6,628) of the specimens. Several trends were observed: influenza circulates throughout the year with two peaks; the major one from September to November and a minor one from March to June. The predominant strains of influenza varied over the years: Seasonal Influenza A(H3) virus was predominant from 2008 to 2009 and from 2012 to 2014; Influenza A (H1N1)pdm01 was dominant in 2010; and Influenza B virus was dominant in 2011. The peaks generally coincided with times of higher humidity, lower temperature, and higher rainfall. Conclusion Influenza circulated throughout the year in Uganda with two major peaks of outbreaks with similar strains circulating elsewhere in the region. Data on the circulating strains of influenza and its patterns of occurrence provided critical insights to informing the design and timing of influenza vaccines for influenza prevention in tropical regions of sub-Saharan Africa.Item The epidemiology of rotavirus disease in under-five-year-old children hospitalized with acute diarrhea in central Uganda, 2012-2013(Archives of virology, 2016) Bwogi, Josephine; Malamba, Samuel; Kigozi, Brian; Namuwulya, Prossy; Tushabe, Phionah; Kiguli, Sarah; Karuhize Byarugaba, Denis; Desselberger, Ulrich; Iturriza-Gomara, Miren; Karamagi, CharlesA cross-sectional study was undertaken during 2012-2013 to determine the prevalence, strains and factors associated with rotavirus infection among under-5-year-old children hospitalized with acute diarrhea in Uganda. Rotaviruses were detected in 37 % (263/712) of the children. The most prevalent strains were G9P[8] (27 %, 55/204) and G12P[4] (18.6 %, 38/204). Mixed infections were detected in 22.5 % (46/204) of the children. The study suggests that consumption of raw vegetables (OR = 1.45, 95 % CI = 1.03-2.03) and family ownership of dogs (OR = 1.9, 95 % CI = 1.04-3.75) increases the risk of rotavirus infection. The study findings will be used to assess the impact of RV vaccination in Uganda.Item Genetic analysis of influenza B viruses isolated in Uganda during the 2009–2010 seasons(Virology Journal, 2013) Byarugaba, Denis K.; Erima, Bernard; Millard, Monica; Kibuuka, Hannah; Lukwago, L.; Bwogi, Josephine; Mimbe, Derrick; Mworozi, Edison A.; Sharp, Bridget; Krauss, Scott; Webby, Richard J.; Webster, Robert G.; Martin, Samuel K.; Wabwire-Mangen, Fred; Ducatez, Mariette F.Influenza B viruses can cause morbidity and mortality in humans but due to the lack of an animal reservoir are not associated with pandemics. Because of this, there is relatively limited genetic sequences available for influenza B viruses, especially from developing countries. Complete genome analysis of one influenza B virus and several gene segments of other influenza B viruses isolated from Uganda from May 2009 through December 2010 was therefore undertaken in this study. Methods: Samples were collected from patients showing influenza like illness and screened for influenza A and B by PCR. Influenza B viruses were isolated on Madin-Darby Canine Kidney cells and selected isolates were subsequently sequenced and analyzed phylogenetically.Item Hepatitis B infection is highly endemic in Uganda: findings from a national serosurvey(African health sciences, 2009) Bwogi, Josephine; Braka, Fiona; Makumbi, Issa; Mishra, Vinod; Bakamutumaho, Barnabas; Nanyunja, Miriam; Opio, Alex; Downing, Robert; Biryahwaho, Benon; Lewis, Rosamund F.Infant immunization against hepatitis B began in Uganda in 2002. Objective: To determine the baseline prevalence of hepatitis B virus (HBV) infection and explore risk factors. Methods: A hepatitis B prevalence study was nested in the 2005 national HIV/AIDS serobehavioural survey. Demographic characteristics and risk factors were explored by questionnaire. One third of blood specimens (n=5875) from adults aged 15 to 59 years were tested for hepatitis B core antibodies (HBcAb); positive specimens were tested for hepatitis B surface antigen (HBsAg). Results: HBcAb was present in 52.3% (95% CI: 51.0-53.6) of adults, and HBsAg in 10.3% (9.5-11.1). By 15-19 years of age, 40.0% had been infected with HBV. Prevalence of both markers was significantly higher across northern Uganda, in rural areas, among the poor and least educated, and in uncircumcised men. Other independent predictors of infection were age, ethnic group, occupation, number of sex partners, and HIV and HSV-2 status. Conclusion: Hepatitis B virus infection is highly endemic in Uganda, with transmission occurring in childhood and adulthood. More than 1.4 million adults are chronically infected and some communities disproportionately affected. The hepatitis B infant immunization programme should be sustained and catch-up vaccination considered for older children.Item Molecular characterization of non‐polio enteroviruses isolated from acute flaccid paralysis patients in Uganda(Journal of Medical Virology, 2021) Tushabe, Phionah; Howard, Wayne; Bwogi, Josephine; Birungi, Molly; Eliku, James P.; Kakooza, Proscovia; Bukenya, Henry; Namuwulya, Prossy; Gaizi, Joseph; Tibanagwa, Mayi; Kabaliisa, Theopista; Mulindwa, Julius; Muhanguzi, Dennis; Suchard, Melinda; Gumede, Nicksy; Bakamutumaho, BarnabasEnteroviruses (EVs) are RNA viruses that can cause many clinical syndromes including acute flaccid paralysis (AFP). Within the global polio laboratory network, EVs are categorized either as polioviruses or non‐polio enteroviruses (NPEVs). Specific NPEVs have been described in polio‐like residual paralytic events in AFP patients. Retrospective analysis of 112 NPEV isolates from AFP patients was performed and thirty one NPEV types were identified of which 91% were Enterovirus B and 9% were Enterovirus A species. The NPEVs were distributed across the country with most patients in the eastern region (41/89; 46.1%). The highest proportion of patients were children less than 5 years (77/89; 86.5%) and male patients were more common (54/89; 60.7%). Echovirus 11 (11/89; 12.4%) was frequently observed and phylogenetic analysis of these sequences revealed high diversity. Coxsackievirus B5 (CV‐B5), CV‐B6, E21, and EV‐B69 were only seen in patients with residual paralysis. Analyses of the EV‐A71 sequence indicated a unique genogroup.Item Molecular Epidemiology of Influenza A/H3N2 Viruses Circulating in Uganda(PLoS ONE, 2011) Byarugaba, Denis K.; Ducatez, Mariette F.; Erima, Bernard; Mworozi, Edison A.; Millard, Monica; Kibuuka, Hannah; Lukwago, Luswa; Bwogi, Josephine; Kaira, Blanche B.; Mimbe, Derrick; Schnabel, David C.; Krauss, Scott; Darnell, Daniel; Webby, Richard J.; Webster, Robert G.; Wabwire-Mangen, FredThe increasing availability of complete influenza virus genomes is deepening our understanding of influenza evolutionary dynamics and facilitating the selection of vaccine strains. However, only one complete African influenza virus sequence is available in the public domain. Here we present a complete genome analysis of 59 influenza A/H3N2 viruses isolated from humans in Uganda during the 2008 and 2009 season. Isolates were recovered from hospital-based sentinel surveillance for influenza-like illnesses and their whole genome sequenced. The viruses circulating during these two seasons clearly differed from each other phylogenetically. They showed a slow evolution away from the 2009/10 recommended vaccine strain (A/ Brisbane/10/07), instead clustering with the 2010/11 recommended vaccine strain (A/Perth/16/09) in the A/Victoria/208/09 clade, as observed in other global regions. All of the isolates carried the adamantane resistance marker S31N in the M2 gene and carried several markers of enhanced transmission; as expected, none carried any marker of neuraminidase inhibitor resistance. The hemagglutinin gene of the 2009 isolates differed from that of the 2008 isolates in antigenic sites A, B, D, and to a lesser extent, C and E indicating evidence of an early phylogenetic shift from the 2008 to 2009 viruses. The internal genes of the 2009 isolates were similar to those of one 2008 isolate, A/Uganda/MUWRP-050/2008. Another 2008 isolate had a truncated PB1-F2 protein. Whole genome sequencing can enhance surveillance of future seasonal changes in the viral genome which is crucial to ensure that selected vaccine strains are protective against the strains circulating in Eastern Africa. This data provides an important baseline for this surveillance. Overall the influenza virus activity in Uganda appears to mirror that observed in other regions of the southern hemisphere.Item Phylogenetic analysis of rubella viruses found in Morocco, Uganda, Cote d’Ivoire and South Africa from 2001 to 2007(Journal of clinical virology, 2008) Caidi, Hayat; Abernathy, Emily S.; Benjouad, Aziz; Smit, Sheilagh; Bwogi, Josephine; Nanyunja, Miriam; Aouad, Rajae E.; Icenogle, JosephRubella virus (RV) causes a mild disease, but maternal infection early in pregnancy often leads to birth defects known as congenital rubella syndrome (CRS). Rubella remains poorly controlled in Africa. Objectives: To identify RV genotypes found in Africa to help establish a genetic baseline for RV molecular epidemiology. Study design: Urine and nasopharyngeal specimens were collected between 2001 and 2004 during measles surveillance in Morocco, Uganda and South Africa, and from two persons in the United States who contracted rubella in Cote d’Ivoire and Uganda in 2004 and 2007, respectively. RVRNAwas obtained directly from specimens or from RV-infected cell cultures, amplified by reverse transcriptase polymerase chain reaction, and the resulting DNAs sequenced. Sequences were assigned to genotypes by phylogenetic analysis with RV reference sequences. Results: Nine RV sequences were assigned as follows: 1E in Morocco, 1G in Uganda and Cote d’Ivoire, and 2B in South Africa. Conclusions: Information about RV genotypes circulating in Africa is improved which should aid in control of rubella and CRS in Africa.Item Phylogenetic Analysis of Rubella Viruses Identified in Uganda, 2003–2012(Journal of medical virology, 2014) Namuwulya, Prossy; Abernathy, Emily; Bukenya, Henry; Bwogi, Josephine; Tushabe, Phionah; Birungi, Molly; Seguya, Ronald; Kabaliisa, Theopista; Alibu, Vincent P.; Kayondo, Jonathan K.; Rivailler, Pierre; Icenogle, Joseph; Bakamutumaho, BarnabasMolecular data on rubella viruses are limited in Uganda despite the importance of congenital rubella syndrome (CRS). Routine rubella vaccination, while not administered currently in Uganda, is expected to begin by 2015. The World Health Organization recommends that countries without rubella vaccination programs assess the burden of rubella and CRS before starting a routine vaccination program. Uganda is already involved in integrated case-based surveillance, including laboratory testing to confirm measles and rubella, but molecular epidemiologic aspects of rubella circulation have so far not been documented in Uganda. Twenty throat swab or oral fluid samples collected from 12 districts during routine rash and fever surveillance between 2003 and 2012 were identified as rubella virus RNA positive and PCR products encompassing the region used for genotyping were sequenced. Phylogenetic analysis of the 20 sequences identified 19 genotype 1G viruses and 1 genotype 1E virus. Genotype-specific trees showed that the Uganda viruses belonged to specific clusters for both genotypes 1G and 1E and grouped with similar sequences from neighboring countries. Genotype 1G was predominant in Uganda. More epidemiological and molecular epidemiological data are required to determine if genotype 1E is also endemic in Uganda. The information obtained in this study will assist the immunization program in monitoring changes in circulating genotypes.Item Poor biosecurity in live bird markets in Uganda: A potential risk for highly pathogenic avian influenza disease outbreak in poultry and spread to humans(Avian Diseases, 2014) Kirunda, Halid; Kibuuka, Hannah; Byaruhanga, Achilles; Mworozi, Edison; Bwogi, Josephine; Lukwago, Luswa,; Millard, Millard; Wabwire-Mangen, Fred; Byarugaba, Denis K.Live bird markets (LBMs) are essential for marketing of poultry, but can be a hub for the rapid spread of diseases including avian influenza (AI). We assessed the status of biosecurity in 108 LBMs in 37 districts of Uganda. In all LBMs, carcasses were disposed of in the open and birds were introduced in the markets without initial quarantine. A high proportion of markets lacked a dedicated site for unloading of birds (86.1%) and a programme for disinfection (99.1%), had dirty feed/water troughs (93.5%), were accessed by stray animals (97.2%), and had sick and healthy birds (96.3%) or different bird species (86.1%) sold together. Differences in practices occurred among geographical regions and market location. Birds were more likely to be slaughtered in the open in urban compared to rural LBMs (OR=14.6, 95% CI: 1.50 - 142), while selling of un-caged birds was less likely in central compared to western region (OR=0.2, 95% CI: 0.04 - 0.17). Different poultry species confined in the same cage were more likely to be sold in urban (OR=22, 95% CI: 1.14 - 435) compared to rural markets. We conclude that LBMs in Uganda are a potential risk for spread of AI to poultry and humans.Item Possible Interruption of Measles Virus Transmission, Uganda, 2006–2009(Emerging infectious diseases, 2011) Baliraine, Frederick N.; Bwogi, Josephine; Bukenya, Henry; Seguya, Ronald; Kabaliisa, Theopista; Kisakye, Annet; Mbabazi, William B.; Smith, Sheilagh B.To determine what measles virus genotype(s) circulated in Uganda after strategic interventions aimed at controlling/ eliminating measles, we examined samples obtained during 2006–2009 and found only genotype B3.1, which had not been previously detected. Kenya was the likely source, but other countries cannot be excluded.Item Prevalence of influenza A viruses in livestock and free-living waterfowl in Uganda(BMC Veterinary Research, 2014) Kirunda, Halid; Erima, Bernard; Tumushabe, Agnes; Kiconco, Jocelyn; Tugume, Titus; Mulei, Sophia; Mimbe, Derrick; Mworozi, Edison; Bwogi, Josephine; Luswa, Lukwago; Kibuuka, Hannah; Millard, Monica; Byaruhanga, Achilles; Ducatez, Mariette F.; Krauss, Scott; Webby, Richard J.; Webster, Robert G.; Wurapa, Kofi; Byarugaba, Denis K.; Wabwire-Mangen, FredAvian influenza viruses may cause severe disease in a variety of domestic animal species worldwide, with high mortality in chickens and turkeys. To reduce the information gap about prevalence of these viruses in animals in Uganda, this study was undertaken. Results: Influenza A virus prevalence by RT-PCR was 1.1% (45/4,052) while sero prevalence by ELISA was 0.8% (24/2,970). Virus prevalence was highest in domestic ducks (2.7%, 17/629) and turkeys (2.6%, 2/76), followed by free-living waterfowl (1.3%, 12/929) and swine (1.4%, 7/511). A lower proportion of chicken samples (0.4%, 7/1,865) tested positive. No influenza A virus was isolated. A seasonal prevalence of these viruses in waterfowl was 0.7% (4/561) for the dry and 2.2% (8/368) for the wet season. In poultry, prevalence was 0.2% (2/863) for the dry and 1.4% (24/1,713) for the wet season, while that of swine was 0.0% (0/159) and 2.0% (7/352) in the two seasons, respectively. Of the 45 RT-PCR positive samples, 13 (28.9%) of them were H5 but none was H7. The 19 swine sera positive for influenza antibodies by ELISA were positive for H1 antibodies by HAI assay, but the subtype(s) of ELISA positive poultry sera could not be determined. Antibodies in the poultry sera could have been those against subtypes not included in the HAI test panel. Conclusions: The study has demonstrated occurrence of influenza A viruses in animals in Uganda. The results suggest that increase in volumes of migratory waterfowl in the country could be associated with increased prevalence of these viruses in free-living waterfowl and poultry.Item Research article Sero-prevalence and risk factors for hepatitis B virus infection among health care workers in a tertiary hospital in Uganda(BMC infectious diseases, 2010) Ziraba, Abdhalah K.; Bwogi, Josephine; Namale, Alice; Wainaina, Caroline W.; Mayanja-Kizza, HarrietHepatitis B virus (HBV) infection is a global public health challenge. Prevalence of current hepatitis B virus infection in the general population in Uganda is about 10%. Health care workers (HCW) have an extra risk of getting infected from their workplace and yet they are not routinely vaccinated against HBV infection. This study aimed at estimating prevalence of hepatitis B virus infection and associated risk factors among health care workers in a tertiary hospital in Uganda. Methods: Data were obtained from a cross sectional survey conducted in Mulago, a national referral and teaching hospital in Uganda among health care workers in 2003. A proportionate to size random sample was drawn per health care worker category. A structured questionnaire was used to collect data on socio-demographic characteristics and risk factors. ELISA was used to test sera for HBsAg, anti-HBs and total anti-HBc. Descriptive and logistic regression models were used for analysis.Item Serum anti-tetanus and measles antibody titres in Ugandan children aged 4 months to 6 years: implications for vaccine programme(Epidemiology and Infection, 2018) Warrener, Lenesha; Bwogi, Josephine; Andrews, Nick; Samuel, Dhanraj; Kabaliisa, Theopista; Bukenya, Henry; Brown, Kevin; Roper, Martha H.; Featherstone, David A.; Brown, DavidTo study the antibody response to tetanus toxoid and measles by age following vaccination in children aged 4 months to 6 years in Entebbe, Uganda. Serum samples were obtained from 113 children aged 4–15 months, at the Mother-Child Health Clinic (MCHC), Entebbe Hospital and from 203 of the 206 children aged between 12 and 75 months recruited through the Outpatients Department (OPD). Antibodies to measles were quantified by plaque reduction neutralisation test (PRNT) and with Siemens IgG EIA. VaccZyme IgG EIA was used to quantify anti-tetanus antibodies. Sera from 96 of 113 (85.0%) children attending the MCHC contained Measles PRNT titres below the protective level (120 mIU/ml). Sera from 24 of 203 (11.8%) children attending the OPD contained PRNT titres <120 mIU/ml. There was no detectable decline in anti-measles antibody concentrations between 1 and 6 years. The anti-tetanus antibody titres in all 113 children attending MCHC and in 189 of 203 (93.1%) children attending the OPD were >0.15 IU/ml by EIA, a level considered protective. The overall concentration of anti-tetanus antibody was sixfold higher in children under 12 months compared with the older children, with geometric mean concentrations of 3.15 IU/ml and 0.49 IU/ml, respectively. For each doubling in age between 4 and 64 months, the anti-tetanus antibody concentration declined by 50%. As time since the administration of the third DTP vaccination doubled, anti-tetanus antibody concentration declined by 39%. The low measles antibody prevalence in the children presenting at the MCHC is consistent with the current measles epidemiology in Uganda, where a significant number of measles cases occur in children under 1 year of age and earlier vaccination may be indicated. The consistent fall in antitetanus antibody titre over time following vaccination supports the need for further vaccine boosters at age 4–5 years as recommended by the WHO.Item Status of Global Virologic Surveillance for Rubella Viruses(The Journal of infectious diseases, 2011) Abernathy, Emily S.; Hu¨bschen, Judith M.; Muller, Claude P.; Jin, Li; Brown, David; Komase, Katsuhiro; Mori, Yoshio; Xu, Wenbo; Zhu, Zhen; Siqueira, Marilda M.; Shulga, Sergey; Tikhonova, Nina; Pattamadilok, Sirima; Incomserb, Patcha; Smit, Sheilagh B.; Akoua-Koffi, Chantal; Bwogi, Josephine; Lim, Wilina W. L.; Woo, Gibson K. S.; Triki, Hinda; Jee, Youngmee; Mulders, Mick N.; Maria Bispo de Filippis, Ana; Ahmed, Hinda; Icenogle, Joseph P.; Ramamurty, Nalini; Featherstone, DavidThe suspected measles case definition captures rubella cases. Therefore, measles surveillance will be improved in the course of the control and eventual elimination of rubella transmission. One aspect of rubella control, virologic surveillance, is reviewed here. A systematic nomenclature for rubella viruses (RVs) based on 13 genotypes has been established and is updated when warranted by increases in information about RVs. From 2005 through 2010, the genotypes of RVs most frequently reported were 1E, 1G, and 2B, and genotypes 1a, 1B, 1C, 1h, 1j, and 2C were less frequently reported. Virologic surveillance can support rubella control and elimination. Synopses of rubella virologic surveillance in various countries, regions, and globally are given, including characterization of viruses from imported cases in a country that has eliminated rubella and studies of endemic viruses circulating in countries without rubella control objectives. Current challenges are discussed.Item Vaccine Associated Paralytic Poliomyelitis Cases From Children Presenting With Acute Flaccid Paralysis in Uganda(Journal of medical virology, 2015) Nanteza, Mary B.; Kisakye, Annet; Ota, Martin O.; Gumede, Nicksy; Bwogi, JosephinePoliomyelitis is caused by Poliovirus 1, 2, and 3 which belong to the family Picornaviridae and the genus Enterovirus. Paralytic polio usually affects one lower limb and presents with hypotonia, reduced reflexes, wasting of muscles but with no loss of sensorium. Plans to eradicate poliomyelitis are intensively on-going and these are being achieved by the use of both oral polio vaccine (OPV) as well as the inactivated polio vaccine (IPV). The viral strains in OPV (Sabins) are unstable (Agol, 2006) for example Sabin poliovirus 1 harbors an attenuating mutation of A480G in the 50UTR whereas that of Sabin Poliovirus 2 and 3 are at the G481A and C472U sites respectively [Kew et al., 2004; Kew, 2009]. The mutations at these specific sites are not infrequent. They are associated rarely with increased neurovirulence and only infrequently cause AFP. This underrates their importance.Item Whole genome analysis of selected human and animal rotaviruses identified in Uganda from 2012 to 2014 reveals complex genome reassortment events between human, bovine, caprine and porcine strains(PLoS ONE, 2017) Bwogi, Josephine; Jere, Khuzwayo C.; Karamagi, Charles; Byarugaba, Denis K.; Namuwulya, Prossy; Baliraine, Frederick N.; Desselberger, Ulrich; Iturriza-Gomara, MirenRotaviruses of species A (RVA) are a common cause of diarrhoea in children and the young of various other mammals and birds worldwide. To investigate possible interspecies transmission of RVAs, whole genomes of 18 human and 6 domestic animal RVA strains identified in Uganda between 2012 and 2014 were sequenced using the Illumina HiSeq platform. The backbone of the human RVA strains had either a Wa- or a DS-1-like genetic constellation. One human strain was a Wa-like mono-reassortant containing a DS-1-like VP2 gene of possible animal origin. All eleven genes of one bovine RVA strain were closely related to those of human RVAs. One caprine strain had a mixed genotype backbone, suggesting that it emerged from multiple reassortment events involving different host species. The porcine RVA strains had mixed genotype backbones with possible multiple reassortant events with strains of human and bovine origin.Overall, whole genome characterisation of rotaviruses found in domestic animals in Uganda strongly suggested the presence of human-to animal RVA transmission, with concomitant circulation of multi-reassortant strains potentially derived from complex interspecies transmission events. However, whole genome data from the human RVA strains causing moderate and severe diarrhoea in under-fives in Uganda indicated that they were primarily transmitted from person-to-person.Item Whole-genome analysis of influenza A(H1N1)pdm09 viruses isolated in Uganda from 2009 to 2011(Influenza and Other Respiratory Viruses, 2016) Byarugaba, Denis K.; Erima, Bernard; Millard, Monica; Kibuuka, Hannah; Lukwago, Luswa; Bwogi, Josephine; Mimbe, Derrick; Kiconco, Jocelyn B.; Tugume, Titus; Mworozi, Edison A.; Turner, Jasmine; Mckenzie, Pamela P.; Webby, Richard R. J.; Webster, Robert G.; Foret, Charlotte; Ducatez, Mariette F.; Coldren, Rodney; Wabwire-Mangen, Fred; Krauss, ScottWe report a whole-genome analysis of 19 influenza A(H1N1)pdm09 isolates from four Ugandan hospitals between 2009 and 2011. The isolates differed from the vaccine strain A/California/07/2009 by three amino acid substitutions P100S, S220T, and I338V in the hemagglutinin and by two amino acid substitutions V106I and N248D in the neuraminidase proteins with consistent mutations in all gene segments distinguishing isolates from the 2009/2010 to 2010/2011 seasons. Phylogenetic analysis showed low genetic evolution, with genetic distances of 0%–1.3% and 0.1%–1.6% for HA and NA genes, respectively. The amino acid substitutions did not lead to antigenic differences from the reference strains.