Browsing by Author "Lutwama, Julius"
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Item Detection of Entebbe Bat Virus after 54 Years(The American journal of tropical medicine and hygiene, 2015) Kading, Rebekah C.; Kityo, Robert; Nakayiki, Teddie; Ledermann, Jeremy; Crabtree, Mary B.; Lutwama, Julius; Miller, Barry R.Entebbe bat virus (ENTV; Flaviviridae: Flavivirus), closely related to yellow fever virus, was first isolated from a little free-tailed bat (Chaerephon pumilus) in Uganda in 1957, but was not detected after that initial isolation. In 2011, we isolated ENTV from a little free-tailed bat captured from the attic of a house near where it had originally been found. Infectious virus was recovered from the spleen and lung, and the viral RNA was sequenced and compared with that of the original isolate. Across the polypeptide sequence, there were 76 amino acid substitutions, resulting in 97.8% identity at the amino acid level between the 1957 and 2011 isolates. Further study of this virus would provide valuable insights into the ecological and genetic factors governing the evolution and transmission of bat- and mosquitoborne flaviviruses.Item First Laboratory-Confirmed Outbreak of Human and Animal Rift Valley Fever Virus in Uganda in 48 Years(The American journal of tropical medicine and hygiene, 2019) Shoemaker, Trevor R.; Nyakarahuka, Luke; Balinandi, Stephen; Ojwang, Joseph; Tumusiime, Alex; Mulei, Sophia; Kyondo, Jackson; Lubwama, Bernard; Sekamatte, Musa; Namutebi, Annemarion; Tusiime, Patrick; Monje, Fred; Mayanja, Martin; Ssendagire, Steven; Dahlke, Melissa; Kyazze, Simon; Wetaka, Milton; Makumbi, Issa; Borchert, Jeff; Zufan, Sara; Patel, Ketan; Whitmer, Shannon; Brown, Shelley; Davis, William G.; Klena, John D.; Nichol, Stuart T.; Rollin, Pierre E.; Lutwama, JuliusIn March 2016, an outbreak of Rift Valley fever (RVF) was identified in Kabale district, southwestern Uganda. A comprehensive outbreak investigation was initiated, including human, livestock, and mosquito vector investigations. Overall, four cases of acute, nonfatal human disease were identified, three by RVF virus (RVFV) reverse transcriptase polymerase chain reaction (RT-PCR), and one by IgM and IgG serology. Investigations of cattle, sheep, and goat samples from homes and villages of confirmed and probable RVF cases and the Kabale central abattoir found that eight of 83 (10%) animals were positive for RVFV by IgG serology; one goat from the home of a confirmed case tested positive by RT-PCR. Whole genome sequencing from three clinical specimens was performed and phylogenetic analysis inferred the relatedness of 2016 RVFV with the 2006–2007 Kenya-2 clade, suggesting previous introduction of RVFV into southwestern Uganda. An entomological survey identified three of 298 pools (1%) of Aedes and Coquillettidia species that were RVFV positive by RT-PCR. This was the first identification of RVFV in Uganda in 48 years and the 10th independent viral hemorrhagic fever outbreak to be confirmed in Uganda since 2010.Item How Severe and Prevalent are Ebola and Marburg Viruses? A Systematic Review and Meta-Analysis of the Case Fatality Rates and Seroprevalence(BMC infectious diseases, 2016) Nyakarahuka, Luke; Kankya, Clovice; Krontveit, Randi; Mayer, Benjamin; Mwiine, Frank N.; Lutwama, Julius; Skjerve, EysteinEbola and Marburg virus diseases are said to occur at a low prevalence, but are very severe diseases with high lethalities. The fatality rates reported in different outbreaks ranged from 24–100%. In addition, sero-surveys conducted have shown different seropositivity for both Ebola and Marburg viruses. We aimed to use a meta-analysis approach to estimate the case fatality and seroprevalence rates of these filoviruses, providing vital information for epidemic response and preparedness in countries affected by these diseases.Published literature was retrieved through a search of databases. Articles were included if they reported number of deaths, cases, and seropositivity. We further cross-referenced with ministries of health, WHO and CDC databases. The effect size was proportion represented by case fatality rate (CFR) and seroprevalence. Analysis was done using the metaprop command in STATA.The weighted average CFR of Ebola virus disease was estimated to be 65.0% [95% CI (54.0–76.0%), I2 = 97.98%] whereas that of Marburg virus disease was 53.8% (26.5–80.0%, I2 = 88.6%). The overall seroprevalence of Ebola virus was 8.0% (5.0%–11.0%, I2 = 98.7%), whereas that for Marburg virus was 1.2% (0.5–2.0%, I2 = 94.8%). The most severe species of ebolavirus was Zaire ebolavirus while Bundibugyo Ebolavirus was the least severe.The pooled CFR and seroprevalence for Ebola and Marburg viruses were found to be lower than usually reported, with species differences despite high heterogeneity between studies. Countries with an improved health surveillance and epidemic response have lower CFR, thereby indicating need for improving early detection and epidemic response in filovirus outbreaks.Item Outbreak of Anthrax Associated with Handling and Eating Meat from a Cow, Uganda, 2018(Emerging Infectious Diseases, 2020) Kisaakye, Esther; Riolexus Ario, Alex; Bainomugisha, Kenneth; Cossaboom, Caitlin M. Ping Zhu; Lowe, David; Bulage, Lilian; Kadobera, Daniel; Sekamatte, Musa; Lubwama, Bernard; Tumusiime, Dan; Tusiime, Patrick; Downing, Robert; Buule, Joshua; Lutwama, Julius; Salzer, Johanna S.; Matkovic, Eduard; Joy Gary, Jana Ritter,; Zhu, Bao-PingOn April 20, 2018, the Kween District Health Office in Kween District, Uganda reported 7 suspected cases of human anthrax. A team from the Uganda Ministry of Health and partners investigated and identified 49 cases, 3 confirmed and 46 suspected; no deaths were reported. Multiple exposures from handling the carcass of a cow that had died suddenly were significantly associated with cutaneous anthrax, whereas eating meat from that cow was associated with gastrointestinal anthrax. Eating undercooked meat was significantly associated with gastrointestinal anthrax, but boiling the meat for >60 minutes was protective. We recommended providing postexposure antimicrobial prophylaxis for all exposed persons, vaccinating healthy livestock in the area, educating farmers to safely dispose of animal carcasses, and avoiding handling or eating meat from livestock that died of unknown causes.Item Proportion of Deaths and Clinical Features in Bundibugyo Ebola Virus Infection, Uganda(Emerging infectious diseases, 2010) MacNeil, Adam; Farnon, Eileen C.; Wamala, Joseph; Okware, Sam; Cannon, Deborah L.; Reed, Zachary; Towner, Jonathan S.; Tappero, Jordan W.; Lutwama, Julius; Ksiazek, Thomas G.; Rollin, Pierre E.; Downing, Robert; Nichol, Stuart T.Ebola hemorrhagic fever (EHF) is a severe disease caused by several species of Ebolavirus (EBOV), in the family Filoviridae. Before 2007, four species of EBOV had been identifi ed; 2 of these, Zaire ebolavirus and Sudan ebolavirus, have caused large human outbreaks in Africa, with proportion of deaths ≈80%–90% and 50%, respectively (1–5). Large outbreaks are associated with person-to-person transmission after the virus is introduced into humans from a zoonotic reservoir. Data suggest that this reservoir may be fruit bats (6,7). During outbreaks of EHF, the virus is commonly transmitted through direct contact with infected persons or their bodily fl uids (8–11). The onset of EHF is associated with nonspecifi c signs and symptoms, including fever, myalgias, headache, abdominal pain, nausea, vomiting, and diarrhea; at later stages of disease, overt hemorrhage has been reported in ≈45% of cases (12). Bundibugyo District is located in western Uganda, which borders the Democratic Republic of Congo. After reports of a mysterious illness in Bundibugyo District, the presence of a novel, fi fth EBOV virus species, Bundibugyo ebolavirus (BEBOV), was identifi ed in diagnostic samples submitted to the Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA, in November 2007 (13). In response to detection of EBOV, an international outbreak response was initiated. In this report, we summarize fi ndings of laboratory-confi rmed cases of BEBOV infection.