Suspected Viral Hemorrhagic Fever Outbreak in South Sudan Sparks Urgent Response
The Africa Centres for Disease Control and Prevention (Africa CDC) is collaborating closely with the Ministry of Health in the Republic of South Sudan to address a suspected outbreak of a disease similar to Viral Hemorrhagic Fever (VHF) in the remote areas of Dukubela, Pacime, and Dajo in Longechuk County, Upper Nile State.
The outbreak was first reported on June 16, 2023 by the Nile Initiative Development Organization (NIDO) during a visit to Dajo Primary Health Care Unit. NIDO discovered that the disease seemed to have originated from Dukubela, a mountainous area in Longechuk county near the Southern Blue Nile in Sudan and Assosa areas in Ethiopia. This region has recently experienced an influx of returning residents and refugees fleeing the ongoing conflict in Sudan.
In response to this health crisis, the Africa CDC has deployed technical experts to assist the Ministry of Health in conducting a comprehensive risk assessment, developing a national response plan, and strengthening coordination, surveillance, laboratory operations, and risk communication and community engagement (RCCE) capabilities.
Affected individuals have exhibited symptoms such as high fever, bloody vomiting and stool, rash, cough, sore throat, red eyes, runny nose, blurred vision, and general weakness. According to NIDO, approximately 150 people have been affected by the disease, resulting in 23 deaths. These deaths occurred within three days of the onset of the illness. However, those who survived past the initial five days have shown signs of improvement.
To address the health crisis, the Ministry of Health and the World Health Organization rapidly dispatched a multidisciplinary Rapid Response Team to Longechuk. This team provided medical supplies, conducted disease-specific consultations, and actively searched for cases in the Dajo and Pacime communities.
Following a thorough field investigation, the Rapid Response Team recorded 227 suspected cases and 29 related deaths. Laboratory tests confirmed cases of malaria and measles among 45 samples, with 71% testing positive for malaria, 58% for measles, and a co-infection rate of 45%. Although all 45 samples tested negative for viral hemorrhagic fevers, thereby ruling it out as the potential source of the outbreak, health authorities remain vigilant by maintaining surveillance measures to promptly identify and respond to any disease threat.
Dr. Ader Macar Aciek, the Undersecretary of the Ministry of Health, stated, Our strategy involves escalating preparedness and response activities, enhancing cross-border collaboration for improved surveillance and information sharing, and implementing an integrated campaign for measles vaccination and malaria control in Longechuk County and surrounding areas. We appeal to our partners, including Africa CDC, to strengthen our laboratory capacity, particularly in pathogen genomic sequencing, for timely detection of disease threats.
Longechuk, a remote location bordering Ethiopia and Sudan, presents unique challenges in managing this health crisis due to its difficult terrain, especially in Pacime. Residents must undertake a strenuous nine-hour walk to reach the nearest healthcare facility in Dajo. The influx of returnees and refugees further strains the already limited medical resources in the area.
Given the absence of communication infrastructure such as phones and the Internet, satellite phones are the only feasible means of communication. Nonetheless, an integrated response plan is currently underway.
Africa CDC is collaborating closely with the Ministry of Health to identify priority areas for intervention that will have the greatest impact. Ongoing initiatives include coordinating emergency response systems at national and sub-national levels, procuring laboratory equipment and supplies, and enhancing laboratory capabilities for efficient sample handling. Discussions are taking place between the Ministry of Health and Africa CDC’s technical team to explore the possibility of establishing sequencing capacities in the Republic of South Sudan.
In conclusion, a suspected outbreak of a disease resembling Viral Hemorrhagic Fever has prompted an urgent response in South Sudan. The Africa CDC and the Ministry of Health are cooperating to address the situation, assess risks, and implement comprehensive national response plans. Efforts are focused on strengthening coordination, surveillance, laboratory operations, and risk communication to effectively manage the outbreak and prevent its further spread.
