A young man, in his early 20s, and an elderly woman reported to Kajjansi Health Centre on Monday May 14 with a severe cough, red eyes and fever. They were not from the same family but had a serious skin rash as well. This forced many patients they found at the health facility to run away to avoid contracting a ‘mysterious’ disease.
One health worker at the centre who declined to reveal his identity because he is not authorised to speak to the media told this reporter that they have received a number of cases in recent days in which people have reported measles-like symptoms.
The nervous patients were calmed down by the health workers when they were told that their colleagues were suffering from a condition known as German measles or Rubella, caused by the rubella virus.
“We have received a number of cases recently with people showing measles-like signs but we have succeeded in treating them,” said the health worker.
He said that despite the scary symptoms, the disease can be easily treated by administering Vitamin A, in addition to treating related conditions such as cough, fever and red eyes.
Dr. Bernard Opa Toliva, the head of the Uganda National Expanded Programme on Immunisation (UNEPI) told this newspaper that the Ministry of Health (MoH) had taken blood samples to a laboratory and confirmed the presence of rubella.
Asked whether the feared outbreak of measles in Wakiso, Kampala and 35 other districts in the country that has been reported since the start of 2018 may in fact be a rubella outbreak, Dr. Opa said: “You’re completely right.”
However, when he was also asked if immunisation against measles confers some level of protection against rubella, Opa said “No”, adding that the two diseases are different. While experts may have found an answer to one part of the puzzle by characterising the disease, the other challenge remains in the fact that the disease, like many other viral infections, so far has no cure.
In a number of countries where the disease has been reported, health authorities have responded through immunisation. And the World Health Organisation (WHO) in its mission to eliminate measles in five major regions including Africa by 2020, the UN body recommends that countries take the opportunity to introduce rubella-containing vaccines.
Dr. Opa said the MoH had placed an order for Rubella vaccine with delivery expected early next year.
Since the start of 2018, Wakiso, Kampala, Kamuli and up to 33 other districts have reported an outbreak of “Measles” despite the fact that the victims had received the measles vaccine.
Like many viral diseases, rubella has no known cure, even though the associated opportunistic infections can be easily treated.
Dr. Babara Nassolo, working at one of the private health facilities in Mengo, Kampala, and Dr. Anne Akullo, a member of the Uganda Paediatric Association, both confirmed that they had received a few patients with rubella symptoms in recent weeks.
They both downplayed the impact of the disease saying it is milder than measles. They however emphasised that among pregnant women, it can lead to serious complications such as birth defects.
Dr. Nassolo said that if a pregnant woman catches rubella, she can have a miscarriage or her baby can have serious birth defects including on the heart, liver, spleen, which results into conditions such as heart failure, too low birth weight, a rash, cataracts, yellow skin , and other types of organ failure.
“What we worry most about rubella is the possibility of affecting pregnant women and the unborn child. Congenital Rubella Syndrome (CRS) can have serious effects. And if a pregnant woman thinks they have been exposed to rubella, they need to see a doctor,” added Dr. Akullo.
The WHO says: “When a woman is infected with the rubella virus early in pregnancy, she has a 90% chance of passing the virus on to her foetus. This can cause the death of the foetus, or it may cause CRS. Even though it is a mild childhood illness CRS causes many birth defects. Deafness is the most common, but CRS can also cause defects in the eyes, heart, and brain.”
Rubella is spread in airborne droplets when infected people sneeze or cough. Once a person is infected, the virus spreads throughout the body in about five to seven days. During this time, pregnant women may pass the virus on to their foetus.