The Africa CDC and the Ministry of Health in the Republic of South Sudan are collaborating closely to contain a disease outbreak with symptoms consistent with Viral Haemorrhagic Fever (VHF) in the outlying Dukubela, Pacime, and Dajo areas of Longechuck County, Upper Nile State.
The epidemic was first detected on June 16, 2023, during a routine supervision visit to the Dajo Primary Health Care Unit by the Nile Initiative Development Organization (NIDO). Dukubela, a hilly region in Longechuk County, was identified by NIDO as the likely epicenter of the outbreak. This region shares a border with the Southern Blue Nile region of Sudan and the Assosa region of Ethiopia. There has been a new inflow of refugees and people seeking asylum from the continuing turmoil in Sudan to this region.
With the help of these experts, the Ministry of Health in Africa was able to conduct a thorough risk assessment, create a comprehensive national response plan, and improve its capacities in coordination, surveillance, laboratory operations, risk communication, and community engagement (RCCE).
High fever, vomiting and diarrhea with blood, a rash, cough, sore throat, red eyes, a runny nose, impaired vision, and overall weakness are some of the symptoms experienced by those who have contracted this illness. According to NIDO, 23 persons had died, and an estimated 150 had been infected. These fatalities happened three days after the first signs of illness appeared. However, those who made it beyond the first week started to feel better.
The Ministry of Health and the World Health Organization (WHO) immediately sent a multidisciplinary Rapid Response Team to Longechuk in response to the health crisis. In the towns of Dajo and Pacime, this group provided medical supplies, consulted on particular diseases, and actively sought new cases.
The Rapid Response Team conducted a detailed examination on the ground and subsequently line-listed 227 possible cases and 29 fatalities. Seventy-one percent of the samples tested positive for malaria, 58% for measles, and 45% for co-infection, according to laboratory tests. Nevertheless, Health officials are on high alert, with monitoring mechanisms to detect and react quickly to any disease danger. However, all 45 samples tested negative for viral hemorrhagic fevers, eliminating it as a possible cause of the epidemic.
Longechuck County and the surrounding regions will be the focus of an integrated measles vaccine and malaria control campaign, an increase in readiness and response actions, increased cross-border cooperation for enhanced monitoring and information sharing, and more. To better identify emerging health threats promptly, we request assistance from our partners, especially the Africa CDC, to build up our laboratory infrastructure, particularly in pathogen genome sequencing.
The isolated position of Longechuck, on the border with Ethiopia and Sudan, and the challenging terrain, especially in Pacime, provide special difficulties in responding to this public health emergency. Dajo’s residents face a grueling nine-hour trek to the closest medical center. The surge of returnees and refugees is further taxing the already stretched medical services in the region.
There is no landline or Internet service in the region. Thus, satellite phones are the only viable option for contact. A coordinated response strategy is being developed despite these obstacles.
The Africa Centers for Disease Control and Prevention (CDC) is collaborating closely with the Ministry of Health to identify high-yield areas for intervention. Ongoing efforts include coordinating emergency response systems on a national and subnational scale, purchasing lab equipment and supplies, and increasing laboratory capacities for effective sample processing. Discussions about the potential institutionalization of sequencing capacity in the Republic of South Sudan are now occurring between the Ministry of Health and the technical team of the Africa CDC.
The Ministry of Health, the Africa CDC, and its partners are working together to relieve the present emergency and build healthcare systems so that they may better handle future disease outbreaks.