Bwamba fever


Bwamba fever

Description, Causes and Risk Factors:

A febrile illness of humans in Africa caused by a virus of the family Bunyaviridae and transmitted by mosquitoes.

Bwamba fever was first encountered as a Clinical entity in 1937 among construction workers on a new road to Bwamba county, western Uganda. Nine patients yielded identical viruses and developed antibodies during a small Epidemic outbreak of the disease. The etiological relationship of the virus to the disease was conclusively demonstrated by the development of specific neutralizing antibody in the serum of each virus donor with convalescence. Bwamba infection has since been recognized by virus isolations from humans in Nigeria, Cameroon, Central African Republic, Kenya, Tanzania, and South Africa.

The disease presents as a relatively severe form of generalized infection of brief duration and benign nature; no fatalities are recorded so far. Exanthema is nearly always present and is frequently associated with meningeal involvement.

Results of samples of serum from 615 residents of various localities in Uganda and Tanzania that were tested for their capacity to neutralize Bwamba fever virus indicated that the disease was very prevalent in both Uganda and Tanzania. The results also indicated that the virus attacks children and adults with approximately equal frequency. Other studies have indicated that antibodies against the virus are distributed as far south as the Republic of South Africa and as far north westwards as Gambia. The virus appears to be endemic in Uganda, Tanzania, and Mozambique. It also appears to be the tenth most frequent arthropod borne virus infecting humans in the African continent. Antibodies to Bwamba virus have been found in birds, monkeys, and donkeys. Routine surveillance of arboviruses in Uganda, in the past, enabled isolation of the virus on several other occasions but for more than one and a half decades, no isolation of Bwamba virus have been made until these herein reported.

Bwamba fever

Bwamba fever may be more common than it is usually thought to be. It is often mistaken for malaria and because it is a mild infection, many people do not go to hospital when infected. Further studies are needed to understand the epidemiology and natural history of Bwamba virus.

Symptoms:

It is usually accompanied with fever, headache, arthralgia, and pains of generalized or local distribution. Intestinal tract involvement, especially diarrhea, is also seen. Some patients may also develop a body rash. Convalescence is characterised by marked asthenia lasting 8 to 10 days. Viremia, in humans, is usually of short duration (24 - 48 hrs) making isolation of the virus difficult. Because Bwamba virus does not generally cause epidemics, it has a limited recognized social and economic impact. Nevertheless, it is widely distributed in tropical Africa.

Diagnosis:

Diagnosis may include:

    Rapid diagnosis - antigen detection systems and the detection of specific IgM antibodies are becoming available as means of rapid diagnosis.

  • Serology - a wide variety of serological techniques are available such as hemagglutination inhibition titer (HAI), complement-fixation test (CFT), immunofluorescence assay (IFA), neutralization tests and ELISAs.

  • Virus isolation - intracranial inoculation of suckling mice is thought to be the most sensitive system available for virus isolation. However, several sensitive cell culture systems are available such as vero. LLC-MC2 and mosquito cells. Once isolated the virus can be types by neutralizing tests.

Treatment:

There is no specific antiviral treatment available. Management is supportive and intensive medical management is required for severe cases. Standard passive treatment include bedrest, maintenance of fluid, and general treatment to reduces aches. Protection against night biting vectors such as Anophelinae and Mansonia species can be obtained through use of mosquito bed nets impregnated with pyrethroid insecticides such as permethrin or deltamethrin. Insecticidal fogging or spraying can result in temporary and localized control and application of larvicides to standing water may be effective.

NOTE: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.

DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.

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