Another Crimean Congo Hemorrhagic Fever outbreak in Uganda: ongoing challenges with prevention, detection, and response

Objective To highlight challenges associated with Crimean-Congo hemorrhagic fever (CCHF) prevention, detection, and response in Uganda. Methods We describe a single confirmed CCHF case in Rakai District in 2022. We reviewed medical records and conducted interviews on the case-patient’s history and possible exposures. To understand CCHF prevention and response efforts, we conducted key informant interviews (KIIs) with the district health and veterinary officers and focus group discussions (FGDs) with farmers in the affected village. Results An 18-year-old Rakai District resident had fever onset on July 5, 2022. Despite hemorrhaging on hospital admission on July 6, a viral hemorrhagic fever (VHF) was not suspected for 24hours, and appropriate personal protective equipment was not used. A blood sample was collected for VHF testing on July 8 but the patient was discharged before receiving results. The case-patient tested positive for CCHF on July 12 and was readmitted. KIIs and FGDs indicated poor tick control measures in the district. The district lacked a formal One Health team and experienced challenges with coordination for outbreak response. Conclusions CCHF prevention, detection, and response face challenges in Uganda and require strong clinical awareness for quick detection, collaboration between animal and human health stakeholders, and implementation of effective tick control measures.