Three deaths reported in Ugandan outbreak

Researchers have shared details of an outbreak at a funeral in Uganda that killed three young people.

Aeromonas bacteria can cause food poisoning with an incubation period of 12 hours to seven days, typically 24 to 48 hours. 

In February 2024, the Ministry of Health was notified of a suspected food poisoning incident in Buyengo Town Council, Jinja District, where people developed gastrointestinal symptoms after a funeral in Bukasami village.

The deceased was a religious leader and his funeral lasted several days, attracting more than 1,000 attendees, according to the study published in the journal BMC Infectious Diseases.

Water use and poor re-cooking
Researchers identified 65 patients and three deaths. These included a 4-year-old boy and 6-year-old girl from the same family and a 20-year-old man. Common symptoms were abdominal pain, diarrhea, vomiting, and fever. The median age of cases was 20.

The fatalities could be explained by delayed health care because they all sought help beyond 12 to 24 hours from symptom onset and were severely dehydrated at admission. Also, treatment centers reported a low stock of medicines and health supplies.

The epidemic curve revealed multiple peaks corresponding to the different serving times at supper and breakfast. For both meals, beef soup was topped up with unboiled water and was inadequately re-cooked. The beef stew was served with freshly prepared brown rice at supper on Monday and leftover brown rice at breakfast the following day. All cases had eaten at least one meal at the funeral, either on the day of the burial or the day after.

The main source of water used at the funeral was a stream. Aeromonas hydrophilia and Aeromonas caviae were isolated in a sample from a dead 4-year-old patient. The water sample from Kabakubya stream tested positive for Aeromonas hydrophilia.

Both of the sample types were negative for other common bacterial causes of food poisoning including Shigella, E. coli, Salmonella, Vibrio cholerae, and Campylobacter.

The suspected beef stew was not sampled as there were no leftovers by the time the investigation started four days after the incident. Food samples tested were found dumped at the funeral site one week after the incident and weren’t useful for microbiology. All toxicological investigations were negative.

Criminal investigations into the incident meant researchers were unable to reach the supplier of the suspected beef and many of the cooks denied participating in food preparation because of potential legal consequences. However, they did interview the main cook involved in preparing the implicated meals.

Anthrax outbreak
Another study reported on an anthrax outbreak linked to the consumption and handling of meat in Kyotera district.

Scientists identified 63 cases in 2023 and 48 were male. Patients ranged in age from 13 to 75 years old. Of all cases, 55 were cutaneous and eight were gastrointestinal. A dozen people died. Cutaneous anthrax results from direct contact with or exposure to infected animals or contaminated animal products. 

According to the study, published in the One Health Outlook journal, there were 68 suspected cases of animal anthrax that died on three different farms.

Poor health-seeking behavior and looking for care from traditional healers likely contributed to the high case fatality rate, said researchers. They recommended inspection of all cattle prior to slaughter and vaccination of livestock against Bacillus anthracis.