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April 03, 2005

Marburg Death Toll In Angola Rises

The Ebola-like disease ravaging Angola has been identified as Marburg. The death toll has risen to 146, the worst ever seen, according to the World Health Organization (WHO). The outbreak has been isolated to the northern city of Uige. Residents have bought all the bleach available for sale as they attempt to disinfect their homes. People are terrified.

There is no cure for Marburg. According to Reuters, "The WHO has deployed 20 experts to help combat the viral fever, characterised by headaches, nausea, vomiting and bloody diarrhoea. It is spread through close contact with bodily fluids including saliva and perspiration. The victims have included an Italian doctor who was treating people with the virus."

The WHO web site provided updates on the situation in Angola:

Marburg virus disease in Angola - update 4

31 March 2005

As of 30 March, 132 cases have been reported. These cases include 12 health care workers. Of the 132 cases, 127 have been fatal. This is the largest number of fatalities ever recorded during an outbreak of this rare, but extremely severe disease.

Mobile surveillance teams have been established and are investigating rumours of additional cases in Uige Province, which remains the epicentre of the outbreak. A mobile field laboratory provided by the Canadian National Microbiology Laboratory arrived yesterday, was set up in Uige today, and will become operational tomorrow. A dedicated isolation facility, operated by Médecins sans Frontières, is preparing to receive further cases that may be identified by the mobile surveillance teams.

Additional staff from the Global Outbreak Alert and Response Network and WHO will be arriving over the weekend. Two logisticians will join teams in Uige and Luanda. A data manager, media coordinator, and medical anthropologist will also be arriving over the weekend.

WHO has despatched a further 500 kg of personal protective equipment and other supplies to assist in the immediate improvement of infection control in hospitals and the protection of front-line staff. To facilitate real-time coordination of response operations, WHO has despatched mobile communication field kits, which should greatly expedite the flow of information.

Here is the April 1 WHO update:

Marburg virus disease in Angola - update 5

1 April 2005

As of 31 March, 140 cases of Marburg virus disease have been reported in Angola. Of these, 132 have been fatal. Cases continue to be concentrated in Uige.

Mobile surveillance teams in Uige continue to follow up on rumours and conduct active searches for additional cases. Contact tracing has also been intensified. These activities are now supported by a mobile laboratory in Uige, which has greatly expedited diagnostic testing.

WHO is working with the Ministry of Health in the Democratic Republic of Congo to train local staff in the border area near Angola in case detection and management.

Symptoms and rates of fatalities are available at the web site for The Centers For Disease Control (CDC):

Marburg virus disease presents as an acute febrile illness and can progress within 6--8 days to severe hemorrhagic manifestations. After an incubation period of 5--10 days, onset of the disease is sudden and is marked by fever, chills, headache, and myalgia. Approximately the fifth day after onset of symptoms, a maculopapular rash might occur, after which nausea, vomiting, chest pain, sore throat, abdominal pain, and diarrhea might appear. Signs and symptoms become increasingly severe and can include jaundice, inflammation of the pancreas, severe weight loss, delirium, shock, liver failure, massive hemorrhaging, and multi-organ dysfunction.

Fatality rates for outbreaks of Marburg VHF have ranged from approximately 25% to 80%; mortality has been higher in outbreaks in which effective case management was lacking. No vaccine or curative treatment is available, and supportive treatment should be used. The virus can be spread to humans through direct contact with body fluids (e.g., blood, saliva, and urine) of an infected person or animal. Thus, the best protection for persons in or traveling to the outbreak area is to avoid direct contact with body fluids from potentially infected persons. Virus transmission also might be possible through contact with objects (e.g., medical equipment) that have been contaminated with infectious material. The virus has been reported to survive for as long as several days on contaminated surfaces (2). Hospital infection-control practices for infected patients should include contact and droplet precautions, in addition to wearing eye protection or a face shield. U.S. clinicians caring for patients with suspected Marburg virus infection should contact CDC or local public health officials for additional information about VHF infection control.

Posted on April 3, 2005 at 10:17 AM | Permalink

Comments

it's amazing how little coverage this is getting. i mean, it's no terri schiavo, but usually when there's an ebola/marburg outbreak, there is at least a couple of newscasters freaking out and showing clips of dustan hoffman walking around in his "outbreak" suite

Posted by: upyernoz at Apr 3, 2005 4:19:06 PM

that's suit

Posted by: upyernoz at Apr 3, 2005 4:19:36 PM

I think the Pope's death eclipsed the Marburg coverage. However, even when the virus was unidentified, it still didn't get much coverage.

Posted by: Trish Wilson at Apr 3, 2005 5:36:26 PM

i don't find it surprising that there has been almost no media coverage of this in the US. this, as with many tragedies that afflict Africa, is of little concern to the powers that be here. when the virus gets on a plane and lands in london or dc, then we'll hear all about it. until then, in the perspective of our free american press, it's just more silently dying Africans.
no, i am not surprised at all. it makes me sad, though.

Posted by: bailey at Apr 15, 2005 11:10:51 AM

Hi Trish! I've alerted my readers that you sometimes blog about the Marburg Virus. Hopefully, they (as I have already done) will bookmark your site!

Posted by: Dave Lucas at Apr 17, 2005 10:38:46 PM

4/21/05--notice the World Health Organization has stopped reporting the death toll since 4/15/05...makes me curious as to why there are no new updates since then. Doctorswithoutborders.org and the CDC have no new information, either. For the WHO.int not to post statistics after giving daily updates (until the toll was 235 deaths per 257 afflicted) something seems really disquieting.
Almost too quiet. I think all hell has broken loose.

Posted by: Helenann Olsen at Apr 22, 2005 2:01:51 AM

Ah hah! Found some more Marburg information...go to: allafrica.com, and to the Angola section. Last death toll was 277, but there is some slowing down that is CAUTIOUSLY reported. Also a good website to learn about the AIDS epidemic and how to help.
Thanks,
Helenann

Posted by: Helenann Olsen at Apr 22, 2005 2:41:39 AM