The demographics began to change several weeks ago when the first health care workers were infected. The number of workers who have died is at least 12. In the past 1-2 weeks deaths have been reported for the first time in the four provinces surrounding Uige.
The latest reports do not have as much detail on the age of patients or the breakdown of locations. They also do not update the status of the passenger in Portugal being tested (a report on the third passenger was scheduled for release last Thursday), or the suspect cases in the Democratic Republic of Congo. There have also been media rumors of additional cases in Cabinda.
The number dead has surpassed the record of 126 for Marburg and now appears likely to surpass the record number of 280 Ebola deaths. Although contact tracing efforts are increasing, the 20 newly diagnosed patients who have not died indicate that the number of contacts should be at least 2-4X the 100 being monitored or traced by WHO. Media reports indicate that 16 are under hospital quarantine in Cabinda and 9 are under quarantine in Italy. These 25 under quarantine are linked to just two of the 155 deaths.
The case fatality rate of 100% and rapid spread of the virus in five provinces is markedly different than prior Marburg outbreaks.
Again, thank you for your informative posts.
>> Allarangar Yokouidé, an epidemiologist with the World Health Organization, told reporters that more than 80 percent of those who contracted the virus in Angola had died, a mortality rate that surpassed previous Ebola epidemics in the region. "Marburg is a very bad virus, even worse than Ebola," he said. <<
The case fatality rate for Marburg in Angola is above 99.4%. There is at most 1 survivor out of 181 outcomes. Thus, hospitalization offers little hope for survival, which has led to mistrust by local residents.
Mobile surveillance operations in Uige have ceased because of damage to vehicles and threats of violence. It is unclear if health care workers have been killed because of the unrest, but clearly contact tracing has been limited in the Uige, which is the epicenter of the outbreak.
Therefore management by contact tracing and quarantine will be difficult. The lack of survivors has also led to relatives hiding sick patients because no one has come out of the hospital alive. However, care by untrained and unprotected relatives leads to further transmission. This transmission has now reached Luanda, Angola's capital.
The 3 million residents of Luanda will get increasingly concerned as the virus spreads in Luanda and the number dead increase. The lack of any survivors creates more suspicion about the motives of health care workers and those trying to monitor and quarantine contacts of infected patients.
--------------------------------------------------------------
Doesn't sound good.