Marburg haemorrhagic fever in Angola - update 12

World Health Organization ^ | 14 April 2005 | World Health Organization

[Covenantor]

Marburg haemorrhagic fever in Angola - update 12

14 April 2005

As of 12 April, 235 cases of Marburg haemorrhagic fever have been reported in Angola. Of these cases, 215 have died.

Uige Province remains the most severely affected area, reporting a cumulative total of 208 cases and 194 deaths. The isolation ward at the province’s large 400-bed hospital, which has been specially equipped and staffed for the care of Marburg patients, is empty, despite the fact that cases and deaths are known to be occurring in the community. It is apparent that, for the time being, the community does not accept the concept of isolation. Residents are unwilling to report suspected cases and allow these people to be managed under conditions that reduce the risk of further transmission.

Measures such as patient isolation and infection control that reduce opportunities for further transmission are the principal tools for bringing the outbreak under control. Given the urgency of the situation, WHO may temporarily introduce, as an emergency measure, a harm reduction strategy aimed at making a dangerous situation somewhat better. Family members and other caregivers who refuse to allow patients to be cared for in the isolation facility are being informed of ways to protect themselves from infection and given appropriate supplies. WHO has placed urgent orders for disinfectants, which are currently in short supply in Angola.

Today, international staff drawn from the Global Outbreak Alert and Response Network began training sessions for staff at the provincial hospital in the use of equipment and supplies to reduce the risk of infection in the health care setting. This training, which has been very well received, will continue through Saturday. Fever-screening units are being established to ensure that all persons admitted to hospital are initially screened for symptoms of Marburg haemorrhagic fever before being admitted to the general hospital wards.

Apart from continuing security concerns, another pressing problem is poor access to remote communities in Uige Province and correspondingly poor surveillance for cases in these areas. With the assistance of a military helicopter, international staff have begun pre-positioning supplies and equipment needed for outbreak control in these areas so that a response can be launched immediately should cases begin to occur.

In a tragic development, four Red Cross volunteers, freshly trained in social mobilization, were killed today by lightening while on their way to work. Support from Red Cross volunteers has been instrumental in controlling large outbreaks of the closely related Ebola haemorrhagic fever. WHO recognizes the importance of this support and deeply regrets the death of these volunteers.

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[Covenantor]

Current WHO update.

[Covenantor]

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...As of 12 April, 235 cases of Marburg haemorrhagic fever have been reported in Angola. Of these cases, 215 have died....

[Covenantor]

Angola is 'Safe Up to Luanda'

The Namibian (Windhoek)
NEWS
April 14, 2005
Posted to the web April 14, 2005

By Christof Maletsky
Windhoek

HEALTH Minister Richard Kamwi says Namibians can travel to any parts south of Luanda in Angola.

"Those areas (north of Luanda) are dangerous," Kamwi told The Namibian as he emphasised the threat posed by the outbreak of the dreaded Marburg fever in northern Angola.

The Ministry has intensified its surveillance at borders, but Kamwi said there was no way they could prevent people moving across the borders.

"It is a known fact that people have loved ones on both sides of the border with Angola and you know how big the border is," he said.

Kamwi said the Ministry of Health was in control and called on people not to panic.

On Monday, his Permanent Secretary Dr Kalumbi Shangula said not a single case of Marburg fever had been reported in the country, but that Government was not taking any risks.

A medical doctor was stationed at the Hosea Kutako International Airport to handle enquiries about the Ebola-like fever and to tip off health authorities of any suspected cases.

An information pamphlet in English and Portuguese was also being distributed to all passengers on incoming flights from Angola.

The early symptoms of Marburg are fever, severe diarrhoea, abdominal pain and vomiting, severe chest pains, a sore throat and a cough.

Bleeding of the lungs and digestive tract develops a few days later.

There is no known treatment for the disease, and there is a 25% to 80% chance of death.

[Dog Gone]

Family members and other caregivers who refuse to allow patients to be cared for in the isolation facility are being informed of ways to protect themselves from infection and given appropriate supplies.

You gotta wonder how effective this will be. I think it's more likely to give the family members a false sense of security.

[Covenantor]

Ruling MPLA Party Promotes Meeting On Marburg Haemorrhagic Fever

Angola Press Agency (Luanda)
NEWS
April 14, 2005
Posted to the web April 14, 2005
Luanda

Angola's ruling MPLA party committee in Luanda will hold on Thursday here a meeting on Marburg haemorrhagic fever, which has already killed 210 people, a press note says.

The Deputy Health Minister, Jose Van-Dunem, will preside the gathering. He is to speak on preventive measures and the efforts being carried out by the Government to fight the sickness.

The initiative aims to provide Mpla militants with essential elements to sensitize the communities, adds the document.

[Covenantor]

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WHO warns tourists of deadly Marburg outbreak

Geneva - The World Health Organisation on Thursday advised travellers to Angola to take precautions against the deadly Marburg virus for the first time since the growing outbreak there was detected last month.

The WHO called on people with existing medical conditions that might require hospital treatment to consider putting off non-essential travel to the country, especially to the epicentre of the outbreak in northern Uige province.

"Travellers to Angola should be aware of the outbreak of Marburg haemorrhagic fever and of the need to avoid close contact with ill persons," the United Nations' health agency added in a statement on its Internet site.

People leaving Angola should also seek medical help if they have any illness with fever with 10 days of leaving the country.

The official death toll from the virus in Angola rose to 215 on Wednesday, with a further 235 people infected.

Uige province was the worst affected, with 194 dead and a further 208 people infected there, health authorities said.

The WHO said it was not aware of any cases among foreigners except those involved in medical care in Uige. - Sapa-AFP

Published on the Web by IOL on 2005-04-14 13:47:15

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© Independent Online 2004. All rights reserved. IOL publishes this article in good faith but is not liable for any loss or damage caused by reliance on the information it contains.

[appalachian_dweller]

215 dead out of 235 infected = 91.5% mortality rate. That is one nasty bug.

[Covenantor]

Uije: Over 150 Families Under Medical Vigilance Due to Marburg Fever

Angola Press Agency (Luanda)
NEWS
April 14, 2005
Posted to the web April 14, 2005
Uije

Over 150 families residing in the Northern Uije Province, whose relatives died of Marburg haemorrhagic fever, are under medical vigilance, on Thursday said Angop a health source.

The chief of the National Technical Commission on the Marburg, Paulo Folo, said the commission decided to fellow-up these families to facilitate a better control on the infection of the virus.

He explained that in the communities and due to the usual practices, such as washing of dead bodies and direct contact with patients, so many people have been infected and thus, are infecting others who are out of the control of the health authorities.

The commission, comprising national and foreign health technicians, is currently holding sensitization campaign in communities and churches located in the Province, on the measures to fight the illness.

Meanwhile, a team with the non-governmental organisation Medicines Without Border on Wednesday met with traditional midwives for exchange of opinion, in the ambit of the mechanisms to avoid the spreading of the sickness.

At least 215 people died of the Marburg haemorrhagic fever, since its outbreak in October 2004.

	Copyright © 2005 Angola Press Agency. All rights reserved. Distributed by AllAfrica Global Media (allAfrica.com).

[Covenantor]

Journalists Leave for Uige Province

Angola Press Agency (Luanda)
NEWS
April 14, 2005
Posted to the web April 14, 2005
Luanda

A group of 25 national and foreign journalists left Luanda today for the northern Uige Province, to check the state of evolution of the haemorrhagic fever epidemic caused by the Marburg virus.

The visit, which is scheduled to last three days, is part of the transparency programme of the Government and the efforts being done to control the disease.

Besides the informative element, the journalists will participate in activities of mobilisation and sensitization of the population on the primary cares of prevention against the epidemic.

The group also includes the coordinator of the national technical commission for social mobilisation, and an official from the World Health Organisation.

According to the press officer of the Health Ministry, Carlos Alberto, the referred delegation will take materials for bio-security and some medicines.

While in Uige, the journalists will visit the Central Hospital where the Marburg infected patients are being cared, as well as go to Songo municipality, a locality with the highest number of cases.

The Uige Province is the most affected by the haemorrhagic fever, having already recorded 197 deaths out the 208 cases.

Since October 2004 to 12 April 2005 have died 210 people, in the country, from the Marburg virus, out of the 231 cases so far recorded.

The other provinces, besides Uige, in which Marburg cases were recorded are Luanda, Kwanza Norte, Kwanza Sul, Malange and Cabinda.

	Copyright © 2005 Angola Press Agency. All rights reserved. Distributed by AllAfrica Global Media (allAfrica.com).

[Covenantor]

Zambia issues Marburg warning

Lusaka - Zambia has sent a medical team to areas bordering Angola to alert residents to the threat posed by the outbreak of the deadly Ebola-like Marburg virus that has claimed more than 200 lives in Angola, an official said on Wednesday.

The team has been dispatched to western and northwestern provinces of Zambia, which shares a long border with eastern Angola, said Central Board of Health spokesperson Dr Victor Mukonka.

"We are mainly alerting people in border areas. We are educating them on the precautionary measures to avoid anyone of them contracting the virus," Mukonka said.

He said the Zambian health personnel were using the guidelines given by the World Health Organisation (WHO) on the prevention of the Marburg virus.

Other measures are being put in place in the capital Lusaka such as screening arrivals at the airport so that those with signs of the virus can be quarantined to avoid the spread of the virus.

Zambia has not recorded any case of Marburg virus.

Thousands of Angolan refugees are currently sheltered in Zambia's western and northwestern provinces in camps and they are scheduled to be repatriated home next month.

[Covenantor]

Chances are that they have already been exposed and this is a palliate measure.

[Covenantor]

Much deadlier than in previous known outbreaks.

[spetznaz]

The funny thing is that until this outbreak Marburg was said to have a mortality rate of around 25-30%. Guess the CDC will have to change that now huh.

[Dog Gone]

215 dead out of 235 infected = 91.5% mortality rate. That is one nasty bug.

91.5% is low because the 235 includes people who just haven't gotten around to dying yet.

[armymarinemom]

Journalists Leave for Uige Province

That's going to help. Now they will visit and hop on flights out of there.

[2ndreconmarine]

As of 12 April, 235 cases of Marburg haemorrhagic fever have been reported in Angola

It is apparent that, for the time being, the community does not accept the concept of isolation

The data are now at least 2 days old. The hospital is empty. This suggests to me that they do not have updated numbers. One of two possibilities then: 1. The epidemic is peaking, or 2. The next set of data will become available when there are a lot more cases and it becomes obvious the epidemic is spreading.

Apparently, Marburg cannot be spread unil symtoms appear. If that is the case, isolation becomes potentially more effective and they may be able to stop this thing.

[rawcatslyentist]

Sounds like the top bug on the list of what to take to the next Hadj.

Islime has to be destroyed. Go for the heart of the beast.

ABC CBS NBC CNN its all the SAME, Propaganda.
Might as well call them all AmeriJazerra.
Show them how much Gravitas Hugh Bris has. Vote with your remote! Shut down the Alphabet channels.

He's Got A Plan
Zippo Hero
Seven Dead Monkeys Page O Tunes

[Covenantor]

The funny thing is that until this outbreak Marburg was said to have a mortality rate of around 25-30%. Guess the CDC will have to change that now huh.

That's one of the questions. Look below and you' see that the reported number of cases in this outbreak are already approaching 50% of all known outbreaks, so this instance is adding to the database. It's suspected that this form is a variant of previously known Marburg strains but I haven't seen any substantiation.

Year	Location	Cases	Mortality	%	Reference
1971	Zaire	1	0	0	Samaranayake & Peiris, 1996
1976	Sudan	360	150	42	Samaranayake & Peiris, 1996
1976	Zaire	318	280	89	Samaranayake & Peiris, 1996
1977	Zaire	2	2	100	Samaranayake & Peiris, 1996
1979	Sudan	34	22	65	Samaranayake & Peiris, 1996
1989	Reston, USA "The Hot Zone"	4	0	0	Sodhi, 1996
1994	Gabon & Cote d'Ivoire	?	?	?	Breman et al, 1997
1995	Zaire	315	246	78	Breman et al, 1997

source:http://www.tulane.edu/~dmsander/WWW/335/Filoviruses.html

[Judith Anne]

I know that you know this, just posting information for all.

Cases identified officially as Marburg are those which had specimens sent to the CDC in Atlanta and confirmed. Many samples could not be confirmed and may have been read as negative due to degradation of the samples during transport, or poor collection technique due to lack of equipment.

Turnaround on sample reads is about two weeks. Thus, this information, while it is the latest available, is two weeks old and unreliable.

This does not take into account the likely cases--some already dead, that are not classified as Marburg due to not having the labs read yet. This also does not take into account the likely cases that refuse what passes for medical attention and actively attempt to evade the WHO and UN.

So, it's the best actual information we have, but it isn't much good.

[Pan_Yans Wife]

Can you please add me to the ping list?