Marburg haemorrhagic fever in Angola - update 12

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

[Covenantor]

Well stated.

[Dog Gone]

One thing that's changed recently is that families are no longer taking patients to the hospital since nobody has come back alive. Consequently, testing and reporting has been largely eliminated.

We're in a period now where we're getting less good data and only can get some data from the corpses when families report them.

The quality of data from Angola is going down rapidly and it tends to indicate a peak in the disease. Perhaps 20 known cases of currently alive patients in the entire country.

However, this practice of not hospitalizing patients is only a recent development, so we may find within a week or so of starting to get more reports of deaths than known cases.

[2ndreconmarine]

I agree. As several of us have mentioned, we are now in the phase of waiting. Either the epidemic will burn out or the next set of data will show a marked increase in the number of cases.

Assuming the growth rate has remained constant, we should be approaching 300 cases tonight.

[redgolum]

Add me to the ping list please.

Scary stuff. This bug is very nasty, and I would hate to see what would happen if it hit a large city.

[Semper911]

Do you have room for one more on your ping list for these update threads?

I have been following the articles Mother Abigail has been posting, and your updates would be very helpful to me.

[Dog Gone]

Scary stuff. This bug is very nasty, and I would hate to see what would happen if it hit a large city.

Uige is a city of over 200,000 people. That's a sizeable urban concentration and one without a lot of modern sanitization. A good portion still gather water to take to their homes, for example.

While this virus is universally deadly, as far as I can tell, it's not as contagious as it first appeared. It looks to me like you actually have to ingest bodily fluids from someone in the mid to late stages of this disease.

Now, it's not hard to to do that when you're in close contact with such a person, but it's not as if touching the door handle of someone who's infected but not showing symptoms yet is any threat.

I might be completely wrong here, and we'll know a lot more in about a week, but I think this thing can be be contained.

[Covenantor]

done

[kanawa]

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.

U.S. Embassy Luanda
As of April 12, 2005, there continues to be four confirmed deaths from Marburg hemorrhagic fever in Luanda. All individuals became ill in Uige province and traveled to Luanda for treatment. There are no reports of people contracting the disease in Luanda, as well as there are no active cases now reported in this city. There is one confirmed case and death in Cabinda province, also of an individual who traveled from Uige province, and one case in Kwanza Norte province. There are five confirmed cases in Malange province, which borders Uige province. In Uige province, the cases were reported outside Uige city, in Songo, Damba, Negage, Puri and Maquela do Zombo. Health officials recommend that normal sanitary precautions should be used, including frequent hand washing, to minimize any chance of exposure.

(Site reports 3 confirmed deaths in Luanda as of Mar.25 and one more as of Apr. 5. No change up to Apr.12)

Info on Songo here

Shows relation of Songo to the city of Uige with populations...also Negage

[He Rides A White Horse]

"The Masque of the Red Death" by Edgar Allen Poe............makes me wonder if this type of disease hasn't been encountered ealier.

[Judith Anne]

I still think your graphs are accurate for the confirmed cases. But, I agree with you, we'll have less and less data about confirmed cases, and likely a leveling off, and we won't know what that leveling off indicates.

I read on recominomics.com a report by Doctors Without Borders, who believe that the outbreak is continuing to expland. They weren't asking for more money, either, just saying that the hospital that has been prepared for Marburg victims is sitting empty--no one is bring patients in, due to the huge mistrust of all medical authorities like WHO.

They are moving efforts toward educating the populace on how to prevent the family cohort from getting sick when they have a Marburg case--how to disinfect, what not to touch, washing after contact, spraying bleach, etc.

This, to me, is just as futile as anything else. My sister, an RN, goes to Haiti every year with them, and told me of a case of serious kidney infection. Medication to CURE the infection was given, with instructions to take a pill three times a day with a clean glass of water, which she said was a laugh. Clean water costs a dollar a gallon, and the average family income was $2-3 dollars a day.

So, how are families who will admit having a Marburg patient going to wash up (clean water, soap, towels) after taking care of the patient? There is no running water, and the only people with electricity are those rich enough to afford a generator. They can't even change to clean clothes after getting vomit or blood on them...

I blame the UN, and I blame the WHO--I blame the damn thugs who each run a little tiny section, and who spend every spare dime on luxury for themselves, instead of an infrastructure. There could not be a worse place for an outbreak than the primitive "city" of Uige.

[kanawa]

There has to be some interesting squabble going back to colonial times about Cabinda province. That's a very odd territorial anomaly.

History
The Enclave of Cabinda originates from the old Kingdoms of Makongo, Mangoyo and Maluangu. These regions were attractive to colonialists and disputes regarding influence and possession arose among European countries such as France, Holland, Germany and Portugal in the 18th and 19th century.

Cabinda was first recognised as a political entity by the 1885 Treaty of Simulambuco, signed between local traditional leaders and the Portuguese Crown. The treaty guaranteed Portuguese protection over the people of the region to counter colonial expansion in the Congo Basin carried out by Belgium's King Leopold II.

Portugal had already established colonial outposts along the coast between the Cunene and Congo Rivers. Following the Berlin Conference of 1885, these outposts were consolidated into the colony of Angola, which eventually grew to encompass the contiguous area that today makes up seventeen of Angola’s eighteen provinces. Cabinda was initially administered separately from Angola, as a protectorate rather than as a colony.

In the 1930s, the Portuguese dictator António de Oliveira Salazar sought to exercise tighter control over the country’s overseas possessions. Angola was declared a province of Portugal, and Cabinda was brought under the same administrative structure as Angola.

As other European colonial powers prepared to grant independence to their colonies in the 1960s, Portugal showed no willingness to relinquish control of its African territories. This gave rise to competing armed independence movements such as the National Front for the Liberation of Angola (FNLA), the Popular Movement for the Liberation of Angola (MPLA) and the National Union for the Total Independence of Angola (UNITA). While these groups competed for influence in the rest of Angola, the Front for the Liberation of the Cabinda Enclave (FLEC) sought independence for Cabinda.

When a change of regime in Lisbon prompted moves toward independence for the Portuguese colonies, the Portuguese government engaged in talks with the FNLA, MPLA, and UNITA, but not with FLEC. The MPLA, which took power on November 11, 1975, soon extended its control to Cabinda.

Since then, Cabinda has been administered as a province of Angola, with government officials appointed directly from Angola's capital, Luanda. The current Angolan constitution does not allow for the election of officials at the provincial and local levels.
more

[Dog Gone]

Thank you for that fascinating post. I have a degree in history, but it sure didn't include much African history.

[Jedidah]

Would you please add me to your Marburg ping list? Thanks.

[Covenantor]

Thanks for that addition.

[Covenantor]

Done

[Covenantor]

Another thanks for that bit of history. Shall I add you to the ping list?

[Covenantor]

Poe had a vivid enough imagination. But it does stir memories of that work.

[kanawa]

For sure....I'm already on Mothers', but the more eyes and ears the better.

[ordinaryguy]

Are families going to report deaths after they happen? As soon as they do that, the people in space suits will come for them. I fear that they will bury them in silence.

[ordinaryguy]

It looks to me like you actually have to ingest bodily fluids from someone in the mid to late stages of this disease.

Ingest? Did the medical workers who contracted the disease ingest bodily fluids from patients?