A Fever's Deadly Path (The worst outbreak of Marburg fever isn't reined in yet)

Newsweek ^ | May 2 edition | Jill Jordan Sieder and Arian Campo-Flores

[bitt]

May 2 issue - The woman lay dead last week in a small mud hut in rural Angola, a trickle of crusted blood snaking from her nostril. Nearby was a syringe she had used in a last hopeless attempt to cure herself of the ghastly sickness. When a team of medics arrived, they sprayed the room with bleach and placed her corpse in a body bag. Outside the hut, some 50 people wailed and screamed, clutching photo-graphs of the loved one they had just lost.

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She was yet another victim claimed by the re-emergence of Marburg hemorrhagic fever in Angola. Virtually identical to Ebola, the Marburg virus is highly contagious and attacks quickly and ferociously, destroying organs and often causing victims to bleed out of their eyes, genitals and other orifices. As of last week, the outbreak had killed 239 people out of 266 reported cases. In response, medical teams from across the globe have rushed in to try to contain the epidemic. But they confront a maddening array of obstacles, from the clinical to the cultural.

Much about Marburg remains a mystery. It surfaces suddenly and can disappear just as quickly. Researchers still aren't sure where the virus hides between outbreaks. Some say in monkeys; others say in bats. In most of the major Marburg outbreaks since 1968, bats have been present or nearby. While no cure or vaccine for the virus exists, investigators at the National Institutes of Health have made strides in developing a vaccine for Ebola and two weeks ago announced a contract with a Dutch biotech company to target Marburg as well.

[bitt]

Judith Anne's ping list

some info, not a lot...

[bitt]

'Two health workers leave a Marburg virus isolation ward in Angola earlier this month'

also see the related story, "Hot Zone II"

http://www.msnbc.msn.com/id/7589190/site/newsweek/

[EBH]

As communities begin to understand the dangers of the virus, though, the number of new cases has dropped from an average of 35 per week to 15, according to the World Health Organization.

http://news.yahoo.com/news?tmpl=story&u=/ap/20050424/ap_on_he_me/un_angola_deadly_virus

[bitt]

or are the cases being hidden from authorities, by the relatives who
a. are afraid to lose them to the death wards or
b. the relatives are already sick?

[EBH]

Oh, put the tin foil hat away. They're braggin' about good news, it's coming under control...t'aint that what we were looking for "news." (sarcasm off)

[null and void]

It will be an interesting case study to compare the responses of the authorities in Angola to that of the authorities in Las Vegas...

[2ndreconmarine]

http://www.msnbc.msn.com/id/7589190/site/newsweek/

That was a great article. Thank you for the post.

This guy provided some of the most intelligent answers we have seen in a long time. It is also entirely consistent with the data we have observed. Including, the drop in cases from 35 to 15 per week.

I have only one concern. He states categorically that Marburg is difficult to catch; it requires close contact with the fluids of an infected and symptomatic patient. However, the Reston outbreak (c.f. The Hot Zone), was airborne transmissable. It seems that an airborne version of Ebola or Marburg that was also infectious to humans (Reston was not), might be possible. The early data from this outbreak suggested that possibility here.

[Judith Anne]

Okay, I read the article. One thing I disagree with I found in these paragraphs:

(1)Dr. Anthony Fauci: It is extremely unlikely to cause a public health threat, other than a very isolated case outside of a setting like sub-Saharan Africa, where there’s a healthcare delivery issue. It is not easily spread. It requires very close personal contact. That’s the reason why health workers, family members who take care of the patient or morticians who handle the body are at grave risk. It is not spread by casual contact.

(2)The next issue that makes it extremely unlikely that it would pose a global health threat in the developed world is that people can only transmit the virus when they’re deathly ill, unlike influenza or maybe even SARS, where people can transmit it when they’re not feeling very well but they’re well enough to travel. Someone with influenza can get on a plane and fly. But the people who have Marburg, when they are capable of transmitting the infection, it is when they are bleeding from the nose, the mouth, the rectum, the vagina.

(3)You would not expect someone who could pass on an infection to be walking around the streets, getting on a plane. As horrible as the disease is for the person who has it, the circumstances of how it spreads make it very unlikely for it, in a developed world, to pose a public health threat.

1. Okay, if it isn't easily spread, why the moon suits? Come ON! If we aren't supposed to be concerned about casual contact being risky, then what's the deal with the 2-hours in, 3-hours-disinfecting and out moon suits? If the people who know best are wearing them, then pleae don't tell me it can't be spread by casual contact.

2. Who says the disease can only be spread by someone who is "deathly ill"? Excuse me, but the viral load in each patient increases at a huge rate over 3-21 days until symptoms begin: back pain, headache, fever, vomiting, diarrhea. I can think of a lot of ways to treat the symptoms--narcotics for one--that would allow the virus to spread and leave the patient able to walk around. No need for bleeding rectums--just sweaty hands...

3. A sick person with narcotics could go to the library, could go to a restaurant, could go to a theater, could get on the subway, could do a lot of things before hemorrhaging started. For instance, a patient with malaria who gets Marburg, has strong pain meds, has antimalarials, these help control the diarrhea and fever, the patient is walking around for a day. Could spread a lot of virus....

Or a patient with malaria comes to NY from, say, a country bordering Angola, and has Marburg. He gets sick, goes to the ER, tells them he has malaria, they check, he does, they treat it and admit him to the general patient population with no particular isolation precautions. He spreads a lot of virus to dietary, x-ray, ER nurses and docs, the other patient in his room and family, laundry, etc.

He goes on: No “Hot Zone II”? Absolutely not. It isn’t like I’m walking down the street and somebody sneezes on me. That’s not the way it happens. You have to be intimately close with a person with advanced disease. When you handle the virus in the laboratory, you have to wear that hot-zone suit.

Excuse me, but those photos of men in moon suits accompanying this article are NOT in laboratories. They're walking down the street. The blatant contrast between their actions and Fauci's statement couldn't be more glaring.

[Judith Anne]

And here's one other comment that tells me how much to respect MSNBC and Dr. Fauci on this:

There's no commercial air travel between Angola and the United States. Should we find that reassuring? Again, it gets back to my question. It doesn’t matter where the airport is. Somebody’s not going to get on the plane because they’re going to be too sick [if they had the Marburg virus].

No commercial air traffic between Houston and Luanda? We knew better than this a month ago.

[Dr. Eckleburg]

Won't be the first time.

[Judith Anne]

PS--hemorrhaging doesn't begin until up to 5 days after the OTHER symptoms start. So.............

[Dr. Eckleburg]

Wouldn't be the first time.

[tet68]

Something about the numbers doesn't seem right,
we've watch it ramp up and up and now it's static?

I don't like it.


Does this mean that the remaining infected have survived?
I didn't know there WERE any survivors?

Perplexed.

[Judith Anne]

I think the average reader of these Marburg threads has access to better information than MSNBC, frankly.

[bitt]

not ready to believe anything positive until I see a LOT more reports from people on the ground. it could be like the reports from Iraq...we COULD choose to believe that the situation is 'a quagmire', like the MSM reporters tell us as they hang around the pool in Kuwait...

lately, all the news is from some scientist say, in Canada, who gets data from WHO and tells us "oh, it's much better....."

Send Jack Bauer to get this in hand. ("24")

[tet68]

Ooorah!

I don't suppose it's possible for someone of a terrorist bent to take blood from one of the victims, keep it alive
in whole blood for transport, then infect carriers,perhaps
even willing ones?

[Judith Anne]

So far, no one who has gotten this new Marburg has survived, but you've made me think...what about a transfusion (like was mentioned on the other thread) from a patient who HAS survived the earlier, less deadly Marburg? Maybe enough antibodies would help...

[tet68]

I don't know about that, you'd think someone would have thought of it before this.

I was mainly concerned with someone intentionally spreading
it.

All that talk of how it would't spread in first world countries seems like such bunk, I would have said it would
propagate that much faster in a dense population, even one
with modern health care simply by overwhelming the services.

[Judith Anne]

Here's an email I got from Dr. Niman, an FYI for FReepers:

The full three hour interview of April 21 will be encored tonight at 10 PM EST and then rebroadcast again at 1 AM

http://rense.com/general57/notice.htm

The show starts with WSN/33 - lots of detail on discovery and how viruses evolve. Next comes discussion of situation in Vietnam followed by details on the H2N2 mailing and alert. Marburg covered in the final 30-45 minutes. The full 3 hours and rebroacast tonight can be heard online at no charge (membership required for archives of the broadcasts from Genesis Communication Netweork).


Past and future interviews on the topics can be accessed from

http://www.recombinomics.com/in_the_news.html