Ugandan Health Worker Dies Of Marburg Virus, Ebola Relative

forbes.com ^ | October 5, 2014

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Bring Out Your Dead

Post to me or FReep mail to be on/off the Bring Out Your Dead ping list.

The purpose of the “Bring Out Your Dead” ping list (formerly the “Ebola” ping list) is very early warning of emerging pandemics, as such it has a high false positive rate.

So far the false positive rate is 100%.

At some point we may well have a high mortality pandemic, and likely as not the “Bring Out Your Dead” threads will miss the beginning entirely.

*sigh* Such is life, and death...

[SunTzuWu]

I might be wrong but this is what I remember from a few years ago:

More than 100 people in Angola have died so far in an outbreak of the deadly Marburg virus, a close relative of Ebola. If you have to fall sick with a viral hemorrhagic fever from the Marburg-Ebola family, which one should you choose?

Go with Marburg. Though we don't know very much about how these viruses work, history suggests that between a quarter and half of all people who get Marburg die from it; there is a 90 percent mortality rate among those who contract Ebola. These numbers may be revised in light of the Marburg outbreak in Angola, however. Early reports indicate a mortality rate of nearly 100 percent.

This comes from:

http://www.slate.com/articles/news_and_politics/explainer/2005/03/marburg_vs_ebola.html

And from the excellent book on the subject "Hot Zone" by Richard Preston.

[Smokin' Joe]

The Marburg outbreak of 2004 really skewed the numbers. We tracked that one here as it was the largest and deadliest at the time. Fatality rates were 90%+.

This post has the links to The Marburg Surveillance Project threads from that outbreak, if you are interested.

[Smokin' Joe]

We have a zoonotic disease in the US, that is 100% fatal if you are exposed and don't know it.

Yep. But not too many critters are getting on planes and flying around frothing at the mouth and biting people. Wild animals which are unusually docile or aggressive, unvaccinated pets (stupid, but there are some) behaving strangely are more obvious than deceitful people from elsewhere or someone who just thinks they are coming down 'with something' who does not realize they have been exposed.

Rabies tends to be more straightforward and avoidable, and there is a vaccine.

[exDemMom]

Every once in a while, someone contracts rabies with no known exposure to a wild animal. The exposure is then extrapolated from the sequence of the virus genome, since rabies viruses are unique to species.

People who are asleep can be bitten by bats and be unaware that they were bitten. In one case, a man was moving wood, and either got bit by a bat or got a sliver covered with rabid bat saliva... in any case, he did not know he was exposed and later died.

Some of the rabies exposure stories would leave you scratching your head at the sheer stupidity some people exhibit. Like the one where a kid found a bat and took it to school for show and tell, and many kids handled it. Later, someone thought to have the bat tested... one of the parents of a kid in the class, I think, since not a single kid or the teacher thought anything bad about having a bat in the classroom. Quite a few had to receive prophylaxis over that one.

I have no evidence that Mr. Duncan was in any way deceitful. Prior to coming to the US, he had helped take a young woman to the hospital. I have heard that her family told people she had malaria. So, if he thought that she died of malaria, he would not have answered that he had contact with someone sick with Ebola.

[Smokin' Joe]

I had read he handled a corpse of a relative. It is not uncommon in Liberia for people to deny contact with Ebola victims to avoid isolation, which is commonly seen as a death warrant.

[Smokin' Joe]

"The documents also show that a nurse recorded early in Duncan’s first hospital visit that he recently came to the U.S. from Africa, though he denied having been in contact with anyone sick."

likn to story

[exDemMom]

The woman that Mr. Duncan handled was his landlord’s daughter. She had been diagnosed with malaria (it is possible she had that as well as Ebola), and her family insisted that it was malaria, even when several other family members got sick and died.

In any case, he should have been admitted to the hospital when he said he came from Liberia. I’m afraid the hospital is going to get in a lot of trouble because of that oversight. Of course, Jesse Jackson showing up to fan the flames of racism is just making a bad situation worse.

[exDemMom]

The documents also show that a nurse recorded early in Duncan’s first hospital visit that he recently came to the U.S. from Africa, though he denied having been in contact with anyone sick.

I wonder about that, what the exact words of the question were, and what his answer was. Any African knows that malaria is not contagious, so he very well could have answered "No," since he'd had no contact that he knew of with anyone who was contagious with anything.

[Smokin' Joe]

In any case, he should have been admitted to the hospital when he said he came from Liberia. I’m afraid the hospital is going to get in a lot of trouble because of that oversight. Of course, Jesse Jackson showing up to fan the flames of racism is just making a bad situation worse.

Agreed, on all counts. The facts will continue to become muddled as the usual suspects gain traction.

The real thought question here, is one of how many such patients' treatment can hospitals absorb, financially (not to mention the lawsuit lotto going on) before they shut down?

Behind it all, the war on healthcare providers continues.