Anomolous Deadly Marburg
Virus Outbreak Spreading

From Patricia Doyle, PhD
Synopsis of National Public Radio Broadcast
on the Marburg Fever Outbreak

National Public Radio - All Things Considered
[1] The World Health Organization (WHO) says Marburg Virus has sickened 140 people in Angola and killed 132, most of them young children. International health organizations are rushing personnel and equipment to the war-ravaged country to stem the epidemic. Still, WHO experts told National Public Radio (NPR)'s Richard Knox that they expect the Marburg toll to get much larger.
Marburg hemorrhagic fever isn't as much feared as its cousin Ebola hemorrhagic fever. But in fact, they're hard to tell apart. [Clinically they are associated with similar disease symptoms, but the 2 viruses do not cross-react antigenically and are easily distinguishable by serology and RT-PCR assay. - Mod.CP]. In both cases, victims bleed to death, often from every orifice and every organ. Few infections are as deadly. That's why the WHO, the US Centers for Disease Control and Prevention, Health Canada and the medical aid group MSF (Medecins sans Frontieres) are rushing to Angola.
Dr. Mike Ryan is managing WHO's response from Geneva. He said that: "The cases counted so far don't include victims who died outside hospitals. Some WHO experts expect a doubling of the current toll. That would make this Angolan outbreak the largest Marburg epidemic ever...and larger than almost any Ebola [hemorrhagic fever] outbreak. International workers and protective gear are just arriving." So Ryan said also that it will take time to show results. "We're going to see further waves. Even with the best of interventions, you're going to see at least 2 waves of transmission before you start to gain control of the problem."
So far most Marburg cases have been in a northern province called Uige. But there are reports of cases across Angola's border with the Democratic Republic of Congo. Dr. Pierre Formenty, the WHO's top Marburg expert, is struck by how widely the virus has already spread. Dr. Formenty stated that: "It is the 1st time we have geographically speaking so large an outbreak of Marburg fever. We have cases not just in Uige city itself but in different cities around Uige, up to 20 to 40 kilometres away. The outbreak probably started last October [2004]. Many people got infected in hospitals." Dr. Formenty thinks sloppy injection practices explain why most victims are below age 5. Doctors often give medicine to young children by injection rather than by mouth.
The biggest fear is that Marburg will begin spreading from person to person in Angolan cities. There have been cases in the provincial capital of Uige, a city of 200 000. And 3 people have died in Luanda, a coastal city of more than three million that is Angola's capital. Luanda has several other possible cases. But Dr. Formenty said the known and suspected victims came from Uige -- and didn't contract Marburg fever in Luanda. Formenty stated that: "Today we have no evidence of transmission within Luanda. We have evidence of people who have escaped Uige to die in Luanda, yes. ...but we have no secondary transmission in Luanda or in any other city. Finding and isolating Marburg cases in a big city is hard enough. Tracing people they might have infected is daunting. That's why Angolan and WHO officials are trying to dampen panic, which could cause people to flee from Uige to the capital...and bring the virus with them."
Dr. Christa Kitz, who is coordinating the work of Medicins sans Frontieres in Luanda, stated that: "In Luanda it's still a little bit calm but we are hearing from Uige province that health-care workers are fleeing hospitals, that they are not returning to work, and also that the population is trying to run away from the area. In Luanda city there is no real panic reaction yet but the fear grows every day."
Richard Knox
NPR News
Date: Fri 1 Apr 2005
From: ProMED-mail <
Source: Australia Broadcasting Corporation, Fri 1 Apr 2005
Suspected Marburg Hemorrhagic Fever Cases Hospitalized in Italy
Italian hospital staff have put 9 patients in isolation, suspected of contact with the Marburg virus, an Ebola-like [disease] which has broken out in Angola, a World Health Organisation spokesperson has said.
"9 people who were in contact with an ill person were isolated in an Italian hospital," Ms Chaib said, without giving details of in which town or what nationality the possible victims were, or if they were ill.
Last week, an Italian paediatrician died of haemorrhagic fever in Angola, according to Medici con Africa, the relief organization for which she worked. The WHO was unable to say whether the 9 patients in Italy had been in touch with this woman.
The WHO ruled out 2 other suspected cases reported in Portugal earlier this week following medical tests.
Date: Sat 2 Apr 2005
From: ProMED-mail
Angola - Marburg Hemorrhagic Fever Spreading: Death Toll Reaches 142
Sydney Morning Herald
The death toll from Marburg virus had reached 142 in the Angolan province of Uige alone, the province's governor Antonio Bento Kangulo said on Fri 1 Apr 2005, after the disease reached the country's 4th province. The governor said a total of 150 cases of the disease had been registered in the northern province [of Uige], which has been the epicentre of the outbreak. "From the beginning up to the last 24 hours we have a total of 150 cases, including 142 dead," the governor said in an interview with private radio Luanda Antena Comercial.
Earlier the southern African country's health ministry said Marburg virus had reached a 4th province in Angola, bringing the disease closer to the capital. According to the last official toll for the country overall given by the health ministry and World Health Organisation, 130 people had been killed by the virus in the country by 31 Mar 2005, with 137 cases registered.
The Marburg outbreak has claimed a record number of lives, overtaking the earlier peak in the Democratic Republic of Congo, Angola's neighbour.
Patricia A. Doyle, PhD
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Zhan le Devlesa tai sastimasa
Go with God and in Good Health
Marburg Hemorrhagic Fever Death Toll Reaches 150
From Patricia Doyle, PhD
The outbreak of [Marburg hemorrhagic fever] has intensified in Angola, claiming more than 20 lives over the past 3 days [1-3 Apr 2005], taking the nationwide toll to 150. "In total, we have registered 163 cases, of whom 150 have died," Angola's Vice Health Minister Jose Van-Dunem told reporters on Sun 3 Apr 2005. The official toll had stood at 130 on Friday [1 Apr 2005]. The Marburg outbreak has claimed a record number of lives in Angola, overtaking an earlier peak in the neighboring Democratic Republic of Congo.
"A 4th person has died in Luanda, but all 4 came from the province of Uige," which is the epicenter of the outbreak, about 300 km north of the coastal capital. A combined statement by the World Health Organization and the Angolan government, meanwhile, said 80 percent of the cases involved children under 15.
Causing a severe hemorrhagic fever similar to Ebola, Marburg virus spreads through contact with bodily fluids, such as blood, urine, excrement, vomit and saliva. The disease was 1st identified in 1967 in Germany, after laboratory workers were infected by monkeys from Uganda.



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