- "Most of the affected persons are children under
one year old. Three nurses were also infected. This week, 12 samples tested
positive for Marburg fever by the US Centers for Disease Control and Prevention
- The above comments by Medecins Sans Frontieres (MSF)
on March 25 suggest that the Marburg outbreak in Angola was initiated via
a childhood vaccine program. The initial WHO announcement indicated around
75% of the cases were in children under the age of 5. The comments by
MSF indicate that more than 67% of the cases under 5 years-of-age were
in children under 1 year-of-age.
- Since Marburg hemorrhagic fever is now readily transmitting
to teenagers and adults, including 17 health care workers, it seems that
the concentration of cases in children under 1 was not due to a lack of
immunity that coud be found in adults. Indeed, the case fatality rate
has been at or near 100% for all cases, regardless of age, with few, if
- Unfortunately, the cases in Angola did not receive significant
attention until health care workers were infected about a month ago. Within
1-2 weeks the Marburg virus was detected in 9 of 12 fatal cases, and resources
began to flow into Angola.
- However, it now seems that the effort failed to interrupt
transmission when the virus was largely confined to the city of Uige, and
now cases in seven provinces have been reported. The number of cases has
more than doubled in the past few weeks.
- Prior Marburg and Ebola hemorrhagic fever outbreaks had
been largely limited to rural areas. However, the cases in the Angola
capital of Luanda, and associated slums like Cacuaco, threaten to create
a novel transmission setting in a densely populated urban area. This setting
could magnify the number of cases, which could lead to a much broader outbreak
inside and outside of Angola, potentially leading to a deadly pandemic.