Posted on 04/10/2005 8:52:43 PM PDT by Mother Abigail
Killer virus red alert as more die April 11, 2005
By Own Correspondents and Sapa-AFP
Pretoria/Uige:
South Africa has begun implementing precautions against the deadly Marburg haemorrhagic fever, which has claimed the lives of 193 of the 218 people infected in Angola in the worst outbreak of the disease yet.
South Africa's precautions follow a World Health Organisation (WHO) warning to countries neighbouring Angola that they should go on the alert.
The WHO said late last night that 360 people were being monitored in Angola, where the disease broke out in October.
A severe haemorrhagic fever akin to Ebola, the Marburg virus is spread through contact with body fluids, such as blood, urine, excrement, vomit and saliva.
It can, however, be contained by taking fairly simple health precautions, experts say.
Detailed life histories are being taken down and vigilance has been increased at all points of entry into South Africa. These measures are South Africa's first line of defence.
"There is concern about an outbreak in South Africa as there is a lot of travel between Angola and South Africa," said Lucille Blumberg, of the National Institute for Communicable Diseases.
Health officials say, however, that it would be too time-consuming and expensive to test everyone entering South Africa for the disease.
"We can't take blood from everyone," said Bonnie Maloba, a doctor.
"What we need to do is exclude people and the best way to do this is to take a detailed history." Top South African pathogen expert Adriano Duse has been asked to join the international team trying to contain and overcome the deadly virus.
Duse, the National Health Laboratory Service's (NHLS) chief specialist, has been contracted by WHO and the Global Alert and Response Network to join the multinational team working in Angola's Uige province - the epicentre of the outbreak.
Through the NHLS, South Africa's expertise has contributed to research and combating infectious diseases, including previous, smaller outbreaks of Marburg fever.
Duse said he had been selected for his expertise in infectious diseases and infection control.
"I will be joining an international team in Luanda and then we are in the hands of the WHO and UN to take us to where we are needed," he said.
The WHO has warned the Congo, the Democratic Republic of Congo, Namibia and Zambia - all bordering Angola - to be on alert for outbreaks of the virus.
Epidemiologists in Uige are working overtime to trace new cases of the virus, which has sparked panic in Angola.
Every morning, teams from the WHO search the town of Uige for new cases.
"We visit our contacts and look for suspected cases," Francois Libama, a WHO epidemiologist, said.
"If we find a suspected case, we call in the special teams to remove the body."
At the WHO's temporary headquarters in the town, a blackboard gives a grim account of the latest death toll.
"Two corpses in Candombe Velho. Two corpses in Candombe-Novo. One alert in the Popular Quarter. One corpse at the cemetery," it reads.
The big question is how many have recovered?
That number appears to be zero.
Transport by aircraft is not airborne transmission; it is simply a modern vector for distant contact.
Bats are thought to carry it.
Here's my conjecture, that I've seen elsewhere: Bats eating insects off fruit, leaving the virus in urine. Child picks and eats fruit, becomes infected.
Yes. Monkeys are the Marburg vector.
Well I didn't want to ask a dumb question, but 218 people in 6 months over such a wide area hardly seems like panic proportions. I'm thinking more along the same lines as you are, unless I'm missing something.
That makes as much sense as any theory I've heard.
Oh, yeah. Bats too. Slipped my mind.
I do note the 17 health-care workers who have given their lives. Even as ill-equipped as they are, that has to give us a clue that this one is really, really nasty.
> You mean 88% fatal.
It depends on which report we rely on, but in any event,
it's not the 23-25% the CDC is showing. With the
collapse of case management in Angola, it may be some
time before a reliable figure emerges. And that's part
of the problem there, as the local population is convinced
it's a 100% fatal disease, and is panicking accordingly.
But the disparity between the CDC figures and even the
lowest of the field numbers makes me think that this is
not the Marburg of yore. Perhaps it's a new strain,
although I'm not a subscriber to fringe theories that
it's some wild new avian cross.
I do tend to agree with one observation here, which is
that is this is a strain that's long incubation, 100%
fatal, and airborne transmissible, infection rates would
be expected to be dramatically higher than have been seen
so far. Puzzles abound.
Excellent point. With the WHO teams out of the Uige area for even a day or two there's a lag in the data. Transmission through the administrative pipeline and waits for confirming lab results contribute in part/ I don't think that WHO or CDC or Medecins sans Frontieres were prepared for this rapid spread,nor could they have been based on the history of Marburg. And this strain very definitely is something different.
There are also some reports it appears to be a Marburg/Ebola hybrid type of virus. Don't look at one source claiming 88% fatality and accept it as absolute fact. I've seen it reported as a 99.4% fatality rate.
New hybrid virus, near 100% fatality rate, possibly airborne.
It amost seems like this is too much of a leap to be made by the virus without a little help from some scientists? Could this be a military bio-weapon?
Just exploring options here, not accusing anyone.
I don't either.
But with that said, there is so little information coming out of the region about it either locally or from WHO - I'm inclined to go more high end than low end.
I personally do not trust numbers from WHO - they are politically and monetarily driven. It's sad to say but for the moment this makes them no money because if it could it would be front page headlines and top of the hour of every MSM outlet on the planet.
Hantavirus, another of the filoviruses found in the US southwest, is transmitted by the inhalation of crystalized mouse urine in barns, etc.
Coughs and sneezes aerosolize virus loaded fluid from the airways and spread them farther than one would think. While that may not be everyone's idea of airborne, it's close enough for me. In addition, imagine picking up a telephone and using it, after someone incubating Marburg...
Having an epidemic of this horror would be a whole lot more time-consuming and expensive. A whole lot.
I'd like to be on a ping list for this too, if there is one.
I'm not sure that it does.
We are very early on the curve. And, when you are close to the beginning of an exponential, it looks linear. (Recall your Taylor expansion).
You mean 88% fatal.
Not necessarily. It's not at all clear from the article whether those numbers refer to people who got sick and recovered or to people who are currently ill and just haven't died yet. I suspect it's the later as I've yet to read any statement by anyone which mentions survivors of this outbreak.
Well, I have no source to link on this, but to my understanding the Soviets were experimenting with Marburg back in the 1980s as part of their Biopreparat weapons R&D and they came up with a variant that appeared 100% fatal. I can't imagine how that would've made it's way to Angola, but the point is that the Soviet research established that Marburg has the capacity to become 100% fatal - or darn close to it. That variant was very, very swift however, if I recall correctly, killing the host within two or three days.
See post 28. That looks geometric to me.
> Transport by aircraft is not airborne transmission;
> it is simply a modern vector for distant contact.
I didn't say that, and I don't think that was the
implication of the article I linked (although they
closed with the warning about that vector).
Their concern seemed to be that the cases among care
providers was higher than expected, which suggested
that CDC-like basic precautions are insufficient
protection for whatever this is, leading to a suspicion
of airborne transmission (cough, sneeze, but it
would be reaching to include breath).
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