Posted on 04/19/2005 11:09:31 AM PDT by Judith Anne
A deadly and contagious Marburg Hemorrhagic Fever outbreak continues to ravage Angola. There is a high mortality rate of patients admitted to the isolation units - only two have survived more than 24 hours. Without a stronger response, the epidemic will continue to spread.
Marburg Fever continues to spread in the Angolan province of Uige. To date, the official deathtoll stands at 235, with 257 reported cases. Biological tests carried out by the WHO confirmed on March 22 the presence of the virus. Since then, 114 new cases have been identified, 107 of which have proved fatal.
Despite these alarming statistics, measures announced to contain the epidemic have been slow to act and have so far failed to stop the epidemic spreading. While the epicentre of the outbreak is in Uige, last week saw the emergence of new areas of infection. In Songo, an hour west of Uige, four cases have been reported. While in Negage, 30 minutes south-west of Uige, the figure stands at three. The health infrastructure in these two localities has been affected.
Fighting a deadly and contagious disease and a complex epidemic
Marburg Fever - from the same family as the Ebola virus - is a deadly and contagious disease. Stamping it out requires a rigorous, multi-level strategy.
Because Marburg Fever can be transmitted through direct contact with bodily fluids, it is imperative that isolation units be put in place to treat those affected. No specific treatment exists but measures must be taken to treat those affected (rehydration, administering of antalgics and drugs to prevent vomiting, etc.)
Since the beginning of the crisis our teams have set up two isolation and treatment units: one in Uige Hospital, and one in Amerigo Boavida Hospital in the capital, Luanda. 23 patients have already been admitted to the centre in Uige. Isolation units are also being set up in Negage and in Songo, while the unit in Camabatela is already in place.
Human and logistical action: Informing the population
To limit the risk of infection, efforts must be made to identify and assess suspected cases, and to locate and check on any people who may have come into contact with those affected by the virus. Nearly 500 'contacts' have so far been counted in Angola - 360 of these in Uige alone. In addition, strict sanitary procedures must be adhered to when burying victims of the Marburg virus - whether they have died at hospital or at home.
Such priorities require important logistic and human efforts. Protective clothing (gloves, gowns, masks, glasses, boots, etc.) is essential, while proper vehicles must be provided to locate suspected cases in different areas of the country, and to transport patients and bodies. All medical and non-medical personnel must be notified immediately.
Our volunteers are in charge of training Angolan medical and military personnel, alerting them to the strictest sanitary precautions to be taken in order to guarantee their own safety in the event of contact with victims and bodies. This effort must however be intensified.
If these measures are to succeed, they must be supported by specific policy aimed at informing the local population. So far little has been done to raise awareness, and in a climate of fear, MSF teams and WHO personnel have been met by hostile reactions during their visits to the areas of Cadongo and KimaKongo in Uige. Because fighting the outbreak means isolating patients and burying the victims in body bags, the local population often see the medical personnel as 'confiscating' the sick and the dead.
What is more, the high mortality rate of patients admitted to the isolation units (only two have survived more than 24 hours) has led to a culture of suspicion among the local population. Consequently, locals sometimes refuse to hand over the sick and the dead to medical teams, preferring instead to keep them at home, which creates a potential for future contamination.
By informing the population and alleviating the panic, those showing early signs of the virus may be hospitalised sooner - a move that will lead to a drop in mortality rates.
Reorganising the hospitals affected
Elsewhere, hospitals affected by the virus must completely reorganised to avoid any risk of the virus 'nosocomiale' infection (this occurs when the virus is spread in the confines of the hospital itself). All services must be disinfected and an isolation ward must be put in place.
Triage of patients must be stepped up in order to isolate suspected cases, and to prevent those infected by the virus coming into contact with patients of other illnesses.
These precautionary measures must be applied throughout the hospital. This involves not only the wearing of safety equipment but also the suspension of all invasive procedures (surgical operations, lab inspections, intravenous and intramuscular injections, etc.) with the exception live-saving operations (emergency surgery, caesarian sections, etc.) which should be carried out in accordance with strict sanitary procedures.
Inadequate reaction
For the time being, our efforts and those at both the national and international level remain largely inadequate given the gravity of the situation. It is imperative that Angolan authorities take into account the extent of the epidemic.
Without proper treatment of patients and protection of the population, Marburg Fever will continue to spread throughout Angola.
Okay, putting that ping list to work...
...they should also take these kinds of measures with AIDS?
Goodness. We've alreaady had a post removed???
I asked for it to be removed. I wasn't sure if I had permission to post comments from an email from Dr. Niman, and to be on the safe side, I asked it be taken off.
Amazing how little press this is really getting isn't it.
In this case it would be DR. Obvious
Probably, unless this gets out of Angola, we'll have to REALLY search for news.
ROFL! There is precious little to laugh about, with this disease--thanks! I feel so understood...;-D
This is really getting out of hand.........
Not to me, but you might find an answer in one of the radio interviews he's given. They are archived, and there are links at his web site.
I tend to think that like many bugs, Marburg has changed, or this is a different branch of the Marburg family we've never seen before.
For instance, Ebola has several different strains, one of which is airborne but does not cause disease in humans, although it's fatal to monkeys. Ebola Reston, I think it is.
As long as it doesn't get out of Angola.......:-<
Thanks for the ping. Just pray that this monster bug burns itself out.
Yes.
Thanks for that information. I didn't know that, but as an idea it makes sense.
That is the key..........
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