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ANGOLA: Cultural practices raise risk of Marburg spreading
IRIN news org ^ | April 18, 2005 | IRIN staff

Posted on 04/20/2005 7:59:50 PM PDT by Judith Anne

[ This report does not necessarily reflect the views of the United Nations]

LUANDA, 18 Apr 2005 (IRIN) - Traditional funeral rites in Angola are putting the families of Marburg victims at risk of contracting the killer virus.

For most Angolan families, preparing the body, and kissing and embracing the deceased loved one are integral to bidding a final farewell. But the secretions from a body increase after death, making such practices highly dangerous in the case of a Marburg-related death.

"We're just telling them: 'please don't touch [suspect corpses]'; 'you cannot touch them - call in the specialised groups from the nearest health unit and let them deal with the corpse because you can get very easily contaminated if you try to touch them'," the UN Children's Fund (UNICEF) communication assistant, Celso Malavoloneke, told IRIN.

The death toll from the epidemic - the world's worst to date - now stood at 235 of a total of 257 known cases.

In northern Uige province - the epicentre of the Marburg crisis - medical teams had been dispatched to people's homes when alerted to a suspected case or death.

Information was being disseminated via radio and television advertisements, traditional leaders and healers, churches and mobile teams of 'activists', telling people how to spot a suspected case of Marburg and to alert the health authorities immediately, and advising family members on how to care for the sick and protect themselves from the Ebola-like fever.

This included wearing masks and gloves, or using strong plastic bags without holes if gloves were not available.

Malavoloneke said passing on the message about how to care for the sick or bid farewell to the deceased while protecting oneself was not always easy.

"We know it's hard, and that's where the cultural challenge comes: we're all parents and it would be very hard for someone to tell you not to touch your own child if he is sick," he pointed out.

"You know that all these African societies are very much tied to ancestry, and also the way you treat deceased beloved ones; for the people here not to be able to pay their last tribute and respect to deceased beloved ones - that's particularly hard," he added.

Overcoming deep-rooted traditions remained the biggest challenge, according to health ministry officials.

Although Uige's provincial hospital now had a fully equipped and staffed isolation unit, many families were still 'hiding' the sick at home.

Medical workers said there was widespread mistrust of the isolation unit, in part because the Marburg mortality rate of more than 90 percent meant the sick did not return home once they were admitted.

World Health Organisation epidemiologist Francois Libama said he had hope that the epidemic could be stamped out, despite the rising death toll.

"If we succeed in managing all the cases and the funerals, we'll start reducing the risk of transmission," he told IRIN.

"In the case of an epidemic it's impossible to say how many days or months lie ahead, but I believe in the days to come we will have more hope," Libama added. "I believe a day will come when we will see the end of the tunnel."


TOPICS: Foreign Affairs
KEYWORDS: angola; marburg; outbreak
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To: EBH

The virus could lead to a serious crisis if it spreads worldwide.

DOH!

I was never scared by the cold war like I am by this.


61 posted on 04/21/2005 7:13:59 PM PDT by tet68 ( " We would not die in that man's company, that fears his fellowship to die with us...." Henry V.)
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To: Fitzcarraldo

Turned out to be malaria. I read elsewhere that the patient responded well to anti-malarial medication (which wouldn't happen if it were Marburg).


62 posted on 04/21/2005 7:28:22 PM PDT by Judith Anne (Thank you St. Jude for favors granted.)
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To: EternalHope; AntiGuv

Dr. Niman replied that he suspects the issue of the upper limits of 14-16 generations of transmissibility will come up in one or both radio interviews tonight.

More information at:

http://www.recombinomics.com/in_the_news.html


63 posted on 04/21/2005 7:41:18 PM PDT by Judith Anne (Thank you St. Jude for favors granted.)
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To: Judith Anne
If and when the panic starts, how will they contain 200,000 people? There will be no way to stop them all from scattering whichever way they can.

If we are not getting (even) accurate fatality data due to unreported cases, there is no way of knowing how fast this is still growing, we only have a minimum rate.

64 posted on 04/21/2005 7:52:24 PM PDT by Smokin' Joe (Grant no power to government you would not want your worst enemies to wield against you.)
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Anyone who listens to either of these interviews, please post information about them here?

Thank you.


65 posted on 04/21/2005 7:52:54 PM PDT by Judith Anne (Thank you St. Jude for favors granted.)
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To: Judith Anne

Looks like Australia is still catching up on the news.


66 posted on 04/21/2005 7:58:28 PM PDT by Fitzcarraldo
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To: Judith Anne
http://news.google.com/news?hl=en&ned=us&ie=UTF-8&scoring=d&q=marburg+Johannesburg&btnG=Search+News
67 posted on 04/21/2005 7:59:40 PM PDT by Fitzcarraldo
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To: Smokin' Joe

It's evident that nobody knows the true case numbers, where they are, what they've done, etc.

As far as panicking and running, a lot of people have apparently already done that. Cases have popped up in 6-7 Angolan provinces already. Due to "administrative reclassification" which was done last weekend, only the cases in Uige that have come to the attention of the medical and civil authorities (and which have been laboratory confirmed) have been counted. We know that there is a significant undercount--but nobody knows how significant. The very fact that there was an "administrative reclassification" would lead me to think it is a substantial undercount.

After decades of war, the infrastructure is destroyed. There is no way to get it up to speed to respond to this outbreak.


68 posted on 04/21/2005 8:02:22 PM PDT by Judith Anne (Thank you St. Jude for favors granted.)
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To: Fitzcarraldo

Thanks for that link--I see that the most recent reports are only 2 hours old. Yet there is an article at the bottom of the linked page that is 15 hours old, that says the case was determined to be malaria.

That's the trouble with the bleeping news. Excuse me while I leave the room to curse.


69 posted on 04/21/2005 8:06:11 PM PDT by Judith Anne (Thank you St. Jude for favors granted.)
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To: Judith Anne

Now that the ANALysis has subsided, communication=contagion; nothing short of quarantine will solve massive infection.


70 posted on 04/21/2005 8:11:04 PM PDT by Old Professer (As darkness is the absence of light, evil is the absence of good; innocence is blind.)
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To: Fitzcarraldo

S.Africa says suspected Marburg case is malaria

Thu April 21, 2005 12:55 PM GMT+02:00
JOHANNESBURG (Reuters) - A sick Angolan traveller under observation in South Africa as a possible victim of the deadly Marburg virus has been determined to be suffering from malaria, health officials said on Thursday.

Gauteng provincial health department spokesman Popo Maja said doctors were no longer observing the man, who was taken to hospital on Tuesday after arriving on a flight from Angola, which is battling the world's worst ever Marburg outbreak.

"We are ruling out Marburg," Maja told Reuters. "He is responding very well to malaria treatment, and is no longer under observation in the isolation ward."


http://www.reuters.co.za/locales/c_newsArticle.jsp;:42678746:444a83728f9e52c?type=topNews&localeKey=en_ZA&storyID=8250895


71 posted on 04/21/2005 8:13:48 PM PDT by Judith Anne (Thank you St. Jude for favors granted.)
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To: All

Good night, FRiends.

If there is any news, I'll be here tomorrow evening.


72 posted on 04/21/2005 8:25:24 PM PDT by Judith Anne (Thank you St. Jude for favors granted.)
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To: Judith Anne

G-night Pinky!


73 posted on 04/21/2005 8:27:00 PM PDT by Petronski (Pope Benedict XVI: A German Shepherd on the Throne of Peter)
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To: tet68
I was never scared by the cold war like I am by this.

You weren't a 9 year old on a southern military base during the Cuban Missile Crisis...

74 posted on 04/21/2005 8:29:28 PM PDT by null and void (You're in Bloody Hands with Allah State...)
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Comment #75 Removed by Moderator

Comment #76 Removed by Moderator

To: Judith Anne; All
Hi Judith Anne,
In regard to your question:
 
What would the response of the world be, if Angola just out and out said that they had a terrible outbreak, that they needed the help and resources of the world to contain--just like the tsunami stricken areas needed help and resources?
 
I think the question begs why didn't they take the deaths seriously in the beginning and ask for help then?  I don't have the answers, but surmise that some of what has already been mentioned is true.
 
I just read this article, interesting info on the portable lab in use.
----------------------------
Canadian special pathogens team sees progress in Angola's Marburg outbreak
Helen Branswell April 21, 2005

(CP) - When hemorrhagic fevers expert Dr. Heinz Feldmann started his career 20 years ago, he and fellow students of the rare pathogens that cause Marburg fever and Ebola toiled in obscurity, often presenting papers at scientific meetings to audiences of two.

No longer. The dramatic nature of outbreaks and concerns about the bioterrorism potential of the lethal viruses make them front page news.

But the head of special pathogens at the Public Health Agency of Canada - who returned Wednesday from combating the ongoing Marburg outbreak in Angola - says it is agonizing that nearly two decades later the best he can do in such situations is help to stop the chain of transmission.

There is still no vaccine, no treatment, no cure for these diseases.

"It's hard. You never forget these faces," Feldmann said Thursday in a news conference at the National Microbiology Laboratory in Winnipeg.

"The most frustrating thing is that after almost 20 years I still can't treat anyone. I still can't help anyone. I still can't do much."

Others would disagree. The World Health Organization was ecstatic when the public health agency sent Feldmann, technician Allen Grolla and a tiny portable lab to Angola three weeks ago to help fight the deadliest Marburg outbreak on record.

The latest update from WHO pegs the number of diagnosed cases in the outbreak at 266, with 239 deaths.

Without lab facilities, Marburg is devilishly difficult to diagnose in the early stages, when symptoms mimic those of numerous other conditions. By the time it's apparent people are suffering from the virus, those caring for them may have already been infected by contact with bodily fluids.

In such a circumstance, Feldmann, Grolla and their lab can make all the difference, according to Dick Thompson, director of communications for the WHO's communicable diseases branch.

"The best thing is just to be able to, in the field - I mean in the centre of the storm - to distinguish those people who need special attention from all those people who have other tropical diseases," Thompson said in an interview from Geneva.

"Having it (the lab) there was just a tremendous boost to the effort. It really helps with control activities."

The lab remains in Angola. A second Canadian team - biologist Lisa Fernando and medical officer Dr. Jim Strong - have taken over from Feldmann and Grolla in Uije, the epicentre of the outbreak.

The two are slated to remain for about 2 1/2 weeks. A decision on whether to send a third team to take over from them will be made later, Feldmann said.

The benefit of the mobile lab - which is small enough to travel as luggage on the plane transporting the scientists - is that it is high-tech enough to make rapid diagnoses, but low-tech enough to be operational in relatively primitive conditions, Feldmann said.

Grolla noted in that Uije, electricity could go off at any time. But the team was able to obtain use of a generator to power the equipment, enabling them to keep working while there was daylight.

"The lab is very simple, very small. It doesn't demand a lot of stuff from the site. The only thing we have to have is some power," Grolla said, adding they were able to turn around test results in the same amount of time as they would in more sophisticated labs in Winnipeg.

Feldmann said some days the team would test only three or four samples and other days 20 to 30, but they never "maxed out" their capacity. A team of two, he said, could easily have run tests on 50 patient samples a day.

Increasingly the tests are coming back negative - a sign, Feldmann suggested, that the tide may be turning on the outbreak.

"This is a guess - my guess - that we might have started to see the end of the outbreak in Uije. But we do not know what's going on in the outside communities and the villages around, because people travel a lot and there's no real control," he cautioned.

"We can only guess whether this is going to end soon or whether it's going to take another month or two months."

WHO's Thompson concurred, adding this is a critical time in the life cycle of a disease outbreak.

"This can be the most dangerous time of an outbreak because people can lower their guard," he said.

"And if one case slips through, it can start the whole process all over again. So it's important that we don't let up, even though a lot of good things are happening."

Feldmann predicted progress will also soon be achieved on the broader issue of treating and stopping these diseases, noting scientists are conducting animal trials on vaccines and therapies.

"It's a very slow process. But I think particularly in Marburg and Ebola, we'll see the fruits of our work - not just my work, many people's work - in the near future."

 
 

77 posted on 04/21/2005 9:40:59 PM PDT by united1000
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To: Judith Anne
Reports don't agree on the sex of the sick passenger:

http://www.sundaytimes.co.za/zones/sundaytimesNEW/newsst/newsst1114144370.aspx:

A man who fell ill on an aircraft from Angola on Tuesday night and was feared to have Marburg fever appeared only to have had malaria, the health department said on Wednesday. Department spokesman Solly Mabotha said the man, who originally comes from Eritrea, would be held under observation in an isolation ward at the Johannesburg Hospital for a "while longer".


http://www.luchtzak.be/article8428.html:

writes "A female passenger fell ill on a South African Airways (SAA) aircraft from Luanda (Angola) Tuesday night shortly before it was due to land. It was feared the air passenger had deadly Marburg fever; in fact she was suffering from malaria.

As a precautionary measure the aircraft was also placed under quarantine. The plane* has been disinfected and will not be used it until SAA gets the go-ahead.

South African Airways SA 055 4 De Fevereiro (LAD), Luanda, Angola 14:05 Johannesburg Int'l (JNB), South Africa Terminal A 18:20 Non-stop / 744

78 posted on 04/22/2005 1:01:17 AM PDT by Fitzcarraldo
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To: Fitzcarraldo
That's OK, Reuter's has it as a 'man' on 'Wednesday' and it being 'malaria.' MSM can't get the facts of a simple story right or there were 3 cases isolated and tested. And all were positive for malaria.
79 posted on 04/22/2005 4:37:39 AM PDT by EBH
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To: Judith Anne

Are we 100% this is a true Marburg strain? I mean we might have something new here.


80 posted on 04/22/2005 6:52:06 AM PDT by redgolum ("God is dead" -- Nietzsche. "Nietzsche is dead" -- God.)
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