Posted on 04/30/2005 9:09:16 AM PDT by EternalHope
Diary from Angola's virus frontline: Part III
Health workers wear special head-to-toe suits to prevent contamination Zoe Young of the medical NGO, Medecins Sans Frontieres (MSF), is keeping a diary for the BBC News Website from Angola as she helps with the emergency response to an outbreak of the deadly Marburg virus. Here she writes about her work in and around the town of Uige in the north-east of the country, which has so far been the area worst hit by the epidemic.
Wednesday 20 April Today was really horrible. We found out that one of the nurses in the hospital has had a temperature for a few days and has been in the emergency room.
I went with the new doctor and Sophie to do the test. I stayed back at a respectful distance with my spray machine at the ready.
It was very sad talking to the man because he was all alone in the room and obviously no-one was going to come and visit him again.
He knew perfectly well what was happening to him and looked resigned to his fate.
Later on we heard that there was another nurse with a temperature. We climbed into our gear and went to make a check.
The man's wife was standing there watching us as we went through our procedure. She had a very odd expression on her face and I couldn't really decide what it was. I'm not sure if it was resignation or just incomprehension at all our activities.
On the way out we found a young girl who had just come out of the sick nurse's room clutching two pens.
I wanted to spray her hands - and she put the pens in her mouth! I couldn't believe it.
I motioned frantically for her to take the pens out and so she put them under her arm and held out her hands to be sprayed. Then I squirted her in the mouth with the chlorine solution and told her to spit it out.
We came home all feeling fairly shell-shocked after such a grim day. Each night we sit here wondering if and when we might have become infected.
Thursday 28 April Today, one of my colleagues went to follow up a potential case in a suburb called Primero de Maio.
The people shouted "killer" at him and told him not to come back. I just saw him and he is looking pretty upset.
We also just learned that the hospital administrator's car had stones thrown at it the other night.
Even though there haven't been any deaths for a few days now, there's clearly still a lot of fear.
Since those two nurses died people link the hospital with the spreading of the disease and it is now absolutely empty.
It's hard because we are doing all we can to contain the disease but people just associate us with death.
So we've invited the Sobas, who are the elders of the community, to come and see the centre.
I'm not sure about ANY of the rest, especially the numbers.
She makes no mention of someone surviving. If someone had, you would think all the medical workers in the country would know, and would be talking about it.
So I'm wondering about that survivor story...
She also mentions that the hospital is empty. And the population she describes is not exactly following good containment procedures.
So I'm wondering about everything the government/WHO has had to say.
Could they have decided it's impossible to implement reasonable containment procedures, and the only thing they can do is try to prevent panic while they wait for it to burn itself out naturally?
I don't have the ping list. Can you take care of it?
The people shouted "killer" at him and told him not to come back. I just saw him and he is looking pretty upset.
We also just learned that the hospital administrator's car had stones thrown at it the other night.
(If what I just wrote makes you sad or angry,
Just like some people...Shoot the messenger!
I think if a virus like this is loose, all they can do is try to prevent panic...thats why I DON'T trust them...esp. in a situation like this where there is the potential for spread,
by accident or on purpose...I have been suspicious of all the non-information not only from Angola and the WHO but also our own CDC...it seems the tone of this weeks entry from Zoe and the WHO update are beginning to contrast with the all is well and under control message the Angolan Health Ministry has been putting out...I don't think many here were buying that anyway perhaps we will be approaching the numbers some predicted earlier and it may become obvious, maybe becoming so in Angola already.........mrs.xvier
I've always wanted a cabin in the woods...
Marburg Case Fatality Rate at 99.6%
Recombinomics Commentary
April 30, 2005
>> But while the number of fatalities had risen, Espirito-Santo said that for the first time an infected patient had recovered and was discharged from an isolation ward at the Uige provincial hospital.
"This patient's case may mean that not all infected will die and that people are developing antibodies to the disease,'' she said.
The patient's age and sex were not known. Espirito-Santo said more people were going to hospitals for treatment after an intensive publicity campaign to alert people of the dangers of Marburg. <<
The official announcement of the first Marburg discharge allows an accurate case fatality rate to be calculated. Various media reports indicated the rate was greater than 90%, but a true rate is based on outcomes. Assuming that the large number of discarded cases was not Marburg, the official count is 1 discharge and 257 deaths. Thus, the case fatality rate is 257/258 or 99.6%, indicating that prior reports of a case fatality rate of 100% were accurate.
The prior high case fatality rate for Marburg or Ebola was 88% and the record death toll is 280. Since the number of official cases is now almost 280 and the case fatality rate is close to 100%, it seems very likely that the current outbreak will cause more deaths than the highest recorded outbreak for Ebola. The prior Marburg record of 126 deaths was broken earlier this month
Any survivor is good news, but this one seems pretty sparse on the details. Age and sex unknown? Discharged from the Uige provincial hospital?
Zoe Young reported in her diary, current through April 28, that the hospital she was in had zero patients. She made no mention of any survivors being discharged, either.
She is working in a hospital in Uige. If it is the same hospital, it casts major doubt on the Angolan government's report that we finally have a survivor. Even if it is a different hospital, why did she not mention it?
Check out the Marburg update 16 post. It actually looks like the hospitals have been the main sources of the spread.
...."But while the number of fatalities had risen, Espirito-Santo said that for the first time an infected patient had recovered and was discharged from an isolation ward at the Uige provincial hospital.
"This patient's case may mean that not all infected will die and that people are developing antibodies to the disease,'' she said.
The patient's age and sex were not known. Espirito-Santo said more people were going to hospitals for treatment after an intensive publicity campaign to alert people of the dangers of Marburg"
Don't know that I can agree with that assessment. In my experience, third-world people are somewhat toughened psychologically, due to repeated exposure to disease, poverty, and various hazardous situations. Even though I am aware of these things intellectually, a friend from a poor country said there are certain common situations (some involving gross deformities and untreated medical conditions) she didn't want me to see, as I would experience an overwhelming sense of shock and helplessness.
I think that a highly communicable, infectious, and disease agent in Times Square, the Chicago Loop, or small-town U.S.A. would create a panic like the world hasn't seen since the Plague.
The girl putting the pens in her mouth!!! Where do you start??? I feel so for poor Zoe. May the Lord be with her!
Yes, definitely
Eternal Hope, here's the ping.
Hope I didn't miss anyone...
Remember, of course, that hospitals are closest to it. We will hear about hospital infections, we might not hear about disease in the back country.
Just pinged you both to a new commentary from Recombinomics.
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