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Posted on 05/04/2005 12:42:04 AM PDT by Judith Anne
Welcome to the Marburg Surveillance Project.
This thread will be used for all of the latest Marburg Outbreak News and comments. This is the place to post all comments about the Marburg outbreak, all articles and links to articles about the Marburg outbreak.
We're going to use just one thread instead of having to go from article to article as we have in the past. We'll use this thread as long as we can.
My guess is that Kelly_2000 has stopped posting on this subject. She is indirectly part of the CDC, and anything she said would be too easy to construe as "official".
If she posted something that was not supposed to be said in public, it could damage her career.
However, her initial reaction upon finding out the truth about this particular Marburg outbreak was quite interesting.
Yup. At this point I fear for her.
I think you're right or close enough to correct as not to matter. As you note she isn't CDC but she works with CDC personnel and I can certainly respect her desire to keep her job.
Angop latest:
[Portugese/Google Translate]
http://www.angolapress-angop.ao/noticia.asp?ID=339085
Uíge: Observance of measures of protecção allows reduction of cases of Marburg
Uíge, 05/05 - the coordinator of the comissção of emergency of combat against the hemorrhagic fever probeen vacant by virus of Marburg, colonel Pascoal Folo, said today, in the Uíge, that the observance on the part of the population of the measures of protecção has allowed the reduction of the number of cases in the province. Speaking to the journalists, the military doctor said to be to believe that the increment of measures of protecção and searchs asset, as well as the strategy of the system in box of all the cases (pursuing of cases in the local had ones) goes to help to eradicate the illness. "the epidemic is, currently, next to being controlled", emphasized the officer, attributing the reduction of cases to the observance of the advice of the sanitary authorities. It made to still know that the commission was worried very about the localities of the Songo, Gombe, Gana and Camana, but since that the active search was developed, the number of cases lowered considerably. Since October of 2004, the hemorrhagic fever for Marburg caused already death more the 250 people.
Some good news for Uige for a change:
http://www.angolapress-angop.ao/noticia.asp?ID=339089
Uíge: Província regista diminuição de crimes em Abril
Crime is down.
[English versions of stories above]
http://www.angolapress-angop.ao/noticia-e.asp?ID=338871
Health Minister Foresees Control Of Marburg
Luanda, 05/05 - Angola`s Health Minister, Sebastião Veloso, Wednesday here predicted the control of Marburg haemorrhagic fever in the Northern Uije Province, in the coming days, after a working visit there, Angop has learnt.
Sebastião Veloso, who left Uije on that day, after a seven-day working visit, said he noticed positive signs which showed that the ilness will be under control.
"This fact is so evident, because for the first time, since the appearance of the sickness, there was not recorded any case, including deaths, over the last 24 hours", he explained.
Meanwhile, the epidemic may be considered as controlled if after 21 days is not recorded any case, and eradicated if verified the same situation in six weeks.
Confident, the Minister said the target has been reached, a fact that represents an alleviation. "We consider that was not in vain the efforts of the national and international communities", underlined that official, who thanks all health technicians for their work to fight the disease.
Over the latest 24 hours, there were not noticed any sign of seriousness. According to the figures, 277 people have died, out of the 308 cases recorded since October 13, 2005.
Northern Uije Province hospital has only one interned patient, admitted two days ago, who is recovering satisfactorily.
http://www.angolapress-angop.ao/noticia-e.asp?ID=339056
Red Cross Sensitizes People On Marburg Virus, HIV/Aids In Uije
Luanda, 05/05- Angola Red Cross (CVA) has sent a team of volunteers to the Northern Uije Province, in order to sensitize the local population on the Haemmorrhagic fever of Marburg virus plus HIV/Aids, Angop has learnt.
A source with the CVA said that those individuals will also distribute lixivium, creaolin and soap for people affected by Marburg, a sickness which has already killed 280 people, most of them in Uije.
The delegation is made up by 22 people, including one representative of the Federation of the Red Cross and other of the National Headquarter in Angola.
The Marburg epidemic appeared in Uije in October 2004, being that the first two cases recorded in March 2005.
As near as I can figure 'lixivium' is like a crude lye. I'm guessing something like quicklime for disposing of the bodies?
Creolin
Deodorant Cleanser
Concentrated cleanser for use in kennels, animal quarters and for general household use. May also be used to wash animals. Contains coal tar. For general use, add 3 Tbsp to wash water; for animal use, add 5 Tbsp to bath water.
Recovering satisfactorily?
Just in case there was any doubt, that should make it pretty clear how reliable the info is...
Australian Broadcasting Corporation
TV PROGRAM TRANSCRIPT
LOCATION: http://www.abc.net.au/lateline/content/2005/s1361086.htm
Broadcast: 05/05/2005
Rowan Gillies speaks with Tony Jones
Reporter: Tony Jones
TONY JONES: The organisation now undertaking the biggest effort to contain the Angolan outbreak is Medicin Sans Frontieres. As it turns out, MSF's international president is an Australian - Dr Rowan Gillies. He is here in the country now and joins us from Melbourne.
Rowan Gillies, can you start by telling us exactly what Marburg Hemorrhagic Fever is?
ROWAN GILLES: Yeah, it's a viral hemorrhagic fever, Tony. The main concern with it is we have no treatment. We don't know how to prevent it. We don't actually know the reservoir of the disease either. So in some ways it is worse than Ebola where we think the reservoir is within monkeys. It's a very mysterious and incredibly deadly disease.
TONY JONES: We don't know where it is coming from then?
ROWAN GILLIES: No, that's one of the things that adds to the mystery and adds to the fear amongst the population, but also amongst the health workers. Well over 95 per cent of the people who've caught the disease have died. So obviously the care we can provide is mainly supportive as opposed to anything else.
TONY JONES: It is not airborne, which is usually the case with the worst contagious diseases. Why is it so dangerous, considering that?
ROWAN GILLIES: I think the close to 100 per cent mortality makes it obviously dangerous and in addition any bodily fluids, whether it is sweat or diarrhoea or vomit, one touch of that and for example if you touch a family member who's been unwell and you get the perspiration from them, you touch your eye afterwards, you've got a reasonable case of catching the disease. So it is very nasty.
TONY JONES: Do the victims die from complications or do they die as a direct result of the fever?
ROWAN GILLIES: They die very quickly and very directly. There's a period of about 10 days of incubation and then when it starts and you get the vomiting of blood, the diarrhoea of blood, people basically bleed out, as we say, and it's an awful thing. In addition with so much fluid around it makes it very infectious at that time.
TONY JONES: So bleed out. They bleed to death effectively; is that what you mean?
ROWAN GILLIES: They bleed to death. Dehydrate and bleed to death, yes.
TONY JONES: How do you recognise the disease in its early stages when it appears the symptoms at that point are very similar to more common diseases in Africa like malaria?
ROWAN GILLIES: That's one of the major problems, recognising an outbreak, and this one did take some time to recognise. It's non-specific symptoms, what they call body pain, joint pain, and a fever. So what we do when we meet people who have had contact is we check their temperature twice a day and monitor them closely and if then if they become a probable case, i.e. start having some of the more violent symptoms, then we isolate them. Again, it is something we know very little about.
TONY JONES: It must be horrific if this takes route in a village or something like that because virtually everyone who gets it will know they are doomed?
ROWAN GILLIES: Yes. Again, it's a very difficult cultural issue as well and at this stage we really haven't succeeded in getting the trust of some of the populations in the areas because, as I mentioned, when the body - when the person dies, when the patient dies, you really have to get rid of all the fluids and so on that have been involved and that involves, as you saw, those space suits and so on. People coming into your village with a space suit in a rush, stealing away dead bodies is culturally completely unacceptable and creates a lot of tension and a lot of mistrust.
TONY JONES: That must be rather dangerous for your own workers. How do you deal with that? How are you going to deal with that as the outbreak continues?
ROWAN GILLIES: Education is required and a huge effort of education, whether it be by radio or by personal - as you saw - personal contact today, but it's. The other thing we do is rotate our people very quickly because if anyone is tired and they are dealing with these issues, any mistake means they could easily die and once you catch it, again, you die. So it's almost an anthropological issue as well as a medical issue, and it's a social problem.
TONY JONES: How do you break the cycle? How do you stop something like this from spreading? Is it an educational thing? Do people have to start, as we saw in that short film, taking the measures themselves - going nowhere near the dead bodies and, rather horrifically in that case, leaving a small child to die without going anywhere near her?
ROWAN GILLIES: Yeah, it's an awful situation and if you have the protection you can go and help the patient and that's what we do, but for the local people in some ways it may be the correct decision. I think isolating and reducing transport and reducing people moving from that particular area is an important way to do it and, in the end, it is education. But it's very hard, as Barnaby mentioned, it is very hard to stop people looking after their family who have died.
TONY JONES: At the moment it appears to be confined to the countryside. What would happen, and how are you trying to prevent it spreading into cities?
ROWAN GILLIES: Well, there's been processes set up by ourselves and by the government, and WHO is involved as well, in that we have set up isolation tents specifically for this disease in Lowanda, the capital, and in other larger villages. The ability for people to travel has been restricted. Having said that, the actual danger of this disease is probably not as great as, for example, an airborne disease as SARS which is even more difficult to contain. You do actually have to have contact with some sort of fluids to catch the disease.
"We don't know how to prevent it."
"close to 100 per cent mortality"
"it's non-specific symptoms, what they call body pain, joint pain, and a fever. So what we do when we meet people who have had contact is we check their temperature twice a day and monitor them closely and if then if they become a probable case, i.e. start having some of the more violent symptoms, then we isolate them."
This last comment concerns me. If you are monitoring someone, i.e. temperature twice a day because they have the non specific symptoms, aren't they likely to be transmitting the disease, if they have Marburg. It appears that they aren't isolated at that point.
Thanks! Great interview. mrs x
Interesting post. It looks like Uige is under some sort of serious transportation quarantine--except for western medical staff.
Semper Fi
Pinging you all to the posts by Unsinkable Molly Brown, in 169 and 170.
Interview with Aussie head of MSF.
Molly--thank you very much--good information.
Emphasis: IF YOU TOUCH A FAMILY MEMBER WHO'S BEEN UNWELL, AND YOU GET THE PERSPIRATION FROM, YOU TOUCH YOUR EYE AFTERWARD, YOU'VE GOT A REASONABLE CASE OF CATCHING THE DISEASE.
If you touch your eye, or your nose, or your mouth, or have a cut, or abrasion and you touch it, after touching a sick family member...
Or, suppose you don't know they have Marburg, because they haven't started the hemorrhaging yet, and they change clothes, and you wash the dirty sweaty ones...
Or, before symptoms of bleeding appear, while they're first sick--the sick one vomits all over the place, and you use a sheet to help clean it up, and wash the sheet...
Just lots of ways to spread it around...
He confirmed our understanding of a mortality rate "well over 95%" as well. No more fiddling around with 89.5% mortality rate--that's just plain wrong.
Now, given how easily this is spread, I just canNOT believe any of the government figures. None of them, as far as case count, can be anywhere near accurate. I note there is no discussion of case numbers in this interview. Nor does he mention anything about fewer cases.
In a few minutes, I'm going to put up some facts about this outbreak that may or may not agree with the conventional Marburg outbreak wisdom.
Neither did I. It was uncanny how early she was on these subjects. Like a guardian angel dropping in with a few pithy words to the wise.
Okay, facts about this outbreak:
1. It started in children. The index patient is unknown
as to age, sex, location, identity.
2. It was first identified last fall.
3. The doctor who raised the alarm, last fall, died from
it this year. Did she get tired, or careless? How was
she infected?
4. February and March saw increasing numbers of confirmed
cases.
5. April saw further increase in the numbers of confirmed
cases, and unconfirmed cases, in multiple locations.
6. The case numbers were "administratively reclassified"
to be much lower, and all within Uige.
7. Given number 6, there are many more cases in many more
locations.
8. In early May, official case numbers took a jump up--
just as the Angolan Minister of Health gave a
reassuring statement that it was almost under control
9. There are no survivors confirmed.
10. There is very little news attention to the outbreak.
What conclusions can we draw from these facts?
No, but I share your concern.
Are there any virologists in the house ?
I have a crude hypothetical 2 part question: If certain (very "active") viruses can evolve to infect bacteria (bacteriophages),is it possible similar very active virus could evolve to infect fungal cells (mycophages)??
Part2: Could Marburg use bacterial or fungal cells as an ad hoc "storage nutrient",then evolve back when "preferred" animal tissue becomes available?
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