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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.
I read on the site I linked above that among the lab workers' precautions are two pair of latex gloves with web gloving between them (to prevent cuts from penetrating).
You're welcome.
Or she just picked up a pencil that another contaminated with their gloved hand. Or any other folmite...
Weekly Epidemolical Record is out--just a reprise of the 29 April WHO update.
http://www.who.int/wer/2005/en/wer8018.pdf
Photoessay up on WHO site.
http://www.who.int/features/2005/marburg/en/index.html
Extremely non-informative. Except for last photo where they note that WHO doctors now put on their protective gear when they arrive. One wonders if this doesn't raise their risk level for contracting the virus.
If I remember right, but wasn't the previous outbreaks of Ebola and Marburg a bit harder to catch?
"If he has a problem with broadly distributing the data, perhaps you could to the analysis and report back. Depending on whether you can get the data, perhaps we could discuss methods for analyzing it. I have a couple of ideas. ",
I cannot get the data, two reasons he will not give it to me, and secondly he is a consultant to the CDC he told me he is absolutely under no conditions able to disclose any details.
A real shame, I am trying a couple of alternative sources but the subject seems quite closed for all normal routes(intranet is not publishing statistics yet, when queried we are told they are not ready yet by WHO.)
I though he would cave in and give them to me at lunch time, I had a memory stick and my shortest skirt on, despite both these no spreadsheets where forthcoming.
GENEVA - The U.N. health agency said Friday it was waiting to see whether a doctor and a nurse exposed to the rare, deadly Marburg virus in Angola have been infected, adding the exposure underscored that the outbreak has yet to be brought under control.
The two medical workers at the provincial hospital in the northern Angolan region hit by the outbreak — the worst ever recorded — were exposed to blood from infected patients because they were working without adequate safety procedures, the World Health Organization said.
"We can't say the virus is under control," said WHO spokesman Iain Simpson. "It is clear the virus is still circulating in the community."
Simpson said it was believed safety procedures had since been improved at the hospital.
There is no vaccine for Marburg, which spreads through contact with bodily fluids and can kill rapidly.
Angolan Health Minister Sebastiao Veloso had said Thursday he was hopeful that the Marburg outbreak could soon be brought under control after officials reported no new cases between noon Tuesday and noon Wednesday.
Veloso said the outbreak would be declared officially under control after 21 consecutive days without new infections.
The incubation period for the virus or the amount of time it takes between becoming infected and falling ill, can be 21 days. WHO does not consider outbreaks to be contained until there have been no new infections for a period lasting double the maximum incubation time.
But Simpson said such predictions were at this point still unrealistic and warned of future setbacks.
"I wouldn't say it's out of control, but I wouldn't say it's under control either," WHO's Simpson told reporters Friday. "We can't say that there won't be more new cases, in fact we expect there will be more cases."
"If the infection control isn't strong enough to protect the health staff, clearly there are problems," he added.
Last week WHO criticized procedures at the northern Angolan provincial hospital, noting that doctors had been exposed and that other safety protocols had been breached.
Simpson said Friday, "Those problems we think have now been addressed. We think the infection control in the hospital has now improved and we hope that we won't see any more cases among health workers."
WHO has reported 308 cases of Marburg fever in the Angolan outbreak. Of these cases, 277 were fatal.
The last and previously most severe outbreak of Marburg occurred in Congo, which neighbors Angola, between 1998 and 2000, killing 128 people.
We have no way of knowing unless we find someone who is directly involved in the research.I had that door firmly closed in my face yesterday.By know there should be a marked difference in the index case and subsequent cases in terms of symptoma, mortality rate and virulence. Virus are supposed to get less virulent by generation in any given outbreak NOT the reverse.
ROTFLMAO
That is really funny!
To be honest, I think that the overwhelming amount of data indicate, even in summary, that this thing is 100% fatal. There has been only 1 confirmed survivor in 6 months. Out of 250 fatalities. We were debating a while back whether there was a second survivor. Either way, the fatality rate is 99.3% or 99.6%. There has been more than enough time in 6 months to determine outcomes, given that the nominal survival time is 7-10 days from symptom onset.
I have confirmed the data a few different ways:
1. All of the official reports have confirmed no survivors. They typically list: cumulative active cases, cumulative deaths, and cumulative survivors. Cumulative survivors = 1.
2. Any survivor has always been a newsworthy item. It has been essentially discussed only once or twice.
3. You can run a simple calculation on their numbers, which I did. For a while, the number of active cases was reported as 20, and this number remained constant for several weeks. Moreover, they also reported 2-3 new cases / day during the same period. The simple calculation indicates a 7-10 day survival period. Either the patient is dead or recovered in this period. At the end of about 4 weeks, the fatalities had increased by 2-3 per day. The survivors had not increased at all.
I believe that the real scientific question here is the transmissability. (sp?). How easily does this thing really spread. Looking at the data, it seemed to be growing much faster earlier. As more data became available, the growth rate appeared to slow. Then it appeared to stop. Because of the uncertainty of the data, we are still somewhat uncertain about the true growth rate and the true transmissability.
You expressed it a lot better than I did. Simple, clean, direct.
Maybe I should run all my posts through you for editing first. (grin)
D_c/I_c = 3/6 = 0.5 ==> growing (integrating over just a few days)
These are the new data points. As promised, I will generate the next growth plot when I get home.
Well thats the most alarming news yet...if YOUR shortest skirt didnt work they must be running very scared indeed ;-)
We appreciate your efforts on our behalf though 'Mata' ;-)
LOL
Thanks for the effort--as others mentioned on this thread. We don't want you to do anything to jepordize your (or anyone else's) job.
The good news we can glean is that the CDC (and one must also assume AMIIRD) is keeping a very close eye on this. Which is good because I don't trust WHO.
As an aside, though this epidemic has severely lowered my opinion of WHO it has increased my appreciation of MSF/DWB--they seem to be doing a great job in the trenches, and are actually working to keep the rest of us informed.
I still have respect for CDC/AMRIID, I just wish they would do a better job of informing the world on the situation, instead of leaving it up to Angola, WHO and MSF.
I love how WHO uses the 308/277 number in today's release--despite the fact that even the Angolan Health Ministry is using 313/280.
Way to go.
[Even better today's WER uses the 277/253 data from 27 April]
That about sums it up. Two survivors have been mentioned in Angolan Health Ministry press releases--they may be the same survivor, they may not be. Significantly, WHO and MSF have never mentioned a survivor in their releases IIRC--I will look back to make sure.
Wouldnt an ability to consistently maintain a high mortality rate and virulence while resisting burnout over an extended period of generations be a 'desirable' :-( characteristic for a weaponized virus?
Wouldnt an ability to take a high toll among health care workers also be a 'desirable' :( characteristic in a weaponized virus?
On the other hand this isnt airborne...a bioweapon should be more easily spread non?
Might a bioweapon designer perhaps SEPARATELY develop two viral lines; one designed to maximize lethality with reduced transmissibility, another designed to maximize transmissibility with reduced lethality, to 'test release' into the wild for experimental verification of their 'improved' :-( characteristics FIELD-effectiveness BEFORE combining those lines characteristics into one [chimera?] viral 'super-weapon'?
Or am I sounding too 'Tom Clancy'/'foil beanie brigade' here?
Please forgive a laypersons ignorance if so.
It seems to me that any reluctance of WHO, CDC, AMRIID to inform could mean either that they simply dont yet know enough to tell or that they are concerned about causing public alarm if they tell what they do know?
The second possibility might suggest that things are worse than they appear...the first that this outbreak is perplexingly anomalous...neither a heartening prospect...but at least as you say they seem to be very attentive to it now...hopefully more public disclosure will be forthcoming soon.
Medecins Sans Frontieres/Doctors Without Borders has once again shown themselves to be admirable with their efforts in this...Bravo for them!
When they announced the recent survivor, they failed to give any information whatsoever. At the absolute minimum they should have described the treatment the person received, and blood and tissue samples should have been collected for extensive analysis by WHO and the CDC.
WHO did not mention anything about any survivors, nor did MSF.
Personally, I doubt there are ANY survivors.
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