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.
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]
Official update from WHO, basis for nicolezmomma's yahoo story above. Very little in addition to her post except for the last paragraph:
Marburg haemorrhagic fever in Angola - update 17
6 May 2005
As of 3 May, the Ministry of Health in Angola has reported 308 cases of Marburg haemorrhagic fever. Of these cases, 277 were fatal. In Uige Province, which remains the epicentre of the outbreak, 297 cases, of which 266 have been fatal, were reported. The large increase in the number of reported cases for Uige is the result of retrospective investigation and entry into the database of cases that occurred previously. However, new confirmed cases and deaths continue to be reported in Uige.
Prevention of opportunities for spread of the virus is essential. Procedures and assigned responsibilities for safe infection control at the large provincial hospital in Uige have been agreed on this week by ministry officials, WHO, and Médecins Sans Frontières. Teams are giving particular attention to screening and admission procedures that prevent suspected cases from being treated on open wards.
To support these efforts, WHO has deployed additional experts in infection control drawn from institutions in the Global Outbreak Alert and Response Network.
Massive public information campaigns aimed at ending unsafe injections have continued this week.
Five new vehicles have been provided by the Angolan government for use by teams at the outbreak site. This will provide greater mobility to investigate rumours of suspected cases and deaths and to follow contacts.