Marburg Surveillance Project

Various ^ | May 4, 2005 | Vanity

[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.

[redgolum]

That is what worries me also.

Someone on this thread posted some recent satellite photos of Uige. If they are regularly updated, keep the look out for big fires.

If the 4000+ mattresses translate into even one third that many cases, they may have to resort to burning the bodies in pyres rather than burying them.

Lord Jesus have mercy.

[null and void]

It is my understanding that she will be returning from Cuvette Ouest in the spring.

The same Cuvette that is a provence in the Republic of the Congo? Where there are TWO Ebola outbreaks? Oh my.

[infominer]

EBH:

I don't have a number for the cases administratively reclassified. However, following is a historical synopsis I have prepared. Excepting quoted items, the statements contained therein are mine. I also calculated the rate increases based from data contained in published reports (mainly WHO). Notice that there are three specific points during the outbreak that "red flags" appear, 1)March 31 when the WHO acknowledged "unusual features"; 2)April 17 when the WHO announced reclassification of cases; and 3)WHO update 18 when the cases and deaths were announced for ONLY UIGE. Also, each time their was an increase in the reported cases WHO made an adjustment in reporting the numbers.

ANGOLA MARBURG OUTBREAK 2005 - A HISTORICAL SYNOPSIS:

Reported by WHO March 23, 2005 as Marburg and the outbreak was identified as beginning in October 2004. Between March 23 and March 31 reported cases had increased by 55% and reported deaths by 43%. At this point in time the WHO made a statement, "Sophisticated laboratory studies of the virus may help shed some light on certain unusual features of the outbreak, including the high fatality rate and the overwhelming concentration of initial cases in children under the age of five years,". By April 8, 2005 the reported rates had increased 4% from the previous report on March 31. Between April 8, 2005 and April 17, 2005 the reported cases had increased by 13%. ON APRIL 17, 2005 WHO announced reclassification of cases. Reported cases continued at a rate increase of between 1% and 3% until May 6 when the rate of reported cases was 12% above the previous reporting period (May 3). At this point the WHO focused on Uige numbers and for WHO update 18 on May 11, 2005 they ONLY REPORTED CASES AND DEATHS FOR UIGE. This is when the reported numbers became extremely muddled.

[EBH]

So clearly there is MUCH variation. It is almost useless fr them to be answering the question "how many people are identified as dying from Marburg" when it is not we who are asking that question. Our question would be more like, "how many are dying of a viral hemorrhagic fever, and how many of something else?"

I am confused by your statement, in that my understanding of the numbers we're getting from the reports indicate only those who have tested positive for the Marburg virus. The second half of your statement is what I am asking! The reports indicate confirmed deaths from Marburg, all other deaths are not Marburg, thereby administratively removed and reclassified. So what the heck are they? There are lots of possiblities, but none have been indicated.

[EBH]

Thank you for evaluating what we know and for providing a timeline. Anyone else with insights into my question are welcome to reply too. Notice that there are three specific points during the outbreak that "red flags" appear, 1)March 31 when the WHO acknowledged "unusual features"; 2)April 17 when the WHO announced reclassification of cases; and 3)WHO update 18 when the cases and deaths were announced for ONLY UIGE. Perhaps later on Sunday evening I'll get a chance to sit down with this thread and links to comb through it too.

[Judith Anne]

Really good post, with the timeline.

I'll put it in a slightly different format:

March 31: WHO acknowledges unusual features.

April 17: Angola Minister of health announces administrative reclassification of numbers.

May 11: WHO announces only case numbers for Uige

Is that correct?

[unseen]

Nah, Marburg is killing them. It is just that the TEST is not being done correctly or the test results are giving false negatives. It goes back IMO to if it walks like a duck and quacks like a duck it is a duck not a chicken.

[null and void]

Which doesn't mean it can't goose you in the end...

[Judith Anne]

I'm calling it Angola Marburg. There has been plenty of anecdotal evidence in the articles posted that collection and delivery of useful samples is difficult, so I have no problem with calling those reclassified cases Marburg.

But in my opinion, this is a different Marburg--more virulent than other outbreaks.

Remember, there has been no information about this variant published by WHO or the CDC. I have no doubt that there IS information about it, just that it hasn't been published.

Marburg USED to be called "Ebola's gentle sister" becaquse it was so much less fatal than Ebola...but not THIS Marburg. THIS Marburg is essentially 100% fatal. Reports of survivors are not credible.

We've been doing some intelligent speculating on this thread, but we need to remember that it's only speculation. Until and unless the truth is revealed both by the Angolan authorities and the CDC, that's all we have.

But I would also argue that Angola and WHO have inflicted on themselves a serious wound--none of them are credible anymore. When the Angolans tell us the outbreak is under control, we rightfully say, "Baloney!" When the WHO parrots Angolan case numbers, again we say, "Baloney!"

The CDC isn't saying anything, and that annoys me. Is there a risk for the west? If not--they should say so! If there is, they should tell us. However, I do not expect any information from them. A matter of homeland security, I expect--funny that it doesn't include giving information to the "homeland," meaning us. At this time, I don't think there's any risk--but I can't even say that for sure.

Dreadful damage has been done by the heavy-handedness and social awkwardness of WHO--damage that may mean Angolans will avoid WHO and any benefits it may have for them for decades.

The Angolan authorities have revealed themselves to be more concerned about their image abroad (as though it could now be any worse) than about the health of the men, women and children living in Uige. The remarkable lack of transparency, clarity, and concern is a black eye to the President of Angola and his Minister of Health.

When such obfuscation is the norm, the likelihood of the worst case scenario being true is increased.

For now, I am just keeping track of what is published, as one watches distant storm clouds, as a precaution.

[Judith Anne]

And one more comment:

No minor outbreak is going to cause the cancellation and postponement of international games, such as we have read here.

And this, this is the largest ever outbreak of Marburg, ever.

[little jeremiah]

Placemark, and a humble "Thank You" to everyone who has contributed to this thread.

Representing the silent lurkers.

[infominer]

Yes, essentially this is correct. Two things though - It looks like I may have incorrectly identified the date for the reclassification, although the source I used was dated April 17, upon review it looks as the the WHO in their April 15 update 13 refers to the reclassification. Also, I don't have the actual announcement for the reclassification - whether it was the Angola Minister of Health or the WHO.

[Oorang]

Thank you for that synopsis.

[Judith Anne]

It was the Angolan Minister of Health that did the administrative reclassification.

[infominer]

Thanks. It is important to maintain accuracy. Without adequate firsthand information it is the analysis of detailed nuances that provide the clues.

BTW - I haven't seen Kelly_2000 interact on this thread in a few days. Anyone keeping in contact at a personal level? I miss the technical expertise.

[Judith Anne]

No, haven't seen her.

[null and void]

She hasn't posted on FR since Wednesday morning.

[null and void]

Not that I'm stalking her...

[Judith Anne]

Her profile says she's a wife and mother, and she has a job. Chances are, she's busy. End of school year, etc.

[EternalHope]

In today's news from Angola:
World Bank sends money to Angola

Although it was announced as if this is an Aids grant, the vast majority of this money will go for "social service delivery, as well as emergency preparedness."

Angola: World Bank Grant Accord Signed for Aids

UN Integrated Regional Information Networks NEWS
May 20, 2005
Posted to the web May 20, 2005
Johannesburg

Angola and the World Bank this week signed a US $125 million agreement covering a number of programmes, including projects for HIV/AIDS, malaria, tuberculosis (TB).

The country's Minister of Planning, Ana Dias Lourenco, told the Angola Press Agency that the funds would boost existing government efforts aimed at tackling the diseases.

Some $21 million of the agreed amount has been allocated to AIDS, malaria and TB, while the remainder will go towards bolstering social service delivery, as well as emergency preparedness. (My emphasis.)

Lourenco said the grant represented a sign of trust and support, won by Angola over the years, as this was the third time the country was receiving such assistance from the World Bank.