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March 25, 2005

Marburg Spreading in Angola

The Marburg outbreak in Angola has spread to the capital of the country, Luanda.

A 15-year-old boy and an Italian pediatrician, Maria Bonino, who had both been in the northern Uige province to which the virus had previously been confined, died from the Marburg virus in Luanda, local health officials said.

At least three other people have been diagnosed with the virus in the capital, they said.
Dr Bonino worked for the Italian medical aid group Cuamm Medici con l'Africa and had 11 years of experience as a volunteer in Africa, with the last two years as a pediatrician in the provincial hospital of Uige.

Angolan health officials are battling to contain the outbreak detected in October in Uige that has claimed the lives of scores of children.

They're losing. A disease with a 21 day incubation period has reached a city of 1.5 million souls, and the most basic preventative measures are not yet in place.

Angolan health officials assisted by WHO experts and teams from Medecins Sans Frontieres and the US Centres for Disease Control were in Uige to try to shore-up measures to control the outbreak.

"The situation is bad, very bad," said health ministry spokesman Carlos Alberto. "There is no isolation room. We are setting it up."

The article does not say whether or not the three other Marburg cases in the capital are from indidviduals who recently traveled from Uige, but that is two more cases than was mentioned earlier in the day, when an association with Uige was being stressed by authorities.

The two fatal cases of Marburg haemorrhagic fever reported from Luanda, the
capital city of Angola, appear to be individuals who had recently visited or
worked in Uige province and were being treated in separate hospitals in
Luanda. So far there has been no confirmation of spread of infection to the
local inhabitants of Luanda, although at least one suspected case is under

At this point, while I would not assume that Marburg has begun to be passed from person to person in Luanda, neither would such an event surprise me, given the lack of an "all these people were recently in Uige" assurance.

Here's a provincial map of Angola. Provinces where Marburg cases have been documented are in red. Provinces previously considered at high risk for infection are in pink. It's a big swath of country, and it does not include possibly affected areas in the former Zaire. Based on the cases reported thus far, it's no stretch to think that fully half the country is at risk of being infected.

Map via ReliefWeb

Note: I'll update the above as more cases are reported.

Update: 6 cases in Luanda, but all connected to Uige.

Filomeno Fortes, the department head for disease control at the health ministry told Reuters, 'Of the six cases we've had in Luanda, we've had two deaths until now. All six came from Uige. None of these represents a primary case from Luanda,' Fortes said. 'Our fear is that if we don't control cases coming from Uige, there is a risk that they could infect people in Luanda,' he added.

Posted by Bigwig at March 25, 2005 12:43 PM | TrackBack
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The only thing working in their favor is that previous filovirus outbreaks have always burned themselves out.

Indeed, in the previous outbreaks of Ebola and Marburg, the most efficient vectors were the doctors and nurses themselves.

Posted by: Captain Holly at March 25, 2005 01:57 PM
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