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April 05, 2005

Marburg News

The death toll from the Marburg virus in Angola has reached 175, and the outbreak is still not under control.

"I wouldn't say (the situation) is under control. But I'm very confident, if I look at the mobilisation of technical resources, the brains that came here and the energy that the (health) ministry is putting into that fight, that things will be improved," he said in an interview.

"It will take time, we must be patient, it is not in two or three days that we can eradicate this. But I'm confident that at the end there will be success," he added.

Meanwhile, the virus has spread to its fourth and fifth provinces, Kwanza Norte, and Malanje, and is rumored to be in a sixth, Kwanza Sol, which I'll leave blue in the map until I see a more definitive media link. In another story that needs a second confirming source, China's Xinhua net is reporting that the outbreak in Cabinda is under control.

Children still form the majority of victims in the outbreak, likely due to contaminated syringes or vaccine vials, though an environmental explanation is still possible.

An outbreak of Lassa fever in Sierra Leone in 2004 in which pediatric cases predominated was ultimately thought to be linked to contaminated multi-dose vials (2). If the hospital can reasonably be excluded, less obvious sources need to be considered. Do children enter for play or work (even very young children often help with family chores in sub-Saharan Africa) into caves where bats, a leading reservoir candidate, roost? Do children find and eat fruit that could be contaminated by bat guano?

If the initial outbreak of Marburg was assisted in its spread by a dirty needle, it was likely magnified by a developing world tendency to give patients an injection whether they need it or not.

In addition, institutionalized children, and children and adults who are ill or hospitalized, including those infected with HIV, are often exposed to 10-100 times as many injections. They noted "an average of 95 percent of injections were therapeutic, the majority of which were judged to be unnecessary." They found that "at least 50 percent of injections were unsafe in 14 of 19 countries for which data were available. 18 studies reported a convincing link between unsafe injections and the transmission of hepatitis B and C, HIV, Ebola and Lassa virus infections and malaria. 5 studies attributed 20-80 percent of all new hepatitis B infections to unsafe injections while 3 implicated unsafe injections as a major mode of transmission of hepatitis C". They concluded that "unsafe injections occur routinely in most developing world regions, implying a significant potential for the transmission of any bloodborne pathogen.

Dogs might also play a role in in transmitting the virus, which could explain the odd age statistics characterizing the Angolan outbreak, as children, being closer in stature to canines, may be more likely to come into close contact with them than teenagers or adults.

Posted by Bigwig at April 5, 2005 01:51 PM | TrackBack
Postscript:
First time visitor to House Hraka? Wondering if everything we produce could possibly be as brilliant/stupid/evil/pedantic/insipid/inspired as the post you just read? Check out the Hraka Essentials, the (mostly) reader-selected guide to Hraka's best posts, and decide for yourself.
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