http://www.recombinomics.com/News/04080501/Marburg_Zaire.html
Marburg Virus Spreads to Zaire
Recombinomics Commentary
April 8, 2005
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The Health Ministry said they control 230 people who had contact with infected people.
Luanda province registered eight cases, being two confirmed, two suspects and six deaths. Twenty people are also being monitored after having contacted affected people.
Uige received 11 alerts from different municipalities and two deaths and 200 contacts being monitored.
Kwanza-sul province is investigating six deaths that occurred from March 20 to April 02 who presented suggestive symptoms, in the municipalities of Amboim and Kilemba.
Zaire registered six deaths including one that happened today. <<
The above detail demonstrates why the Marburg outbreak will not be quickly contained. The outbreak originated in Uige, where there are the most cases and the largest number being monitored. However, the virus has radiated out from Uige, and there is little monitoring in the outlying regions. Thus, the monitoring is chasing the virus, which continues to transmit ahead of the monitoring.
Warnings last week indicated Uige was the Marburg epicenter, and all cases originated in Uige. This week warnings have gone out to countries adjacent to Angola (Congo, Democratic Republic of Congo, Namibia, and Zambia), warning that Angola is the epicenter. There are already reports of suspect cases in South Africa, including one death.
The above update indicates Marbug has now spread to Zaire. WHO just announced Kwanza-sul yesterday, although the above report indicates there have been deaths there since March 20, and the spread to Kwanza-sul was reported earlier. Provinces previously reported, but not listed above include Cabinda, Kwanza-Norte, and Malange.
The update on Luanda is most alarming because there is a population of 4 million and an international airport.
There have been two widely reported cases in Cacuaco, a slum on the outskirts of Luanda. The first case was a 12 year-old, who began to hemorrhage badly two days after admission. She was then transferred to Americo Boa Verde in Luanda. There would have been many contacts at the clinic alone, because she did not initially present as a Marburg case, and when she was admitted March 25, the staff was poorly equipped with gloves, masks, and gowns. At that time there were already 6 other cases in Luanda, and since only 20 people are being monitored, many contacts of these initial cases are not being found.
A 22 year-old patient was admitted April 6, and she too was hemorrhaging badly. Her transfer to Luanda was delayed because only one ambulance was available and risk of contamination of the vehicle was too high.
These two cases highlight the difficulties in treating these patients and monitoring contacts. Controlling the spread of the virus in the slums near Luanda will be particularly challenging because of a high population density, and an increase in the number of people who want to leave the area.
Thus, as the virus radiates out from Uige, controlling spread via contact tracing and quarantine will be increasingly difficult.
And,
http://www.sabcnews.com/south_africa/health/0,2172,101651,00.html
Fears that Marburg virus has reached South Africa
April 08, 2005, 07:45
There are new fears that the Marburg virus has reached South African soil. A child with Angolan ties with symptoms of the infection is reportedly being treated in Johannesburg.
The health department has already set up precautionary measures in all nine provinces.
Meanwhile, the World Health Organisation is recommending that four countries around Angola go on a Marburg virus alert. The countries are the Congo, the Democratic Republic of Congo, Namibia and Zambia.
In Angola 159 people have already died.
http://www.news24.com/News24/South_Africa/News/0,,2-7-1442_1686757,00.html
New Marburg fears in SA
07/04/2005 23:01 - (SA)
Carien du Plessis
Port Elizabeth - New fears were expressed on Thursday that the Marburg virus had reached South African soil when a child in Morningside Clinic in Johannesburg showed symptoms of the infection.
Steps have been taken to prepare provincial hospitals in case haemorrhagic fever is diagnosed.
Solly Mabotha, spokesperson of the national health department, said isolation wards had been prepared in hospitals in all nine provinces and health practitioners had been thoroughly briefed on the symptoms of haemorrhagic fever.
The deadly virus has killed 159 people in Angola, so far, and a man is believed to have died of it in South Africa.
Mabotha said the child "has ties with Angola".
He said, however, that a thorough investigation had indicated that she did not show symptoms of the untreatable haemorrhagic fever, which is caused by the Marburg virus.
There is no laboratory in South Africa that can perform tests for the Marburg virus, it was learned on Thursday.
Mabotha said tissue from the body of Elijah Nongqo, 50, who is believed to have died of the virus infection last week, was sent on Thursday to a laboratory in Atlanta, America, where tests will be carried out.
Laboratories for Angola
The result of these tests will be known only in the next week or two.
Mabotha acknowledged that a Johannesburg laboratory could not handle such tests at present.
Sapa reports that laboratories will be set up in Angola to test for the virus, which means results will be available within two days rather than three weeks, as at present.
Mabotha said the cases involving the disease did illustrate that good communication existed between all role players in the country.
Examination for symptoms
Travellers arriving in South Africa from the high-risk areas are exposed to thorough questioning and examination to ensure they do not have symptoms.
Mabotha said: "It is important that cases are treated immediately as there is no vaccination against the virus."
The Marburg virus is similar to Ebola and is passed through contact with body fluids such as blood, urine or faeces.
Mabotha also said Nongqo's relatives and the health workers who treated him had not yet shown any signs of haemorrhagic fever.
Angola's neighbours on alert
Meanwhile, AFP reports that the World Health Organisation has recommended that four countries around Angola go on a Marburg alert.
Angola is the epicentre of the outbreak, which has so far claimed 174 lives.
"Everybody should be on alert. Not only other provinces in Angola, but all its neighbouring countries - the Congo, the Democratic Republic of Congo, Namibia and Zambia," said Anarfi Asamoa-Baah, the Geneva-based UN health organisation's assistant director general of communicable diseases. - Beeld/AFP
Edited by Iaine Harper
