Fear Follows Deadly Virus Across Angola/ Marburg worse than Ebola/ 180 dead

Seabird

Veteran Member
It's odd that the suspected cases in Italy went quiet so quickly. It makes one think that there is more meat to the story than the PTB want known.

Seabird


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Fear and Violence Accompany a Deadly Virus Across Angola

http://www.nytimes.com/2005/04/09/h...000&en=f97b1446766612eb&ei=5065&partner=MYWAY

By SHARON LaFRANIERE and DENISE GRADY

Published: April 9, 2005


UANDA, Angola, April 8 - The death toll in Angola from an epidemic caused by an Ebola-like virus rose to 174 Friday as aid workers in one northern provincial town reported that terrified people had attacked them and that a number of health workers had fled out of fear of catching the disease.



International health officials said the epidemic, already the largest outbreak of Marburg virus ever recorded, showed no signs of abating. Seven of Angola's 18 provinces have now reported suspected cases and several neighboring countries have announced health alerts.

"It's becoming a huge problem," said Dick Thompson, a spokesman for the World Health Organization, which has dispatched surveillance teams to the country's northern provinces. "We clearly don't know the dimensions of the outbreak."

Health officials said some Angolans are hiding sick relatives out of fear that they will die if taken to the hospitals, thereby increasing the chance the disease will spread. There is no cure or vaccine for the highly contagious virus. Victims suffer a high fever, diarrhea, vomiting and severe bleeding from bodily orifices and usually die within a week.

The initial outbreak appears to have spread through a pediatric ward in Uige, a town in a farming district about 180 miles north of the capital of Luanda. More than 60 percent of the victims so far have been children.

One health official in Uige said that more than a dozen health care workers have perished from the disease, including two doctors, and that many workers are deserting the town's hospital in fear. Some townspeople are refusing to allow their sick relatives to be taken to an isolation unit set up at the hospital there by Doctors Without Borders, fearing it leads only to a graveyard.

As field workers tried to trace suspected cases in two Uige neighborhoods Thursday, townspeople threw stones at them, accusing them of killing people who had been taken away sick and who were returned to them dead. The violence forced the health workers to suspend their checks, according to officials from the World Health Organization and Doctors Without Borders. The government has dispatched soldiers to the province but so far made only a limited effort to educate an increasingly terrified public.

"We want people to understand that in a public health emergency you sometimes have to take unpopular measures," said Monica Castellarnau, the emergency coordinator for Doctors Without Borders in Uige. "At the moment all they understand is that we take someone to a locked-up place in a hospital, and then they die."

The World Health Organization officials said the disease so far appears confined to Angola but have recommended that four bordering countries be on the lookout for cases of the virus. The disease is spread through bodily fluids, including blood, excrement, saliva and vomit.

The United Nations appealed Friday for $3.5 million to fight the disease, saying Angola needs field laboratories, field workers to spot cases early, isolation units for the sick and a huge information campaign. Officials said the epidemic was spreading much faster than it did in the Democratic Republic of Congo, which until now had recorded the highest number of Marburg deaths. That two-year outbreak killed 123 people and ended in 2000.

Allarangar Yokouidé, an epidemiologist with the World Health Organization, told reporters that more than 80 percent of those who contracted the virus in Angola had died, a mortality rate that surpassed previous Ebola epidemics in the region. "Marburg is a very bad virus, even worse than Ebola," he said.

The intensity of Angola's outbreak is apparently partly due to the horrific state of the nation's hospitals after a 27-year civil war that ended in 2002, the failure to identify the disease for months after the first case and some traditional burial customs, including kissing corpses. Only when health care workers began dying in early March, six months after what health officials now believe was probably the first case, was the alarm fully raised.

The number of suspected cases, now at 200, shot up dramatically in the past two weeks, as epidemiologists have fanned out to try to identify the sick. The government is broadcasting daily radio warnings, asking people to transport any people with Marburg-like symptoms to the hospital and not to touch the corpses.

A cousin to the Ebola virus, Marburg is named for the town in Germany where it was first identified in 1967 after laboratory workers were infected by monkeys from Uganda.

Scientists do not know the source of the virus or how the current outbreak began, but they suspect that the virus was transmitted from an animal, possibly a bat. Health experts say that to control the epidemic, medical workers must check everyone who had contact with a victim after the first display of symptoms. That can mean 10 or 20 people to follow for each suspected case, each of whom should be checked once a day.

"As soon as someone is suspected and hospitalized, then you start to follow all the contacts, all the people with him in the last few days when he was still O.K.," said Dr. Pierre Rollin, a physician in the Special Pathogens Branch of the Centers for Disease Control and Prevention. In one Ebola outbreak, he said, epidemiologists had to track 3,000 people a day.

"It is quite impossible sometimes," he said.

The task may be especially daunting in Angola, with its rutted dirt roads, teeming townships, remote villages and countryside still littered with land mines from decades of conflict. Epidemiologists say teams of specialists may be needed for months to come.


Sharon LaFraniere reported from Luanda for this article, and Denise Gradyfrom London.
 
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Seabird

Veteran Member
http://news.yahoo.com/news?tmpl=story&u=/afp/20050408/wl_afp/angolahealthvirus_050408214447

World - AFP


UN says Marburg outbreak in Angola worse than Ebola, launches aid appeal

Fri Apr 8, 5:44 PM ET World - AFP



LUANDA (AFP) - The outbreak of the deadly Marburg virus in Angola is worse than Ebola, a UN disease expert said, as the world body launched an urgent appeal for funds to fight the fever which has claimed 180 lives.

"Marburg is a very bad haemorrhagic fever, even worse than Ebola," said Allarangar Yokouib from the UN World Health Organisation (WHO).


"We have had several Ebola epidemics in the region but none with such a high mortality rate," he told reporters at a press conference in Luanda.


In Geneva, the WHO said the world's worst-ever outbreak of the virus was not yet under control.


Mike Ryan, head of the WHO's emergency response unit, said international agencies and local health authorities must remain firmly engaged in Angola for the next four to six weeks, adding that the situation "now in Angola is not under control yet."


The world body on Friday launched an emergency appeal for 3.5 million dollars (2.7 million euros) to "intensify the fight" against the outbreak which "was the largest ever recorded and still growing."


"The appeal for 3.5 million dollars will enable UN agencies, including the WHO, UNICEF and the WFP to support the Angolan government intensifying outbreak control efforts," said the UN's resident co-ordinator in Angola, Pierre-Francois Pirlot.


"It is clear that this epidemic is unprecedented not only in Angola, but everywhere. It is the biggest epidemic of haemorrhagic fever so far," he said.


Most of the victims come from the northern town of Uige, the epicentre of the outbreak some 300 kilometres (180 miles) north of the seaboard capital Luanda. Some 200 cases had been reported since it first surfaced in October.


"The victims included nine health workers, seven nurses and two doctors," said Angolan vice health minister Jose Van Dunem.


Fear has gripped the capital and the country of 14 million people, which emerged three years ago from a brutal 27-year civil war.


The Ebola-like Marburg virus, whose exact origin is unknown, spreads through contact with bodily fluids such as blood, excrement, vomit and saliva, but can be contained with relatively simple health precautions, according to experts.


Yokouibd told reporters that the disease "was transmitted through contact with all bodily fluids which also included sweat and tears if you touch a sick person," but he stressed that it was "not an airborne disease".


He said the worst-ever outbreak of Ebola, in the same family as Marburg, was in Uganda where some 404 cases were reported at the end of the outbreak.


"We had several epidemics of Ebola in the region but none of which had such a high mortality rate," said Yakouibd. "It's worse than for example in Uganda."


There was another Ebola outbreak in the Democratic Republic of Congo, with "only 144 cases" and another in Gabon, with 100 cases.


The WHO has recommended that four neighbouring countries: Congo, the Democratic Republic of Congo, Namibia and Zambia go on a Marburg alert.

The DRC has been on "rapid general alert" since March 30, while the Congo and Gabon have alerted its network of epidemiology watchers.

Sao Tome and Principe, the tiny island country off the west coast of Africa, was screening all travellers from Angola, and Kenya has taken preventative measures.

The death toll from the virus has jumped from 174 to 180 and has more than doubled in the last three weeks, now reaching into seven of the poor southern African country's 18 provinces.
 

Seabird

Veteran Member
http://cnn.health.printthis.clickab...04/08/angola.marbug/index.html&partnerID=2012


Marburg virus death toll hits 180
205 cases have been reported




(CNN) -- The World Health Organization is investigating an outbreak of hemorrhagic fever in northwestern Angola, it said Friday.

As of Thursday, 205 cases of Marburg hemorrhagic fever had been reported in the country, and 180 of those affected had died. Seven provinces have been affected, the latest being Zaire province, where six cases have been reported, the WHO said in its most recent update.

"It is a very, very dangerous and lethal virus in human beings," Mike Ryan, director of alert and response operations for WHO, told CNN. The virus -- in the same family as the Ebola virus -- spreads through blood and body fluid contact.

In this case -- only the second natural outbreak of the virus -- there is evidence it has been amplified through ineffective containment in hospitals, Ryan said.

According to WHO, the first large outbreak under natural conditions occurred from 1998-2000 in the Democratic Republic of Congo.

Some Angolans have taken their anxiety out on health workers.

Mobile surveillance teams in Uige were forced to suspend operations Thursday when vehicles were attacked and damaged by residents, the WHO said Friday. "As the situation has not improved, no surveillance teams were operational today in the province."

In addition, organization staff in Uige were notified Friday of several workers' fatalities, but teams were unable to investigate the causes of death or collect the bodies for burial. Discussions "to find urgent solutions" were under way with provincial authorities, the WHO said.

A WHO worker in Angola told CNN that health workers had been killed by residents who erroneously believed the workers were exposing them to the virus.

"The dramatic symptoms of Marburg hemorrhagic fever and its frequent fatality are resulting in a high level of fear, which is further aggravated by a lack of public understanding about the disease," the organization said. "Moreover, because the disease has no cure, hospitalization is not associated with a favorable outcome, and confidence in the medical care system has been eroded."

WHO said it has seen similar reactions during outbreaks of the Ebola virus. Two medical anthropologists are in Uige and will be joined by experts in social mobilization from Angola, the Democratic Republic of Congo and Mozambique.

Through the United Nations, WHO launched an appeal Friday for $2.4 million to support the emergency response to the outbreak. In addition, the organization has established an international network of laboratories to help in the investigation of this and other viral hemorrhagic fevers. They include two portable field laboratories in Angola.

"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," said a WHO statement.

A longer-term objective, the organization said, is to determine where the Marburg virus hides in nature between outbreaks. Studies of the Angolan virus may offer some clues.
 
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