Marburg death toll in Angola reaches 122

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Mar 28, 2005 (CIDRAP News) – The death toll in the Marburg hemorrhagic fever outbreak in Angola has risen to 122, just one fewer than in the largest previous outbreak of the disease, according to news reports from Africa.

The death toll was given in an Agence-France Presse (AFP) report quoting Carlos Alberto, a spokesman for the Angolan health ministry. The largest previous Marburg outbreak occurred in the Democratic Republic of the Congo from 1998 to 200 and killed 123 of 149 people infected.

Today's report did not give the total number of cases in the outbreak, which began last October. A Mar 23 report from the World Health Organization (WHO) said 95 of 102 patients had died, for a case-fatality rate of 93% at that point.

About 75% of those infected in Angola have been children under 5 years old, the WHO has said.

Most of the cases have occurred in the northeastern province of Uige, but seven have occurred in the capital, Luanda, on the Atlantic coast, according to AFP. Two of the seven patients—an Italian doctor and a 15-year-old boy, both of whom had been to Uige—have died, the story said.

The Italian doctor was identified in a Mar 25 AFP report as Maria Bonino, who worked in Africa for the United Nations for 11 years. A Vietnamese doctor also has died in the outbreak, today's report said, but he or she was not identified.

Alberto said the disease has been spreading from children to parents and vice-versa. He said many victims died because they first consulted traditional healers, called kimbandeiros, and didn't go to a hospital until it was too late.

The AFP report said a travel clinic in Johannesburg, South Africa, warned travelers yesterday to stay away from Angola for at least a week. The clinic spokesman, Andrew Jamieson, said many people were considering evacuating their families from Angola.

Last week the European Union pledged to give 500,000 euros ($650,000) to the Spanish arm of Medicins sans Frontieres to help battle the outbreak, AFP reported.

There is no vaccine or cure for Marburg fever. Besides fever and weakness, early symptoms include severe diarrhea, abdominal pain, nausea and vomiting, severe chest pain, sore throat, and cough, according to the WHO. The incubation period is 3 to 9 days, and most deaths in the current outbreak have occurred between 3 and 7 days after symptoms appeared, the agency has said. Contact with bodily fluids of infected people increases the risk of infection.

The disease was first seen in 1967 in German and Yugoslavian laboratory workers who had been exposed to green monkeys imported from Uganda. Researchers have not been able to identify its primary animal reservoir between the rare outbreaks, however.

Last week the WHO said it had sent an outbreak response team to work with the Angolan health ministry to support case management, contact tracing and surveillance, infection control, and raising community awareness of the disease.

See also:

Mar 24 WHO statement
http://www.who.int/csr/don/2005_03_24a/en/

Mar 23 WHO statement
http://www.who.int/csr/don/2005_03_23/en/

CIDRAP overview of Marburg hemorrhagic fever

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