Mysterious hemorrhagic fever in Angola has killed 39

Mar 22, 2005 (CIDRAP News) – An unidentified hemorrhagic fever appears to be targeting children younger than 5 in an outbreak in the African country of Angola.

At least 39 people are believed to have died of the suspected hemorrhagic fever syndrome in the northern province of Uige between January and mid-March, the World Health Organization (WHO) announced on Mar 17.

Testing is under way to determine which of the many hemorrhagic fevers is causing the deaths. Among the most infamous is Ebola, which has case-fatality rates of 50% to 90%.

While the signs of the disease—vomiting, bloody discharge, and high fever—resemble those of Ebola, the age distribution does not, said Dick Thompson, a WHO spokesman in Geneva. Four-fifths of the victims of the outbreak are children, which is not typical for Ebola.

Tests of samples sent to the Pasteur Institute of Dakar in Senegal have ruled out yellow fever, dengue fever, West Nile virus, Crimean-Congo hemorrhagic fever, and Rift Valley fever, according to a British Broadcasting Corp. (BBC) story today. It said Ebola had not been ruled out.

But the deputy health minister of Angola, Natalia do Espirito Santo, said yesterday that Ebola had been ruled out by testing in Senegal, according to the Angola Press Agency. However, her department is still awaiting results of testing at the US Centers for Disease Control and Prevention (CDC) in Atlanta.

"We are in the presence of a digestive hemorrhage in which the diagnosis are not conclusive enough to ascertain whether [they] are caused by virus, bacteria, mosquitoes or other agent," do Espirito Santo said. In addition, she urged residents of Uige to take needed hygienic, drinking, and food precautions and advised people not to travel to or from the region until the outbreak is controlled.

The case count is difficult to pin down. The BBC said today that more than 90 people have died in the past 5 months in Angola.

Jose Caetano, a WHO spokesman in Angola, was quoted by Reuters news service on Mar 18 as saying that at least 77 of the 83 people believed to be infected had died.

WHO listed the more conservative figure of 39 fatalities. Thompson told the Associated Press (AP) that deaths from other diseases may be included in the Angolan figures.

A task force has been established in Angola, with the WHO country office supporting the national health ministry, WHO noted. The WHO Regional Office for Africa (AFRO) has alerted its rapid response network. Staff from the AFRO Inter-country Programme for Southern Africa are planning to send supplies for investigation and management of the situation.

Angola, almost twice the size of Texas, lies in southwestern Africa, bordering the South Atlantic Ocean, the Democratic Republic of the Congo, the Republic of the Congo, and Namibia.

See also:

Mar 17 WHO announcement
http://www.who.int/csr/don/2005_03_17b/en/

CIDRAP overview of viral hemorrhagic fevers
http://www.cidrap.umn.edu/cidrap/content/bt/vhf/biofacts/index.html

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