Marburg cases jump again

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May 3, 2005 (CIDRAP News) – Thirty-eight new cases of Marburg hemorrhagic fever have been reported in the northern Angola province of Uige in the past few days, despite hopes that the outbreak was being contained.

The tally yesterday stood at 313 cases, including 280 deaths, with another 208 people under observation, the World Health Organization (WHO) and the Angolan health ministry announced yesterday, according to a report by Agence France-Presse (AFP). The WHO had reported 275 cases with 255 deaths as of Apr 27, which included only 9 new cases in the preceding week.

The latest figures mean the deadly Marburg, which has no cure, has an 89.5% fatality rate among known cases in this outbreak.

The AFP story said no new cases have been reported recently outside Uige Province. But despite a major international response to the epidemic, transmission in Uige appears to be continuing.

A health team that traveled to a village called Ngombe on Sunday learned that a woman who had attended a funeral in Uige had spread the illness to her village, said Jose Van Dunem, Angola's deputy health minister, as reported by AFP.

"When she returned to Ngombe, she contaminated 12 other members of her family, and they all died," Van Dunem said. In addition, a traditional healer who had Marburg patients also died. Neither of those incidents appeared to have a connection with recent lapses in hospital infection control that had prompted statements by WHO officials on Apr 29.

Since the outbreak drew international attention, healthcare workers have worked diligently to stop it. Some lessons clearly have taken hold among the residents of Uige. A British Broadcasting Corporation (BBC) report today described one incident involving the infection of a 1-month-old girl.

Marburg virus had killed the baby's mother, and the rest of the family had fled, the BBC reported. Neighbors, knowing they would risk infection and death by responding to the ailing baby, had little choice but to listen to her cries. After she died, they pointed the home out to healthcare workers, who sanitized the home and the baby before burying her, the BBC story said.

The same report quoted David Daigle, a WHO spokesman, as saying that healthcare workers are receiving more alerts about sick people than about dead bodies.

"We have a whole contingent of Angolan doctors here now and we've strengthened our team sizes," Daigle said. "So we're optimistic, but certainly not ready to say it is contained."

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