Dutch woman dies of Marburg fever

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Jul 11, 2008 (CIDRAP News) – A Dutch woman who fell ill with Marburg hemorrhagic fever after visiting a bat-infested cave in Uganda has died, Dutch authorities announced today.

Authorities said the 40-year-old woman, who was not identified, died overnight at Leiden University Medical Centre, according to reports from Reuters and Agence France-Presse (AFP). The woman's illness was first announced yesterday.

In a statement yesterday, the World Health Organization (WHO) said the woman was reportedly exposed to fruit bats during a visit to the "python cave" in the Maramagambo forest on Jun 19. The cave is thought to harbor bat species that have been found to carry Marburg virus and its close relative, Ebola virus, in other parts of Africa, the agency said.

"A large bat population was seen in the cave and the woman is reported to have had direct contact with one bat," the WHO said.

The woman had visited another cave 3 days earlier, but no bats were seen there, the WHO said. She returned to the Netherlands in good health on Jun 28, but she became ill with a fever Jul 2 and was hospitalized Jul 5. She deteriorated rapidly and suffered liver failure and severe hemorrhaging Jul 7.

WHO spokesman Gregory Hartl said people who had contact with the woman have been monitored and have not shown any symptoms, Reuters reported. The WHO statement said no attempts were made to alert passengers who were on the woman's return flight from Uganda, because she didn't get sick until 4 days after the flight.

"The chance of the virus spreading through the Netherlands is very small," the Dutch National Institute for Public Health and the Environment (RIVM) said in a statement yesterday. Marburg virus spreads through contact with bodily fluids of infected people or animals.

Hartl said people don't need to cancel trips to Uganda because of the case, but they should not enter caves with bats, according to Reuters.

Uganda's health ministry issued a statement advising people entering caves or mines in the western district of Kamwenge to take "maximum precaution not to get into close contact with the bats and non-human primates in the nearby forests," Reuters reported.

The story said the Kitaka mine in Kamwenge, about 155 miles from Kampala, the capital, was closed last August after three miners contracted Marburg and one died.

There is no specific treatment or vaccine for Marburg fever, which is fatal in up to 90% of cases. In a major outbreak in Angola in 2004 and 2005, 227 of 252 confirmed cases were fatal.

See also:

Jul 10 WHO statement
http://www.who.int/csr/don/2008_07_10/en/index.html

Jul 10 RIVM statement
http://www.rivm.nl/en/Library/Common_and_Present/Newsmessages/2008/Dutch_tourist_infected_with_Marburg_virus

Jul 10 CIDRAP News story "Marburg fever case reported in Netherlands"

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