More Spread of Marburg in Angola
Recombinomics Commentary
March 30, 2005
>> [Confirmation that the 2 travelers hospitalized in Portugal on return from Angola are not suffering from Marburg hemorrhagic fever removes any suspicion that the disease may spread beyond central Africa. - Mod.CP] <<
Clearly the above commentary is in error. Hopefully it is just a misprint. Since the Marburg virus spread from central Africa to Marburg, Germany in 1967, there seems to be little doubt that some time in the future it will again spread beyond central Africa. The next spread may not be from laboratory monkeys however. Infected people transmit Marburg from central Africa.
The negative data on the two travelers significantly lowers concern of spread by them. Even the most casual observations of recent events in Angola would create suspicion that the disease could spread beyond central Africa, and such spread could happen relatively soon.
The number of Marburg deaths in Angola has exploded in recent weeks to an unofficial total of 130. This has led to fatal infections of 6 nurses, 2 physicians, and 2 policemen. The main hospital in Uige, the epicenter of the outbreak, has closed. Although all reported cases have been in people linked to Uige, the two physicians died in Luanda and at least one arrived by plane. Since Luanda is the capital of Angola and has an international airport, transmission of Marburg via air throughout the world is a clear possibility, since the virus has a 3-7 day incubation period. There are valid reasons for some to leave Angola to either minimize risk of exposure, or seek treatment at a hospital that is less likely to be serving other patients infected with Marburg.
There have been eight reported deaths in the past two days, so the disease transmission is far from stable. Two of the deaths were in Negage, which had no prior reported deaths, and the first death in Cabinda was recorded a few days ago. These recent cases generated 21 day quarantine of contacts, but the number of infections almost certainly extends beyond the cases mentioned by WHO or recent media reports.
Thus, the situation in Angola requires close watch,.and offers little assurance that Marburg will not spread beyond central Africa.
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